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ACLS Exam A 2020 With Correct Solutions
Which of these tests should be performed for a pt with suspected stroke as early as possible but no more than 20 min after hospital arrival? - correct answerNoncontrast CT scan of head Which best describes this rhythm? - correct answerMonomorphic Vent Tach Which is an acceptable method of selecting an appropriately sized oropharyngeal airway? - correct answerMeasure from the corner of the mouth to the angle of mandible You are caring for a pt with a suspected stroke whose symptoms started 2 hours ago. The CT scan was normal, with no signs of hemorrhage. The pt does not have any contraindications to fibrinolytic therapy. Which treatment is best for this pt? - correct answerGive fibrinolytic therapy as soon as possible and consider endovascular therapy Which is the recommended next step after a defibrillation attempt? - correct answerResume CPR, starting with chest compressions Which of the following signs is a likely indicator of cardiac arrest in an unresponsive pt?
- correct answerAgonal gasps You are evaluating a 58YO man with chest discomfort. His BP is 92/50 mmHG, his HR is 92/min, his nonlabored RR is 14/min, and his pulse ox is 97%. Which assessment step is most important now? - correct answerObtaining a 12-lead ECG During post-cardiac arrest care, which is the recommended duration of targeted temperature management after reaching the correct temperature range? - correct answerAt least 24 hours Your rescue team arrives to find a 59YO man lying on the kitchen floor. You determine that he is unresponsive. What is the next step in your assessment and management of this pt? - correct answerCheck the pt's breathing and pulse (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib.
On the basis of this pt's initial presentation, which condition do you suspect led to the cardiac arrest? - correct answerAcute Coronary Syndrome (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. In addition to defibrillation, which intervention should be performed immediately? - correct answerChest compressions (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. Despite 2 defib attempts, the pt remains in VFib. Which drug and dose should you administer FIRST to this pt? - correct answerEpi 1mg (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. Despite the drug provided above and continued CPR, the pt remains in VFib. Which other drug should be administered NEXT? - correct answerLido 1 to 1.5mg/kg (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. The pt has ROSC and is not able to follow commands. Which immediate post-cardiac arrest care intervention do you choose for this pt? - correct answerInitiate targeted temperature management (SET) A 45YO man had coronary stents placed 2 days ago. Today he is in severe distress and is reporting "crushing" chest discomfort. Pale, diaphoretic, cool to touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, 89% RA. VTach changed to VFib. Which would you have done first if the pt had not gone into VFib? - correct answerPerformed synchronized cardioversion How can you increase chest compression fraction during a code? - correct answerCharge the defib 15s before conducting a rhythm check A team member is unable to perform an assigned task because it is beyond the team member's scope of practice. Which action should the team member take? - correct answerAsk for a new task or role
On the basis of this pt's initial assessment, which ACLS algorithm should you follow? - correct answerAdult Tachycardia With a Pulse (SET) A 68YO woman presents with light-headedness, nausea and chest discomfort. Your assessment finds her awake and responsive but appearing ill, pale and grossly diaphoretic. Weak, thready, fast radial pulse. Unable to obtain BP. No obvious dependent edema, flat neck veins. Her lung sounds are equal, with moderate rales bilaterally. The pt's pulse ox shows a reading of 84% on room air. Which initial action should you take? - correct answerApply oxygen (SET) A 68YO woman presents with light-headedness, nausea and chest discomfort. Your assessment finds her awake and responsive but appearing ill, pale and grossly diaphoretic. Weak, thready, fast radial pulse. Unable to obtain BP. No obvious dependent edema, flat neck veins. Her lung sounds are equal, with moderate rales bilaterally. After your initial assessment of this pt, which intervention should be performed next? - correct answerSynchronized cardioversion (SET) A 68YO woman presents with light-headedness, nausea and chest discomfort. Your assessment finds her awake and responsive but appearing ill, pale and grossly diaphoretic. Weak, thready, fast radial pulse. Unable to obtain BP. No obvious dependent edema, flat neck veins. Her lung sounds are equal, with moderate rales bilaterally. If the pt became apneic and pulseless but the rhythm remained the same, which would take the highest priority? - correct answerPerform defibrillation You instruct a team member to give 1mg atropine IV. Which response is an example of closed-loop communication? - correct answer"I'll draw up 1mg of atropine." Which best describes an action taken by the Team Leader to avoid inefficiencies during a resuscitation attempt? - correct answerClearly delegate tasks What is an effect of excessive ventilation? - correct answerDecreased cardiac output Which best describes the length of time it should take to perform a pulse check during the BLS assessment? - correct answer5-10 seconds Which is the recommended FIRST IV dose of amiodarone for a patient with refractory VFib? - correct answer300mg
Which facility is the most appropriate EMS destination for a pt with sudden cardiac arrest who achieved ROSC in the field? - correct answerCoronary reperfusion-capable medical center A pt has a witnessed LOC. The lead II ECG reveals this rhythm (VFib). Which is the appropriate treatment? - correct answerDefibrillation For STEMI pt's, which best describes the recommended maximum goal time for first medical contact-to-balloon inflation time for PCI? - correct answer90 minutes You are performing chest compressions during an adult resuscitation attempt. Which rate should you use to perform the compressions? - correct answer100-120/min Which is the maximum interval you should allow for an interruption in chest compressions? - correct answer10 seconds To properly ventilate a pt with a perfusing rhythm, how often do you squeeze the bag? - correct answerOnce every 6 seconds EMS providers are treating a pt with a suspected stroke. According to the Adult Suspected Stroke Algorithm, which critical action performed by the EMS team will expedite this pt's care on arrival and reduce the time to treatment? - correct answerProvide prehospital notification What is the recommended range from which a temperature should be selected and maintained constantly to achieve targeted temperature management after cardiac arrest? - correct answer32C to 36C A responder is caring for a pt with a history of CHF. The pt is experiencing shortness of breath, a BP of 68/50 mmHg, and a HR of 190/min. The pt's lead II ECG is displayed. - correct answerUnstable SVT
