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ACLS.Pre-Course.Self-Assessment
Typology: Exams
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Identify.The.ECG.Strip.-......ANSWER................Atrial.Flutter. Identify.The.ECG.Strip.-......ANSWER................Second-degree.atrioventricular.block. (Mobitz.I.Wenckebach) Identify.The.ECG.Strip.-......ANSWER................Ventricular.fibrillation Identify.The.ECG.Strip.-......ANSWER................Second-degree.atrioventricular.block. (Mobitz.I.Wenckebach) Identify.The.ECG.Strip.-......ANSWER................Monomorphic.ventricular.tachycardia
Identify.The.ECG.Strip.-......ANSWER................Second-degree.atrioventricular.block. (Mobitz.II.block) Identify.The.ECG.Strip.-......ANSWER................Ventricular.fibrillation Identify.The.ECG.Strip.-......ANSWER................Ventricular.fibrillation Identify.The.ECG.Strip.-......ANSWER................Atrial.fibrillation Identify.The.ECG.Strip.-......ANSWER................Pulseless.electrical.activity
Identify.The.ECG.Strip.-......ANSWER................Polymorphic.Ventricular.Tachycardia Identify.The.ECG.Strip.-......ANSWER................Agonal.Rhythm/Asystole Identify.The.ECG.Strip.-......ANSWER................Second-degree.Atrioventricular.Block. (Mobitz.II.Block) Identify.The.ECG.Strip.-......ANSWER................Sinus.Bradycardia Identify.The.ECG.Strip.-......ANSWER................Supraventricular.Tachycardia
A.monitored.patient.in.the.ICU.developed.a.sudden.onset.of.narrow- complex.tachycardia.at.a.rate.of.220/ min..The.patient's.blood.pressure.is.128/58.mm.Hg,.the.PETCO2.is. 38 .mm.Hg,.and.the.pulse.oxi metry.reading.is.98%..There.is.vascular.access.in.the.left.arm,.and.the.patient.has.not.been.given. any.vasoactive.drugs..A.12- lead.ECG.confirms.a.supraventricular.tachycardia.with.no.evidence.of.ischemia.or.infarction..Th e.heart.rate.has.not.responded.to.vagal.maneuvers..What.is.your.next.action? Administer.amiodarone. 300 .mg.IV.push. Administer.adenosine. 6 .mg.IV.push. Perform.synchronized.cardioversion.at. 200 .J. Perform.synchronized.cardioversion.at. 50 .J.-......ANSWER................Administer.adenosine. 6 .mg. IV.push You.are.caring.for.a.66-year- old.man.with.a.history.of.a.large.intracerebral.hemorrhage. 2 .months.ago..He.is.being.evaluated.f or.another.acute.stroke..The.CT.scan.is.negative.for.hemorrhage..The.patient.is.receiving.oxygen .via.nasal.cannula.at. 2 .L/ min,.and.an.IV.has.been.established..His.blood.pressure.is.180/100.mm.Hg..Which.drug.do.you. anticipate.giving.to.this.patient? Aspirin. rtPA. Glucose.(D50). Nicardipine.-......ANSWER................Aspirin A.patient.is.in.pulseless.ventricular.tachycardia..Two.shocks.and. 1 .dose.of.epinephrine.have.bee n.given..Which.drug.should.be.given.next? Epinephrine. 3 .mg. Lidocaine.0.5.mg/kg. Amiodarone. 300 .mg. Adenosine. 6 .mg.-......ANSWER................Amiodarone. 300 .mg
0.1.mg. 1 .mg. 3 .mg. 0.5.mg.-......ANSWER................ 1 .mg A.patient.with.STEMI.has.ongoing.chest.discomfort..Heparin. 4000 .units.IV.bolus.and.a.heparin. infusion.of. 1000 .units.per.hour.are.being.administered..The.patient.did.not.take.aspirin.because.h e.has.a.history.of.gastritis,.which.was.treated. 5 .years.ago..What.is.your.next.action? Give.enteric-coated.aspirin. 325 .mg.rectally. Give.aspirin. 162 .to. 325 .mg.to.chew. Give.enteric-coated.aspirin. 75 .mg.orally. Give.clopidogrel. 300 .mg.orally.-......ANSWER................Give.aspirin. 162 .to. 325 .mg.to.chew A.57-year- old.woman.has.palpitations,.chest.discomfort,.and.tachycardia..The.monitor.shows.a.regular.wid e-complex.QRS.at.a.rate.of.180/ min..She.becomes.diaphoretic,.and.her.blood.pressure.is.80/60.mm.Hg..Which.action.do.you.tak e.next? Seek.expert.consultation. Perform.electrical.cardioversion. Establish.IV.access. Obtain.a.12-lead.ECG.-......ANSWER................Perform.electrical.cardioversion A.patient.is.in.refractory.ventricular.fibrillation.and.has.received.multiple.appropriate.defibrillati on.shocks,.epinephrine. 1 .mg.IV.twice,.and.an.initial.dose.of.amiodarone. 300 .mg.IV..The.patient. is.intubated..Which.best.describes.the.recommended.second.dose.of.amiodarone.for.this.patient? 150 .mg.IV.push. 1 .to. 2 .mg/min.infusion. 300 .mg.IV.push. 1 .mg/kg.IV.push.-......ANSWER................ 150 .mg.IV.push A.patient.has.sinus.bradycardia.with.a.heart.rate.of.36/ min..Atropine.has.been.administered.to.a.total.dose.of. 3 .mg..A.transcutaneous.pacemaker.has.fai
led.to.capture..The.patient.is.confused,.and.her.blood.pressure.is.88/56.mm.Hg..Which.therapy.is .now.indicated? Adenosine. 6 .mg. Epinephrine. 2 .to. 10 .mcg/min. Normal.saline. 250 .mL.to. 500 .mL.bolus. Atropine. 1 .mg.-......ANSWER................Epinephrine. 2 .to. 10 .mcg/min A.patient.is.in.cardiac.arrest..Ventricular.fibrillation.has.been.refractory.to.an.initial.shock..If.no. pathway.for.medication.administration.is.in.place,.which.method.is.preferred? Endotracheal.tube. Central.line. External.jugular.vein. IV.or.IO.-......ANSWER................IV.or.IO A.patient.is.in.cardiac.arrest..Ventricular.fibrillation.has.been.refractory.to.a.second.shock..Whic h.drug.should.be.administered.first? Epinephrine. 1 .mg.IV/IO. Lidocaine. 1 .mg/kg.IV/IO. Atropine. 1 .mg.IV/IO. Sodium.bicarbonate. 50 .mEq.IV/IO.-......ANSWER................Epinephrine. 1 .mg.IV/IO A.patient.has.a.rapid.irregular.wide-complex.tachycardia..The.ventricular.rate.is.138/ min..He.is.asymptomatic,.with.a.blood.pressure.of.110/70.mm.Hg..He.has.a.history.of.angina..W hat.action.is.recommended.next? Performing.synchronized.cardioversion. Giving.lidocaine. 1 .to.1.5.mg.IV.bolus. Giving.adenosine. 6 .mg.IV.bolus. Seeking.expert.consultation.-......ANSWER................Seeking.expert.consultation In.which.situation.does.bradycardia.require.treatment? Diastolic.blood.pressure.greater.than. 90 .mm.Hg. 12-lead.ECG.showing.a.normal.sinus.rhythm. Hypotension.
Hold.aspirin.for.at.least. 24 .hours.if.rtPA.is.administered.-......ANSWER................Hold.aspirin.fo r.at.least. 24 .hours.if.rtPA.is.administered How.often.should.you.switch.chest.compressors.to.avoid.fatigue? About.every. 2 .minutes. About.every. 4 .minutes. About.every. 5 .minutes. About.every. 3 .minutes.-......ANSWER................About.every. 2 .minutes Your.patient.is.a.56-year- old.woman.with.a.history.of.type. 2 .diabetes.who.reports.feeling.dizzy..She.is.pale.and.diaphoreti c..Her.blood.pressure.is.80/60.mm.Hg..The.cardiac.monitor.documents.the.rhythm.shown.here..S he.is.receiving.oxygen.at. 4 .L/ min.by.nasal.cannula,.and.an.IV.has.been.established..What.do.you.administer.next? . Dopamine.at. 2 .to. 10 .mcg/kg.per.minute. Morphine.sulfate. 4 .mg.IV. Atropine. 1 .mg.IV. Glucose.50%.IV.push.-......ANSWER................Atropine. 1 .mg.IV What.action.minimizes.the.risk.of.air.entering.the.victim's.stomach.during.bag-mask.ventilation? Ventilating.as.quickly.as.you.can. Ventilating.until.you.see.the.chest.rise. Squeezing.the.bag.with.both.hands. Delivering.the.largest.breath.you.can.-......ANSWER................Ventilating.until.you.see.the.chest. rise How.does.complete.chest.recoil.contribute.to.effective.CPR? Reduces.the.risk.of.rib.fractures. Allows.maximum.blood.return.to.the.heart. Reduces.rescuer.fatigue. Increases.the.rate.of.chest.compressions.-......ANSWER................Allows.maximum.blood.return. to.the.heart
A.patient's.12- lead.ECG.is.transmitted.by.the.paramedics.and.shows.a.STEMI..When.the.patient.arrives.in.the.e mergency.department,.the.rhythm.shown.here.is.seen.on.the.cardiac.monitor..The.patient.has.res olution.of.moderate. (5/10).chest.pain.after. 3 .doses.of.sublingual.nitroglycerin..Blood.pressure.is.104/70.mm.Hg..Whi ch.intervention.is.most.important.in.reducing.this.patient's.in-hospital.and.30-day.mortality.rate? Reperfusion.therapy. Nitroglycerin.administration. Application.of.transcutaneous.pacemaker. Atropine.administration.-......ANSWER................Reperfusion.therapy Which.action.is.likely.to.cause.air.to.enter.the.victim's.stomach.(gastric.inflation).during.bag- mask.ventilation? Ventilating.too.quickly. Providing.a.good.seal.between.the.face.and.the.mask. Giving.breaths.over. 1 .second. Providing.just.enough.volume.for.the.chest.to.rise.-......ANSWER................Ventilating.too.quick ly A.patient.becomes.unresponsive..You.are.uncertain.if.a.faint.pulse.is.present..The.rhythm.shown. here.is.seen.on.the.cardiac.monitor..An.IV.is.in.place..Which.action.do.you.take.next? Start.high-quality.CPR. Begin.transcutaneous.pacing. Administer.epinephrine. 1 .mg.IV. Administer.atropine. 1 .mg.-......ANSWER................Start.high-quality.CPR A.patient.has.been.resuscitated.from.cardiac.arrest..During.post- ROSC.treatment,.the.patient.becomes.unresponsive,.with.the.rhythm.shown.here..Which.action.i s.indicated.next? Perform.synchronized.cardioversion. Repeat.amiodarone. 300 .mg.IV. Give.lidocaine. 1 .to.1.5.mg/kg.IV. Give.an.immediate.unsynchronized.high-energy.shock. (defibrillation.dose).-......ANSWER................Give.an.immediate.unsynchronized.high- energy.shock.(defibrillation.dose)
Give.amiodarone. 300 .mg.IV. Check.the.carotid.pulse. Give.atropine. 1 .mg.IV.-......ANSWER................Resume.high-quality.chest.compressions A.45-year-old.woman.with.a.history.of.palpitations.develops.light- headedness.and.palpitations..She.has.received.adenosine. 6 .mg.IV.for.the.rhythm.shown.here,.wit hout.conversion.of.the.rhythm..She.is.now.extremely.apprehensive..Her.blood.pressure.is.128/ .mm.Hg..What.is.the.next.appropriate.intervention? Perform.synchronized.cardioversion. Perform.unsynchronized.cardioversion. Administer.adenosine. 12 .mg.IV. Perform.vagal.maneuvers.-......ANSWER................Administer.adenosine. 12 .mg.IV What.is.the.recommended.depth.of.chest.compressions.for.an.adult.victim? At.least. 3 .inches. At.least.2.5.inches. At.least.1.5.inches. At.least. 2 .inches.-......ANSWER................At.least. 2 .inches You.are.the.code.team.leader.and.arrive.to.find.a.patient.with.CPR.in.progress..On.the.next.rhyth m.check,.you.see.the.rhythm.shown.here..Team.members.tell.you.that.the.patient.was.well.but.re ported.chest.discomfort.and.then.collapsed..She.has.no.pulse.or.respirations..Bag- mask.ventilations.are.producing.visible.chest.rise,.and.IO.access.has.been.established..Which.int ervention.would.be.your.next.action? Intubation.and.administration.of.100%.oxygen. Epinephrine. 1 .mg. Dopamine.at. 10 .to. 20 .mcg/kg.per.minute. Atropine. 1 .mg.-......ANSWER................Epinephrine. 1 .mg After.initiation.of.CPR.and. 1 .shock.for.ventricular.fibrillation,.this.rhythm.is.present.on.the.next. rhythm.check..A.second.shock.is.given,.and.chest.compressions.are.resumed.immediately..An.I V.is.in.place,.and.no.drugs.have.been.given..Bag- mask.ventilations.are.producing.visible.chest.rise..What.is.your.next.intervention? Give.epinephrine. 1 .mg.IV/IO.
Administer. 3 .sequential.(stacked).shocks.at. 320 .J.(monophasic.defibrillator). Intubate.and.administer.100%.oxygen. Give.amiodarone. 300 .mg.IV/IO.-......ANSWER................Give.epinephrine. 1 .mg.IV/IO A.35-year- old.woman.presents.with.a.chief.complaint.of.palpitations..She.has.no.chest.discomfort,.shortnes s.of.breath,.or.light- headedness..Her.blood.pressure.is.120/78.mm.Hg..Which.intervention.is.indicated.first? Adenosine. 3 .mg.IV.bolus. Metoprolol. 5 .mg.IV.and.repeat.if.necessary. Vagal.maneuvers. Adenosine. 12 .mg.IV.slow.push.(over. 1 .to. 2 .minutes).-......ANSWER................Vagal.maneuvers You.are.providing.bag- mask.ventilations.to.a.patient.in.respiratory.arrest..How.often.should.you.provide.ventilations? Every. 6 .seconds. Every. 12 .seconds. Every. 14 .seconds. Every. 10 .seconds.-......ANSWER................Every. 6 .seconds What.is.the.recommended.compression.rate.for.high-quality.CPR? 70 .to. 80 .compressions.per.minute. 100 .to. 120 .compressions.per.minute. 50 .to. 20 .compressions.per.minute. 90 .to. 100 .compression.per.minute.-......ANSWER................ 100 .to. 120 .compressions.per.minute
