ACLS

Tachycardia is defined as:

An arrhytmia with a rate greater than 100/min

The key clinical question when determining steps to take for the patient with symptomatic bradycardia is:

Are the symptoms caused by bradycardia or some other illness?

The chest compression fraction should be:

As high as possible or as close to 80%

Drugs for bradycardia

Atropine Dopamine (infusion) Epi (infusion)

Pulse checks should: A. Performed every 50 cycles of CPR B. Be performed during rhythm analysis, only if an organized rhythm is present C. Take at least 15 seconds to ensure accuracy D. Give the rescuer enough information to treat the victim

B. Be performed during rhythm analysis, only if an organized rhythm is present

Synchronized cardioversion is recommended for: A. Monomorphic VT in a stable patient B. Pulseless rhythms C: Unstable SVT D: Polymorphic VT

C: Unstable SVT

The most important algorithm to know for adult resuscitation is:

Cardiac Arrest

If the initial shock terminates VF but the arrhythmia recurs later in the resuscitation:

Deliver subsequent shocks at the previously successful energy level

List the 8 D's of stroke care

Detection Dispatch Delivery Door Data Decision Drug/device Disposition

Defibrillation restarts the heart (T/F)

False; it actually stops the heart from beating totally in attempt to allow its pacemaker to restart in a perfusing rhythm

Effective resuscitation team dynamics would include all of the following statements except which one: 1. Team leaders and team members should have clear, closed-loop communication. 2. Team members inform the team leader when a task begins or ends. 3. Team members do not question team leaders orders even if doubt exists. 4. Team leaders define all roles of team members in the clinical setting.

3. Team members do not question team leaders orders even if doubt exists.

During the Primary Assessment when assessing (B) breathing, which of the following is correct about supplementary oxygen delivery? 1. Administer 100% oxygen for cardiac and respiratory arrest patients 2. Other than cardiac and respiratory arrest, administer oxygen to maintain O2 saturation value of ≥ 94% by pulse oximetry 3. both 1 and 2 are correct 4. neither 1 and 2 are correct

3. both 1 and 2 are correct

During CPR with no advanced airway in place the compression-to-ventilation ratio is

30:2

During CPR after an advanced airway is in place, which of the following is true: 1. The breaths should be synchronized with the chest compressions. 2. The goal is 20 or greater breaths per minute 3. Chest compressions should be stopped while giving breaths. 4. One breath every 6 seconds should be given

4. One breath every 6 seconds should be given

Preparation for transcutaneous pacing should be made for which of the following? 1. unstable sinus bradycardia 2. third degree AV block 3. Mobitz type II second-degree AV block 4. all of the above

4. all of the above

The goal of BLS interventions for a patient in respiratory or cardiac arrest is to: 1. restore effective oxygenation 2. restore effective ventilation 3. restore or support effective circulation 4. all of the above

4. all of the above

Transcutaneous pacing should be started immediately if: 1. there is no response to atropine 2. atropine is unlikely to be effective or if IV access cannot be quickly established 3. the patient is severely symptomatic 4. all of the above

4. all of the above

Which of the following is true about chest compressions: 1. push hard and fast 2. ensure full chest recoil 3. minimize interruptions in chest compression 4. all of the above

4. all of the above

Success of any resuscitation attempt is built on: 1. high quality CPR 2. defibrillation when required by the patients ECG rhythm 3. neither 1 or 2 4. both 1 and 2

4. both 1 and 2

When performing BLS/ACLS you should avoid all of the following except: 1. prolonged rhythm analysis 2. frequent pulse checks 3. taking too long to give rescue breaths to the patient 4. keeping the patients airway open

4. keeping the patients airway open

For patients experiencing respiratory arrest with a perfusing rhythm, deliver rescue breaths at 1 breath every ____ to ____ seconds.

5 to 6 seconds

For every minute that passes between collapse and defibrillation, how much does the chance of survival decrease from a witnessed VF sudden cardiac arrest if no bystander CPR is provided?

7% to 10%

What is the minimum systolic threshold for NTG administration

90 mmHg

Oxygen saturation should be above what percentage?

90%

What are the common underlying causes of PEA?

Hypoxia and Hypovolemia

What type if MI should you exercise caution in regards to NTG administration

Inferior wall MI

Which ECG rhythm is associated with bradycardia? 1. PEA 2. Mobitz II 3. ventricular fibrillation 4. sinus rhythm

Mobitz II

If the patient has a true allergy to ASA do you give it anyway?

No

If using a biphasic defibrillator and the recommended dosage is not known: A Do not shock until the recommended dose has been identified B.Shock using the minimum energy dose available C.Shock using a 360 J energy dose D. Shock using the maximum energy dose available

Shock using the maximum energy dose available

After providing a shock with an AED you should

Start CPR, beginning with chest compression's

Define complete block

The impulse generated in the SA node in the atrium does not propagate to the ventricles and there is no apparent relationship between P waves and QRS complexes.

(T/F) For transcutaneous pacing, the demand rate should be started at 60/min with adjustment based on clinical response

True

(T/F) Signs of symptomatic bradycardia include hypotension, orthostatic hypotension, diaphoresis, pulmonary congestion, runs of PVC's or VT.

True

(T/F) The systematic approach with a person in cardiac arrest should include the BLS Assessment and the Primary Assessment?

True

(T/F) VF and Pulseless VT are shockable rhythms

True

The primary decision point in the bradycardia algorithm is the determination of

adequate perfusion

For transcutaneous pacing, the current milliamperes (mA) output should be:

set 2 mA above capture dose

Transcutaneous pacing is contraindicated in the patient with ________________. 1. severe hypothermia 2. hypokalemia 3. chest pain 4. all of the above

severe hypothermia

Typically, suctioning attempts in ACLS situations should be:

ten seconds or less

Which of the following best describes how to select the proper size of an (OPA) oropharyngeal airway?

the OPA should be the length from the corner of the mouth to the angle of the mandible.

What is generally considered the most important and clinically significant degree of block?

third-degree AV block

The treatment of choice for symptomatic bradycardia with signs of poor perfusion is

transcutaneous pacing

The correct dose of atropine given in the bradycardia algorithm is:

0.5 mg atropine, may repeat up to a total dose of 3 mg

The proper dosing of epinephrine for VF/pVT is:

1 mg IV/IO - repeated every 3 to 5 minutes

The purpose of a Rapid Response Team is: 1. improve patient outcomes by identifying and treating early clinical deterioration 2. reduce hospital costs related to expense of emergency treatment 3. keep floor nurses from having to be involved in emergency situations. 4. all of the above

1. improve patient outcomes by identifying and treating early clinical deterioration

Examples of advanced airway adjuncts include all the following except: 1. oropharyngeal airway 2. laryngeal tube 3. laryngeal mask airway 4. combitube 5. endotracheal tube

1. oropharyngeal airway

The treatment sequence for bradycardia with poor perfusion is: 1. prepare for transcutaneous pacing, consider atropine while preparing TCP, use epinephrine or dopamine while awaiting pacemaker or if pacing is ineffective. 2. give epinephrine, if ineffective give atropine, if atropine is ineffective start transcutaneous pacing 3. start IV drip of dopamine or epinephrine, if ineffective begin transcutaneous pacing, and if this is not effective, give atropine 4. begin cpr, give epinephrine, give atropine, defibrillate, repeat epinephrine if needed.

1. prepare for transcutaneous pacing, consider atropine while preparing TCP, use epinephrine or dopamine while awaiting pacemaker or if pacing is ineffective.

Interruptions in chest compressions should be limited to no longer than _____seconds.

10

When checking for a carotid pulse during CPR you should take no longer than ______seconds before restarting CPR

10

During CPR with an advanced airway in place the compression rate is:

100 -120/min

The correct dose of epinephrine given in the bradycardia algorithm is:

2-10 mcg/min infusion

The correct dose of dopamine given in the bradycardia algorithm is:

2-20 mcg/kg/min infusion

For bradycardia unresponsive to atropine, what other drug should be considered? 1. vasopressin 2. epinephrine 3. magnesium sulfate 4. all of the above

2. epinephrine

What is the first-line antiarrhythmic agent given in cardiac arrest?

Amiodarone

The most important intervention with witnessed sudden cardiac arrest is:

early defibrillation

Bradyarrhythmia is defined as:

any rhythm disorder with a heart rate less than 60 beats per minute

Transcutaneous pacing is not recommended for which of the following? 1. 2nd degree block type II 2. asystole 3. complete block 4. both 1 and 2

asystole

What is the first-line agent for treatment of symptomatic bradycardia?

atropine

After it is determined that the patient does not have adequate perfusion your first step is to:

give atropine while awaiting transcutaneous pacer

Epinephrine is used during resuscitation because:

it causes vasoconstriction

Which of the following is performed before the BLS Assessment?

make sure the scene is safe