ACLS REVIEW QUESTIONS WITH CORRECT ANSWERS GRADED A+

What is the primary purpose of the CPR coach on a resuscitation team? increasing CPR quality What is the most common type of stroke? ischemic stroke What is a contraindication to the administration of aspirin for the management of a pt with acute coronary syndromes? recent gastrointestinal bleeding What blood component is acted upon by aspirin administration during the management of a pt with ACS? platelets What is the most appropriate destination for pts with suspected acute ischemic stroke? certified stroke center A 49-year-old man arrives at the emergency department with chest discomfort. He states that he was working in the garden this morning when his chest started hurting. The last episode lasted about 25 minutes, and he was sweaty. The chest discomfort is not relieved with rest. Within the first 10 minutes, on the basis of the pt showing symptoms suggestive of MI, what will your first actions include (if not completed by EMS before arrival)? If SpO2 is less than 90%, start oxygen Obtain a 12-lead EKG Administer aspirin and establish IV access Assess ABCs Consider nitroglycerin, morphine, and a P2Y inhibitor Activate the STEMI team His initial VS are HR 120/min, BP 135/88 mmHg, RR 23/min, SpO2 87%, and temperature 37.3 degrees C. When considering oxygen saturation, what is your course of action? Start oxygen at 4L/min via nasal cannula Do not start oxygen Intubate pt immediately Administer albuterol nebulizer Start oxygen at 4L/min via nasal cannula What additional questions help you determine next steps? When did the symptoms start? Do you have any allergies? Do you take any medication? Your pt continues to say that he has chest discomfort. What treatment can you repeat as long as it is not contraindicated by vital signs? Nitroglycerin IV every 1 to 3 mins Morphine sublingual every 1 to 3 mins Nitroglycerin sublingual or translingual every 3 to 5 mins Morphine IV every 1 to 3 mins Nitroglycerin sublingual or translingual every 3 to 5 mins What is your interpretation of the pt's EKG tracing? Anterior STEMI With the diagnosis of STEMI, what is the most probable treatment? Admission for observation Admission for PCI or fibrinolysis Admission to ICU Release to home Admission for PCI or fibrinolysis What is your goal for PCI when treating this patient? First medical contact-to-balloon inflation time of 90 mins First medical contact-to-needle time of 30 mins Door-to-needle time of 90 mins Door-to-balloon inflation time of 30 mins First medical contact-to-balloon inflation time of 90 mins Among others, which of the following factors has been associated with improved survival in pts with cardiac arrest? Immediate high-quality CPR Presence of 2 or more rescuers Compression-only CPR Manual defibrillation Immediate high-quality CPR Upon reviewing a pt's 12-lead EKG, you note ST-segment elevation of 2 mm in leads II, III, and aVF. How would you classify the electrocardiographic findings? ST segment elevation myocardial infarction What is the time goal for neurologic assessment by the stroke team or designee and noncontrast CT or MRI performed after hospital arrival? 20 mins 25 mins 10 mins 15 mins 20 mins What blood glucose level should trigger the administration of IV or subcutaneous insulin for a pt with an acute ischemic stroke? 180 mg/dL We have an expert-written solution to this problem! In addition to decreased IHCA, what are some other benefits of implementing a rapid response team? Decrease in total hospital length of stay Decreased ICU length of stay A 74-year-old man was brought to the hospital by his wife. She states that her husband started having sudden left-arm weakness and left-sided facial paralysis during lunch. He has a past medical history of poorly controlled HTN. The pt's VS show HR 92/min, RR 14/min, BP 130/86 mmHg, SpO2 97%, and AFib on the monitor. What additional assessment and stabilization activities should be completed within the first 10 mins after the pt's arrival? Check glucose Activate stroke team Establish IV access Complete neuro screening Order an emergent CT scan or MRI of the brain and review pt history What needs to be completed for this pt within 20 mins after hospital arrival? Neurologic assessment As part of the neurologic assessment, you perform a physical and neurologic examination. What are some general questions you need to ask? Do you take any medications? When did the symptoms start? Do you have any allergies? What other symptoms do you have? Within 45 mins, the neuroimaging interpretation of the CT scan of the brain suggests an acute ischemic infarction. There are no signs of hemorrhage or mass lesions. Is this pt a potential candidate for fibrinolytic therapy? Yes No Not enough info Yes To determine whether the pt is a candidate for fibrinolytic therapy, what actions should be taken? Repeat neurologic exam