Advanced Life Support (ALS) Online Session Final Exam questions with complete answers.

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1.A patient's ECG reveals a narrow QRS complex with a regular rhythm,
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indicating a narrow-complex supraventricular tachyarrhythmia. The patient is
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hemodynamically stable. Which intervention would be initiated first?: Vagal
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maneuvers
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For a patient who is hemodynamically stable and experiencing a narrow-
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complex supraventricular tachyarrhythmia, vagal maneuvers are
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attempted first. If ineffective, adenosine is given.
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2.A patient's capnogram reveals the following waveform. Which segment
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would the healthcare provider interpret as reflecting the beginning of exha-
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lation?: A-B ee




The A-B segment is the respiratory baseline that represents the
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begi exhalation.
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3.A patient experiencing an unstable bradyarrhythmia does not respond to
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atropine or transcutaneous pacing. Which intervention would the healthcare
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provider use next?: Administration of an epinephrine infusion.
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Epinephrine or dopamine may be administered to patients with ee ee ee ee ee ee ee ee




symptomatic brady- cardia if atropine and transcutaneous pacing are no
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effective.
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4.A patient with a suspected stroke arrives at the emergency department at
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7:10 p.m. The stroke team ensures that a neurologic assessment and brain
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computed tomography or magnetic resonance imaging is obtained by which
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time?: 7:30 p.m.
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In accordance with National Institute of Neurological Disorders and Strok
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guide- lines, the stroke team, emergency physician or other expert must
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conduct a neuro- logic assessment and obtain computed tomography or
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magnetic resonance imaging within 20 minutes after the patient's arrival i
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the emergency department. That would be 7:30 p.m. for this patient.
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5.A patient in the telemetry unit is stable. Cardiac monitoring indicates the
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patient has ventricular tachycardia with a pulse. Further assessment reveals
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that the corrected QT interval is greater than 0.46 seconds. Which treatment
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would be appropriate at this time?: Synchronized cardioversion
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For a patient with ventricular tachycardia who is stable, has a pulse and
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has a corrected QT interval greater than 0.46 seconds, synchronized
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cardioversion is the recommended treatment.
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, Advanced Life Support (ALS) Online Session Final Exam ee ee ee ee ee ee ee




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6.A resuscitation team is debriefing following a recent event. A patient ex-
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perienced cardiac arrest, and advanced cardiac life support was initiated.
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The patient required the placement of an advanced airway to maintain air-
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way patency. Which statement indicates that the team performed high-quality
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CPR?: "We delivered 1 ventilation every 6 seconds and chest
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compressions at a rate of 100 to 120 compressions per minute."
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When an advanced airway has been placed in a patient who is in cardiac
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arrest, compressions and ventilations are delivered continuously with no
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interruptions. One provider delivers 1 ventilation every 6 seconds, while
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the second provider performs compressions at a rate of 100 to 120
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compressions per minute.
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7.A healthcare provider initiates ventilations to ensure adequate breathing
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and oxygenation. While ventilations are being performed, capnography is es-
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tablished to evaluate the adequacy of the ventilations. The healthcare provider
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determines that ventilations are adequate based on which end-tidal carbon
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dioxide (ETCO2) value?: 35 to 45 mmHg
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End-tidal carbon dioxide values in the range of 35 to 45 mmHg confirm
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adequacy of ventilation.
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8.An ECG strip of a patient in the emergency department reveals the following
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rhythm. Which feature would the healthcare provider interpret as indicating
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atrial fibrillation?: Absence of discrete P waves and presence of
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irregularly irreg- ular QRS complexes.
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The two key features of atrial fibrillation on ECG are the absence of discrete
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P waves and the presence of irregularly irregular QRS complexes.
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9.A patient in cardiac arrest experiences return of spontaneous circulation. As
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part of post-cardiac arrest care, the patient is receiving mechanical ventilation.
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Which finding(s) would indicate the need for change in the ventilator settings
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to optimize the patient's ventilation and oxygenation?: 1. ETCO2 50 mmHg
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2.PaCO2 35 mmHg ee ee




3.SaO2 92% ee




Mechanical ventilation should be started at a rate of 10 to 12 breaths ee ee ee ee ee ee ee ee ee ee ee ee




per minute and adjusted as necessary to keep ETCO2 levels in the
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range of 35 to 40 mmHg and PaCO2 levels in the range of 40 to 45
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mmHg. The minimum fraction of inspired oxygen necessary to maintain
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an SaO2 of at least 94% is used.
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, Advanced Life Support (ALS) Online Session Final Exam
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10.The following capnogram is from a patient experiencing respiratory dis-
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tress. At which point in the waveform would the patient's ETCO2 level be
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