Acls Exam Prep B

ACLS Exam PREP B ACLS Exam PREP B What should be done to minimize interruptions in chest compressions during CPR? - ANS Continue CPR while the defibrillator is charging. which condition is an indication to stop or withhold resuscitative efforts? - ANS Safety threat to providers. After verifying the absence of a pulse, you initiate CPR with adequate bag-mask ventilation. The patient's lead II ECG appears below. What is your next action? (strip missing displays PEA) - ANS IV or IO access After verifying unresponsiveness and abnormal breathing, you activate the emergency response team. What is your next action? - ANS Check for pulse What is the recommendation on the use of cricoid pressure to prevent aspiration during cardiac arrest? - ANS Not recommended for routine use What survival advantages does CPR provide to a patient in ventricular fibrillation? - ANS Produces a small amount of blood flow to the heart. What is the recommended compression rate for performing CPR? - ANS At least 100 per minute EMS personnel arrive to find a patient in cardiac arrest. Bystanders are performing CPR. After attaching a cardiac monitor, the responder observes the following rhythm strip. What is the most important early intervention? (strip missing displays Ventricular fibrillation) - ANS Defibrillation A patient remains in ventricular fibrillation despite 1 shock and 2 minutes of continuous CPR. - ANS Administer a 2nd shock What is the recommended next step after a defibrillation attempt? - ANS Begin CPR, starting with chest compressions. Which of the following is the recommended first choice for establishing intravenous access during the attempted resuscitation of a patient in cardiac arrest? - ANS Antecubital What is the recommended first intravenous dose of aAmiodarone for a patient with refractory ventricular fibrillation? - ANS 300mg IV/IO drug administration during CPR should be - ANS given rapidly during compressions How often should the team leader switch chest compressors during a resuscitation attempt? - ANS Every 2 minutes Which finding is a sign of ineffective CPR? - ANS PETCO2 10 mm Hg A team leader orders 1mg of epinephrine, and a team member verbally acknowledges when the medication is administered. What element of effective resuscitation team dynamics does this represent? - ANS Closed-loop communication How long should it take to perform a pulse check during the BLS survey? - ANS 5-10 seconds Your team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive and notice that he is taking agonal breaths. What is the next step in your assessment and management of this patient? - ANS Check the patient's pulse Which treatment or medication is appropriate for the treatment of a patient in asystole? - ANS Epinephrine An AED advises a shock for a pulseless patient lying in snow. What is the next action? - ANS Administer the shock immediately and continue as directed by the AED. What is the minimum depth of chest compressions for an adult in cardiac arrest? - ANS 2 inches A patient with pulseless ventricular tachycardia is defibrillated. What is the next action? - ANS Start chest compressions at a rate of at least 100/min. You have completed your first 2-minute period of CPR. You see an organized, nonshockable rhythm on the ECG monitor. What is the next action? - ANS Have a team member attempt to palpate a carotid pulse. Emergency medical responders are unable to obtain a peripheral IV for a patient in cardiac arrest. What is the next most preferred route for drug administration? - ANS Intraosseous (IO) What is the appropriate rate of chest compressions for an adult in cardiac arrest? - ANS At least 100/min You are receiving a radio report from an EMS team en route with a patient who may be having an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation? - ANS Divert the patient to a hospital 15 minutes away with CT capabilities . A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patients blood pressure is 102/59 mm hg, the heart rate is 230/min, the respiratory rate is 16 breaths/min, and the pulse oximetry reading is 96%. The lead II ECG is displayed below. Patient has a peripheral IV is in place. What is the next action? (strip missing displays tachycardic sinus rhythm with narrow QRS) - ANS Vagal maneuvers A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. The patient's 12-lead ECG shows ST-segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What is the next action? - ANS Administer 2 to 4 mg of morphine by slow IV bolus. A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing. The blood pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95%. The lead II ECG displays a wide-complex tachycardia. What is the next action after establishing an IV and obtaining a 12-lead ECG? - ANS Seeking expert consultation A postoperative patient in the ICU reports new chest pain. What actions have the highest priority? - ANS Obtain a 12-lead ECG and administer aspirin if not contraindicated. An 80-year-old woman presents to the emergency department with dizziness. She now states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She is alert and oriented. Her lead II ECG is below. After you start an IV, what is the next action? (strip missing displays a 2nd degree AV block AKA Wenkebach) - ANS Conduct a problem-focused history and physical examination. What is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes? - ANS 160 to 325 mg A responder is caring for a patient with a history of congestive heart failure. The patient is experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of 190/min. The patient's lead II ECG is displayed below. (strip missing displays Unstable supraventricular tachycardia) Which of the following terms best describes this PT? - ANS Unstable supraventricular tachycardia What is the most appropriate intervention for a rapidly deteriorating patient who has this lead II ECG? (strip missing displays a persistent tachyarrhythmia) - ANS Synchronized cardioversion What is the purpose of a medical emergency team (MET) or rapid response team (RRT)? - ANS Improving patient outcomes by identifying and treating early clinical deterioration What is the recommended assisted ventilation rate for patients in respiratory arrest with a perfusing rhythm? - ANS 10 to 12 breaths per minute You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most important now? - ANS Obtaining a 12-lead ECG Family members found a 45-year-old woman unresponsive in bed. The patient is unconscious and in respiratory arrest. What is the recommended initial airway management technique? - ANS Performing a head tilt-chin lift maneuver A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the following lead II ECG rhythm: (strip missing displays persistent tachyarrhythmia) - ANS Synchronized cardioversion A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm: (strip missing displays polymorphic ventricular tachycardia) - ANS Defibrillation What is the recommended energy dose for biphasic synchronized cardioversion of atrial fibrillation? - ANS 120 to 200 J Which of the following is an acceptable method of selecting an appropriately sized oropharyngeal airway (OPA)? - ANS Measure from the corner of the mouth to the angle of the mandible. Which is a contraindication to nitroglycerin administration in the management of acute coronary syndromes? - ANS Right ventricular infarction and dysfunction What is the recommended initial intervention for managing hypotension in the immediate period after return of spontaneous circulation (ROSC)? - ANS Administration of IV or IO fluid bolus Which is an appropriate and important intervention to perform for a patient who achieves ROSC during an out-of-hospital resuscitation? - ANS Transport the patient to a facility capable of performing PCI. What is the immediate danger of excessive ventilation during the post-cardiac arrest period for patients who achieve ROSC? - ANS Decreased cerebral blood flow What is the recommended target temperature range for achieving therapeutic hypothermia after cardiac arrest? - ANS 32°C to 34°C What is the recommended duration of therapeutic hypothermia after reaching the target temperature? - ANS 12 to 24 hours What is the danger of routinely administering high concentrations of oxygen during the post- cardiac arrest period for patients who achieve ROSC? - ANS Potential oxygen toxicity What is the recommended dose of epinephrine for the treatment of hypotension in a post- cardiac arrest patient who achieves ROSC? - ANS 0.1 to 0.5 mcg/kg per minute IV infusion