ACLS Practice Questions ACLS PALS BLS
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Development of sudden PEA due to a tension pneumothorax is almost always associated with:
The best answer is: 1 and 2 only
The most common cause of treatable PEA is the development of a tension pneumothorax. In order for the lung to collapse and adequate pressure develop which suddenly tamponades blood vessels closed, requires positive airway pressure. Patients receiving positive airway pressure should be monitored carefully and if a tension pneumothorax develops, immediate decompression of the affected side of the chest will reverse the problem. No patient should die of an untreated tension pneumothorax in a critical care or anesthesia setting.
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The ECG strip shows:
The best answer is: 3rd degree (complete) AV block
This ECG shows 3rd degree (complete) AV block. Note that the p-p intervals, as well as the R-R intervals are equidistant and regular. There is complete dissociation from the sinus activity and the ventricular escape pacemaker.
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Precordial thump is no longer recommended for VT or VF.
The best answer is: true
Best treatment of ventricular fibrillation or unstable or pulseless ventricular tachycardia is electrical counter-shock. Although some patients with ventricular tachycardia will convert when a fist crashes down on their chest at high velocity, the poor number of conversions coupled with the potential for chest trauma makes shocking the patient more sensible.
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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.
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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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A normal respiratory frequency for a 16-month-old child is:
The best answer is: 20-30/minute
Although a “normal” respiratory rate range for a 16-month old is approximately 20-30/minute, always consider all potential causes of tachypnea: anxiety; increased body temperature; hypoxia; pain; and airway resistance. Assess each patient comprehensively to best determine the cause(s) of the rapid breathing.
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Crystaloids recommended for fluid resuscitation are:
- 1. 5% dextrose and water
- 2. 20% dextrose and water
- 3. Lactated Ringer’s solution (LR)
- 4. 0.9 saline solution (NS)
The best answer is: (3,4 only)
Current PALS guidelines recommend that glucose NOT be given unless documented hypoglycemia is present. Thus, LR and NS are both acceptable crystaloids for use in fluid resuscitation.
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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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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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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.
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When there are two rescuers on the scene of an unresponsive infant or child, which compression-ventilation ratio should be used?
The best answer is: 15:2
15:2
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Sudden collapse in the adult is more likely a result of an arrhythmia that may require a defibrillator.
The best answer is: True
True
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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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When 2 or more healthcare providers are performing CPR on an infant, compressions should be done with
The best answer is: The 2 thumb-encircling hand technique
The 2 thumb-encircling hand technique
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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