ACLS test

You find an unresponsive patient who is not breathing. After activating the emergency response system, you determine there is no pulse. What is your next action?Start chest compressions of at least 100 per min.
You are evaluating a 58 yo man with chest pain. The BP is 92/50 and HR is 92/min, non-labored respiratory rate is 14 breaths/min and the pulse O2 is 97%. What assessment step is most important now?Obtaining a 12 lead ECG.
What is the preferred method of access for epi administration during cardiac arrest in most patients?Peripheral IV

An AED does not properly analyze a rhythm. What is your next step?Begin chest compressions.
You have completed 2 min of CPR. The ECG monitor displays the lead below (PEA) and the patient has no pulse. Your partner resumes chest compressions and an IV is in place. What management step is your next priority?Administer 1mg of epi.
During a pause in CPR, you see a narrow complex rhythm on the monitor. The patient has no pulse. What is the next action?Resume compressions.
What is a common but sometimes fatal mistake in cardiac arrest management?Prolonged interruptions in chest compressions.
Which action is a component of high-quality chest compressions?Allowing complete chest recoil
Which action increases the chance of successful conversion of ventricular fibrillation?Providing quality compressions immediately before a defibrillation attempt.
Which situation BEST decree PEA?Sinus rhythm without a pulse.
What is the best strategy for performing high-quality CPR on a patient with an advanced airway in place?Provide continuous chest compressions without pauses and 10 ventilations per minute.
3 min after witnessing a cardiac arrest, one member of your team inserts an ET tube while another performs continuous chest compressions. During subsequent ventilation, you notice the presence of a waveform on the capnography screen and PETCO2 of 8 mmHg. What is the significance of this finding?Chest compressions may not be effective.
The use of quantitative capnography in intubated patients does what?Allows for monitoring CPR quality
For the past 25 min, EMS crews have attempted resuscitation of a patient who originally presented with v-fib. After the 1st shock, the ECG screen displayed systole which has persisted despite 2 doses of epi, a flood bolus, and high quality CPR.Consider terminating resuscitative efforts after consulting medical control.
Which is a safe and effective practice within the defibrillation sequence?Be sure O2 is NOT blowing over the patients chest during shock.
During your assessment, your patient suddenly loses consciousness. After calling for help and determining that the patient is not breathing, you are unsure whether the patient has a pulse. What is your next action?Begin chest compressions.
What is an advantage of using hands-free d-fib pads instead of d-fib paddles?Hands free allows for more rapid d-fib.
What action is recommended to help minimize interruptions in chest compressions during CPR?Continue CPR while charging the defibrillator.
Which action is included in the BLS survey?Early defibrillation
Which drug and dose are recommended for the management of a patient in refractory v-fib?Amiodarone 300 mg
What is the appropriate interval for an interruption in chest compressions?10 seconds or less
Which of the following is a sign of effective CPR?PETCO2 = or ;10 mmHg
What is the primary purpose of a medical emergency team or rapid response team?Identifying and treating early clinical deterioration.
Which action improves the quality of chest compressions delivered during resuscitative attempts?Switch providers about every 2 min or every 5 compression cycles
What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse of 80 beats/min?1 breath every 5-6 seconds
A patient presents to the ER with a new onset of dizziness and fatigue. On examination, the patients HR is 35 beats/min, BP is 70/50, respiration rate is 22/min, O2 sat is 95%. What is the appropriate 1st medication?Atropine 0.5 mg
A patient presents to the ER with dizziness and SOB with a sinus brady of 40/min. The initial atropine dose was ineffective and your monitor does not provide TCP. What is the appropriate dose of dopamine for this patient?2-10 mcg/kg/min
A patient has an onset of dizziness. The patients HR is 180, BP is 110/70, respiration rate is 18, O2 sat is 98%. This is a reg narrow complex tach rhythm. What is the next intervention?Vagal maneuver
A monitored patient in the ICU developed a sudden onset of narrow complex tach at a rate of 220/min. The patients BP is 128/58, the PET CO2 is 38mmHg, and the O2 sat is 98%. There is an ET established for vascular access. The patient denies taking any vasodilators. A 12 lead shows no ischemia or infarction. Vagal maneuvers are ineffective. What is the next intervention?Adenosine 12 mg IV
You receive a radio report from an EMS team enroute with a patient who may be having a stroke. The hospital CT scanner is broken. What should you do?Divert the patient to a hospital 15 min away with CT capabilities.
Choose an appropriate indication to stop or withhold resuscitative efforts.Evidence of rigor mortis
A 49 yo female arrives in the ER with persistent epigastric pain. She has been taking antacids PO for the past 6 hours because she had heartburn. BP is 118/72, HR is 92/min, respiration rate is 14 non-labored, and o2 sat is 96%. What is the most appropriate next action?Obtain a 12 lead ECG
A patient in respiratory failure becomes apneic but continues to have a strong pulse. The HR is dropping rapidly and now shows a sinus brady rate at 30/min. What intervention has the highest priority?Simple airway maneuvers and assisted ventilations
What is the appropriate procedure for ET suctioning after the catheter is selected?Suction during withdrawal, but not longer than 10 seconds.
While treating a stable patient for dizziness, a BP of 68/30, cool and clammy, you see a brady rhythm on the ECG. How do you treat this?Atropine 0.5 mg
A 68 yo female patient experienced a sudden onset of right arm weakness. BP is 140/90, pulse is 78/min, respiration rate is non-labored 14/min, and O2 sat is 97%. Lead 2 in the ECG shows a sinus rhythm. What would be your next action?Cincinnati stroke scale
You are transporting a patient with positive stroke assessment. BP is 138, pulse is 80/min, respiration rate is 12/min, O2 sat is 95% room air. Glucose levels are normal and the ECG shows a sinus rhythm. What is next?Head CT scan
What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in place?8-10 breaths per minute
A 62 yo male patient in the ER says his heart is beating fast. No chest pain or SOB. BP is 142/98, pulse is 200/min, respiration rate is 14/min, and O2 sat is 95% room air. What should be the next evaluation?Obtain a 12 lead ECG
You are evaluating a 48 yo male with crushing substernal pain. He is cool, pale, diaphoretic, and slow to respond to your questions. BP is 58/32, pulse is 190/min, respiration rate is 18, and you are unable to obtain an O2 sat due to no radial pulse. The ECG shows a wide complex tach rhythm. What intervention should be next?Synchronized cardioversion
What is the initial priority for an unconscious patient with any tachycardia on the monitor?Determine if a pulse is present
Which rhythm requires synchronized cardioversion?Unstable SVT
What is the recommended dose for adenosine for patients in refractory but stable narrow complex tachycardia?12 mg
What is the usual post-cardiac arrest target range for PET CO2 who achieves return of spontaneous circulation (ROSC)?35-40 mmHg
Which condition is a contraindication to therapeutic hypothermia during the post-cardiac arrest period for patients who achieve return of spontaneous circulation (ROSC)?Responding to verbal commands
What is the potential danger to using ties that pass circumferentially around the patients neck when securing an advanced airway?Obstruction of venous return from the brain
What is the most reliable method of confirming and monitoring correct placement of an ET tube?Continuous waveform capnography
What is the recommended IV fluid (NS or LR) bolus dose for a patient who achieves ROSC but is hypotensive during the post-cardiac arrest period?1-2L
What is the minimum systolic BP one should attempt to achieve with fluid, inotropic, or vasopressor administration in a hypotensive post-cardiac arrest who achieves ROSC?90 mmHg
What is the 1st treatment priority for a patient who achieves ROSC?Optimizing ventilation and oxygenation
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