1. The stroke team is assessing a patient with a suspected stroke. The patient is
alert and able to carry on a conversation, although the patient has difficulty
getting the words out. Testing confirms that the patient has had an ischemic
stroke. Based on the patient's medical history, a history of which arrhythmia
would alert the team to the patient's increased risk for stroke?
Atrial fibrillation
Atrial tachycardia
Bradycardia
Ventricular fibrillation
Answer Atrial fibrillation
Between 15 and 20 percent of embolic strokes are caused by atrial fibrillation.
2. A 30-year-old patient has been brought to the emergency department 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?
Cardiac tamponade
Electrocution
,Hemorrhage
Antibiotic use
Answer Electrocution
The rhythm is ventricular fibrillation. Precipitating causes of ventricular fibrillation include electrocution, myocardial ischemia or
infarction, shock, stimulant overdose and ventricular tachycardia.
3. A 28-year-old pregnant patient who resides in transitional housing presents to
the emergency department with complaints of feeling feverish and very faint.
The patient tells the emergency nurse that she does not know when she became
pregnant. Upon palpation, the fundus is not at or above the umbilicus. The
patient's condition quickly deteriorates and she goes into cardiac arrest. If
available and able to be used without impeding or delaying the resuscitation
effort, what diagnostic tool could be used to guide decision-making in the care of
this patient?
Point-of-care ultrasound
Fetal monitoring
Fetal echocardiogram
Abdominal radiograph
Answer Point-of-care ultrasound
Gestational age is an important consideration when determining the approach to a pregnant patient in cardiac arrest. If the
gestational age is not known and point-of-care ultrasound is available and able to be performed without impeding or delaying
, the resuscitation ettort, it can be used to quickly estimate gestational age and guide decision-making.
4. A person suddenly collapses while sitting in the sunroom of a healthcare
facility. A healthcare provider observes the event and hurries over to assess the
situation. The healthcare provider performs which assessment first?
Secondary assessment
Primary assessment
Rapid assessment
Basic life support assessment
Answer Rapid assessment
A systematic approach to assessment is necessary. The healthcare provider should first perform a rapid assessment. A rapid
assessment is a visual survey to ensure safety, form an initial impression about the patient's condition (including looking for lif
threatening bleeding), and determine the need for additional resources. This would be followed by a primary assessment an
then a secondary assessment.
5. A patient is receiving ventilation support via bag-valve-mask (BVM) resus-
citator. Capnography is established and a blood gas is obtained to evaluate the
adequacy of the ventilations. Which arterial carbon dioxide (PaCO2) value
signifies adequate ventilations?
10 to 15 mmHg
20 to 25 mmHg