ACLS Post Test Answer Key 2022

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1. You find an unresponsive patient who is not breathing. After activating the emergency response system, you determine that there is no pulse. What is your next action?

A. Open the airway with a head tilt–chin lift.
B. Administer epinephrine at a dose of 1 mg/kg.
C. Deliver 2 rescue breaths each over 1 second.
D. Start chest compressions at a rate of at least 100/min.

2. You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most important now?

A. PETCO2
B. Chest x-ray
C. Laboratory testing
D. Obtaining a 12-lead ECG

3. What is the preferred method of access for epinephrine administration during cardiac arrest in most patients?

A. Intraosseous
B. Endotracheal
C. Central intravenous
D. Peripheral intravenous

4. An activated AED does not promptly analyze the rhythm. What is your next action?

A. Begin chest compressions.
B. Discontinue the resuscitation attempt.
C. Check all AED connections and reanalyze.
D. Rotate AED electrodes to an alternate position.

5. You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm below, and the patient has no pulse. Another member of your team resumes chest compressions, and an IV is in place. What management step is your next priority?

A. Give 0.5 mg of atropine.
B. Insert an advanced airway.
C. Administer 1 mg of epinephrine.
D. Administer a dopamine infusion.

 

6. During a pause in CPR, you see this lead II ECG rhythm on the monitor. The patient has no pulse. What is the next action?

A. Establish vascular access.
B. Obtain the patient’s history.
C. Resume chest compressions.
D. Terminate the resuscitative effort.

7. What is a common but sometimes fatal mistake in cardiac arrest management?

A. Failure to obtain vascular access
B. Prolonged periods of no ventilations
C. Failure to perform endotracheal intubation
D. Prolonged interruptions in chest compressions

8. Which action is a component of high-quality chest compressions?

A. Allowing complete chest recoil
B. Chest compressions without ventilation
C. 60 to 100 compressions per minute with a 15:2 ratio
D. Uninterrupted compressions at a depth of 1½ inches

9. What should be done to minimize interruptions in chest compressions during CPR?

A. Perform pulse checks only after defibrillation.
B. Continue CPR while the defibrillator is charging.
C. Administer IV medications only when breaths are given.
D. Continue to use AED even after the arrival of a manual defibrillator.

10. Which condition is an indication to stop or withhold resuscitative efforts?

A. Unwitnessed arrest
B. Safety threat to providers
C. Patient age greater than 85 years
D. No return of spontaneous circulation after 10 minutes of CPR

11. After verifying the absence of a pulse, you initiate CPR with adequate bag-mask ventilation. The patient’s lead II ECG appears below. What is your next action?

A. IV or IO access
B. Endotracheal tube placement
C. Consultation with cardiology for possible PCI
D. Application of a transcutaneous pacemake

12. After verifying unresponsiveness and abnormal breathing, you activate the emergency response team. What is your next action?

A. Retrieve an AED.
B. Check for a pulse.
C. Deliver 2 rescue breaths.
D. Administer a precordial thump.

 

You are caring for a patient with a suspected stroke whose symptoms started 2 hours ago. The CT was normal with no sign of hemorrhage. The patient does not have any contraindications to fibrinolytic therapy. Which treatment is best?
a. start fibrinolytic therapy ASAP
b. hold fibrinolytic therapy for 24 hours
c. order an echo before fibrinolytic administration
d. wait for MRI result
a. start fibrinolytic therapy ASAP

For STEMI pt, maximum goal time for ED door-to-balloon-inflation time for PCI?

a. 150 mins
b. 180 mins
c. 120 mins
d. 90 mins

d. 90 mins

Which is the recommended oral dose of aspirin for a patient with suspected acute coronary syndrome?

a. 81 mg
b. 325-650 mg
c. 160-325 mg
d. 40 mg

c. 160-325 mg

chest compressions during for adult rate

a. 40-60/min
b. 60-80/min
c. 80-100/min
d. 100-120/min

d. 100-120/min

What is the effect of excessive ventilation?

a. decresed cardiac output
b. decreased intrathoracic pressure
c. increased perfusion pressure
d. increased venous return

a. decreased cardiac output

temperature to achieve targeted temperature management after cardiac arrest

a. 30-34C
b. 32-36C
c. 36-40C
d. 38-42C

b. 32-36C

3 mins into cardiac arrest resuscitation attempt, one member of your team inserts an endotracheal tube while another performs chest compressions. Capnography shows a persistent waveform & a PETCO2 of 8mmHg. What is the significance of the finding?

a. chest compression may not be effective
b. The endotrachael tube is in the esophagus
c. the team is ventilating the patient too often
d. the patient meets the criteria for termination of efforts

a. chest compression may not be effective

Your patient is in cardiac arrest and has been intubated. To assess CPR quality, you should?

a. obtain a chest x-ray
b. check the patient’s pulse
c. monitor the patient’s PETCO2
d. obtain a 12-lead ECG

c. monitor the patient’s PETCO2

In addition to clinical assessment, which is the most reliable method to confirm & monitor correct placement of an endotracheal tube?

a. arterial blood gas
b. hemoglobin levels
c. chest radiography
d. continuous waveform capnography

d. continuous waveform capnography
A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting “crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40, respiratory is 28 bpm/min and O2 set is 89% on room air.
answer has to do with acute coronary syndrome

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting “crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40, respiratory is 28 bpm/min and O2 set is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

WhIn addition to defibrillation, which intervention should be performed immediately?

a. chest compression
b. vasoactive meds
c. vascular access
d. advanced airway

a. chest compression

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting “crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40, respiratory is 28 bpm/min and O2 set 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 V-fib. Which drug and dose should you administer?

a. lidocaine 1 mg/kg
b. amiodarone 300mg
c. epinephrine 1mg
d. atropine 1 mg

c. epinephrine 1 mg

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting “crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40, respiratory is 28 bpm/min and O2 set 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 v-fib. Which drug should be administered next?

a. atropine 1mg
b. mag sulfate 1g
c. amiodarone 300mg
d. epi 1 mg

c. amiodarone 300mg

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting “crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40, respiratory is 28 bpm/min and O2 set 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 the patient?

a. extubate
b. check the glucose level
c. administer epinephrine
d. initiate targeted temperature management

d. initiate targeted temperature management

A 45M had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting “crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40, respiratory is 28 bpm/min and O2 set 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. given atropine 1mg
b. established IV access
c. obtained a 12 lead
d. performed synchronized cardioversion

d. performed synchronized cardioversion

During post-cardiac arrest, which is recommended duration of targeted temp. management after reaching the correct temperature range?

a. at least 24 hours
b. 0-8 hour
c. at least 36 hours
d. at least 48 hours

a. at least 24 hours

which is the primary purpose of medical emergency team or rapid response team?

a. provide diagnostic consultation to emergency department patients
b. provide online consultation to EMS personnel
c. improving patient outcomes by identifying & treating early clinical deterioration
d. improving care for patients admitted to critical care units

c. improving patient outcomes by identifying & treating early clinical deterioration

Which of these tests should be performed for a patient with suspected stroke within 25 mins of hospital arrival?

a. coagulation studies
b. cardiac enzymes
c. noncontrast CT scan of the head
d. 12 lead ECG

c. non-contrast CT scan of the head

Which of the following signs are likely indicator of cardiac arrest in an unresponsive patient?

a. slow, weak pulse rate
b. cyanosis
c. irregular, weak pulse
d. agonal gasps

d. agnoal gasps
a patient is being resuscitated in a very noisy environment. A team member thinks he heard an order of 500mg of amiodarone IV. Which is the best response from the team member?
I have an order to give 500mg of amiodarone IV. Is this correct?

Which is the recommended next step after a defibrillation attempt?

a. check the ECG for evidence of a rhythm
b. determine if a carotid pulse is present
c. resume CPR, starting with chest compressions
d. open the patient’s airway

c. resume CPR, starting with chest compressions
A responder is caring for a patient with a history of congestive heart failure. The patient is experiencing shortness of breath, 68/50 mmHg, heart rate 190/min. The patient's lead 2 ECG is shown. Which best characterizes this patient's rhythm?
A responder is caring for a patient with a history of congestive heart failure. The patient is experiencing shortness of breath, 68/50 mmHg, heart rate 190/min. The patient’s lead 2 ECG is shown. Which best characterizes this patient’s rhythm?
unstable supraventicular tachycardia
which is one way to minimize interruptions in chest compressions during CPR?
continue CPR while the defibrillator charges
A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. Based on the patient's initial assessment, what adult ACLS algorithm should you follow?
A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. Based on the patient’s initial assessment, what adult ACLS algorithm should you follow?
tachycardia
wide complex (monophasic) tachycardia
A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. After your initial assessment, which intervention should be preformed?
A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. After your initial assessment, which intervention should be preformed?
synchronized cardioversiion
A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. If the patient became apnic & pulseless but the rhythm remained the same, which would take the highest priority?
A 68F lightheadedness, nausea, chest discomfort. Your assessment finds her awake & responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready & fast. Your are unable to get a BP. She has no obvious dependent edema, & her neck veins are flat. Her lung sounds are equal w/ moderate rales present bilaterally. The cardiac monitor shows rhythm seen here. If the patient became apnic & pulseless but the rhythm remained the same, which would take the highest priority?
perform defibrillation
Which best describes the rhythm?
Which best describes the rhythm?
monomorphic ventricular tachycardia
A patient in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the 1st dose of adenosine. Which dose would you administer next?
12mg
You instruct a team member to give 0.5mg atropine IV. Which response is an example of closed-loop communication?
I’ll draw up 0.5mg of atropine
A patient has a witnessed loss of consciousness. The lead 2 ECG is shown. appropriate treatment?
A patient has a witnessed loss of consciousness. The lead 2 ECG is shown. appropriate treatment?
defibrillation
You have completed 2 mins of CPR. The ECG monitor shows the lead 2 rhythm, and the patient has no pulse. Another member of your team resumes chest compression, and an IV is in place. Which do you do next?
Give epi 1mg IV

to properly ventilate a patient w/ perfusing rhythm, how often do you squeeze the bag?

a. once every 10 seconds
b. once every 5 to 6 seconds
c. once every 3 to 4 seconds
d. once every 12 seconds

b. once every 5-6 seconds

Which is the recommended 1st IV dose of amiodarone for a patient w/ refractory ventricular fibrillation?

a. 150 mg
b. 250 mg
c. 300 mg
d. 100 mg

c. 300mg

Which best describes the length of time it should take to perform a pulse check during BLS assessment?

a. 1 to 4 seconds
b. 5 to 10 seconds
c. 11 to 15 seconds
d. 16 to 20 seconds

b. 5 to 10 seconds
Which best describes an action taken by the team leader to avoid inefficiencies during a resuscitation attempt?
clearly delegate tasks
Which is the maximum interval you should allow for an interruption in chest compression?
10 seconds

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. address the team member immediately
b. conduct a debriefing after the resuscitation attempt
c. remove the team member from the area
d. reassign the team members

a. address the team member immediately
Which facility is the most appropriate EMS destination for a patient w/ a sudden cardiac arrest who achieved return of spontaneous circulation in the field?
coronary reperfusion-capable medical center
which is an acceptable method of selecting an appropriately sized oropharyngeal airway?
measure from the corner of the mouth to the angle of the mandible
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?
ask for a new task or role
What is the minimum systolic blood pressure one should attempt to achieve w/ fluid administration or vasoactive agents in a hypotensive post-cardiac arrest patient who achieves return of spontaneous circulation?
90 mmHg
You are evaluating a 58M w/ chest discomfort, BP 92/50, heart rate 92/min, his non-labored respiratory rate is 14 bpm, and his pulse oximetry reading is 97%. Which assessment step is most important now?
obtaining a 12 lead

As a team leader, when do you tell the chest compressors to switch?

a. about every 2 minutes
b. about every 5 minutes
c. only when they tell you that they are fatigued
d. about every 7 minutes

a. about every 2 minutes
The patient’s pulse ox shows a reading of 84% on room air. Which initial action do you take?
apply oxygen
(I think I put Bag valve mask for this and I got it wrong)

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