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ACLS EXAM VERSION B 50 QUESTIONS AND ANSWERS COMPLETE]| GRADE A. ZF) cowntoao ACLSExam Version B Advanced Cardiovascular Life SupportPxam Version B (50 questions) Please do not mark on this exam. Record the best answer on the separate answer sheet, 1. What should be done to minimize interruptions in chest compressions during CPR? A B. C. Dz Perform pulse checks only after defibrillation, Administer 1V medications only when breaths are given. Continue to use AED even after the arrival ofa manual defibrillator. 2. Which condition is an indication to stop or withhold resuscitative efforts? A. Unwitnessed arrest B._ Safety threat to providers C. Patient age greater than 85 years D. No return of spontaneous circulation after 10 minutes of CPR 3. After verifying the absence ofa pulse, you initiate CPR with adequate bag-mask ventilation. The patient’s lead I] ECG appears below, What is your next action? I: ~— i i { af A B, Endotracheal tube placement C. Consultation with cardiology for possible PCL D. Application of a transcutaneous pacemaker 4. After verifying unresponsiveness and abnormal breathing, you activatethe emergency response team. What is your next action? A, Retrieve an AED, B. Check for a pulse, C, Deliver 2 rescue breaths. D. Administer a precordial thump. C, administer epinephrine. D. insert an advanced airway. 10. What is the recommended next step after a defibrillation attempt? Open the patient’s airway. Determine if'a carotid pulse is present. eck the ECG for evidence of a mre 11. Which of the following is the recommended first choice for establishing intravenous access gO > during the attempted resuscitation of a patient in cardiac arrest? A. Subclavian vein B. Antal in C, Intraosseous line D. Internal jugular vein 12. What is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation? A, 1mg B. 1 mg/kg Cc. 1 mEg/kg | 13. 1V/1O drug administration during CPR should be administered slowly during the pause for a pulse check, given by infusion. given before any defibrillation attempts. SOF Pp 14. How often should the team leader switch chest compressors during a resuscitation attempt? A. Byery minute B, Every 2 minutes C. Every 3 minutes D. Every 4 minutes 15. Which finding is a sign of ineffective CPR? Patient temperature >32°C (89.6°F) Diastolic intra-arterial pressure >20 mm Hg Measured patient urine output of 1 mL/kg per hour pos > a American Heart Associations 16. A team leader orders 1 mg of epinephrine, anda team member verbally acknowledges when gos > 17. How long should it take to perform a pulse ct A B. C. Dz the medication is administered, What element of effective resuscitation team dynamics does this represent? Clear messages —_—, one’s limitations Clear roles and responsibilities 1 to 5 seconds 10 to 15 seconds 15 to 20 seconds heck during the BLS Survey? 18. Your rescue team arrives to find a 59-year-old man lying on the kitchen floor, You determine that he gos p is unresponsive and notice that he is taking agonal breaths, What is the next step in your assessment and management of this patient? Apply the AED. Open the patient’s airway. Check for the presence of breathing. 19. Which treatment or medication is appropriate for the treatment of a patient inasystole? A B. GQ D. Atropine Defibrillation Transcutaneous pacing 20. An AED advises a shock for a pulseless patient lying in snow. What is the next action? A B. GQ D. A B. GQ D. Place a backboard beneath the patient and administer the shock. Move the patient off the snow to bare ground and deliver the shock. Remove o—_ beneath the patient and then administer the shock. 21. What is the minimum depth of chest compressions for an adult in cardiac arrest? 1 inch 1¥% inches 2% inches é American Heart Associations 27. A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient’s blood pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rateis 16 breaths/min, and the pulse oximetry reading is 96%, The lead IT FOG is displayed below. A patent peripheral IV is in place, What is the next action? gos > Oo Bp gos > Acquisition of a 12-lead BCG Procedural sedation Immediate defibrillation . A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the heart rate is 110/min, the respiratory rate is 22 breaths/min,and the pulse oximetry value is 95%, The patient’s 12-lead ECG shows ST- segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is described as an 8 ona scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What is the next action? Administer an additional dose of aspirin. Administer an additional nitroglycerin tablet. Administer ama cali via an ois mask. . A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing. The blood pressure is 132/68 mm Hg, the pulse is 130/minand regular, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95%, The lead II ECG displays a wide-complex tachycardia. What isthe next action after establishing an IV and obtaininga 12-lead ECG? Administration of TV epinephrine Procedural sedation Synchronized cardioversion . A postoperative patient in the ICU reports new chest pain. What actions havethe highest priority? Administer an IV fluid bolus and obtain arterial blood gas. Start dopamine at 2 meg/kg per minute and obtain a chest x-ray. é American Heart Associations C. Send blood to the laboratory for chemistry and cardiac enzymes. é American Heart Associations 31. An 80-year-old woman presents to the emergency department with dizziness. She now states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She is alert and oriented. Her lead TI FCG is below. After you start an IV, what is the next action? A, Give an TV fluid bolus. Give atropine and monitor for changes in mental status. Startan — infusion and titrate to patient ua 32. What is the recommended oral dose of aspirin for patients suspected of having one SOF} of the acute coronary syndromes? 2 to 4 mg 80 to 120 ~ 400 to 600 mg gos > 33. A responder is caring for a patient with a history of congestive heart failure, The patient is experiencing shortness of breath, a blood pressure of 68/50 mm Hg, anda heart rate of 190/min. The patient’s lead TI FCG is displayed below. . b Which of the following terms best describes this patient? Sinus tachycardia Perfusing ventricular tachycardia Stable supraventricular a A B. Cc. D. a American Heart Associations 34. What is the most appropriate intervention for a rapidly deteriorating patient who hasthis lead. TT ECG? A. Valsalva maneuver 5, Synchronized cardioversion C. Intravenous administration of adenosine TD. Immediate unsynchronized countershock 35, What is the purpose of a medical emergency team (MET) or rapid response team (RRT)? A. Providing online consultation to EMS personnel in the field Providing diagnostic consultation to emergency department patients Im _ care for vacomes by patients admitted to critical care units 36. What is the recommended assisted ventilation rate for patients in respiratory arrest with a ween perfusing rhythm? 4 to 6 breaths per minute 14 to 16 breaths per minute 16 to 18 breaths per minute gO > 37. You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step ismost important now? A, PETCO, B. Chest x-ray C. Laboratory testin: 1 Obiininga ead BCG 38. Family members found a 45-year-old woman unresponsive in bed, The patient is unconscious and in respiratory arrest. What is the recommended initial airway management technique? Placing a nasopharyngeal airway a an advanced. _e device Os > a American Heart Associations 39. A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presentswith the following lead. IT BCG rhythm: What is the appropriate next intervention? Defibrillation Amiodarone 150 mg IV . Adenosine 6 S TV ve 40. A patient has a witnessed loss of consciousness. ‘I'he lead I] ECG reveals this rhythm: A B. C. D. {3 S555 5SSS=5==5=5: ¥ ¥ ¥ ¥ {S555 55555555: ¥ ¥ ¥ ¥ 3 t :: pu bee seeee bs : : i i : eee cones bees i i i i : : : + gaaeez ; (peee=e: + LAL AL AN AL i A EH Hi is ie: \ } AN Fy ABE Ha Hi GEp eee, = ee ig oe] = zea sees: oH i | | aE + i EEEEEE SEER PEE + bzees: ==: + + :===5==-- =: : + = EEEEEEEEEEEEEEEEEE SERRE EERE EERE EERE EEE - EEE EE FEET is EEEEPEEE SEEPS What is the appropriate next intervention? A, Defibrillation B. Adenosine 6 mg IV push Cc. Epinephrine 1 mg TV push D. Synchronized cardioversion 41. What is the recommended energy ~—dose._—for_—-biphasic —_ synchronized cardioversion of atrial fibrillation? 50 to 75 J 75 to 100 J gO > 200 to 300 J a American Heart Associations 42. Which of the following is an acceptable method of selecting an appropriately sized oropharyngeal airway (OPA)? Estimate by using the size of the patient’s thumb, Estimate by using the formula Weight (kg)/8 + 2. Measure from the thyroid cartilage to the angle of the mandible. gOw > 43. Which is a contraindication to nitroglycerin administration in themanagement of acute coronary syndromes? Heart rate greater than 80/min Phosphodiesterase inhibitor use more than 72 hours ago Systolic blood pressure greater than 100 mm Hg SOs > 44. What is the recommended initial intervention for managing hypotension inthe immediate period after return of spontaneous circulation (ROSC)? Atropine bolus Placement of a central line to monitor pulmonary wedge pressure Phenylephrine hydrochloride titrated to keep systolic blood pressure >100 mm Hg Sos Pp 45. Which is an appropriate and important intervention to perform for a patientwho achieves ROSC during an out-of-hospital resuscitation ? Initiate an antiarrhythmic infusion. Replace any supraglottic airway with an endotracheal tube. Place a central venous catheter for hemodynamic monitoring. gos p 46. What is the immediate danger of excessive ventilation during the post-cardiac arrest period for patients who achieve ROSC? A. Oxygen toxicity Pulmonary hypertension C. D. Ventilation/perfusion mismatch : 47. What is the recommended target temperature range for achieving therapeutic hypothermia after cardiac arrest? a American Heart Associations 48. What is the recommended duration of therapeutic hypothermia atterreaching the target temperature? A. 0 to 12 hours #12t0 2 hous C. 24 to 36 hours D. 36 to 48 hours 49. What is the danger of routinely administering high concentrations of oxygen during the post- cardiac arrest period for patients who achieve ROSC? Adverse hemodynamic effects Decrease in cerebral blood flow Increased intrathoracic pressure Con 50. What is the recommended dose of epinephrine for the treatment of hypotension in a post- cardiac arrest patient who achieves ROSC? 2to10 =_ TV infusion 1 mg IV push every 3 to 5 minutes 10 mg IV push every 3 to 5 minutes DOS 
