Chapter 13 BLS Resuscitation
Your partner is performing one-rescuer CPR on a middle-aged woman in cardiac arrest. When you apply the AED pads, you note that she has a medication patch over the same area where one of the AED pads will be placed. You should: Select one: A. continue CPR until you can determine the name of the medication contained in the patch. B. apply the AED pad at least 1 inch away from the medication patch to avoid skin burns. C. remove the medication patch, wipe away any medication residue, and apply the AED pads. D. move the patch to another area of the patient's chest and then properly apply the AED pads.
C. remove the medication patch, wipe away any medication residue, and apply the AED pads.
Complications associated with chest compressions include all of the following, EXCEPT: Select one: A. rib fractures. B. a fractured sternum. C. liver laceration. D. gastric distention.
D. gastric distention.
* (INCORRECT ANSWER CHOICES) Several attempts to adequately open a trauma patient's airway with the jaw-thrust maneuver have been unsuccessful. You should: Select one: A. when you deliver minimal tidal volume. B. in patients who are intubated. C. when the airway is completely obstructed. D. if you ventilate a patient too quickly.
D. if you ventilate a patient too quickly.
The impedance threshold device (ITD) may improve circulation during active compression-decompression CPR by: Select one: A. maintaining increased intrathoracic pressure during the downward stroke of each chest compression, which forces more blood from both of the ventricles. B. drawing all of the air out of the lungs in between chest compressions, which causes positive intrathoracic pressure and a reduction of blood return to the right side of the heart. C. maximizing the amount of air in the lungs following chest recoil, which hyperinflates the lungs and forces more blood from the ventricle during each compression. D. limiting the amount of air that enters the lungs during the recoil phase between chest compressions, which results in negative intrathoracic pressure and improved cardiac filling.
D. limiting the amount of air that enters the lungs during the recoil phase between chest compressions, which results in negative intrathoracic pressure and improved cardiac filling.
Basic life support (BLS) is defined as: Select one: A. invasive emergency medical interventions such as intravenous therapy, manual defibrillation, and advanced airway management. B. basic lifesaving treatment that is performed by bystanders while EMS providers are en route to the scene of an emergency. C. any form of emergency medical treatment that is performed by advanced EMTs, paramedics, physicians, and emergency nurses. D. noninvasive emergency care that is used to treat conditions such as airway obstruction, respiratory arrest, and cardiac arrest.
D. noninvasive emergency care that is used to treat conditions such as airway obstruction, respiratory arrest, and cardiac arrest.
Which of the following is considered an obvious sign of death and would not require the initiation of CPR? Dependent blood pooling Pulselessness and apnea Agonal respiratory effort Severe cyanosis to the face
Dependent blood pooling
When ventilating an apneic adult with a bag-valve mask, you should deliver each breath: over a period of about 2 to 3 seconds. while watching for adequate chest rise. with a tidal volume of about 500 mL. quickly to ensure adequate ventilation.
while watching for adequate chest rise.
What is the correct management of a conscious infant who is choking? Back blows and chest thrusts Chest compressions Abdominal thrusts Blind finger sweep
Back blows and chest thrusts
What is the correct compression-to-ventilation ratio for adult CPR? Select one: A. 3:2 B. 5:1 C. 30:2 D. 30:1
C. 30:2
CPR is in progress on a pregnant woman. Shortly after manually displacing her uterus to the left, return of spontaneous circulation occurs. Which of the following would MOST likely explain this? Select one: A. Displacement of her uterus caused blood to flow backward, which increased blood flow to her heart. B. Displacement of her uterus allowed her lungs to expand more fully, which restored her pulse. C. Pressure was relieved from her aorta and vena cava, which improved chest compression effectiveness. D. Increased blood flow to her heart caused her ventricles to stop fibrillating, which restored her pulse.
C. Pressure was relieved from her aorta and vena cava, which improved chest compression effectiveness.
A team of EMTs and paramedics are attempting to resuscitate a man who is in cardiac arrest while his wife and son are present. Which of the following should occur during the resuscitation attempt? One EMT should update the family on the interventions that have been performed and how the patient has responded. Each member of the resuscitation team should update the family at various intervals throughout the attempt. Communication with the family should be minimal until the final outcome of the resuscitation attempt is known. A law enforcement officer should prepare the family for the patient's death and contact the funeral home.
One EMT should update the family on the interventions that have been performed and how the patient has responded.
To ensure that you will deliver the appropriate number of chest compressions during one-rescuer adult CPR, you should compress the patient's chest at a rate of: 80 to 100 compressions per minute. at least 120 compressions per minute. 100 to 120 compressions per minute. no greater than 100 compressions per minute.
100 to 120 compressions per minute.
The pulse check should take: A. 1 second. B. at least 1 second but no more than 5 seconds. C. at least 10 seconds. D. at least 5 seconds but no more than 10 seconds.
Answer: D Rationale: The pulse check should take at least 5 seconds but no more than 10 seconds.
CPR will NOT be effective if the patient is: Select one: A. horizontal. B. prone. C. on a firm surface. D. supine.
B. prone.
CPR should be initiated when: Select one: A. signs of putrefaction are present. B. a valid living will is unavailable. C. rigor mortis is obvious. D. the carotid pulse is very weak.
CPR should be initiated when: Select one: A. signs of putrefaction are present. B. a valid living will is unavailable. C. rigor mortis is obvious. D. the carotid pulse is very weak.
Which of the following maneuvers should be used to open a patient's airway when a spinal injury is suspected? Jaw-thrust Tongue-jaw lift Head tilt-neck lift Head tilt-chin lift
Jaw-thrust
Which of the following is true of infants and children? They usually go into respiratory arrest due to cardiac arrest. They can store oxygen more efficiently than adults. They require less-frequent ventilations than adults. They consume oxygen much faster than adults.
They consume oxygen much faster than adults.
The main benefit of using a mechanical device for chest compressions is: the minimal training required to correctly operate the devices. the elimination of rescuer fatigue that results from manual compressions. the elimination of the need to place a firm, flat device under the patient. its ability to be used with any patient, regardless of age, weight, or body size.
the elimination of rescuer fatigue that results from manual compressions.
In two-rescuer adult CPR, you should deliver a compression to ventilation ratio of: 5:1. 5:2. 15:2. 30:2.
30:2.
After ________ minutes without oxygen, permanent brain damage is possible. 1 to 2 4 to 6 2 to 3 7
4 to 6
ou should attempt to maintain a chest compression fraction of at least: 40% 50% 60% 75%
60%
Between each chest compression, you should __________. Select one: A. allow full chest recoil B. check for a pulse C. remove your hands from the chest D. administer a breath
A. allow full chest recoil
Signs of a sudden severe upper airway obstruction include all of the following, EXCEPT: Select one: A. forceful coughing. B. grasping the throat. C. acute cyanosis. D. inability to speak.
A. forceful coughing.
In most cases, cardiopulmonary arrest in infants and children is caused by: Select one: A. respiratory arrest. B. a cardiac dysrhythmia. C. a drug overdose. D. severe chest trauma.
A. respiratory arrest.
Which of the following statements regarding the use of an AED in children is correct? If the patient is younger than 1 year of age, an AED is preferred over a manual defibrillator. AEDs are only effective in pediatric patients if severe trauma is the cause of their cardiac arrest. AED use in children up to 8 years of age involves pediatric pads and an energy reducer. AEDs are not used in pediatric patients because they do not experience ventricular fibrillation.
AED use in children up to 8 years of age involves pediatric pads and an energy reducer.
Artificial ventilation may result in the stomach becoming filled with air, a condition called: A. gastric distention. B. vomitus. C. abdominal-thrust maneuver. D. acute abdomen.
Answer: A Rationale: Artificial ventilation may result in the stomach becoming filled with air, a condition called gastric distention. Gastric distention is likely to occur if you ventilate too fast, if you give too much air, or if the airway is not opened adequately. Therefore, it is important for you to give slow, gentle breaths.
For CPR to be effective, the patient must be on a firm surface, lying in the ______________ position. A. Fowler B. prone C. supine D. recovery
Answer: C Rationale: For CPR to be effective, the patient must be lying supine on a firm surface, with enough clear space around the patient for two rescuers to perform CPR. If the patient is crumpled up or lying face down, you will need to reposition him or her. The few seconds that you spend repositioning the patient properly will greatly improve the delivery and effectiveness of CPR.
A 60-year-old man is found to be unresponsive, pulseless, and apneic. You should: Select one: A. determine if he has a valid living will. B. begin CPR until an AED is available. C. start CPR and transport immediately. D. withhold CPR until he is defibrillated.
B. begin CPR until an AED is available.
Your conscious patient has a mild partial airway obstruction. You should: Select one: A. administer back blows. B. encourage the patient to cough. C. perform abdominal thrusts. D. place the patient supine.
B. encourage the patient to cough.
Without practice, your CPR skills will __________. Select one: A. come back automatically when needed B. become part of your muscle memory C. deteriorate over time D. improve over time
C. deteriorate over time
CPR retraining is the MOST effective when it: Select one: A. occurs every 24 months. B. is delivered by computer. C. involves hands-on practice. D. is self-paced and brief.
C. involves hands-on practice.
While rescuer one is finishing his or her fifth cycle of 30 compressions, rescuer two should: Select one: A. give two breaths and prepare to start compressions. B. assess for a carotid pulse for 15 seconds. C. move to the opposite side of the patient's chest. D. suction the patient's mouth and give two more ventilations.
C. move to the opposite side of the patient's chest.
f an object is visible in the unconscious patient's airway, you should __________. Select one: A. leave it in place B. place the patient on his or her side C. remove it D. continue chest compressions
C. remove it
When performing CPR on a child, you should compress the chest: Select one: A. 80 to 100 times per minute. B. to a depth of 1 to 2 inches. C. with one or two hands. D. until a radial pulse is felt.
C. with one or two hands.
Which of the following statements regarding CPR is correct? CPR corrects most causes of cardiac arrest. CPR temporarily provides minimal circulation and ventilation. CPR often prevents the need for advanced life support. CPR should be discontinued once an AED is available.
CPR temporarily provides minimal circulation and ventilation.
Which of the following is NOT an indication to stop CPR once you have started? Pulse and respirations return You are physically exhausted. A physician directs you to do so. Care is transferred to a bystander
Care is transferred to a bystander
Gastric distention will MOST likely occur: Select one: a. in patients who are intubated. b. if you ventilate a patient too quickly. d. when you deliver minimal tidal volume. e. when the airway is completely obstructed.
b. if you ventilate a patient too quickly.
If your patient has no pulse, you should immediately __________. rule out airway obstruction begin ventilations check for breathing begin chest compressions
begin chest compressions
Respiratory arrest usually occurs before cardiac arrest in __________. adults children the elderly all patients
children
After an advanced airway device has been inserted during two-rescuer CPR, you should: pause compressions to deliver ventilations. deliver one rescue breath every 6 seconds. decrease the compression rate to about 80 per minute. increase rescue breathing to a rate of 14 breaths/min.
deliver one rescue breath every 6 seconds.
A patient should be placed in the recovery position when he or she: is semiconscious, injured, and breathing adequately. has experienced trauma but is breathing effectively. is unresponsive, uninjured, and breathing adequately. has a pulse but is unresponsive and breathing shallowly.
is unresponsive, uninjured, and breathing adequately.
Instead of the abdominal-thrust maneuver, use ___________ for women in advanced stages of pregnancy and patients who are obese. A. chest thrusts B. Sellick maneuver C. basic life support D. DNR orders
Answer: A Rationale: You can perform the abdominal-thrust maneuver safely on all adults and children. However, for women in advanced stages of pregnancy and patients who are obese, you should use chest thrusts.
Once you begin CPR in the field, you must continue until one of the following events occurs: A. The patient stops breathing and has no pulse. B. The patient is transferred to another person who is trained in BLS, to ALS-trained personnel, or to another emergency medical responder. C. You are out of gas in the ambulance. D. A police officer assumes responsibility for the patient and gives direction to discontinue CPR.
Answer: B Rationale: The "T" in the "STOP" mnemonic stands for patient transfer to another person who is trained in BLS, to ALS-trained personnel, or to another emergency medical responder.
The ______________ is a circumferential chest compression device composed of a constricting band and backboard. mechanical piston device load-distributing band impedance threshold device cardiopulmonary resuscitation
Answer: B Rationale: The load-distributing band is a circumferential chest compression device composed of a constricting band and backboard. The device is either electronically or pneumatically driven to compress the heart by putting inward pressure on the thorax. As with the mechanical piston device, use of the device frees the rescuer to complete other tasks. It is lighter and easier to apply than the mechanical piston device.
Which of the following sequences of events describes the AHA's chain of survival? A. Early access, integrated post-arrest care, early advanced care, early CPR, early defibrillation B. Early advanced care, early defibrillation, integrated post-arrest care, early CPR, early access C. Early access, early CPR, early defibrillation, early advanced care, integrated post-arrest care D. Early access, early riser, early CPR, early advanced care
Answer: C Rationale: The AHA has determined an ideal sequence of events that, if taken, can improve the chance of successful resuscitation of a patient who has an occurrence of sudden cardiac arrest: early access, early CPR, early defibrillation, early advanced care, and integrated post-arrest care. If any one of the links in the chain is absent, the patient is more likely to die.
You and your partner arrive at the side of a 60-year-old woman who collapsed about 7 minutes ago. She is unresponsive, apneic, and pulseless. You should: begin CPR and apply the AED as soon as it is available. immediately apply the AED and analyze her cardiac rhythm. begin CPR at a compression to ventilation ratio of 15:2. apply the AED if there is no response after 10 cycles of CPR.
begin CPR and apply the AED as soon as it is available.
Your initial attempt to ventilate an unresponsive, apneic 30-year-old man is met with resistance and you do not see the chest rise. Your second ventilation attempt is also unsuccessful. You should: suction the oropharynx. perform a blind finger sweep. perform 30 chest compressions. ventilate again with greater force.
perform 30 chest compressions.
Which of the following scenarios would warrant an interruption in CPR procedures? A. An hysterical family member trying to gain access to the unconscious patient B. A vehicle honking its horn anxious to pass by the scene on a blocked road C. A small set of steps leading to the exit of the building, on the way to the ambulance D. Being tired from trying to resuscitate a patient
Answer: C Rationale: Try not to interrupt CPR for more than a few seconds, except when it is absolutely necessary. For example, if you have to move a patient up or down stairs, you should continue CPR until you arrive at the head or foot of the stairs, interrupt CPR at an agreed-on signal, and move quickly to the next level where you can resume CPR.
Brain damage is very likely in a brain that does not receive oxygen for: A. 0-1 minutes. B. 0-4 minutes. C. 4-6 minutes. D. 6-10 minutes.
Answer: D Rationale: Permanent brain damage is very likely if the brain is without oxygen for 6 minutes or longer. After 10 minutes without oxygen, irreversible brain damage is likely.
In infants who have signs and symptoms of an airway infection, you should not waste time trying to dislodge a foreign body. You should intervene only if signs of ____________ develop, such as a weak, ineffective cough; cyanosis; stridor; absent air movement; or a decreasing level of consciousness. A. sudden infant death syndrome B. child abuse C. bronchitis D. severe airway obstruction
Answer: D Rationale: With a mild airway obstruction, the patient can cough forcefully, although there may be wheezing between coughs. As long as the patient can breathe, cough, or talk, you should not interfere with his or her attempts to expel the foreign body. As with an adult, encourage the child to continue coughing. Administer 100% oxygen with a nonrebreathing mask and provide transport to the emergency department.
