AHA ACLS Pre-Test Study Guide Terms in this set (97) 3˚ AV block p and qrs completely separate Identify the rhythm. Pulseless electrical activity (PEA) Identify the rhythm. Coarse ventricular fibrillation Identify the rhythm. Reentry suprave

AHA ACLS Pre-Test Study Guide Terms in this set (97) 3˚ AV block p and qrs completely separate Identify the rhythm. Pulseless electrical activity (PEA) Identify the rhythm. Coarse ventricular fibrillation Identify the rhythm. Reentry supraventricualr tachycardia (SVT) Identify the rhythm. Sinus bradycardia Identify the rhythm. Polymorphic ventricular tachycardia Identify the rhythm. 3˚ AV block Identify the rhythm. Reentry Supraventricular tachycardia (SVT) Identify the rhythm. 2˚ AV block (Mobitz type II) no p-r prolonged, random drops Identify the rhythm. Sinus bradycardia Identify the rhythm. Atrial flutter Identify the rhythm. Reentry supraventricular tachycardia (SVT) Identify the rhythm. 2˚ AV block (Mobitz type I Wenckebach) Identify the rhythm. Normal sinus rhythm Identify the rhythm. Sinus tachycardia Identify the rhythm. Atrial fibrillation irreg, irreg Identify the rhythm. Sinus tachycardia Identify the rhythm. Fine ventricular fibrillation Identify the rhythm. 2˚ AV block (Mobitz type I Wenchkebach) Identify the rhythm. Agonal rhythm/asystole Identify the rhythm. Coarse ventricular fibrillation Identify the rhythm. Monomorphic Ventricular tachycardia Identify the rhythm. 2. Magnesium is indicated for VF/pulseless VT associated with torsades de pointes. Which of the following statements about the use of magnesium in cardiac arrest is most accurate? 1. Magnesium is indicated for shock-refractory monomorphic VT. 2. Magnesium is indicated for VF/pulseless VT associated with torsades de pointes. 3. Magnesium is contraindicated for VT associated with a normal QT interval. 4. Magnesium is indicated for VF refractory to shock and amiodarone or lidocaine. 1. Give aspirin 160 to 325 mg chewed immediately. A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic therapy has been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion of 1000 units per hour is being administered. Aspirin was not taken by the patient because he had a history of gastritis treated 5 years ago. Your next action is to: 1. Give aspirin 160 to 325 mg chewed immediately. 2. Give 75 mg enteric-coated aspirin orally. 3.Give 325 mg enteric-coated aspirin rectally. 4. Substitute clopidogrel 300 mg loading dose. 4. Start epinephrine 2 to 10 mcg/min. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 110/60 mm Hg. Which of the following is now indicated? 1. Give additional 1 mg atropine. 2. Start dopamine 10 to 20 mcg/kg per minute. 3. Give normal saline bolus 250 mL to 500 mL. 4. Start epinephrine 2 to 10 mcg/min. 1. Do not give aspirin for at least 24 hours if rtPA is administered. A 62-year-old man suddenly experienced difficulty speaking and left-side weakness. He was brought to the emergency department. He meets initial criteria for fibrinolytic therapy, and a CT scan of the brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy? 1. Do not give aspirin for at least 24 hours if rtPA is administered. 2. Give aspirin 160 mg and clopidogrel 75 mg orally. 3. Administer heparin if CT scan is negative for hemorrhage. 4. Administer aspirin 160 to 325 mg chewed immediately. 4. Use of a phosphodiesterase inhibitor within 12 hours A patient with possible ST-segment elevation MI has ongoing chest discomfort. Which of the following would be a contraindication to the administration of nitrates? 1. Heart rate 90/min. 2. Left ventricular infarct with bilateral rales. 3. Blood pressure greater than 180 mm Hg. 4. Use of a phosphodiesterase inhibitor within 12 hours AHA ACLS Pre-Test Study Guide 1. Epinephrine 1 mg A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Of the following, which drug and dose should be administered first by the IV/IO route? 1. Epinephrine 1 mg 2. Vasopressin 20 units 3. Sodium bicarbonate 50 mEq 4. Atropine 1 mg 2. Adenosine 6 mg A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has been established. What drug should be administered IV? 1. Lidocaine 1mg/kg 2. Adenosine 6 mg 3. Epinephrine 2 to 10 mcg/kg per minute 4. Atropine 0.5 mg 4. Dose of 0.5mg A patient with sinus bradycardia and heart rate of 42/min has diaphoresis and a blood pressure of 80/60 mm Hg. What is the initial dose of atropine? 1. Dose of 0.1mg 2. Dose of 3 mg 3. Dose of 1 mg 4. Dose of 0.5mg 5. 150 mg IV push. A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amiodarone IV. The patient is intubated. A second dose of amiodarone is now called for. The recommended second dose of amiodarone is: 1. An endotracheal dose of 2 to 4 mg/kg. 2. 300 mg IV push. 3. 1 mg/kg IV push. 4. An infusion of 1 to 2 mg/min. 5. 150 mg IV push. 1. Give normal saline 250 mL to 500 mL fluid bolus. A patient with a possible acute coronary syndrome has ongoing chest discomfort unresponsive to 3 sublingual nitroglycerin tablets. There are no contraindications, and 4 mg of morphine sulfate was administered. Shortly afterward, blood pressure falls to 88/60 mm Hg, and the patient has increased chest discomfort. You should: 1. Give normal saline 250 mL to 500 mL fluid bolus. 2. Give an additional 2 mg of morphine sulfate. 3. Give sublingual nitroglycerin 0.4 mg. 4. Start dopamine at 2 mcg/kg per minute and titrate to a systolic blood pressure reading of 100 mm Hg. 2. Seeking expert consultation. A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. Which of the following actions is recommended? 1. Giving adenosine 6 mg IV bolus. 2. Seeking expert consultation. 3. Giving lidocaine 1 to 1.5 mg IV bolus. 4. Immediate synchronized cardioversion. 1. Gain IV or IO access. You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previously advised "no shock indicated." A rhythm check now finds asystole. After resuming high-quality compressions, your next action is to: 1. Gain IV or IO access. 2. Place an esophageal-tracheal tube or laryngeal mask airway. AHA ACLS Pre-Test Study Guide 1. Amiodarone 300 mg A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which is the next drug/dose to anticipate to administer? 1. Amiodarone 300 mg 2. Amiodarone 150 mg 3. Vasopressin 40 units 4. Epinephrine 3 mg 5. Lidocaine 0.5 mg/kg 4. Lidocaine, epinephrine, vasopressin Your patient has been intubated. IV/IO access is not available. Which combination of drugs can be administered by the endotracheal route? 1. Vasopressin, amiodarone, lidocaine 2. Amiodarone, lidocaine, epinephrine 3. Epinephrine, vasopressin, amiodarone 4. Lidocaine, epinephrine, vasopressin 2. IV or IO A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. What is the recommended route for drug administration during CPR? 1. Femoral vein 2. IV or IO 3. Central line 4. Endotracheal 5. External jugular vein 2. Second dose of epinephrine 1 mg A patient is in refractory ventricular fibrillation. High-quality CPR is in progress, and shocks have been given. One does of epinephrine was given after the second shock. An antiarrhythmic drug was given immediately after the third shock. What drug should the team leader request to be prepared for administration next? 1. Escalating dose of epinephrine 3 mg. 2. Second dose of epinephrine 1 mg 3. Repeat the antiarrhythmic drug 4. Sodium bicarbonate 50 mEq 2. Perform immediate electrical cardioversion. A 57-year-old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular wide-complex ORS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60 mm Hg. The next action is to: 1. Give amiodarone 300 mg IV push. 2. Perform immediate electrical cardioversion. 3. Establish IV access. 4. Obtain a 12-lead ECG. 4. Chest pain or shortness of breath is present. Bradycardia requires treatment when: 1. The blood pressure is less than 100 mm Hg systolic with or without symptoms. 2. The heart rate is less than 60/min with or without symptoms. 3. The patient's 12-lead ECG show an MI. 4. Chest pain or shortness of breath is present. 3. The correct dose of vasopressin is 40 units administered by IV or IO. Which of the following statements is most accurate regarding the administration of vasopressin during cardiac arrest? 1. Vasopressin can be administered twice during cardiac arrest. 2. Vasopressin is indicated for VF and pulseless VT before delivery of the first shock. 3. The correct dose of vasopressin is 40 units administered by IV or IO. 4. Vasopressin is recommended instead of epinephrine for the treatment of asystole. 1. Epinephrine 1 mg or vasopressin 40 units IV or IO. A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is intubated and an IV has been started. The rhythm is asystole. Which is the first drug/dose to administer? 1. Epinephrine 1 mg or vasopressin 40 units IV or IO. 2. Atropine 1 mg IV or IO. 3. Atropine 0.5 mg IV or IO. 4. Epinephrine 3 mg via endotracheal route. 5. Dopamine 2 to 20 mcg/kg per minute IV or IO. 4. Repeat adenosine 12 mg IV . A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She has received adenosine 6 mg IV for the rhythm shown above without conversion of the rhythm. She is now extremely apprehensive. Blood pressure is 108/70 mm Hg. What is the next appropriate intervention? 1. Repeat adenosine 3 mg IV. 2. Perform immediate unsynchronized cardioversion. 3. Sedate and perform synchronized cardioversion. 4. Repeat adenosine 12 mg IV . 5. Perform vagal maneuvers and repeat adenosine 6 mg IV. 1. Sublingual nitroglycerin 0.4 mg. A patient in the emergency department develops recurrent chest discomfort (8/10) suspicious for ischemia. His monitored rhythm becomes irregular as seen above. Oxygen is being administered by nasal cannula at 4 L/min, and an IV line is in place. Blood pressure is 160/96 mm Hg. There are no allergies or contraindications to any medication. You would first order: 1. Sublingual nitroglycerin 0.4 mg. 2. Morphine sulfate 2 to 4 mg IV. 3. Lidocaine 1 mg/kg IV and infusion 2 mg/min. 4. Amiodarone 150 mg IV. 5. IV nitroglycerin initiated at 10 mcg/min and titrated to patient response. 5. Prepare to give epinephrine 1 mg IV. Following initiation of CPR and 1 shock for VF, this rhythm is present on the next rhythm check. A second shock is given and chest compressions are resumed immediately. An IV is in place and no drugs have been given. Bag-mask ventilations are producing visible chest rise. What is your next order? 1. Administer 3 sequential (stacked) shocks at 360 J (monophasic defibrillator). 2. Prepare to give amiodarone 300 mg IV. 3. Administer 3 sequential (stacked) shocks at 200 J (biphasic defibrillator). 4. Perform endotracheal intubation; administer 100% oxygen. 5. Prepare to give epinephrine 1 mg IV. 4. Atropine 0.5 mg IV . You arrive on the scene to find a 56-year-old diabetic woman with dizziness. She is pale and diaphoretic. Her blood pressure is 80/60 mm Hg. The cardiac monitor documents the rhythm below. She is receiving oxygen at 4 L/min by nasal cannula and an IV has been established. Your next order is: 1. Dopamine at 2 to 10 mcg/kg per minute. 2. Sublingual nitroglycerin 0.4 mg. 3. Morphine sulfate 4 mg IV. 4. Atropine 0.5 mg IV . 5. Atropine 1 mg IV. 2. Begin CPR, starting with high-quality chest compressions. A patient becomes unresponsive. You are uncertain if a faint pulse is present with the rhythm below. What is your next action? 1. Order transcutaneous pacing. 2. Begin CPR, starting with high-quality chest compressions. 3. Start an IV and give epinephrine 1 mg IV. 4. Consider causes of pulseless electrical activity. 5. Start an IV and give atropine 1 mg. 3. Give an immediate unsynchronized high- energy shock (defibrillation dose). This patient has been resuscitated from cardiac arrest. During the resuscitation, amiodarone 300 mg was administered. The patient developed severe chest discomfort with diaphoresis. He is now unresponsive. What is the next indicated action? 1. Perform immediate synchronized cardioversion. 2. Repeat amiodarone 150 mg IV. 3. Give an immediate unsynchronized high-energy shock (defibrillation dose). 4. Repeat amiodarone 300 mg IV. 5. Give lidocaine 1 to 1.5 mg/kg IV. 3. Give atropine 0.5 mg IV . You are monitoring the patient and note the rhythm below on the cardiac monitor. She has dizziness and her blood pressure is 80/40 mm Hg. She has an IV in place. What is your next action? 1. Start transcutaneous pacing. 2. Give atropine 1 mg IV. 3. Give atropine 0.5 mg IV . 4. Administer sedation and begin immediate transcutaneous pacing at 80/min. 5. Start dopamine at 2 to 10 mcg/kg per minute and titrate to patient response. 4. Give epinephrine 1 mg IV . You arrive on the scene to find CPR in progress. Nursing staff report that the patient was recovering from a pulmonary embolism and suddenly collapsed. There is no pulse or spontaneous respirations. High-quality CPR and effective bag- mask ventilation are being provided. An IV has been initiated. What would you do now? 1. Give atropine 1 mg IV. 2. Give atropine 0.5 mg IV 3. Order immediate endotracheal intubation. 4. Give epinephrine 1 mg IV . 5. Initiate transcutaneous pacing. 1. Perform vagal maneuvers. A 35-year-old woman presents to the emergency department with a chief compliant of palpitations. She has no chest discomfort, shortness of breath, or light-headedness. Which of the following is indicated first? 1. Perform vagal maneuvers. 2. Give adenosine 12 mg IV slow push (over 1 to 2 minutes). 3. Give metoprolol 5 mg IV and repeat if necessary. 4. Give adenosine 3 mg IV bolus. 5. Administer adenosine 6 mg; seek expert consultation. You are monitoring a patient. He suddenly has the persistent rhythm shown below. You ask about symptoms and he reports that he has mild palpitations, but otherwise he is clinically stable with unchanged vital signs. What is your next action? 1. Give an immediate synchronized shock. 2. Give sedation and perform synchronized cardioversion. 3. Administer magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes. 4. Give an immediate unsynchronized shock. 5. Administer adenosine 6 mg; seek expert consultation. 4. Give atropine 0.5 mg IV . The patient suddenly becomes unconscious and has a weak carotid pulse. Cardiac monitoring, supplementary oxygen, and an IV have been initiated. The code cart with all the drugs and transcutaneous pacer are immediately available. Next you would: 1. Begin transcutaneous pacing. 2. Initiate dopamine at 10 to 20 mcg/kg per minute and to patient response. 3. Initiate dopamine at 2 to 10 mcg/kg per minute and titrate to patient response. 4. Give atropine 0.5 mg IV . 5. Initiate epinephrine at 2 to 10 mcg/kg per minute. 1. Reperfusion therapy. A patient's 12-lead ECG was transmitted by the paramedics and showed an acute MI. The above findings are seen on rhythm strip when a monitor is placed in emergency department. The patient had resolution of moderate (5.10) chest pain with 3 doses of sublingual nitroglycerin. Blood pressure is 104/70 mm Hg. Which intervention below is most important, reducing in-hospital and 30-day mortality? 1. Reperfusion therapy. 2. IV nitroglycerin for 24 hours. 3. Temporary pacing. 4. Atropine 0.5 mg IV, total dose 2 mg as needed. 5. Atropine 1 mg IV, total dose 3 mg as needed. 5. Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes This patient was admitted to the general medical ward with a history of alcoholism. A code is in progress and he has recurrent episodes of this rhythm. You review his chart. Notes about the 12- lead ECG say that his baseline QT interval is high normal to slightly prolonged. He has received 2 doses of epinephrine 1 mg and 1 dose of amiodarone 300 mg IV so far. What would you order for his next medication? 1. Lidocaine 1 to 1.5 mg IV and start infusion 2 mg/min. 2. Repeat amiodarone 300 mg IV. 3. Repeat amiodarone 150 mg IV. 4. Give sodium bicarbonate 50 mEq IV. 5. Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes 4. Administer epinephrine 1 mg. You are the code team leader and arrive to find a patient with above rhythm and CPR in progress. Team members report that the patient was well but reported chest pain and then collapsed. She has no pulse or respirations. Bag-mask ventilations are producing visible chest rise, high-quality CPR is in progress, and an IV has been established. What would be your next order? 1. Administer atropine 1 mg. 2. Perform endotracheal intubation. 3. Start dopamine at 10 to 20 mcg/kg per minute. 4. Administer epinephrine 1 mg. 5. Administer amiodarone 300 mg. 2. Continue monitoring and seek expert consultation. A patient presents with the rhythm below and reports an irregular heartbeat. She has no other symptoms. Her medical history is significant for a myocardial infarction 7 years ago. Blood pressure is 110/70 mm Hg. What would you do at this time? 1. Perform elective synchronized cardioversion with presedation. 2. Continue monitoring and seek expert consultation. 3. Administer nitroglycerin 0.4 sublingual or spray. 4. Administer lidocaine 1mg/kg IV. 5. Perform emergency synchronized cardioversion 2. Resume high-quality chest compressions. A patient was in refractory ventricular fibrillation. A third shock has just been administered. Your team looks to you for instructions. Your immediate next order is: 1. Perform endotracheal intubation. 2. Resume high-quality chest compressions. 3. Check the carotid pulse. 4. Give atropine 1 mg IV. 5. Give amiodarone 300 mg IV. 4. Continue monitoring the patient and seek expert consultation. You are evaluating a patient with chest discomfort lasting 15 minutes during transportation to the emergency department. He is receiving oxygen and 2 sublingual nitroglycerin tablets have relieved his chest discomfort. He reports no other symptoms but appears anxious. Blood pressure is 130/70 mm Hg. You observe the rhythm below on the monitor. What is your next action? 1. Give atropine 0.5 mg IV. 2. Initiate transcutaneous pacing (TCP). 3. Start epinephrine 2 to 10 mcg/min and titrate to patient response. 4. Continue monitoring the patient and seek expert consultation. 5. Administer sublingual nitroglycerin 0.4 mg. 2. Seek expert consultation. Following resuscitation with CPR and a single shock, you observe this rhythm while preparing the patient for transport. Your patient is stable and blood pressure is 120/80 mm Hg. She is apprehensive but has no symptoms other than palpitations. At this time you would: 1. Give magnesium sulfate 1 to 2 g over 20 minutes. 2. Seek expert consultation. 3. Give lidocaine 1 to 1.5 mg IV and start infusion. 4. Give amiodarone 300 mg IV and start infusion 5. Give a single shock. You are monitoring a patient with chest discomfort who suddenly becomes unresponsive. You observe the following rhythm on the cardiac monitor. A defibrillator is present. What is your first action? 1. Intubate the patient and give epinephrine 2 to 4 mg via the endotracheal tube. 2. Being CPR with chest compressions for 2 minutes or about 5 cycles of compressions and ventilations. 3. Establish an IV and give epinephrine 1 mg. 4. Establish and IV and give vasopressin 40 units. 5. Give a single shock. 4. 1 to 2 L of normal saline. A patient has been resuscitated from cardiac arrest and is being prepared for transport. She is intubated and is receiving 100% oxygen. Blood pressure is 80/60 mm Hg. During the resuscitation, she received 2 doses of epinephrine 1 mg and 1 does of amiodarone 300 mg IV. You now observe this rhythm on the cardiac monitor. The rhythm abnormality is becoming more frequent and increasing in number. You should order: 1. Amiodarone 150 mg IV bolus; start infusion. 2. A repeat dose of epinephrine 1 mg IV. 3. Lidocaine 1 to 1.5 mg IV; star infusion. 4. 1 to 2 L of normal saline. 5. Amiodarone 300 mg IV. Amiodarone (Cordarone) Antidysrhythmic agent. Prolongs repolarization, relaxes smooth muscles, decreases vascular resistance. For ventricular fibrillation and unstable ventricular tachycardia. Incompatible with heparin, may be given in PO maintenance dose, monitor for respiratory complications. Lidocaine (Xylocaine) 1. also available in topical 2. Safe in pregnancy 3. Medium duration 4. MRD: 3mg/pound, up to a maximum of 500mg ANTIARRHYTHMIC Epinephrine injected to help restore blood flow Neurotransmitter secreted by the adrenal medulla in response to stress. Also known as adrenaline The recommended dose of epinephrine hydrochloride is 1.0 mg (10 mL of a 1:10 000 solution) administered IV every 3 to 5 minutes during resuscitation. Each dose given by peripheral injection should be followed by a 20-mL flush of IV fluid to ensure delivery of the drug into the central compartment. Vasopressin (ADH) Stimulates water reabsorption in the kidneys raises blood pressure and makes kidneys conserve water Magnesium Sulfate Indications 1. Refractory VFIB/pulseless VTAC(ACLS) 2. Treatment for Torsades de Pointes (polymorphic VTAC) 3. Seizures associated with eclampsia and alcohol withdrawal 4. Dysrhythmias associated with digitalis toxicity 5. Bronchospasms refectory to traditional medications Nitroglycerin (Nitrostat) Angina (vasodilator) Atropine Indications Hemodynamically significant bradycardia Organophosphate poisoning Normal Saline (NS) For patients with acute brain injury, 0.9% saline is preferred. crystalloids remain the “first-line” for fluid resuscitation Sodium Bicarbonate Indications 1. Cardiopulmonary arrest with: a. unsucessful drug therapy and defibrillation b. suspected hyperkalemia (elevated potassium in dialysis patients. 2. Crush Syndrome or crush injury greater than 4 hours. 3. Suspected TCA overdose (acidosis) with cardiac dysrhythmias. ***Metabolic acidosis during cardiac arrest Ringer's lactate Ringer's lactate may be preferred in hemorrhagic shock because it somewhat minimizes acidosis and will not cause hyperchloremia. dextrose Dextrose is contraindicated in cardiac arrest. Dextrose is contraindicated in cardiac arrest. You cannot trust point-of-care blood glucose testing in shock states. The heart does not operate primarily on glucose, it runs on fatty acid oxidation. Hypoglycemia does not cause cardiac arrest Dextrose for hypoglycemic emergency Which action is likely to cause air to enter the victim's stomach during bag-mask ventilation? Ventilating too quickly You are the code team leader and arrive to find a patient with CPR in progress. On the next rhythm check you see the Rhythm shown here team members tell you that the patient was well but reported chest discomfort and then collapse. She has no pulse or respirations. Bag mask ventilation are producing visible chest rise and IO access has been established. Which intervention would be your next action? Epinephrine 1 milligram In which situation does bradycardia require treatment? Hypotension A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of 220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38 mm Hg, and the pulse oximetry reading is 98%. There is vascular access in the left arm, and the patient has not been given any vasoactive drugs. A 12- lead ECG confirms a supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate has not responded to vagal maneuvers. What is your next action? Administer adenosine 6 mg IV push A 35-year-old woman has palpitations, light- headedness, and a stable tachycardia. The monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has been established. Which drug should be administered?A. adenosine 6 mgB. atropine 0.5 mgC. epinephrine 2 to 10 mcg/kg per minuteD. lidocaine 1 mg/kg A. adenosine 6 mg A patient with possible STEMI has ongoing chest discomfort. What is a contradiction to nitrate administration? Use of a phosphodiesterase inhibitor within the past 24 hours A patient with sinus bradycardia and a heart rate of 42 bpm has diaphoresis and a BP of 80/60 mm Hg. What is the initial dose of atropine? 0.5 mg of atropine Which intervention is most appropriate for the treatment of a patient in asystole? When treating asystole, epinephrine can be given as soon as possible but its administration should not delay initiation or continuation of CPR. After the initial dose, epinephrine is given every 3-5 minutes. Rhythm checks should be performed after 2 minutes (5 cycles) of CPR. You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage 2 months ago. He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The patient is receiving oxygen via nasal cannula at 2 L/min, and an IV has been established. His blood pressure is 180/100 mm Hg. Which drug do you anticipate giving to this patient? A. aspirin B. glucose (D50) C. nicardipine D. rtPA A. aspirin A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 88/56 mmHg. Which therapy is now indicated? Epinephrine 2-10 mcg/min How does complete chest recoil contribute to effective CPR? Allows max blood return to the heart Your patient is a 56-year-old woman with a history of type 2 diabetes who reports feeling dizzy. She is pale and diaphoretic. Her blood pressure is 80/60 mm Hg. The cardiac monitor documents the rhythm shown here. She is receiving oxygen at 4L/min by nasal cannula, and an IV has been established. What do you administer next? Atropine 1 mg IV Your patient is not responsive and is not breathing. You can palpate a carotid pulse. Which action do you take next? If a patient is unresponsive but has a palpable carotid pulse, the immediate action to take is to start rescue breathing to maintain blood oxygen levels and prevent possible brain damage. What is the recommended compression rate for high-quality CPR? 100-120 compressions per minute You are providing bag-mask ventilations to a pt in respiratory arrest. How often should you provide ventilations? Every 5-6 seconds A 35-year-old woman presents with a chief complaint of palpitations. She has no chest discomfort, shortness of breath, or light- headedness. Her blood pressure is 120/78 mm Hg. Which intervention is indicated first? Vagal maneuvers A patient's 12-lead ECG is transmitted by the paramedics and shows a stemi when the patient arrives in the emergency department the Rhythm shown here is seen on the cardiac monitor. the patient has resolution of moderate 5/10 chest pain after 3 doses of sublingual nitroglycerin. blood pressure is 104 / 70. Which intervention is most important in reducing this patients in hospital and 30-day mortality rate? Reperfusion therapy Reperfusion therapy Reperfusion therapy is defined as the first reperfusion therapy used to restore blood flow through a suspected or known occluded coronary artery immediately on diagnosis and includes intravenous thrombolysis, primary angioplasty, intracoronary AHA ACLS Pre-Test Study Guide How often should you switch chest compressors to avoid fatigue? Rescuers performing chest compressions (CCs) should be rotated every 2 min or sooner if rescuers become fatigued. A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She has received adenosine 6 mg IV for the rhythm shown here, without conversion of the rhythm. She is now extremely apprehensive. Her blood pressure is 128/70 mm Hg. What is the next appropriate intervention? Administer adenosine 12 mg IV A patient's 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the patient arrives in the emergency department, the rhythm shown here is seen on the cardiac monitor. The patient has resolution of moderate (5/10) chest pain after 3 doses of sublingual nitroglycerin. Blood pressure is 104/70 mm Hg. Which intervention is most important in reducing this patient's in-hospital and 30-day mortality rate? You arrive on the scene to find CPR in progress. Nursing staff report the pt was recovering from a pulmonary embolism and suddenly collapsed. Two shocks have been delivered, and and IV has been initiated. What do you administer now? Epinephrine 1mg IV A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the patient becomes unresponsive, with the rhythm shown here. Which action is indicated next? give an immediate un-synchronized high energy shock (defibrillation dose)