ACLS FINAL EXAM 3
1. The EKG of a patient who arrived in the ED complaining of dizziness, syncope and SOB
reveals sinus bradycardia. When reviewing the patients medication history, the HCP identifies
which agents as a potential cause?
Answer:
-Metoprolol
Verapamil
Digoxin
2. A patient with bradycardia and signs of hemodynamic compromise doesn'trespond to
atropine. Which interventions could the HCP use next?
Answer:
•Epinephrine or dopamine infusion
• Transcutaneous pacing
3. A patient's EKG reveals narrow QRS complex with a regular rhythm, indicating a narrow
complex SVT. The patient is not showing signs of hemodynamic compromise. Which
interventions would be initiated first if it does notdelay other interventions?
Answer: Vagal maneuvers
4. EKG of a patient in the ED reveals the following rhythm. Which feature would the HCP
interpret as indicating atrial fibrillation?
Answer: Absence of discreteP waves and presence of irregularly irregular QRS
5. Cardiac monitoring indicates that a patient has a ventricular tachyarrhythmia. The patient
has a pulse and is not showing any signs of hemodynamic compromise. A 12 lead EKG
reveals an irregular rhythm with a QRS greater than 0.12 secs. Which action would be
appropriate at this time?
Answer: Consider an antiarrhythmic medication
6. A patient is brought into the ED.The patient doesn't have a pulse. Thecardiac monitor
shows the following rhythm.
Answer: V. Tach.
7. A patient with acute renal failure experiences cardiac arrest. Just before the cardiac arrest,
the patient's EKG showed peaked T waves. What might becausing the patients cardiac arrest?
Answer: Hyperkalemia
8. A member of the resuscitation team is preparing to defibrillate a patient in cardiac arrest
using a biphasic defibrillator. The team member would set the energy dose according to the
manufacturer's recommendations, which isusually:
Answer: 120-200 joules
, 9. A member of the resuscitation team is preparing to administer medicationsintravenously to a
patient in cardiac arrest. The team member follows each medication administration with a
normal saline flush. How much would the team member give?
Answer: 10-20 ml
10. A 30YO patient has been brought to the ED in cardiac arrest. The cardiac monitor shows
the following rhythm. Interpretation of this rhythm would suggest which of the following as a
possible precipitating factor?
Answer: Electrocution
11. Cardiac monitoring of a patient in cardiac arrest reveals Ventricular Fibrillation. In
addition to high quality CPR, what intervention should be priority?-
Answer: Defibrillation
12. The resuscitation team suspects that hyperkalemia is the cause of cardiacarrest in a patient
brought to the ED.Which finding on a 12 lead would confirmthis?
Answer: Wide complex ventricular rhythm & tail, peaked T waves.
13. A patient has experienced ROSC after cardiac arrest. The healthcare team is conducting a
secondary assessment to determine the possible cause of the patients cardiac arrest. Before the
arrest, the patient exhibited JVD, cyanosis,
apnea and hyperresonance on percussion.The team would most likely sus-pect which
condition as the cause?
Answer: Tension pneumothorax
14. A patient in cardiac arrest experiences ROSC. As part of post-cardiac arrest, the patient is
receiving mechanical ventilation at an initial rate of 10 breaths/min and a FiO2 of 0.30. Which
findings would indicate the need for change in the ventilator settings to optimize the patients
ventilation andoxygenation?
Answer:
PaCO2 48mmHg
SaO2 90% ETCO2 55mmHg
15. After cardiac arrest and successful resuscitation, the patient has a ROSC.The patient is
unable to follow verbal commands. TTM is initiated. Which methods would be appropriate
for the resuscitation team to use?
Answer:
•Giving an Ice cold IV fluid bolus
• Applying cooling blankets to the pt's body
• Using an endovascular catheter
16. A patient with suspected acute coronary syndromes has a pulse oximetryof 86% and is
given supplemental O2. The provider determines that the supplemental O2 dose is correct
based on which SaO2 level?
1. The EKG of a patient who arrived in the ED complaining of dizziness, syncope and SOB
reveals sinus bradycardia. When reviewing the patients medication history, the HCP identifies
which agents as a potential cause?
Answer:
-Metoprolol
Verapamil
Digoxin
2. A patient with bradycardia and signs of hemodynamic compromise doesn'trespond to
atropine. Which interventions could the HCP use next?
Answer:
•Epinephrine or dopamine infusion
• Transcutaneous pacing
3. A patient's EKG reveals narrow QRS complex with a regular rhythm, indicating a narrow
complex SVT. The patient is not showing signs of hemodynamic compromise. Which
interventions would be initiated first if it does notdelay other interventions?
Answer: Vagal maneuvers
4. EKG of a patient in the ED reveals the following rhythm. Which feature would the HCP
interpret as indicating atrial fibrillation?
Answer: Absence of discreteP waves and presence of irregularly irregular QRS
5. Cardiac monitoring indicates that a patient has a ventricular tachyarrhythmia. The patient
has a pulse and is not showing any signs of hemodynamic compromise. A 12 lead EKG
reveals an irregular rhythm with a QRS greater than 0.12 secs. Which action would be
appropriate at this time?
Answer: Consider an antiarrhythmic medication
6. A patient is brought into the ED.The patient doesn't have a pulse. Thecardiac monitor
shows the following rhythm.
Answer: V. Tach.
7. A patient with acute renal failure experiences cardiac arrest. Just before the cardiac arrest,
the patient's EKG showed peaked T waves. What might becausing the patients cardiac arrest?
Answer: Hyperkalemia
8. A member of the resuscitation team is preparing to defibrillate a patient in cardiac arrest
using a biphasic defibrillator. The team member would set the energy dose according to the
manufacturer's recommendations, which isusually:
Answer: 120-200 joules
, 9. A member of the resuscitation team is preparing to administer medicationsintravenously to a
patient in cardiac arrest. The team member follows each medication administration with a
normal saline flush. How much would the team member give?
Answer: 10-20 ml
10. A 30YO patient has been brought to the ED in cardiac arrest. The cardiac monitor shows
the following rhythm. Interpretation of this rhythm would suggest which of the following as a
possible precipitating factor?
Answer: Electrocution
11. Cardiac monitoring of a patient in cardiac arrest reveals Ventricular Fibrillation. In
addition to high quality CPR, what intervention should be priority?-
Answer: Defibrillation
12. The resuscitation team suspects that hyperkalemia is the cause of cardiacarrest in a patient
brought to the ED.Which finding on a 12 lead would confirmthis?
Answer: Wide complex ventricular rhythm & tail, peaked T waves.
13. A patient has experienced ROSC after cardiac arrest. The healthcare team is conducting a
secondary assessment to determine the possible cause of the patients cardiac arrest. Before the
arrest, the patient exhibited JVD, cyanosis,
apnea and hyperresonance on percussion.The team would most likely sus-pect which
condition as the cause?
Answer: Tension pneumothorax
14. A patient in cardiac arrest experiences ROSC. As part of post-cardiac arrest, the patient is
receiving mechanical ventilation at an initial rate of 10 breaths/min and a FiO2 of 0.30. Which
findings would indicate the need for change in the ventilator settings to optimize the patients
ventilation andoxygenation?
Answer:
PaCO2 48mmHg
SaO2 90% ETCO2 55mmHg
15. After cardiac arrest and successful resuscitation, the patient has a ROSC.The patient is
unable to follow verbal commands. TTM is initiated. Which methods would be appropriate
for the resuscitation team to use?
Answer:
•Giving an Ice cold IV fluid bolus
• Applying cooling blankets to the pt's body
• Using an endovascular catheter
16. A patient with suspected acute coronary syndromes has a pulse oximetryof 86% and is
given supplemental O2. The provider determines that the supplemental O2 dose is correct
based on which SaO2 level?
