ACLS Practice Questions ACLS PALS BLS
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Which of the following constitute elements of quality CPR?
The best answer is: all of the above
“High-quality CPR” is identified in the most recent Guidelines for CPR as: compression rate of 100-120/minute; 2-2.4 inch compression depth; complete chest recoil following each compression; minimizing interruptions to chest compressions, and, avoiding excessive ventilation.
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If a patient receiving emergency synchronized cardioversion develops ventricular fibrillation:
The best answer is: immediately turn off the synchronizer mode and defibrillate
In the event that a synchronized shock induces ventricular fibrillation, the patient should be immediately shocked after turning off the synchronized mode. CPR cannot terminate the ventricular fibrillation, and statistically, the faster the patient receives defibrillation following the onset of the ventricular fibrillation, the more likely successful conversion will be.
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Based on this patient’s presenting complaint and symptoms, how likely would this event be cardiac asystole vs. severe transient pauses?
The best answer is: not at all likely that this patient has developed asystolic cardiac arrest vs. a transient pause
An asystolic cardiac arrest is almost always observed secondary to fatal issues. In addition, asystolic cardiac arrest is never transient and ends with a rapid return to stability. A diagnosis of asystole usually means essentially no good outcome likely. Thus, this patient presented with a history of what is likely a similar episode. All of this information suggests a transient conduction defect is present. With that in mind, CPR, epinephrine, etc. would be potentially dangerous choices. Atropine or immediate transcutaneous cardiac pacing would be the most efficient interventions. People whose ECG leads become detached do not turn blue and lose consciousness as a result. This young woman may be a candidate for a permanent cardiac pacemaker.
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What factors may reduce the likelihood of adenosine working?
The best answer is: all of the above
Caffeine and methylxanthanes (aminophylline, theophylline) antagonize the action of adenosine.
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Dopamine infusion can be used to treat the hypotension caused by very slow 3rd degree heart block.
The best answer is: false
When a slow heart rate causes a decrease in cardiac output and instability, the treatment should first be to speed up the heart rate. Using a vasopressor to treat symptomatic bradycardia is a bad choice. Pacing is the right choice.
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Adenosine should be given:
- 1. 0.1 mg/kg (up to a maximum of 6 mg)
- 2. in an IV closest to the central circulation
- 3. by slow IV drip infusion
- 4. followed immediately by a bolus of IV fluid
The best answer is: (1,2,4)
The recommended initial dose of adenosine in pediatrics is 0.1 mg/kg. Once a child is 60 kg or greater, the adult recommendation is an initial dose of 6 mg. If unsuccessful, the initial dose can be doubled. Because adenosine has a rapid alpha half-life, it must be delivered rapidly to the right side of the heart. An IV close to the central circulation (usually antecubital) and pushing the adenosine bolus rapidly with a 20-30 ml bolus of IV fluid is the recommended method.
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Patients requiring continuous positive airway pressure therapy (mechanical ventilation and/or CPAP) should:
The best answer is: all of the above
Critically ill or unstable patients receiving ventilatory support should be transferred to an intensive care setting where the staff is trained and capable of managing this higher level patient. All patients receiving positive airway pressure are at risk for life-threatening events like the development of a tension pneumothorax. The staff needs to be able to rapidly diagnose and treat this problem to prevent a bad outcome for the patient.
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It is always advisable to:
The best answer is: all of the above
Keeping children with respiratory distress relaxed and quiet is the safest and ideal way to manage them. Agitation, screaming and crying may worsen airway swelling and/or bronchospasm. Additionally, a struggling child requires increased oxygen consumption, which should be avoided. Using individuals whom the child is comfortable with is often an easy solution. All pediatric patients with signs of potential respiratory dysfunction should receive supplemental oxygen.
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Epinephrine can be properly administered down the endotracheal tube during CPR if an IV is not available.
The best answer is: true
Epinephrine can be administered via the endotracheal tube and should be given using 0.1 ml of the 1:1,000 solution. It should be diluted 1:1 using sterile water.
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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.
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When an infant or child is found collapsed, which sequence is best to follow?
The best answer is: Check responsiveness, quickly check pulse, start chest compressions
Check responsiveness, quickly check pulse, start chest compressions
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How long should it take to deliver one rescue breath?
The best answer is: 1 second
1 second
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When rescue breaths are given without compressions to a victim with a pulse, how many breaths per minute should be given to an infant or child?
The best answer is: 12 to 20
12 to 20
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When there is more than one person at the scene of an adult cardiac arrest, what are the roles of the rescuers?
The best answer is: One should stay with the victim to begin CPR while another rescuer calls 911 and retrieves an AED
One should stay with the victim to begin CPR while another rescuer calls 911 and retrieves an AED
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The correct compression ventilation ratio for CPR for an adult is:
The best answer is: 30 compressions to 2 ventilations
30 compressions to 2 ventilations