ACLS Practice Questions ACLS PALS BLS
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Oxygen may be considered in most patients with ischemic chest pain.
The best answer is: true
While the most recent Guidelines downplay the routine administration of oxygen in the stable, non-hypoxemic cardiac patient, it is reasonable to consider low-flow oxygen as a strategy for potentially enhancing oxygen deliver to the myocardium. For signs of hypoxemia/hypoxia, oxygen is indicated.
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Oral beta blocker drug therapy should be initiated within the first 24 hours of ST elevation myocardial infarction (STEMI) unless contraindicated.
The best answer is: true
Initiation of oral beta blocker therapy within the first 24 hours of ST elevation myocardial infarction (STEMI) is recommended unless there is a contraindication.
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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.
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Durable power of attorney for healthcare:
The best answer is: all of the above
When an adult assigns another adult durable power of attorney for healthcare, they essentially make that assignee them for the purposes of requesting or rejecting healthcare services. With the assignment of this legal authority, the agent has the right and the ability, as would the patient, to view their medical records, and, can terminate any and all contracts for medical care. They are not required to do anything but act on behalf of the patient.
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Emergency cesarean section should be done when:
The best answer is: 4 minutes of resuscitation has failed to return spontaneous circulation
Because CPR does not maintain fetal blood flow, the more rapidly the flow is restored, the less potential damage to the fetus and the mother. The most recent Guidelines recommend that emergency cesarean section be performed when 4 minutes of resuscitation has been unsuccessful.
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Blood can be administered via an intra-osseous device.
The best answer is: true
Virtually anything that can be administered IV can be given via the intra-osseous route. Blood products are technically more difficult to administer due to their viscosity. All fluids must be bolused (pushed) into the patient rather than using a continuous drip method.
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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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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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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.
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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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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
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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
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The correct compression ventilation ratio for CPR for an adult is:
The best answer is: 30 compressions to 2 ventilations
30 compressions to 2 ventilations
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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
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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