Acls Exam

ACLS EXAM 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 with-hold resuscitative efforts? - ANS Safety threat to providers After verifying unresponsiveness and abnormal breathing, you activate the emergency response team. What is your next action? - ANS Check for a 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 A patient remains in ventricular fibrillation despite 1 shock and 2 minutes of continuous CPR. The next intervention is to - ANS Administer a second 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 vein What is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation? - ANS 300 mg 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 1 mg 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 rescue 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 patients 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 2min period of CPR. You see an organized, non-shockable 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 49 year old man has retrosternal chest pain radiating into his 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 22bpm, and the pulse oximetry value is 95%. The patients 12 lead ECG shows ST elevation in the anterior leads. First responders administered 160mg of aspirin, and there is a patent peripheral IV. The pain is described as an 8 on a scale of 1-10 and is unrelieved after 3 doses of nitroglycerin. What is the next action? - ANS Administer 2-4 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 12bpm, 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 What is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes? - ANS 160 to 325 mg 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 10-12 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 non-labored respiratory rate is 14 bpm, 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 What is the recommended energy dose for biphasic synchronized cardioversion of atrial fibrillation? - ANS 120-200 J Which of the following is an acceptable method of selecting an appropriately sized orpharyngeal 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 hypo-tension 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 and 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 32-34 degrees Celsius What is the recommended duration of therapeutic hypothermia after reaching the target temperature? - ANS 12-24 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 - 0.5 mcg/kg per minute IV infusion