Acls Exam A 2020

ACLS Exam A 2020 ACLS Exam A 2020 Which of these tests should be performed for a pt with suspected stroke as early as possible but no more than 20 min after hospital arrival? - ANS Noncontrast CT scan of head Which best describes this rhythm? - ANS Monomorphic Vent Tach Which is an acceptable method of selecting an appropriately sized oropharyngeal airway? - ANS Measure from the corner of the mouth to the angle of mandible You are caring for a pt with a suspected stroke whose symptoms started 2 hours ago. The CT scan was normal, with no signs of hemorrhage. The pt does not have any contraindications to fibrinolytic therapy. Which treatment is best for this pt? - ANS Give fibrinolytic therapy as soon as possible and consider endovascular therapy Which is the recommended next step after a defibrillation attempt? - ANS Resume CPR, starting with chest compressions Which of the following signs is a likely indicator of cardiac arrest in an unresponsive pt? - ANS Agonal gasps You are evaluating a 58YO man with chest discomfort. His BP is 92/50 mmHG, his HR is 92/min, his nonlabored RR is 14/min, and his pulse ox is 97%. Which assessment step is most important now? - ANS Obtaining a 12-lead ECG During post-cardiac arrest care, which is the recommended duration of targeted temperature management after reaching the correct temperature range? - ANS At least 24 hours Your rescue team arrives to find a 59YO man lying on the kitchen floor. You determine that he is unresponsive. What is the next step in your assessment and management of this pt? - ANS Check the pt's breathing and pulse (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. On the basis of this pt's initial presentation, which condition do you suspect led to the cardiac arrest? - ANS Acute Coronary Syndrome (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. In addition to defibrillation, which intervention should be performed immediately? - ANS Chest compressions (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. Despite 2 defib attempts, the pt remains in VFib. Which drug and dose should you administer FIRST to this pt? - ANS Epi 1mg (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. Despite the drug provided above and continued CPR, the pt remains in VFib. Which other drug should be administered NEXT? - ANS Lido 1 to 1.5mg/kg (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. The pt has ROSC and is not able to follow commands. Which immediate post-cardiac arrest care intervention do you choose for this pt? - ANS Initiate targeted temperature management (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. Which would you have done first if the pt had not gone into VFib? - ANS Performed synchronized cardioversion How can you increase chest compression fraction during a code? - ANS Charge the defib 15s before conducting a rhythm check A team member is unable to perform an assigned task because it is beyond the team member's scope of practice. Which action should the team member take? - ANS Ask for a new task or role In addition to clinical assessment, which is the most reliable method to confirm and monitor correct placement of the ET tube? - ANS Continuous waveform capnography Your pt is in cardiac arrest and has been intubated. To assess CPR quality, which should you do? - ANS Monitor the pt's PETCO2 Three minutes into a cardiac arrest resuscitation attempt, one member of your team inserts an ET tube while another performs chest compressions. Capnography shows a persistent waveform and a PETCO2 of 8mmHg. Which is the significance of this finding? - ANS Chest compressions may not be effective If a team member is about to make a mistake during a resuscitation attempt, which best describes the action that the Team Leader or other team members should take? - ANS Address the team member immediately A pt in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the first dose of adenosine. Which dose would you administer next? - ANS 12mg Which is the primary purpose of a medical emergency team or rapid response team? - ANS Improving pt outcomes by identifying and treating early clinical deterioration A pt is being resuscitated in a very noisy environment. A team member thinks he heard an order for 500mg of amiodarone IV. Which is the best response from the team member? - ANS "I have an order to give 500mg of amiodarone. Is this correct?" Which is the recommended oral dose of aspirin for a pt with a suspected acute coronary syndrome? - ANS 162-325mg What is the minimal SBP one should attempt to achieve with fluid administration or vasoactive agents in a hypotensive post-cardiac arrest pt who achieves spontaneous circulation? - ANS 90 mmHg What should be the primary focus of the CPR Coach on a resuscitation team? - ANS To ensure high-quality CPR (SET) A 68YO woman presents with light-headedness, nausea and chest discomfort. Your assessment finds her awake and responsive but appearing ill, pale and grossly diaphoretic. Weak, thready, fast radial pulse. Unable to obtain BP. No obvious dependent edema, flat neck veins. Her lung sounds are equal, with moderate rales bilaterally. On the basis of this pt's initial assessment, which ACLS algorithm should you follow? - ANS Adult Tachycardia With a Pulse (SET) A 68YO woman presents with light-headedness, nausea and chest discomfort. Your assessment finds her awake and responsive but appearing ill, pale and grossly diaphoretic. Weak, thready, fast radial pulse. Unable to obtain BP. No obvious dependent edema, flat neck veins. Her lung sounds are equal, with moderate rales bilaterally. The pt's pulse ox shows a reading of 84% on room air. Which initial action should you take? - ANS Apply oxygen (SET) A 68YO woman presents with light-headedness, nausea and chest discomfort. Your assessment finds her awake and responsive but appearing ill, pale and grossly diaphoretic. Weak, thready, fast radial pulse. Unable to obtain BP. No obvious dependent edema, flat neck veins. Her lung sounds are equal, with moderate rales bilaterally. After your initial assessment of this pt, which intervention should be performed next? - ANS Synchronized cardioversion (SET) A 68YO woman presents with light-headedness, nausea and chest discomfort. Your assessment finds her awake and responsive but appearing ill, pale and grossly diaphoretic. Weak, thready, fast radial pulse. Unable to obtain BP. No obvious dependent edema, flat neck veins. Her lung sounds are equal, with moderate rales bilaterally. If the pt became apneic and pulseless but the rhythm remained the same, which would take the highest priority? - ANS Perform defibrillation You instruct a team member to give 1mg atropine IV. Which response is an example of closed-loop communication? - ANS "I'll draw up 1mg of atropine." Which best describes an action taken by the Team Leader to avoid inefficiencies during a resuscitation attempt? - ANS Clearly delegate tasks What is an effect of excessive ventilation? - ANS Decreased cardiac output Which best describes the length of time it should take to perform a pulse check during the BLS assessment? - ANS 5-10 seconds Which is the recommended FIRST IV dose of amiodarone for a patient with refractory VFib? - ANS 300mg Which facility is the most appropriate EMS destination for a pt with sudden cardiac arrest who achieved ROSC in the field? - ANS Coronary reperfusion-capable medical center A pt has a witnessed LOC. The lead II ECG reveals this rhythm (VFib). Which is the appropriate treatment? - ANS Defibrillation For STEMI pt's, which best describes the recommended maximum goal time for first medical contact-to-balloon inflation time for PCI? - ANS 90 minutes You are performing chest compressions during an adult resuscitation attempt. Which rate should you use to perform the compressions? - ANS 100-120/min Which is the maximum interval you should allow for an interruption in chest compressions? - ANS 10 seconds To properly ventilate a pt with a perfusing rhythm, how often do you squeeze the bag? - ANS Once every 6 seconds EMS providers are treating a pt with a suspected stroke. According to the Adult Suspected Stroke Algorithm, which critical action performed by the EMS team will expedite this pt's care on arrival and reduce the time to treatment? - ANS Provide prehospital notification What is the recommended range from which a temperature should be selected and maintained constantly to achieve targeted temperature management after cardiac arrest? - ANS 32C to 36C A responder is caring for a pt with a history of CHF. The pt is experiencing shortness of breath, a BP of 68/50 mmHg, and a HR of 190/min. The pt's lead II ECG is displayed. - ANS Unstable SVT