ACLS Practice Questions ACLS PALS BLS
-
Which of the following are critical EMS assessments and actions regarding the care of the adult with suspected stroke?
The best answer is: all of the above
Actions that are critical for EMS include: supporting ABC’s and providing oxygen if needed; document time of symptom onset; conduct a pre-hospital stroke assessment; triage to nearest Stroke Center; alert receiving hospital; and check blood glucose level.
-
Patients developing unstable ventricular tachycardia:
The best answer is: all of the above
Any patient who develops perfusion failure due to a broad QRS tachycardia requires immediate electrical therapy. The level of therapeutic energy often can be predicted by the arrhythmia. Arrhythmias, which are circuitry-based (atrial flutter, re-enterant types, etc.), respond to lower energy. Atrial fibrillation requires a critical mass of fibrillating myocardium to be depolorized in order to convert the arrhythmia. This requires higher energy. Numerous studies have demonstrated that patients with anti-arrhythmic drug blood levels may also be more difficult to convert a lower energy.
-
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.
-
What symptoms occurring from bradycardia usually indicate the patient has become unstable?
The best answer is: all of the above
When determining stable vs. unstable, perfusion is the most important issue. Patients who become suddenly hypotensive often become diaphoretic. As blood flow is reduced to the brain, symptoms can range from confusion to loss of consciousness. Although chest pain related to bradycardia may not be related to systemic perfusion, it may relate to coronary perfusion. If ischemic type pain seems related to the bradycardia, acceleration of the heart rate is indicated. Atropine can be considered for sinus bradycardia and mechanisms at the AV node and above. For wide QRS bradycardia, atropine is not likely to accelerate the ventricular rate. Immediate use of the transcutaneous cardiac pacer (TCP) is appropriate, regardless of the site of the problem. In addition, drug therapy may inadvertently cause unwanted tachycardia. This will never occur when using TCP. If you don’t like what the pacer is doing, you can turn it off and have no residual effects.
-
Atropine may speed heart rate by blocking vagal response.
The best answer is: true
Atropine has no direct effect on direct action on cardiac tissue. It is a parasympatholytic agent which via its action on the vagal tone may speed sinus node discharge rate and enhance AV conduction.
-
If IV access is unsuccessful, which drugs can be given via the intraosseous route?
- 1. epinephrine
- 2. lidocaine
- 3. magnesium
- 4. amiodarone
The best answer is: (all of the above)
Virtually all drugs that can be given IV can also be administered via the intraosseous route. The major exception is adenosine. This drug needs to reach the heart within milliseconds of injection, which could not happen when injecting the bolus into bone marrow.
-
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.
-
Wheezing is caused by:
The best answer is: all of the above
Wheezing is commonly a symptom of broncospasm, however, swelling of distal airways or mucous may cause or create the wheezing heard on auscultation.
-
Adenosine can be properly used to attempt to convert:
- 1. sinus tachycardia
- 2. narrow QRS, supraventricular tachycardia
- 3. broad QRS, regular tachycardia
- 4. all of the above
The best answer is: (2,3)
Because adenosine stops conduction through the AV node for several seconds, it often converts tachyarrhythmias whose circuitry bisects with the AV node (i.e., AV nodal reentrant tachycardia, etc.). Certain SVT’s have wide QRS complexes, and if the R-R interval is regular, adenosine can be administered as long as the patient is stable. Sinus tachycardia is not an arrhythmia per se, but a response to things such as anxiety, pain, hypovolemia, and fever. Patients with sinus tachycardia need the underlying causes treated. Adenosine will not be of benefit and should not be given.
-
A young trauma patient is brought into your emergency department, barely responsive, pale, with an 8 second capillary refill. The abdomen is distended and rigid. Stat hemoglobin comes back 6.6 gm. What would be the ideal fluid to treat this patients hypovolemic shock?
The best answer is: whole blood or packed cells
Although normal saline or Lactated Ringer’s Solution are commonly used in hypovolemia caused by hemorrhage, it is only because blood is not immediately available. Crystaloid solutions contain no red blood cells. Because red blood cells carry the majority of oxygen to tissues, it is essential to replete lost red blood cells as soon as possible.
-
Sudden collapse in the adult is more likely a result of an arrhythmia that may require a defibrillator.
The best answer is: True
True
-
CPR can double or triple the victim’s chance of survival when performed immediately after collapse from ventricular fibrillation sudden cardiac arrest.
The best answer is: True
True
-
Compressions should depress the chest of the infant and child by
The best answer is: One-third to one-half the depth of the chest
One-third to one-half the depth of the chest
-
Healthcare providers should first verify that the victim is unresponsive after witnessing a sudden collapse.
The best answer is: True
True
-
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