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Advanced Cardiovascular Life Support (ACLS) EXAM
ACTAUL EXAM 1, 2 & 3 TEST BANK ALL 400
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Advanced Cardiovascular Life Support EXAM 1 QUESTION: 1. What is the BEST strategy for performing high-quality CPR on a patient with an advanced airway in place? Provide compressions and ventilations with a 15:2 ratio. Provide compressions and ventilations with a 30:2 ratio. Provide a single ventilation every 6 seconds during the compression pause. Provide continuous chest compressions without pauses and 10 ventilations per minute. - ANSWER-Provide continuous chest compressions without pauses and 10 ventilations per minute. QUESTION: 2. 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?
Chest compressions may not be effective. The endotracheal tube is no longer in the trachea. The patient meets the criteria for termination of efforts. The team is ventilating the patient too often (hyperventilation). - ANSWER-Chest compressions may not be effective. QUESTION: 3. The use of quantitative capnography in intubated patients: allows for monitoring of CPR quality. measures oxygen levels at the alveoli level. determines inspired carbon dioxide relating to cardiac output. detects electrolyte abnormalities early in code management. - ANSWER-allows for monitoring of CPR quality. QUESTION: 4. An activated AED does not promptly analyze the rhythm. What is your next action? Begin chest compressions. Discontinue the resuscitation attempt. Check all AED connections and reanalyze.
Failure to obtain vascular access Prolonged periods of no ventilations Failure to perform endotracheal intubation Prolonged interruptions in chest compressions - ANSWER-Prolonged interruptions in chest compressions QUESTION: 8. Which action is a component of high-quality chest compressions? Allowing complete chest recoil Chest compressions without ventilation 60 to 100 compressions per minute with a 15:2 ratio Uninterrupted compressions at a depth of 11⁄2 inches - ANSWER-Allowing complete chest recoil QUESTION: 9. Which action increases the chance of successful conversion of ventricular fibrillation? Pausing chest compressions immediately after a defibrillation attempt Administering 4 quick ventilations immediately before a defibrillation attempt
Using manual defibrillator paddles with light pressure against the chest Providing quality compressions immediately before a defibrillation attempt - ANSWER- Providing quality compressions immediately before a defibrillation attempt QUESTION: 10. Which situation BEST describes pulseless electrical activity? Asystole without a pulse Sinus rhythm without a pulse Torsades de pointes with a pulse Ventricular tachycardia with a pulse - ANSWER-Sinus rhythm without a pulse 1 1. You find an unresponsive patient who is not breathing. After activating the emergency response system, you determine that there is no pulse. What is your next action? Open the airway with a head tilt-chin lift. Administer epinephrine at a dose of 1 mg/kg. Deliver 2 rescue breaths each over 1 second. Start chest compressions at a rate of at least 100/min. - ANSWER-Start chest compressions at a rate of at least 100/min.
displayed asystole, which has persisted despite 2 doses of epinephrine, a fluid bolus, and high- quality CPR. What is your next treatment? Apply a transcutaneous pacemaker. Administer 1 mg of intravenous atropine. Administer 40 units of intravenous vasopressin. Consider terminating resuscitative efforts after consulting medical control. - ANSWER-Consider terminating resuscitative efforts after consulting medical control. QUESTION: 15. Which is a safe and effective practice within the defibrillation sequence? Stop chest compressions as you charge the defibrillator. Be sure oxygen is not blowing over the patient's chest during the shock. Assess for the presence of a pulse immediately after the shock. Commandingly announce "clear" after you deliver the defibrillation shock. - ANSWER-Be sure oxygen is not blowing over the patient's chest during the shock. QUESTION: 16. 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?
Leave and get an AED. Begin chest compressions. Deliver 2 quick ventilations. Check the patient's mouth for the presence of a foreign body. - ANSWER-Begin chest compressions. QUESTION: 17. What is an advantage of using hands-free defibrillation pads instead of defibrillation paddles? Hands-free pads deliver more energy than paddles. Hands-free pads increase electrical arc. Hands-free pads allow for a more rapid defibrillation. Hands-free pads have universal adaptors that can work with any machine. - ANSWER-Hands- free pads allow for a more rapid defibrillation. QUESTION: 18. What action is recommended to help minimize interruptions in chest compressions during CPR? Continue CPR while charging the defibrillator. Perform pulse checks immediately after defibrillation.
10 seconds or less 10 to 15 seconds 15 to 20 seconds Interruptions are never acceptable - ANSWER-10 seconds or less QUESTION: 22. Which of the following is a sign of effective CPR? PETCO2 ≥10 mm Hg Measured urine output of 1 mL/kg per hour Patient temperature >32°C (89.6°F) Diastolic intra-arterial pressure <20 mm Hg - ANSWER-PETCO2 ≥10 mm Hg QUESTION: 23. What is the primary purpose of a medical emergency team (MET) or rapid response team (RRT)? Identifying and treating early clinical deterioration Rapidly intervening with patients admitted through emergency department triage Responding to patients during a disaster or multiple-patient situation
Responding to patients after activation of the emergency response system - ANSWER- Identifying and treating early clinical deterioration QUESTION: 24. Which action improves the quality of chest compressions delivered during a resuscitation attempt? Observe ECG rhythm to determine depth of compressions. Do not allow the chest to fully recoil with each compression. Compress the upper half of the sternum at a rate of 150 compressions per minute. Switch providers about every 2 minutes or every 5 compression cycles. - ANSWER-Switch providers about every 2 minutes or every 5 compression cycles. QUESTION: 25. What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse rate of 80/min? 1 breath every 3 to 4 seconds 1 breath every 5 to 6 seconds 2 breaths every 5 to 6 seconds 2 breaths every 6 to 8 seconds - ANSWER-1 breath every 5 to 6 seconds
QUESTION: 28. 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: What is the next appropriate intervention? Vagal maneuvers Metoprolol 5 mg IV Adenosine 6 mg IV Normal saline 1 L bolus - ANSWER-Vagal maneuvers QUESTION: 29. 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? Adenosine 6 mg IV push Amiodarone 300 mg IV push Synchronized cardioversion at 50 J Synchronized cardioversion at 200 J - ANSWER-Adenosine 6 mg IV push
QUESTION: 30. 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? Contact the patient's family to see what they would prefer. Have the EMS crew choose an appropriate patient disposition. Accept the report and provide care within your present capability. Divert the patient to a hospital 15 minutes away with CT capabilities. - ANSWER-Divert the patient to a hospital 15 minutes away with CT capabilities. QUESTION: 31. Choose an appropriate indication to stop or withhold resuscitative efforts. Arrest not witnessed Evidence of rigor mortis Patient age greater than 85 years No return of spontaneous circulation after 10 minutes of CPR - ANSWER-Evidence of rigor mortis QUESTION: 32. 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
Suction during insertion but for no longer than 30 seconds. Suction the mouth and nose for no longer than 30 seconds. Suction during withdrawal but for no longer than 10 seconds. Hyperventilate before catheter insertion, and then suction during withdrawal. - ANSWER- Suction during withdrawal but for no longer than 10 seconds. QUESTION: 35. While treating a patient with dizziness, a blood pressure of 68/30 mm Hg, and cool, clammy skin, you see this lead II ECG rhythm: (Shark fin EKG) What is the most appropriate first intervention? A. Aspirin B. Atropine C. Lidocaine D. Nitroglycerin - ANSWER-B. Atropine QUESTION: 36. A 68-year-old woman experienced a sudden onset of right arm weakness. EMS personnel measure a blood pressure of 140/90 mm Hg, a heart rate of 78/min, a nonlabored
respiratory rate of 14 breaths/min, and a pulse oximetry reading of 97%. The lead II ECG displays sinus rhythm. What is the most appropriate action for the EMS team to perform next? 12 - lead ECG assessment Administration of 100% supplementary oxygen Cincinnati Prehospital Stroke Scale assessment Administration of a low-dose aspirin - ANSWER-Cincinnati Prehospital Stroke Scale assessment QUESTION: 37. EMS is transporting a patient with a positive prehospital stroke assessment. Upon arrival in the emergency department, the initial blood pressure is 138/78 mm Hg, the pulse rate is 80/min, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95% on room air. The lead II ECG displays sinus rhythm. The blood glucose level is within normal limits. What intervention should you perform next? Head CT scan Transfer to the stroke unit Immediate rtPA administration Administration of 100% oxygen - ANSWER-Head CT scan QUESTION: 38. What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in place?
Procedural sedation 12 - lead ECG Amiodarone administration Synchronized cardioversion - ANSWER-Synchronized cardioversion QUESTION: 41. What is the initial priority for an unconscious patient with any tachycardia on the monitor? Review the patient's home medications. Evaluate the breath sounds. Determine whether pulses are present. Administer sedative drugs. - ANSWER-Determine whether pulses are present. QUESTION: 42. Which rhythm requires synchronized cardioversion? Unstable supraventricular tachycardia Atrial fibrillation Sinus tachycardia
NSR on monitor but no pulse - ANSWER-Unstable supraventricular tachycardia QUESTION: 43. What is the recommended second dose of adenosine for patients in refractory but stable narrow-complex tachycardia? A. 3mg B. 6mg C. 9mg D. 12mg - ANSWER-D. 12mg QUESTION: 44. What is the usual post-cardiac arrest target range for PETCO2 when ventilating a patient who achieves return of spontaneous circulation (ROSC)? A. 30to35mmHg B. 35to40mmHg C. 40to45mmHg D. 45to50mmHg - ANSWER-B. 35to40mmHg QUESTION: 45. Which condition is a contraindication to therapeutic hypothermia during the post-cardiac arrest period for patients who achieve return of spontaneous circulation ROSC?
