ACLS Practice Questions ACLS PALS
When using an older, conventional defibrillator, (non-biphasic) the recommended energy used for adult defibrillation is:
The best answer is: 360, 360, 360
With the newer biphasic defibrillators, lower energy is used because of its greater effectiveness via refined waveform delivery patterns. The current recommendation for those using the older, conventional defibrillator is to start at maximum (360 joules) and remain there.
All patients with bradycardia (adult with a heart rate < 60/minute) must receive treatment to accelerate the heart rate.
The best answer is: false
The textbook definition of bradycardia, a heart rate less than 60 per minute is a general statement that does not apply to every situation. Each stable patient with bradycardia needs to be assessed to determine whether the slow heart rate has an emergency significance. In many cases such as the patient suffering an inferior-wall myocardial infarction the slower heart may be protective in that it may be reducing myocardial oxygen demand. Another example is the professional athlete whose heart is 48. The athlete’s heart rate is a sign of physical conditioning, not disease. Generally, patients with “stable” bradycardia should not receive drug intervention.
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.
A “do not attempt to resuscitate” (DNR/DNAR) order is:
The best answer is: a medical prescription not to provide certain care for the patient
A “do not resuscitate” (DNR), or “do not attempt to resuscitate” (DNAR) order is a prescription issued by a practitioner licensed and authorized to prescribe care for the patient. Prescriptions only have to be signed by the prescriber and their effect is not limited to any particular healthcare venue (i.e. hospital, etc.). Prescriptions can be issued for patients of any age group. “Next of kin” has no authority to make healthcare decisions until given that authority by the patient (durable power of attorney for healthcare), or by a specific state law or court order.
Oral beta blocker drug therapy should be initiated within the first 24 hours of ST elevation myocardial infarction (STEMI) unless contraindicated.
The best answer is: true
Initiation of oral beta blocker therapy within the first 24 hours of ST elevation myocardial infarction (STEMI) is recommended unless there is a contraindication.
When providing fluid resuscitation, what should be carefully monitored?
- 1. response to the aggressive fluid administration
- 2. airway and breathing
- 3. circulation
- 4. serum electrolytes
The best answer is: (all of the above)
When providing aggressive fluid repletion therapy, the patient should be carefully monitored for airway, breathing and circulation. Also, it is essential to observe and understand the unstable patient’s response to the fluid. Whether vomiting, diarrhea or hemorrhage, rapid volume loss is often accompanied by significant electrolyte imbalances, which may be life-threatening. Careful monitoring and repletion of electrolytes can prevent many secondary disasters.
After stabilizing a patient in respiratory failure, the most important clinical goal is:
The best answer is: to identify and treat the disease that is causing the respiratory failure
After establishing clinical stabilization of the patient in respiratory failure, it is essential to determine the cause of the respiratory failure and begin aggressive treatment. Simply maintaining adequate minute ventilation with a ventilator will do nothing to treat an underlying condition such as bacterial pneumonia. Obviously, antibiotic therapy is the proper treatment, not the mechanical ventilator.
Vagal maneuvers can be appropriately considered in patients with stable tachyarrhythmias.
The best answer is: true
Patients who are stable (tolerating the arrhythmia) may be good candidates for vagal maneuvers, although many practitioners may opt to employ drug therapy initially, instead.
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.
In the unstable, bradycardic pediatric patient, if assisted ventilation with 100% oxygen fails to bring up the heart rate, CPR is recommended.
The best answer is: true
Unlike adult patients, children with life-threatening, severely unstable bradycardia refractory to emergency positive pressure assisted ventilation with 100% oxygen should receive CPR while other treatments are in progress.