ACLS (Pretest) possible Skills Questions

Ans: B. 30:2 30:1 is incorrect. 30:2 is the correct ratio for compressions to ventilations according to the 2010 AHA guidelines. 15:2 is incorrect. 15:1 is incorrect.

The compression-to-ventilation ratio during CPR for an adult prior to placement of an advanced airway is:* a. 30:1 b. 30:2 c. 15:1 d. 20:2

Ans: D All of the Above Hyperventilation increases intrathoracic pressure during diastole which decreases venous return to the heart. This decreases preload which diminishes cardiac output.

How can hyperventilation be detrimental?* a. Increase intrathoracic pressure b. Decrease venous return to the heart c. Diminish cardiac output d. All of the above

Ans: d. Airway, Breathing, Circulation, Differential Diagnosis While deformity may provide clues to traumatic injury, deformity is not part of the ACLS survey. While defibrillation is an important intervention, it is covered under "Circulation" and is not the "D" represented in the ACLS survey. While blood pressure is an important vital sign, it is a component of "Circulation". In the ACLS survey the "B" stands for "Breathing". The ACLS survey is Airway, Breathing, Circulation, and Differential Diagnosis.

The ACLS Survey includes assessing which of the following?* a. Airway, Breathing, Chest Compressions, Deformity b. Airway, Breathing, Circulation, Defibrillation c. Airway, Blood Pressure, CPR, Differential Diagnosis d. Airway, Breathing, Circulation, Differential Diagnosis

Ans: A 10 seconds In the 2015 guidelines, it's emphasized that limiting interruptions to chest compressions to 10 seconds or less. When chest compressions are interrupted perfusion to the heart and brain rapidly drops, increasing the chance of damage due to lack of oxygen. Keeping the heart well-perfused increases the likelihood of return of spontaneous circulation, as well as the effectiveness of defibrillation.

What amount of time should ACLS providers minimize interruptions during chest compressions?* a. 10 seconds b. 20 seconds c. 30 seconds d. 60 seconds

Ans: b. Responsiveness, Activate EMS, and get AED, Circulation, Defibrillation "Airway, Breathing, Circulation..." was the BLS survey prior to the last AHA guideline revision in 2010 and has been replaced. Responsiveness, Activate EMS and get AED, Circulation, and Defibrillation is the correct sequence in the AHA 2010 guidelines. Blood Pressure is not part of the BLS survey. Cardiac assessment and drugs are not part of the BLS survey.

What does the BLS Survey want you to assess which of the following? a. airway, breathing, circulation, defibrillation b. Responsiveness, Activate EMS, and get AED, Circulation, Defibrillation c. Airway, Blood Pressure, CPR, Differential Diagnosis d. Circulation, Breathing, Cardiac Assessment, Drugs

Ans: B Rigid catheter (Yankauer) The pediatric soft flexible catheter has small openings, poorly suited to suctioning thick secretions and particulate matter. The Yankauer rigid suction catheter has large openings and a bulb shaped head which allow it to suction thick secretions and particulates from the oropharynx. The laryngeal tube is an intubation tube, not a suction catheter

What is the suction catheter that provides the most competent suctioning of the thick particulate matter and oropharynx?* a. Pediatric soft flexible catheter b. Rigid catheter (Yankauer) c. Laryngeal tube d. None of the above

Ans: A. Nasopharyngeal airway (NPA) The Combitube ™, laryngeal mask airway (LMA), and endotracheal tube (ET tube) are all examples of advanced airways. The nasopharyngeal airway is used to keep oral structures from falling to the back of the oropharynx and occluding the airway. It is an airway adjunct and not considered an advanced airway.

What item is NOT an example of Advanced Airways?* a. Nasopharyngeal airway (NPA) b. Esophageal-tracheal tube (combitube) c. Laryngeal mask airway (LMA) d. Endotracheal tube (ET tube)

Ans: D. Individuals in asystole respond well to late defibrillation. Ventricular fibrillation is a common out-of-hospital arrhythmia which results in sudden cardiac arrest and should be treated with rapid defibrillation. Delayed defibrillation increases myocardial ischemia, further disorganizes cardiac electrical activity, and reduces the likelihood of successful defibrillation. Asystole is the absence of meaningful electrical activity in the heart. It is not a fibrillating rhythm and therefore does not respond to defibrillation.

What reason is NOT valid during the critical early defibrillation for individuals experiencing sudden cardiac arrest?* a. A common initial rhythm in out-of-hospital witnessed sudden cardiac arrest is ventricular fibrillation (VF). b. The most effective treatment for VF is electrical defibrillation. c. The probability of successful defibrillation decreases quickly over time. d. Individuals in asystole respond well to late defibrillation.

Ans: d. Placement of laryngeal mask airway (LMA) Head tilt-chin lift is the basic method of managing an airway in ACLS and BLS protocols. Jaw thrust without manipulation of the cervical spine is the basic method of managing the airway in victims in whom a spinal injury is suspected. Bag-mask ventilation is a basic airway skill for two rescuer CPR when equipment is available. Intubation with a laryngeal mask airway (LMA) is an advanced airway management device and is not considered a basic airway skill.

Which item is NOT a basic airway skill?* a. Head tilt-chin-lift maneuver b. Jaw-thrust maneuver without head extension c. Bag-mask ventilation d. Placement of laryngeal mask airway (LMA)

c. Multiple leaders of the team Closed loop communication is present when team members repeat instructions back to the team leader confirming that the instruction was heard and understood as intended. This is an element of effective resuscitation team dynamics. Clear roles and responsibilities allow each team member to perform tasks and be accountable for them. Overlap and omission are both eliminated with clear roles and responsibilities of team members and therefore are essential to effective resuscitation team dynamics. Multiple team leaders create overlap and conflict and will reduce the effectiveness of a resuscitation team. Knowing one's limitations is important to effective resuscitation team dynamics to allow roles and responsibilities to be assigned to team members proficient in them.

Which of the following is NOT an element of effective resuscitation team dynamics?* a. Closed-loop communication b. Clear roles and responsibilities c. Multiple leaders of the team d. Knowing one's limitations