ACLS Practice Questions ACLS PALS
Atropine when given in bradyarrhythmias/pauses:
The best answer is: should be administered 0.5 mg IV, and can be repeated up to 0.04 mg/kg
Atropine given IV push in adults is recommended at 0.5 mg every 3-5 minutes up to a total of 0.04 mg/kg (3 mg in a 75 kg patient) Atropine may be administered IV, IO and via an ET tube. Because of atropine’s proven lack of benefit, the AHA removed atropine administration from it’s asystole and PEA arrest algorithms.
All health care professionals are legally obligated to begin CPR on any person found in cardiac arrest
The best answer is: b. false
Health care professionals usually have no automatic duty to provide medical care to a person with whom no contract to do so exists. Some states have created certain automatic obligations, thus, a wise practitioner should understand the laws which govern their practice.
Patients who are pregnant and develop cardiac arrest should never be defibrillated.
The best answer is: false
Pregnant patients in cardiac arrest are treated essentially the same as non-pregnant patients. However, displacing the uterus during CPR and rapid cesarean section are important differences. Because fetal viability is limited, no time should be wasted. Use of the AED in pregnancy has not been studied but is recommended.
"Unstable" when referring to an arrhythmia means:
The best answer is: the arrhythmia has caused the patient's cardiac output to decrease to a level inadequate to maintain perfusion
When an arrhythmia causes inadquate perfusion evidenced by changes in level of consciousness; signs of decreased cardiac output such as skin becoming cold and damp, etc., the patient is then described as "unstable".
Although the algorithm for PEA appears to indicate CPR and epinephrine as appropriate interventions, the primary goal should be:
The best answer is: identify a treatable/reversible cause and correct the problem
The clinical difference between a pulseless, agonal, idioventricular escape complexes, which are virtually always associated with mortality and a patient with a treatable cause of PEA, such as an untreated tension pneumothorax clearly demonstrates the need for thought when using treatment algorithms. A practitioner can administer epinephrine forever, and the patient with PEA caused by the tension pneumothorax will remain pulseless. The current guidelines do not discourage the use of epinephrine nor vasopressin. They removed atropine from the cardiac arrest algorithm.
If treating a 10-kg infant with oxygen refractory unstable bradycardia, how much epinephrine should be administered?
The best answer is: 1.0 ml of 1:10,000 solution
The recommended dose of epinephrine is 0.1 ml/kg of the 1:10,000 solution. Expressed in mg: 0.01 mg/kg. The 1:1,000 solution can be used diluted for administration down the ET tube, or for subcutaneous injection. Epinephrine can also be given via the intraosseous route.
The clinical diagnosis for respiratory failure includes which of the following signs and symptoms?
- 1. decreased level of consciousness associated with a breathing problem
- 2. cyanosis
- 3. bradycardia associated with a breathing problem
- 4. hypercarbia and/or severe hypoxemia (PaCO2 > 50 mmHg and/or a PaO2 < 70 mmHg)
The best answer is: (all of the above)
Children with respiratory distress who become obtunded (decreased level of consciousness) develop cyanosis; become bradycardic; or are unable to maintain ventilation/oxygenation and are in respiratory failure.
Pediatric patients who develop “unstable” supraventricular or ventricular tachycardia should receive immediately electrical cardioversion.
The best answer is: true
When an arrhythmia reduces cardiac output, and signs of shock and deterioration can be seen, electrical cardioversion should be undertaken immediately. Left untreated, a patient with an unstable tachycardia could end up in cardiac arrest.
Albuterol can be delivered:
- 1. via small volume nebulizer
- 2. using a continuous nebulizer system
- 3. using a gas-operated inhaler
- 4. via intraosseous infusion
The best answer is: (1,2,3 only)
The most common delivery device used when administering albuterol is the small-volume nebulizer, and can be used with a continuous nebulizer in monitored units. It is also available as an inhaler. It is not given via an intraosseous injection.
The automated external defibrillator (AED) is acceptable for use in children.
The best answer is: true
The AED can be used as effectively in pediatrics as in adults. In the small child (1-8 years old), pediatric patches are recommended. However, if not available, use the adult patches. AED’s are not recommended for children under 1 year of age.