ACLS Practice Questions ACLS PALS BLS
Which of the following constitute elements of quality CPR?
The best answer is: all of the above
“High-quality CPR” is identified in the most recent Guidelines for CPR as: compression rate of 100-120/minute; 2-2.4 inch compression depth; complete chest recoil following each compression; minimizing interruptions to chest compressions, and, avoiding excessive ventilation.
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.
Patients who are pregnant and develop cardiac arrest should never be defibrillated.
The best answer is: false
Pregnant patients in cardiac arrest are treated essentially the same as non-pregnant patients. However, displacing the uterus during CPR and rapid cesarean section are important differences. Because fetal viability is limited, no time should be wasted. Use of the AED in pregnancy has not been studied but is recommended.
Which of the following arrhythmias would likely be the most difficult to convert at 50 joules?
The best answer is: rapid atrial fibrillation
Arrhythmias involving circuits and bypass tracks (most PSVT's, atrial flutter and ventricular tachycardia) respond well to lower delivered energy.
To convert fibrillation (atrial and ventricular fibrillation), a critical mass of fibrillating myocardium must be simultaneously depolorized frequently requiring much higher levels of delivered energy.
Emergency Departments should have a written plan describing for EMS the specialized procedures in managing the stroke patient. EMS triage of stroke patients directly to a designated “Stroke Center” is a Class I recommendation. Extended time limits for use of rtPA are now being recommended with certain qualifications
The best answer is: true
The most recent Guidelines emphasize the benefit of patients being rapidly transported to a designated “Stroke Center” rather than the nearest hospital. This typically happens when there is a written policy. Several studies have shown benefit when the inclusion time limits are expanded when using fibrinolytic therapy.
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.
Capillary refill in a properly perfused patient should be:
The best answer is: 2 seconds or less
Normal capillary refill is 1 second or less. Although unusual, co-existent conditions such as hypothermia, may make assessment difficult. All physiologic parameters should be looked at to assure a proper diagnosis.
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.
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.
The initial (1st shock) energy level which should be administered for pediatric defibrillation, should be:
The best answer is: 2.0 joules/kg
The initial energy recommendation for the first shock when treating pediatric patients is 2.0 joules/kg.
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
Healthcare providers should first verify that the victim is unresponsive after witnessing a sudden collapse.
The best answer is: True
Resuscitation is most successful if defibrillation is performed in the first
The best answer is: 5 minutes of collapse
5 minutes of collapse
When an infant or child is found collapsed, which sequence is best to follow?
The best answer is: Check responsiveness, quickly check pulse, start chest compressions
Check responsiveness, quickly check pulse, start chest compressions
If a manual defibrillator is used on a child 8 years or younger, what dose is recommended?
The best answer is: 2 J/kg for the first shock and 4 J/kg for subsequent shocks
2 J/kg for the first shock and 4 J/kg for subsequent shocks