ACLS COMPLETE
You find an unresponsive pt. who is not breathing. After activating the emergency
response system, you determine there is no pulse. What is your next action? -
ANSWER: Start chest compressions of at least 100 per min.
You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm
Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the
pulse oximetry reading is 97%. What assessment step is most important now? -
ANSWER: Obtaining a 12 lead ECG.
What is the preferred method of access for epi administration during cardiac arrest in
most pts? - ANSWER: Peripheral IV
An AED does not promptly analyze a rythm. What is your next step? - ANSWER: Begin
chest compressions.
You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm
below, and the patient has no pulse. Another member of your team resumes chest
compressions, and an IV is in place. What management step is your next priority? -
ANSWER: Administer 1mg of epinephrine
During a pause in CPR, you see this lead II ECG rhythm on the monitor. The patient
has no pulse. What is the next action? - ANSWER: Resume compressions
What is a common but sometimes fatal mistake in cardiac arrest management? -
ANSWER: Prolonged interruptions in chest compressions.
Which action is a componant of high-quality chest comressions? - ANSWER: Allowing
complete chest recoil
Which action increases the chance of successful conversion of ventricular fibrillation? -
ANSWER: Providing quality compressions immediately before a defibrillation attempt.
Which situation BEST describes pulseless electrical activity? - ANSWER: Sinus rythm
without a pulse
What is the BEST strategy for performing high-quality CPR on a patient with an
advanced airway in place? - ANSWER: Provide continuous chest compressions without
pauses and 10 ventilations per minute.
,Three minutes after witnessing a cardiac arrest, one member of your team inserts an
endotracheal tube while another performs continuous chest compressions. During
subsequent ventilation, you notice the presence of a waveform on the capnography
screen and a PETCO2 level of 8 mm Hg. What is the significance of this finding? -
ANSWER: Chest compressions may not be effective.
The use of quantitative capnography in intubated patients - ANSWER: allows for
monitoring of CPR quality.
For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who
originally presented in ventricular fibrillation. After the first shock, the ECG screen
displayed asystole, which has persisted despite 2 doses of epinephrine, a fluid bolus,
and high-quality CPR. What is your next treatment? - ANSWER: Consider terminating
resuscitive efforts after consulting medical control.
Which is a safe and effective practice within the defibrillation sequence? - ANSWER: Be
sure oxygen is not blowing over the patient's chest during the shock.
During your assessment, your patient suddenly loses consciousness. After calling for
help and determining that the patient is not breathing, you are unsure whether the
patient has a pulse. What is your next action? - ANSWER: Begin chest compressions.
What is an advantage of using hands-free defibrillation pads instead of defibrillation
paddles? - ANSWER: Hands-free pads allow for a more rapid defibrillation.
What action is recommended to help minimize interruptions in chest compressions
during CPR? - ANSWER: Continue CPR while charging the defibrillator.
Which action is included in the BLS survey? - ANSWER: Early defibrillation
Which drug and dose are recommended for the management of a patient in refractory
ventricular fibrillation? - ANSWER: Amioderone 300mg
What is the appropriate interval for an interruption in chest compressions? - ANSWER:
10 seconds or less
Which of the following is a sign of effective CPR? - ANSWER: PETCO2 ≥10 mm Hg
What is the primary purpose of a medical emergency team (MET) or rapid response
team (RRT)? - ANSWER: Identifying and treating early clinical deterioration.
Which action improves the quality of chest compressions delivered during a
resuscitation attempt? - ANSWER: Switch providers about every 2 minutes or every 5
compression cycles.
, What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse
rate of 80/min? - ANSWER: 1 breath every 5-6 seconds
A patient presents to the emergency department with new onset of dizziness and
fatigue. On examination, the patient's heart rate is 35/min, the blood pressure is 70/50
mm Hg, the respiratory rate is 22 breaths/min, and the oxygen saturation is 95%. What
is the appropriate first medication? - ANSWER: Atropine 0.5mg
A patient with dizziness and shortness of breath with a sinus bradycardia of 40/min. The
initial atropine dose was ineffective, and your monitor/defibrillator is not equipped with a
transcutaneous pacemaker. What is the appropriate dose of dopamine for this patient? -
ANSWER: 2 to 10 mcg/kg per minute
A patient has sudden onset of dizziness. The patient's heart rate is 180/min, blood
pressure is 110/70 mm Hg, respiratory rate is 18 breaths/min, and pulse oximetry
reading is 98% on room air. The lead II ECG is shown below: - ANSWER: Vagal
manuever.
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
at the left internal jugular vein, 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 the next
recommended intervention? - ANSWER: Adenosine 6mg IV push
You are receiving a radio report from an EMS team en route with a patient who may be
having an acute stroke. The hospital CT scanner is not working at this time. What
should you do in this situation? - ANSWER: Divert the patient to a hospital 15 minutes
away with CT capabilities.
Choose an appropriate indication to stop or withhold resuscitative efforts. - ANSWER:
Evidence of rigor mortis.
A 49-year-old woman arrives in the emergency department with persistent epigastric
pain. She had been taking oral antacids for the past 6 hours because she thought she
had heartburn. The initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and
regular, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry
reading is 96%. Which is the most appropriate intervention to perform next? - ANSWER:
Obtain a 12 lead ECG.
A patient in respiratory failure becomes apneic but continues to have a strong pulse.
The heart rate is dropping rapidly and now shows a sinus bradycardia at a rate of
30/min. What intervention has the highest priority? - ANSWER: Simple airway
manuevers and assisted ventilations.
You find an unresponsive pt. who is not breathing. After activating the emergency
response system, you determine there is no pulse. What is your next action? -
ANSWER: Start chest compressions of at least 100 per min.
You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm
Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the
pulse oximetry reading is 97%. What assessment step is most important now? -
ANSWER: Obtaining a 12 lead ECG.
What is the preferred method of access for epi administration during cardiac arrest in
most pts? - ANSWER: Peripheral IV
An AED does not promptly analyze a rythm. What is your next step? - ANSWER: Begin
chest compressions.
You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm
below, and the patient has no pulse. Another member of your team resumes chest
compressions, and an IV is in place. What management step is your next priority? -
ANSWER: Administer 1mg of epinephrine
During a pause in CPR, you see this lead II ECG rhythm on the monitor. The patient
has no pulse. What is the next action? - ANSWER: Resume compressions
What is a common but sometimes fatal mistake in cardiac arrest management? -
ANSWER: Prolonged interruptions in chest compressions.
Which action is a componant of high-quality chest comressions? - ANSWER: Allowing
complete chest recoil
Which action increases the chance of successful conversion of ventricular fibrillation? -
ANSWER: Providing quality compressions immediately before a defibrillation attempt.
Which situation BEST describes pulseless electrical activity? - ANSWER: Sinus rythm
without a pulse
What is the BEST strategy for performing high-quality CPR on a patient with an
advanced airway in place? - ANSWER: Provide continuous chest compressions without
pauses and 10 ventilations per minute.
,Three minutes after witnessing a cardiac arrest, one member of your team inserts an
endotracheal tube while another performs continuous chest compressions. During
subsequent ventilation, you notice the presence of a waveform on the capnography
screen and a PETCO2 level of 8 mm Hg. What is the significance of this finding? -
ANSWER: Chest compressions may not be effective.
The use of quantitative capnography in intubated patients - ANSWER: allows for
monitoring of CPR quality.
For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who
originally presented in ventricular fibrillation. After the first shock, the ECG screen
displayed asystole, which has persisted despite 2 doses of epinephrine, a fluid bolus,
and high-quality CPR. What is your next treatment? - ANSWER: Consider terminating
resuscitive efforts after consulting medical control.
Which is a safe and effective practice within the defibrillation sequence? - ANSWER: Be
sure oxygen is not blowing over the patient's chest during the shock.
During your assessment, your patient suddenly loses consciousness. After calling for
help and determining that the patient is not breathing, you are unsure whether the
patient has a pulse. What is your next action? - ANSWER: Begin chest compressions.
What is an advantage of using hands-free defibrillation pads instead of defibrillation
paddles? - ANSWER: Hands-free pads allow for a more rapid defibrillation.
What action is recommended to help minimize interruptions in chest compressions
during CPR? - ANSWER: Continue CPR while charging the defibrillator.
Which action is included in the BLS survey? - ANSWER: Early defibrillation
Which drug and dose are recommended for the management of a patient in refractory
ventricular fibrillation? - ANSWER: Amioderone 300mg
What is the appropriate interval for an interruption in chest compressions? - ANSWER:
10 seconds or less
Which of the following is a sign of effective CPR? - ANSWER: PETCO2 ≥10 mm Hg
What is the primary purpose of a medical emergency team (MET) or rapid response
team (RRT)? - ANSWER: Identifying and treating early clinical deterioration.
Which action improves the quality of chest compressions delivered during a
resuscitation attempt? - ANSWER: Switch providers about every 2 minutes or every 5
compression cycles.
, What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse
rate of 80/min? - ANSWER: 1 breath every 5-6 seconds
A patient presents to the emergency department with new onset of dizziness and
fatigue. On examination, the patient's heart rate is 35/min, the blood pressure is 70/50
mm Hg, the respiratory rate is 22 breaths/min, and the oxygen saturation is 95%. What
is the appropriate first medication? - ANSWER: Atropine 0.5mg
A patient with dizziness and shortness of breath with a sinus bradycardia of 40/min. The
initial atropine dose was ineffective, and your monitor/defibrillator is not equipped with a
transcutaneous pacemaker. What is the appropriate dose of dopamine for this patient? -
ANSWER: 2 to 10 mcg/kg per minute
A patient has sudden onset of dizziness. The patient's heart rate is 180/min, blood
pressure is 110/70 mm Hg, respiratory rate is 18 breaths/min, and pulse oximetry
reading is 98% on room air. The lead II ECG is shown below: - ANSWER: Vagal
manuever.
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
at the left internal jugular vein, 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 the next
recommended intervention? - ANSWER: Adenosine 6mg IV push
You are receiving a radio report from an EMS team en route with a patient who may be
having an acute stroke. The hospital CT scanner is not working at this time. What
should you do in this situation? - ANSWER: Divert the patient to a hospital 15 minutes
away with CT capabilities.
Choose an appropriate indication to stop or withhold resuscitative efforts. - ANSWER:
Evidence of rigor mortis.
A 49-year-old woman arrives in the emergency department with persistent epigastric
pain. She had been taking oral antacids for the past 6 hours because she thought she
had heartburn. The initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and
regular, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry
reading is 96%. Which is the most appropriate intervention to perform next? - ANSWER:
Obtain a 12 lead ECG.
A patient in respiratory failure becomes apneic but continues to have a strong pulse.
The heart rate is dropping rapidly and now shows a sinus bradycardia at a rate of
30/min. What intervention has the highest priority? - ANSWER: Simple airway
manuevers and assisted ventilations.
