ACLS

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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? A. Ask for a new task or role B. Assign it to another team member C. Do it anyway D. Seek expert advice

A. Ask for a new task or role

Which of these tests should be performed for a patient with suspected stroke within 25 minutes of hospital arrival? A. 12-lead ECG B. Cardiac enzymes C. Coagulation studies D. Noncontrast CT scan of the head

D. Noncontrast CT scan of the head

f the patient became apneic and pulseless but the rhythm remained the same, which would take the highest priority? A. Administer amiodarone 300 mg B. Administer atropine 0.5 mg C. Insert an advanced airway D. Perform defibrillation

D. Perform defibrillation

Which would you have done first if the patient had not gone into ventricular fibrillation? A. Established IV access B. Obtained a 12-lead ECG C. Given atropine 1 mg D. Performed synchronized cardioversion

D. Performed synchronized cardioversion

Which is the maximum interval you should allow for an interruption in chest compressions? A. 10 seconds B. 15 seconds C. 20 seconds D. 25 to 30 seconds

A. 10 seconds

Based on this patient's initial presentation, which condition do you suspect led to the cardiac arrest? A. Acute coronary syndrome B. Acute heart failure C. Acute ischemic stroke D. Supraventricular tachycardia with ischemic chest pain

A. Acute coronary syndrome

EMS providers are treating a patient with suspected stroke. According to the Adult Suspected Stroke Algorithm, which critical action performed by the EMS team will expedite this patient's care on arrival and reduce the time to treatment? A. Alert the hospital B. Establish IV access C. Review the patient's history D. Treat hypertension

A. Alert the hospital

Three minutes into a cardiac arrest resuscitation attempt, one member of your team inserts an endotracheal tube while another performs chest compressions. Capnography shows a persistent waveform and a PETCO2 of 8 mm Hg. Which is the significance of this finding? A. Chest compressions may not be effective B. The endotracheal tube is in the esophagus C. The patient meets the criteria for termination of efforts D. The team is ventilating the patient too often (hyperventilation)

A. Chest compressions may not be effective

What is an effect of excessive ventilation? A. Decreased cardiac output B. Decreased intrathoracic pressure C. Increased perfusion pressures D. Increased venous return

A. Decreased cardiac output

Despite 2 defibrillation attempts, the patient remains in ventricular fibrillation. Which drug and dose should you administer first to this patient? A. Epinephrine 1 mg B. Amiodarone 300 mg C. Lidocaine 1 mg/kg D. Atropine 1 mg

A. Epinephrine 1 mg

The patient has return of spontaneous circulation and is not able to follow commands. Which immediate post-cardiac arrest care intervention do you choose for this patient? A. Initiate targeted temperature management B. Check the glucose level C. Administer epinephrine D. Extubate

A. Initiate targeted temperature management

Which is an acceptable method of selecting an appropriately sized oropharyngeal airway? A. Measure from the corner of the mouth to the angle of the mandible B. Measure from the thyroid cartilage to the bottom of the earlobe C. Estimate by using the formula Weight (kg)/8 + 2 D. Estimate by using the size of the patient's finger

A. Measure from the corner of the mouth to the angle of the mandible

Your patient is in cardiac arrest and has been intubated. To assess CPR quality, which should you do? A. Monitor the patient's PETCO 2 B. Obtain a 12-lead ECG C. Check the patient's pulse D. Obtain a chest x-ray

A. Monitor the patient's PETCO 2

After your initial assessment of this patient, which intervention should be performed next? A. Synchronized cardioversion B. Administration of amiodarone 150 mg IM C. Immediate defibrillation D. Endotracheal intubation

A. Synchronized cardioversion

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? A. Conduct a debriefing after the resuscitation attempt B. Reassign the team tasks C. Address the team member immediately D. Remove the team member from the area

C. Address the team member immediately

Which of the following signs is a likely indicator of cardiac arrest in an unresponsive patient? A. Slow, weak pulse rate B. Cyanosis C. Agonal gasps D. Irregular, weak pulse rate

C. Agonal gasps

The patient's pulse oximeter shows a reading of 84% on room air. Which initial action do you take? A. Perform bag-mask ventilation B. Intubate the patient C. Apply oxygen D. Check the pulse oximeter probe

C. Apply oxygen

A patient 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? A. 3mg B. 12mg C. 20mg D. 40mg

B. 12mg

Which best describes the length of time it should take to perform a pulse check during the BLS Assessment? A. 1 to 4 seconds B. 5 to 10 seconds C. 11 to 15 seconds D. 16 to 20 seconds

B. 5 to 10 seconds

As the team leader, when do you tell the chest compressors to switch? A. Only when they tell you that they are fatigued B. About every 2 minutes C. About every 5 minutes D. About every 7 minutes

B. About every 2 minutes

During post-cardiac arrest care, which is the recommended duration of targeted temperature management after reaching the correct temperature range? A. 0to8hours B. At least 24 hours C. At least 36 hours D. At least 48 hours

B. At least 24 hours

16. Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive. Which is the next step in your assessment and management of this patient? A. Apply the AED B. Check the patient's breathing and pulse C. Open the patient's airway D. Check for a medical alert bracelet

B. Check the patient's breathing and pulse

Which is the primary purpose of a medical emergency team or rapid response team? A. Improving care for patients admitted to critical care units B. Improving patient outcomes by identifying and treating early clinical deterioration C. Providing diagnostic consultation to emergency department patients D. Providing online consultation to EMS personnel in the field

B. Improving patient outcomes by identifying and treating early clinical deterioration

To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag? A. Once every 3 to 4 seconds B. Once every 5 to 6 seconds C. Once every 10 seconds D. Once every 12 seconds

B. Once every 5 to 6 seconds

You are caring for a patient with a suspected stroke whose symptoms started 2 hours ago. The CT scan was normal, with no signs of hemorrhage. The patient does not have any contraindications to fibrinolytic therapy. Which treatment approach is best for this patient? A. Hold fibrinolytic therapy for 24 hours B. Start fibrinolytic therapy as soon as possible C. Order an echocardiogram before fibrinolytic administration D. Wait for the results of the MRI

B. Start fibrinolytic therapy as soon as possible

Which is the recommended next step after a defibrillation attempt? A. Check the ECG for evidence of a rhythm B. Open the patient's airway C. Determine if a carotid pulse is present D. Resume CPR, starting with chest compressions

D. Resume CPR, starting with chest compressions

You instruct a team member to give 0.5 mg atropine IV. Which response is an example of closed-loop communication? A. "I'll give it in a few minutes." B. "OK." C. "I'll draw up 0.5 mg of atropine." D. "Are you sure that is what you want given?"

C. "I'll draw up 0.5 mg of atropine."

You are performing chest compressions during an adult resuscitation attempt. Which rate should you use to perform the compressions? A. Less than 80/min B. 80 to 90/min C. 100 to 120/min D. More than 120/min

C. 100 to 120/min

31. Which is the recommended oral dose of aspirin for a patient with a suspected acute coronary syndrome? A. 40mg B. 81mg C. 160 to 325 mg D. 350 to 650 mg

C. 160 to 325 mg

What is the recommended range from which a temperature should be selected and maintained constantly to achieve targeted temperature management after cardiac arrest? A. 26°C to 28°C B. 29°C to 31°C C. 32°C to 36°C D. 35°C to 37°C

C. 32°C to 36°C

In addition to defibrillation, which intervention should be performed immediately? A. Advanced airway insertion B. Vasoactive medication administration C. Chest compressions D. Vascular access

C. Chest compressions

Which best describes an action taken by the team leader to avoid inefficiencies during a resuscitation attempt? A. Assign most tasks to the more experienced team members B. Perform the most complicated tasks C. Clearly delegate tasks D. Assign the same tasks to more than one team member

C. Clearly delegate tasks

In addition to clinical assessment, which is the most reliable method to confirm and monitor correct placement of an endotracheal tube? A. Arterial blood gases B. Chest radiography C. Continuous waveform capnography D. Hemoglobin levels

C. Continuous waveform capnography

You are evaluating a 58-year-old man with chest discomfort. His blood pressure is 92/50 mm Hg, his heart rate is 92/min, his nonlabored respiratory rate is 14 breaths/min, and his pulse oximetry reading is 97%. Which assessment step is most important now? A. Evaluating the PETCO 2 reading B. Requesting a chest x-ray C. Obtaining a 12-lead ECG D. Requesting laboratory testing

C. Obtaining a 12-lead ECG

A patient is being resuscitated in a very noisy environment. A team member thinks he heard an order for 500 mg of amiodarone IV. Which is the best response from the team member? A. "OK." B. "Are you sure?" C. "Amiodarone 500 mg IV has been given." D. "I have an order to give 500 mg of amiodarone IV. Is this correct?"

D. "I have an order to give 500 mg of amiodarone IV. Is this correct?"

Which is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation? A. 100 mg B. 150 mg C. 250 mg D. 300 mg

D. 300 mg

For STEMI patients, which best describes the recommended maximum goal time for emergency department door-to-balloon inflation time for percutaneous coronary intervention? A. 180 minutes B. 150 minutes C. 120 minutes D. 90 minutes

D. 90 minutes

What is the minimum systolic blood pressure one should attempt to achieve with fluid administration or vasoactive agents in a hypotensive post-cardiac arrest patient who achieves return of spontaneous circulation? A. 75mmHg B. 80mmHg C. 85mmHg D. 90mmHg

D. 90mmHg

Despite the drug provided above and continued CPR, the patient remains in ventricular fibrillation. Which other drug should be administered next? A. Epinephrine 1 mg B. Atropine 1 mg C. Magnesium sulfate 1 g D. Amiodarone 300 mg

D. Amiodarone 300 mg

Which is one way to minimize interruptions in chest compressions during CPR? A. Administer IV medications only when delivering breaths B. Check the pulse immediately after defibrillation C. Use an AED to monitor the patient's rhythm D. Continue CPR while the defibrillator charges

D. Continue CPR while the defibrillator charges

Which facility is the most appropriate EMS destination for a patient with sudden cardiac arrest who achieved return of spontaneous circulation in the field? A. Comprehensive stroke care unit B. Acute rehabilitation care unit C. Acute long-term care unit D. Coronary reperfusion-capable medical center

D. Coronary reperfusion-capable medical center


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