AHA ACLS Written Test Guide

AHA ACLS Written Test 1. You find an unresponsive pt. who is not breathing. Start chest comAfter activating the emergency response system, you pressions of at determine there is no pulse. What is your next action? least 100 per min. 2. You are evaluating a 58 year old man with chest pain. Obtaining a 12 The BP is 92/50 and a heart rate of 92/min, non-labored lead ECG. respiratory rate is 14 breaths/min and the pulse O2 is 97%. What assessment step is most important now? 3. What is the preferred method of access for epi admin- Peripheral IV istration during cardiac arrest in most pts? 4. An AED does not promptly analyze a rythm. What is your next step? Begin chest compressions. 5. You have completed 2 min of CPR. The ECG monitor Administer 1mg of displays the lead below (PEA) and the pt. has no pulse. epinepherine You partner resumes chest compressions and an IV is in place. What management step is your next priority? 6. During a pause in CPR, you see a narrow complex Resume compresrythm on the monitor. The pt. has no pulse. What is the sions next action? 7. What is acommon but sometimes fatal mistake in car- Prolonged interdiac arrest management? ruptions in chest compressions. 8. Which action is a componant of high-quality chest comressions? Allowing complete chest recoil 9. Which action increases the chance of successful con- Providing quality version of ventricular fibrillation? compressions immediately before a defibrillation attempt. 10. Which situation BEST describes PEA? 1/6 Sinus rythm without a pulse 11. What is the best strategy for perfoming high-quality Provide CPR on a pt.with an advanced airway in place? continuous chest compressionswithout pauses and 10 ventilations per minute. 12. 3 min after witnessing a cardiac arrest, one memeber Chest compresof your team inserts an ET tube while another persions may not be forms continuous chest comressions. During subse- effective. quent bentilation, you notice the presence of a wavefom on the capnogrophy screen and a PETCO2 of 8 mm Hg. What is the significance of this finding? 13. The use of quantitative capnography in intubated pt's Allowsfor monitordoes what? ing CPR quality 14. For the past 25 min, EMS crews have attemptedresuscitation of a pt who originally presented with V-FIB. After the 1st shock, the ECG screen displayed asystole which has persisted despite 2 doses of epi, a fluid bolus, and high quality CPR. What is your next treatment? Consider terminating resuscitive efforts after consulting medical control. 15. Which is a safe and effective practice within the defib- Be sure O2 is NOT rillation sequence? blowing over the pt's chest during shock. 16. During your assessment, your pt suddenly loses con- Begin chest comsciousness. After calling for help and determining that pressions. the pt. is not breathing, you are unsure whether the pt. has a pulse. What is your next action? 17. What is an advantage of using hands-free d-fib pads Hands-free allows instead of d-fib paddles? for more rapid d-fib. 18. What action is recommended to help minimize interruptions in chest compressions during CPR? 2/6 Continue CPR while charging the defibrillator. 19. Which action is included in the BLS survey? Early defibrillation 20. Which drug and dose are recommended for the man- Amioderone agement of a pt. in refractory V-FIB? 300mg 21. What is the appropriate intervalfor an interruption in 10 seconds or less chest compressions? 22. Which of the following is a sign of effective CPR? PETCO2 = or > 10mm Hg 23. What is the primary purpose of a medical emergency Identifying and team or rapid response team? treating early clinical deterioration. 24. Which action improves the quality of chest compres- Shitch providers sions delivered during resuscitave attemepts? about every 2 min or every 5 compression cycles. 25. What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse of 80 beats/min? 1 breath every 5-6 seconds 26. A pt. presents to the ER with a new onset of dizziness Atropine 0.5mg and fatugue. Onexamination, the pt's heart rate is 35 beats/min, BP is 70/50, resp. rate is 22 per min, O2 sat is 95%. What is the appropriate 1st medication? 27. A pt. presents to the ER with dizziness and SOB with 2-10mcg/kg/min a sinus brady of 40/min. The initial atropine dose was ineffective and your monitor does not provide TCP. What is the appropriate dose of Dopamine for this pt? 28. A pt. has an onset of dizziness. The pt.s heart rate is Vagal manuever. 180, BP is 110/70, resp. rate is 18, O2 sat is 98%. This 3/6 is a reg narrow complex tach rythm. What is the next intervention? 29. A monitored pt. in the ICU developed a suddent onset Adenosine 12mg of narrow complex tach at a rate of 220/min. The pt's IV BP is 128/58, the PETCO2 is 38mm Hg, and the O2 sat is 98%. There is an EJ established for vascular access. The pt. denies taking any vasodialators. A 12 lead shows no ischemia or infarction. Vagal manuevers are ineffective. What is the next intervention? 30. You receiving a radio report from an EMS team enDivert the pt. to route with a pt. who may be having a stroke. The a hospital 15 min hospital CT scanner is broken. What should you do? away with CT capabilities. 31. Choose an appropriate inidication to stop or withhold Evidence of rigor resuscitive efforts. mortis. 32. A 49 y/ofmaile arrives in the ER with persistant epigas- Obtain a 12 lead tric pain. She has been taking antacids PO for the past ECG. 6 hours because she she had heartburn. BP is 118/72, heart rate is 92/min, resp. rate is 14 non-labored and O2 sat is 96%. What is the most appropriate next action? 33. A pt. in respiratory failure becomes apneic but contineues to have a strong pulse. The heart rate is dropping paridly and now shows a sinus brady rate at 30/min. What intervention has the highest priority? Simple airway manuevers and assisted ventilations. 34. What is the appropriate procedure for ET suctioning Suction during after the catheter is selected? withdrawl, but not for longer than 10 seconds. 35. While treating a stable pt for dizziness, a BP of 68/30, Atropine 0.5mg cool and clammy, you see a brady rythm on the ECG. How do you treat this? 4/6 36. A 68 y/o female pt. experienced a sudden onset of Cinncinati Stroke right arm weakness. BP is 140/90, pulse is 78/min, resp Scale rate is non-labored 14/min, 02 sat is 97%. Lead 2 in the ECG shows a sinus rythm. What would be your next action? 37. You are transporting a pt. with a positive stroke assessment. BP is 138, pulse is 80/min, resp rate is 12/min, 02 sat is 95% room air. Glucose levels are normal and the ECG shows a sinus rythm. What is next. Head CT scan 38. What is the proper ventilation rate for a pt. in cardiac 8-10 breaths per arrest who has an advanced airway in place? minute 39. A 62 y/o male pt. in the ER says his heart is beating Obtain a 12 lead fast. No chest pain or SOB. BP is 142/98, pulse rate is ECG. 200/min, reps rate is 14/min, O2 sats are 95 at room air. What should be the next evaluation? 40. You are evaluating a 48 y/o male with crushing Syncronized carsub-sternal pain. He is cool, pale, diaphretic, and slow dioversion. to respond to your questions. BP is 58/32, pulse is 190/min, resp rate is 18, and you are unable to obtain an 02 sat due to no radial pulse. The ECG shows a wide complex tach rythm. What intervention should be next? 41. What is the initial priority for an unconscious pt. with Determine if a any tachycardia on the monitor? pulse is present. 42. Which rythm requires synchronized cardioversion? Unstable SVT 43. What is the recommended dose for adenosine for pt's 12mg in refractory, but stable narrow complex tachycardia? 44. What is the usual post-cardiac arrest target range for 35-40mm Hg PETCO2 who achieves return of spontaneous circulation (ROSC)? 5/6 45. Which conditionis a contraindication to theraputic hy- Responding to pothermia during the post-cardiac arrest period for verbal commands pt's who achieve return of spontaneous circulation (ROSC)? 46. What is the potential danger to using ties that pass Obstruction of vecircumfrentially around the pt's neck when securing neous return from an advanced airway? the brain 47. What is the most reliable method of confirming and montioring correct placement of an ET tube? Continuous waveform capnography 48. What is the recommended IV fluid (NS or LR) bolus 1 to 2 Liters dose for a pt. who achieves ROSC but is hypotensive during the post-cardiac arrest period? 49. What is the minimum systolic BP one should attempt 90mm Hg to achieve with fluid, Inotropic, or vasopressor administration in a hypotensive post-cardiac arrest who achieves ROSC? 50. What is the 1st treatment priority for a pt. who achieves ROSC? 6/6 Optimizing ventilation and oxygenation.