ACLS Practice Questions ACLS PALS BLS
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It is better practice to identify medical futility and prescribe DNR status prior to a cardiac arrest.
The best answer is: true
Initiating futile care is medically improper. Once futility is diagnosed, it is proper to prescribe "do not attempt to resuscitate" (DNR) in the patient record.
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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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Obtaining a 12-lead ECG takes priority over obtaining rapid CT or MRI scans.
The best answer is: false
Although a secondary assessment tool, the 12-lead ECG does not take priority over determining the mechanism of the stroke using CT or MRI scans. ECG monitoring is recommended for the first 24 hours of evaluation in patients with acute ischemic stroke to detect significant arrhythmias and the onset of atrial fibrillation.
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In the event that atropine failed to work effectively, dopamine or epinephrine infusions (carefully titrated) can be considered.
The best answer is: true
For treatable bradycardia and heart blocks that do not adequately improve with atropine, carefully titrated dopamine or epinephrine infusions can be used. Bolus epinephrine is reserved for only patients in true cardiac arrest.
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Epinephrine:
The best answer is: all of the above
Epinephrine can be administered IV, IO and via the ET tube. It is recommended in refractory VF, asystole and possibly other pulseless situations where no cause can be identified. (i.e. PEA) A strong argument for vasopressin vs. epinephrine relates to epinephrine’s strong beta-1 actions, which have the ability to accelerate heart rate, increase myocardial oxygen consumption and potentially worsen ischemic damage. The most recent clinical recommendations are to omiit vasopressin as an alternative..
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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.
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The proper treatment of hypercarbia (ventilatory failure – PaCO2 > 70 mmHg) is:
The best answer is: assisted (augmented) ventilation (bag/valve or mechanical ventilation device)
If adequate minute ventilation cannot be maintained by a patient, the only treatment is to support and augment the patient minute ventilation using positive pressure devices such as the bag/valve and mechanical ventilator.
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If a patient does not have a shockable ECG rhythm, what is the recommended treatment?
- 1. continue quality CPR
- 2. give epinephrine (IV/IO/ETT)
- 3. find and treat causes
- 4. shock the patient anyways (jump start the asystolic heart)
The best answer is: (1,2,3)
CPR is essential in pulseless patients regardless of their ECG rhythm. If there is no need to defibrillate, epinephrine is recommended. The stark reality is that if the cause of the arrest is not identified and treated very quickly, death is ruled. During the resuscitation, attempts should be made to identify medical futility. If it exists, resuscitation attempts should cease.
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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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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
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Would you use a pediatric-specific AED system for a 14-year-old?
The best answer is: No
No
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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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CPR is important before and after defibrillation.
The best answer is: True
True