Chapter 17 Pre-Test

What is the target systolic blood pressure in a hypotensive patient in shock who has ongoing​ bleeding? A. 90 to 100 mmHg B. 80 to 90 mmHg C. 115 to 120 mmHg D. 100 to 110 mmHg

80 to 90 mmHg

The target systolic blood pressure for a patient with both hemorrhagic shock and suspected traumatic brain injury​ is: A. 90 mmHg. B. 110 mmHg. C. 120 mmHg. D. 80 mmHg.

90 mmHg.

Which of the following statements regarding chest compressions in CPR is​ accurate? A. You must pause chest compressions to check a pulse every minute during CPR. B. Effective chest compressions can produce 50 percent of the normal cardiac output. C. The adult chest must be compressed 1.0 to 1.5 inches to generate cardiac output during CPR. D. Adequate chest compressions build up pressure enough within the cardiovascular system to allow perfusion.

Adequate chest compressions build up pressure enough within the cardiovascular system to allow perfusion.

During transport to the​ hospital, a patient who presented with chest pain becomes unresponsive and pulseless with agonal respirations. Which sequence below provides for the​ highest-quality, safest​ care? A. Begin​ CPR, notify the receiving​ hospital, and continue CPR until arrival at the hospital. B. Attach the​ AED, stop the​ ambulance, analyze the​ rhythm, shock if​ indicated, perform two minutes of​ CPR, reanalyze the​ rhythm, shock if​ indicated, perform two minutes of​ CPR, reanalyze, shock if​ indicated, resume​ CPR, and resume transport. C. Stop the​ ambulance, perform two minutes of​ CPR, attach​ AED, analyze the​ rhythm, shock if​ indicated, perform two minutes of​ CPR, analyze​ rhythm, shock if​ indicated, resume​ CPR, and resume transport. D. Attach the​ AED, analyze the​ rhythm, shock if​ indicated, perform two minutes of​ CPR, reanalyze the​ rhythm, shock if​ indicated, perform two minutes of​ CPR, reanalyze, shock if​ indicated, and resume CPR.

Attach the​ AED, stop the​ ambulance, analyze the​ rhythm, shock if​ indicated, perform two minutes of​ CPR, reanalyze the​ rhythm, shock if​ indicated, perform two minutes of​ CPR, reanalyze, shock if​ indicated, resume​ CPR, and resume transport.

When delivering ventilations during CPR to a patient who does not have an advanced airway in​ place, which guideline below should be​ followed? A. Deliver each breath over one​ second, looking for the chest to just begin to rise. B. Deliver both breaths within one​ second, even if you are not able to achieve chest rise. C. Deliver each breath over two​ seconds, ensuring full chest rise. D. Deliver breaths​ asynchronously, one every six to eight seconds.

Deliver each breath over one​ second, looking for the chest to just begin to rise.

Which of the following best describes the way in which defibrillation has its​ effect? A. Electricity from the external shock passes through the​ myocardium, causing uniform depolarization to eliminate chaotic electrical activity in the heart with the hope that the​ heart's normal pacemaker will take over. B. The defibrillation shock produces a normal depolarization of the SA node so that it can take over the pacemaker functions of the heart. C. Once depolarized by the application of​ electricity, the abnormally firing cells will cease to function. D. The application of electricity through the chest wall restarts the normal electrical conduction system of the heart.

Electricity from the external shock passes through the​ myocardium, causing uniform depolarization to eliminate chaotic electrical activity in the heart with the hope that the​ heart's normal pacemaker will take over.

Which of the following best describes how a biphasic defibrillator​ functions? A. The operator must perform two steps to deliver an electrical current through the heart. B. Electrical energy is simultaneously directed in two directions through the heart. C. Two shocks are​ delivered, one at a lower level of energy and one at a higher level of energy. D. For half the defibrillation​ cycle, energy is delivered in one​ direction, and for half the defibrillation cycle energy is delivered in the opposite direction.

For half the defibrillation​ cycle, energy is delivered in one​ direction, and for half the defibrillation cycle energy is delivered in the opposite direction.

During​ post-cardiac arrest resuscitation​ efforts, you notice that the paramedic managing the​ patient's airway and breathing is delivering ventilations at a greater rate and volume than recommended by AHA guidelines and your protocols. What should you​ do? A. Immediately point out to the paramedic what you have noticed. B. After the​ call, document what you witnessed and contact your supervisor for advice. C. Do not say anything about​ it; the paramedic is a higher medical authority. D. After the​ call, take the paramedic aside and point out what you noticed.

Immediately point out to the paramedic what you have noticed.

Which of the following statements regarding the use of topical hemostatic agents is most ​accurate? A. Prehospital research on topical hemostatic agents is limited and has mixed results. B. TraumaDex is widely accepted as the most effective topical hemostatic agent. C. QuikClot causes burns from intense exothermic reaction upon application. D. HemCon is associated with several​ life-threatening episodes of anaphylaxis in patients with seafood allergies.

Prehospital research on topical hemostatic agents is limited and has mixed results.

You have arrived on the scene of a​ "sick person" to find an elderly woman unresponsive in bed. Her husband said he could not wake her this morning. The woman does not appear to be​ breathing, and you confirm that she is pulseless. Which of the following should you do​ next? A. Request advanced life support backup. B. Quickly check for rigor mortis and dependent lividity. C. Move the patient to the floor to begin CPR. D. Attach the AED.

Quickly check for rigor mortis and dependent lividity.

Which of these is the best way to maintain the highest perfusion pressure possible during​ CPR? A. Use a​ "push hard and push​ fast" approach to chest compressions. B. Apply PASG. C. Ensure that the compression cycle is 75 percent compression time and 25 percent release time. D. Ventilate with a minimum of​ 1,000 mL per breath.

Use a​ "push hard and push​ fast" approach to chest compressions.

As you arrive on the scene of a cardiac​ arrest, the​ patient's wife tells you that the patient has an implanted defibrillator. You confirm that the patient is pulseless and that there is an implanted battery unit under the skin of his left chest. In which of the following ways does this change your approach to the​ patient? A. You should place defibrillator pads directly over the implanted defibrillator battery pack. B. The use of an AED is contraindicated in all patients with implanted defibrillators. C. You should avoid placing the AED pads over the battery pack. D. Use a magnet to deactivate it before touching the patient.

You should avoid placing the AED pads over the battery pack.

A return of spontaneous circulation in a patient in cardiac arrest is confirmed by all of the following except​: A. sudden increase in ETCO2. B. carotid pulse detected during a brief interruption in chest compressions. C. resumption of spontaneous breathing effort. D. an organized rhythm on the cardiac monitor.

an organized rhythm on the cardiac monitor.

Upon removing the shirt of a patient in cardiac arrest so you can apply defibrillator​ pads, you see a bulge beneath the​ patient's left clavicle. There is a scar over the​ bulge, and it is hard to palpation. You​ should: A. use an​ anterior-posterior pad placement and decrease the defibrillation dosage by half. B. allow the implanted device to do the job that would otherwise be performed by the AED. C. place the defibrillation pads as​ usual, but decrease the defibrillation dosage to 120 J. D. avoid placing the defibrillator pads directly over the​ bulge, but otherwise defibrillate as usual.

avoid placing the defibrillator pads directly over the​ bulge, but otherwise defibrillate as usual.

The first link in the Chain of Survival from cardiac arrest​ is: A. immediate CPR. B. immediate defibrillation. C. bystander activation of the EMS system. D. initiation of therapeutic hypothermia.

bystander activation of the EMS system.

In which situation would resuscitative efforts generally be​ withheld? A. patient with a chronic illness B. cardiac arrest due to severe blunt trauma C. cardiac arrest that was not witnessed D. patient who is cyanotic

cardiac arrest due to severe blunt trauma

Which of the following situations calls for the use of a​ tourniquet? A. stab wound to the groin with​ severe, ongoing bleeding uncontrolled by direct pressure B. ​"clean" amputation of the hand at the wrist with minimal bleeding noted C. a large avulsion to the scalp with​ significant, ongoing bleeding that is difficult to control with direct pressure D. chain saw laceration to the inner thigh in which direct pressure is being used but substantial bleeding continues

chain saw laceration to the inner thigh in which direct pressure is being used but substantial bleeding continues

Which of the following supports the emphasis on the need for early defibrillation in cardiac​ arrest? A. The most common dysrhythmias in sudden cardiac death are shockable ventricular dysrhythmias. B. Even if a patient has a​ pulse, defibrillation is safe and effective. C. Defibrillation can restart a heart that has stopped functioning. D. If defibrillation occurs within five​ minutes, CPR is unnecessary.

The most common dysrhythmias in sudden cardiac death are shockable ventricular dysrhythmias.

You arrive on a scene and find an​ off-duty EMT performing CPR. Which of the following​ facts, if discovered during your assessment and​ history, should make you consider terminating​ resuscitation? A. The pulse oximeter does not register a reading. B. The patient does not have a pulse. C. The​ patient's husband tells you she has ovarian cancer. D. The patient is unresponsive patient with rigor mortis.

The patient is unresponsive patient with rigor mortis.

Which of these is an advantage of using a mechanical CPR​ device? A. The quality of compressions is consistent over time. B. Such devices have been proven superior at producing effective cardiac output. C. Mechanical CPR devices allow for a longer compression than relaxation phase of each compression. D. Mechanical CPR devices have a lower risk of injuring the patient than does manual CPR.

The quality of compressions is consistent over time.

Why are AEDs especially important in reducing cardiac arrest​ mortality? A. They can be used by the lay public and EMS providers with minimal training. B. They cannot shock a patient with a pulse. C. They have been proven to cause less damage to the myocardium than manual defibrillators. D. They can provide a higher level of defibrillation energy than manual defibrillators.

They can be used by the lay public and EMS providers with minimal training.

Which of the following is true regarding the efficacy of mechanical CPR​ devices? A. The devices are recommended in all cases of​ out-of-hospital cardiac arrest. B. Research has determined that these devices are not effective and they should not be used. C. They have been proven superior to manual chest compressions. D. They can be useful when manpower is​ limited, but research is limited.

They can be useful when manpower is​ limited, but research is limited.

Which of the following is the most accurate description of myocardial​ ischemia? A. irregularity of the cardiac rhythm B. irritability of the heart muscle C. inability of the heart muscle to contract effectively D. inadequate perfusion of the heart muscle

inadequate perfusion of the heart muscle

Aggressive fluid administration in a patient with hemorrhagic shock and ongoing bleeding directly increases the risk of all of the following except​: A. acidosis. B. impaired blood clotting. C. infection. D. hypothermia.

infection

A patient who regained spontaneous circulation after CPR and defibrillation has a blood pressure of​ 84/50 mmHg. Medical direction gives you an order to start an IV and infuse one liter of normal saline to treat the hypotension. The order provides an example​ of: A. activation of the emergency response system. B. rapid defibrillation. C. early advanced care. D. integrated​ post-cardiac arrest care

integrated​ post-cardiac arrest care

All of the following statements regarding the return of spontaneous circulation in cardiac arrest patients are true except​: A. when circulation​ improves, the carbon dioxide that has accumulated can be transported to the​ lungs, resulting in an increase in ETCO2. B. it is important to pause compressions every 60 seconds to check for a carotid pulse. C. continuing CPR in the first few minutes after a pulse returns is not known to be​ harmful, and may benefit the patient. D. obvious signs of return of spontaneous circulation including spontaneous breathing and response to stimuli rarely occur.

it is important to pause compressions every 60 seconds to check for a carotid pulse.

Which of the following processes constitutes a CQI process for resuscitation​ programs? A. regular testing and maintenance of AEDs B. frequent continuing education C. having medical direction for the AED program D. measuring benchmarks for program performance

measuring benchmarks for program performance

Which situation below may be treated using an​ AED? A. ventricular tachycardia in a patient with or without a pulse B. asystole C. patient in ventricular fibrillation D. pulseless electrical activity

patient in ventricular fibrillation

Which of the following will help provide the best cardiac output for a patient in cardiac​ arrest? A. performing chest compressions while the AED delivers a shock B. performing chest compressions while the AED is charging C. performing chest compressions while the AED is analyzing D. performing chest compressions during the complete AED cycle

performing chest compressions while the AED is charging

Which of the following contributes most to survival from cardiac​ arrest? A. public access defibrillation programs and the public being trained in CPR B. having paramedics on the scene within five minutes of cardiac arrest C. early administration of ACLS medications D. allowing Advanced EMTs to interpret ECGs and perform manual defibrillation

public access defibrillation programs and the public being trained in CPR

A high school basketball player collapses on the court in cardiac arrest with immediate CPR initiation and EMS activation. Advanced EMTs arrive on the​ scene, take over​ CPR, and prepare to transport the patient. Within​ minutes, the Advanced EMTs arrive with the patient at the emergency​ department, where the staff immediately place defibrillator pads on the​ patient, recognize ventricular​ fibrillation, and deliver a shock. Which link in the Chain of Survival was omitted in this​ patient's care? A. rapid defibrillation B. immediate activation of the emergency response system C. early advanced life support D. early CPR

rapid defibrillation

Which of these would be an appropriate quality indicator of a​ community's resuscitation​ program? A. the number of traumatic cardiac arrests in a community B. the average age of cardiac arrest survivors in the community C. the percentage of witnessed cardiac arrests in which bystander CPR is started D. rates of​ obesity, diabetes, and smoking in the community

the percentage of witnessed cardiac arrests in which bystander CPR is started

You arrive on the scene of an injured person to find a young adult man who was cut with a broken bottle. He has a​ three-inch laceration on the medial aspect of his left​ arm, about four inches proximal to the elbow. Bleeding is profuse and the patient is diaphoretic and anxious. The best way to approach bleeding control in this patient​ is: A. apply a tourniquet two inches proximal to the wound. B. use an absorbent dressing and roller bandage to create a pressure dressing over the injury. C. elevate the extremity and apply arterial pulse point pressure over the brachial artery. D. use an absorbent dressing to apply firm direct pressure over the injury.

use an absorbent dressing to apply firm direct pressure over the injury.

Which of the following is a cardiac arrhythmia that can be defibrillated by an​ AED? A. pulseless electrical activity B. ventricular tachycardia with a pulse C. asystole D. ventricular fibrillation

ventricular fibrillation

You are managing a cardiac arrest 18 minutes from the nearest hospital. Under what circumstances would advanced life support intervention be most valuable to the​ patient? A. unwitnessed​ arrest, unknown​ down-time, with no bystander CPR B. witnessed arrest with bystander CPR C. unwitnessed​ arrest, unknown​ downtime, with bystander CPR initiated D. witnessed​ arrest, down-time 10​ minutes, with no bystander CPR

witnessed arrest with bystander CPR

You are caring for a 70 lb​ (32 kg) child in hemorrhagic shock. An appropriate initial fluid bolus for this patient​ is: A. 450 mL. B. 650 mL. C. 750 mL. D. 250 mL.

650 mL.