ACLS

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

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation. 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

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation. Despite 2 defibrillation attempts, the patient remains in ventricular fibrillation. Which drug and dose should you administer first to this patient? A. Epinephrine 1mg B. Amiodarone 300mg C. Lidocaine 1mg/kg D. Atropine 1mg

A

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation. 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

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

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. Provide prehospital notification B. Establish IV access C. Review the patient's history D. Treat hypertension

A

How can you increase chest compression fraction during a code? A. Charge the defibrillator 15 seconds before conducting a rhythm check B. Interchange the ventilator and compressor during a rhythm check C. Administer epinephrine during the 2-minute cycle D. Initiate intravenous or intraosseous access during the 2-minute cycle

A

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

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

A

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

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

Your patient is in cardiac arrest and has been intubated. To assess CPR quality, which should you do? A. Monitor the patients Petco2 B. Obtain a 12-lead ECG C. Check the patient's pulse D. Obtain a chest x-ray

A

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

During post-cardiac arrest care, which is the recommended duration of targeted temperature management after reaching the correct temperature range? A. 0 to 8 hours B. At least 24 hours C. At least 36 hours D. At least 48 hours

B

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

B

What should be the primary focus of the CPR coach on a resuscitation team? A. To covey positive feedback B. To ensure high-quality CPR C. To resolve team arguments D. To document CPR outcomes

B

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

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

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 the 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

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation. In addition to defibrillation, which intervention should be performed immediately? A. Advance airway insertion B. Vasoactive medication administration C. Chest compressions D. Vascular access

C

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

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

C

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

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

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

C

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

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 the most important now? A. Evaluating the PETCO2 reading B. Requesting a chest x-ray C. Obtaining a 12-lead ECG D. Requesting laboratory testing

C

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

You instruct a team member to give 1.0 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 1.0 mg of atropine." D. "Are you sure that is what you want given?"

C

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation. Despite the drug provided above and continued CPR, the patient remains in ventricular fibrillation. Which other drug should be administered next? A. Epinephrine 1mg B. Atropine 1mg C. Magnesium Sulfate 1 g D. Lidocaine 1 to 1.5mg/kg

D

A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation. 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 1mg D. Performed synchronized cardioversion

D

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

D

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

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. 75 mm Hg B. 80 mm Hg C. 85 mm Hg D. 90 mm Hg

D

Which facility is the most appropriate EMS destination for a patient with sudden cardiac arrest who achieved ROSC 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

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

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

Which of these tests should be performed for a patient with suspected stroke as soon as possible but no more than 20 minutes after hospital arrival? A. 12-lead ECG B. Cardiac enzymes C. Coagulation studies D. Noncontrast CT scan of the head

D