ACLS Practice Questions   ACLS PALS

The best answer is: all of the above

According to the most recent Guidelines, the following are relative exclusion criteria:

• Symptoms that seem minor and are clearing rapidly
• Onset of symptoms accompanied by seizure with residual impairment
• Significant trauma or surgery in the previous 14 days
• GI or GU hemorrhage with the last 21 days
• Acute MI within 3 months

The above need to be considered by carefully weighing the risk vs. the benefit when deciding to employ fibrinolytic therapy.

The best answer is: identify a treatable/reversible cause and correct the problem

The clinical difference between a pulseless, agonal, idioventricular escape complexes, which are virtually always associated with mortality and a patient with a treatable cause of PEA, such as an untreated tension pneumothorax clearly demonstrates the need for thought when using treatment algorithms. A practitioner can administer epinephrine forever, and the patient with PEA caused by the tension pneumothorax will remain pulseless. The current guidelines do not discourage the use of epinephrine nor vasopressin. They removed atropine from the cardiac arrest algorithm.

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.

The best answer is: all of the above

Retrospective analysis of true asystolic cardiac arrest reports a virtually null survival rate. Atropine works by altering vagal tone, which may speed up the sinus node and accelerate conduction through the AV node. When treating a defective conduction system, atropine may be quite useful. However, a “dead heart with no electrical activity” suggests atropine wiil be useless. When history makes the etiology of the ECG uncertain, atropine will cause no harm.

The best answer is: 6.0 mg IV bolus

Adenosine has a very short alpha half-life requiring it to reach the AV node immediately. Thus, in adults, the first dose is 6 mg rapid IV push (as close to the central circulation as possible) followed immediately by a 20-30 ml bolus of IV fluid. If unsuccessful, a 2nd bolus of 12 mg is recommended. Patients with high levels of methylxanthines (caffeine, aminophylline, etc.) may not respond to the adenosine due to competitive antagonism.