ACLS Practice Questions ACLS PALS BLS
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When administering adenosine, the IV site should:
The best answer is: a. be as close to the central circulation as possible
Because adenosine gets sequestered rapidly by red blood cells, it is essential to get an intact bolus into the right heart. To do this, the IV site should be as close to the core circulation as possible. In the field, this is almost always a right-sided antecubital IV.
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When a patient ECG shows asystole in the course of an resuscitation attempt, what needs to be done?
The best answer is: check the patient ECG leads to rule out a lead fault (disconnect)
ECG leads frequently become disconnected, thus, with CPR ongoing, and personnel working around the patient, it is important to periodically vary the proper placement of the monitoring leads. Sodium bicarbonate is not indicated, neither is "intracardiac" epinephrine. Defibrillation is not recommended for anything other the changing an existing rhythm. (i.e. fibrillation, anomolous circuitry, etc.)
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A high priority once the stroke patient has arrived at the hospital is:
The best answer is: obtain stat CT scan or MRI
Unnecessary arterial punctures should be avoided due to the possibility of creating a contraindication to the use of fibrinolytic therapy. The verbal symptoms assisting in reaching a diagnosis, but do not require urgent evaluation. Unless there are specific cardiac symptoms, angiography of coronary vessels is not part of the routine stoke evaluation. Early determination of the stroke’s etiology via CT or MRI scans allows timely implementation of the proper intervention. (fibrinolytic vs. surgical)
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In the monitored patient developing ventricular fibrillation, what should occur first?
The best answer is: defibrillation
When ventricular fibrillation occurs in the monitored patient, no time should be wasted on anything other than terminating the arrhythmia. Immediate defibrillation is required. When initial attempts at defibrillation fail, quality CPR should be administered while advanced airway management occurs and drugs are administered. Lidocaine does not enhance the ability to treat refractory ventricular fibrillation, however, it may be helpful in preventing re-induction. The routine use of lidocaine is not indicated.
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Atropine may increase heart rate by:
The best answer is: blocking parasympathetic tone (parasympatholytic)
Atropine's action on the heart is indirect via it's ability to block vagal tone. In doing that, the rate of the sinus node may increase, and, conduction through the A-V node may be enhanced. There is nothing below the A-V node which could be altered by giving atropine.
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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.
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Which of the following are commonly observed signs of shock in children?
- 1. pale or mottled skin color
- 2. skin: cold and moist
- 3. confusion or reduced level of consciousness
- 4. prolonged capillary refill
The best answer is: all of the above
All of the aforementioned signs and symptoms are related to perfusion failure (shock).
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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.
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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.
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A transcutaneous cardiac pacemaker (TCP) can be used to treat children.
The best answer is: true
Manufacturers supply pediatric chest patches that better fit the smaller chest. In an extreme emergency, if only larger adult patches are available, place the patch in an anterior/posterior* position, making certain there is no contact between the two electrodes.
*Place one patch on the front of the chest, over the heart, left of the sternum if possible. Place the second patch at the cardiac level on the rear chest.
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The American Heart Association recommends against using AEDs on infants.
The best answer is: AHA does not have a recommendation for or against the use of AEDs for infants (under 1 year of age)
AHA does not have a recommendation for or against the use of AEDs for infants (under 1 year of age)
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Resuscitation is most successful if defibrillation is performed in the first
The best answer is: 5 minutes of collapse
5 minutes of collapse
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CPR should be continued until an automatic external defibrillator or manual defibrillator is available.
The best answer is: True
True
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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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How long should it take to deliver one rescue breath?
The best answer is: 1 second
1 second