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ALS FINAL EXAM ADVANCED LIFE SUPPORT
EXAM | ALL QUESTIONS AND CORRECT
ANSWERS | GRADED A+ | VERIFIED ANSWERS |
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A patient is brought into the emergency department. The patient does not have a pulse. The cardiac monitor shows the following rhythm. The team interprets this as which condition? ------CORRECT ANSWER--------------- Ventricular tachycardia A member of the resuscitation team is preparing to defibrillate a patient in cardiac arrest using a biphasic defibrillator. The team member would set the energy dose according to the manufacturer's recommendations, which is usually: ------CORRECT ANSWER---------------120 to 200 joules A member of the resuscitation team is preparing to administer medications intravenously to a patient in cardiac arrest. The team member should follow each peripherally administered drug dose with a normal saline flush. How much would the team member give? ------CORRECT ANSWER--------------- 10 to 20 ml A 30-year-old patient has been brought to the emergency department in cardiac arrest. The cardiac monitor shows the following rhythm. Interpretation of this rhythm would suggest which of the following as a possible precipitating factor? ------CORRECT ANSWER--------------- Electrocution The rhythm is ventricular fibrillation. Precipitating causes of ventricular fibrillation include electrocution, myocardial ischemia or infarction, shock, stimulant overdose and ventricular tachycardia.
Cardiac monitoring of a patient in cardiac arrest reveals ventricular fibrillation. In addition to high-quality CPR, what intervention should be a priority for the team? ------CORRECT ANSWER---------------Defibrillation The resuscitation team suspects that hyperkalemia is the cause of cardiac arrest in a patient brought to the emergency department. Which finding on a 12-lead ECG would confirm this suspicion? ------CORRECT ANSWER---- -----------Wide-complex ventricular rhythm and tall, peaked T waves A patient has experienced return of spontaneous circulation (ROSC) after cardiac arrest. The healthcare team is conducting a secondary assessment to determine the possible cause of the patient's cardiac arrest. Before the arrest, the patient exhibited jugular venous distension, cyanosis, apnea and hyperresonance on percussion. The patient was also difficult to ventilate during the response. The team would most likely suspect which condition as the cause? ------CORRECT ANSWER---------------Tension pneumothorax A patient in cardiac arrest experiences return of spontaneous circulation. As part of post-cardiac arrest care, the patient is receiving mechanical ventilation at an initial rate of 10 breaths/min and a fraction of inspired oxygen (FiO2) of 0.30. Which finding(s) would indicate the need for change in the ventilator settings to optimize the patient's ventilation and oxygenation? ------CORRECT ANSWER---------------ETCO2 55 mmHg PaCO2 48 mmHg SaO2 90% After cardiac arrest and successful resuscitation, the patient has a return of spontaneous circulation. The patient is unable to follow verbal commands.
An ECG strip of a patient in the emergency department reveals the following rhythm. Which feature would the healthcare provider interpret as indicating atrial fibrillation? ------CORRECT ANSWER---------------Absence of discrete P waves and presence of irregularly irregular QRS complexes For a patient with third-degree atrioventricular (AV) block and a blood pressure of 70/48 mmHg, what interventions should be considered? ------ CORRECT ANSWER---------------Initiate a dopamine infusion Administer atropine Initiate transcutaneous pacing A patient with acute renal failure experiences cardiac arrest. Just before the cardiac arrest, the patient's ECG showed peaked T waves. What might be causing the patient's cardiac arrest? ------CORRECT ANSWER--------------- Hyperkalemia A patient is admitted to the emergency department of a large medical center. The patient is diagnosed with STEMI. The facility is capable of administering PCI. To achieve the best outcomes, therapy should be administered to this patient within what time frame? ------CORRECT ANSWER---------------Within 90 minutes of the patient's first medical contact A patient is receiving ventilation support via bag-valve-mask (BVM) resuscitator. Capnography is established and a blood gas is obtained to evaluate the adequacy of the ventilations. Which arterial carbon dioxide (PaCO2) value signifies adequate ventilations? ------CORRECT ANSWER-- -------------35 to 45 mmHg
Which statements accurately reflect the recommendations for post-cardiac arrest patient care? ------CORRECT ANSWER---------------Arterial blood gases may be used to guide ventilation and oxygenation in the post-cardiac arrest patient. Perfusion should be assessed and maintained to ensure the best outcome for the post-cardiac arrest patient. A person suddenly collapses while sitting in the sunroom of a healthcare facility. A healthcare provider observes the event and hurries over to assess the situation. The healthcare provider performs which assessment first? ------CORRECT ANSWER---------------Rapid assessment A patient experiences cardiac arrest, and the resuscitation team initiates ventilations using a bag-valve-mask (BVM) resuscitator. The development of which condition during the provision of care would lead the team to suspect that improper BVM technique is being used? ------CORRECT ANSWER---------------Pneumothorax A resuscitation team is debriefing following a recent event. A patient experienced cardiac arrest, and advanced life support was initiated. The patient required the placement of an advanced airway to maintain airway patency. Which statement indicates that the team performed high-quality CPR? ------CORRECT ANSWER---------------"We provided chest compressions at a rate of 100 to 120 compressions per minute while giving 1 ventilation every 6 seconds without pausing compressions." Assessment of a patient reveals an ETCO2 level of 55 mmHg and an arterial oxygen saturation (SaO2) level of 88%. The provider would
The ETCO2 value is measured at the end of exhalation (point D), which represents the peak level. A patient is experiencing respiratory distress secondary to an exacerbation of chronic obstructive pulmonary disease. The patient begins to exhibit signs and symptoms of worsening respiratory function and experiences respiratory arrest. The team intervenes, delivering ventilations via BVM resuscitator. The team should provide ventilations at a rate of 1 ventilation: ------CORRECT ANSWER---------------Every 6 seconds A patient enters the emergency department in respiratory compromise. The team is monitoring the patient using capnography and identifies that ETCO2 levels are initially 33 mmHg and later 40 mmHg. From these readings, the team identifies that the patient is progressing in what stage of respiratory compromise? ------CORRECT ANSWER---------------Respiratory Distress A patient is in cardiac arrest. The underlying cause is thought to be opioid toxicity. Which statement accurately describes the use of naloxone for this patient? ------CORRECT ANSWER---------------Naloxone should be administered as soon as possible but is not a priority over high-quality CPR and AED use. A patient in the telemetry unit is receiving continuous cardiac monitoring. The patient has a history of myocardial infarction. The patient's ECG rhythm strip is shown in the following figure. The provider interprets this strip as indicating which arrhythmia? ------CORRECT ANSWER--------------- Third-degree AV block
A patient with dyspnea, inadequate blood pressure and a change in mental status arrives at the emergency department. The healthcare team completes the necessary assessments and begins to care for the patient, including initiating cardiac monitoring and pulse oximetry; providing supplemental oxygen and ensuring adequate ventilation; and obtaining vascular access. The team reviews the patient's ECG rhythm strip, as shown in the following figure. Which agent would the team most likely administer? ------CORRECT ANSWER---------------Atropine 1 mg every 3 to 5 minutes A patient comes to the emergency department complaining of palpitations and "some shortness of breath." Cardiac monitoring is initiated and reveals the following ECG rhythm strip. The provider interprets this strip as indicating which arrhythmia? ------CORRECT ANSWER---------------Atrial flutter The ECG rhythm strip of a patient who arrived in the emergency department complaining of dizziness, syncope and shortness of breath reveals sinus bradycardia. When reviewing the patient's medication history, the healthcare provider identifies which agent(s) as a potential cause of the patient's current condition? ------CORRECT ANSWER---------------Verapamil Digoxin Metoprolol A patient with bradycardia and signs of hemodynamic compromise does not respond to atropine. Which interventions could the healthcare provider use next? ------CORRECT ANSWER---------------Transcutaneous pacing Epinephrine or dopamine infusion A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a narrow-complex supraventricular tachyarrhythmia. The patient
initiated within what time frame? ------CORRECT ANSWER--------------- Within 1 hour of the patient's arrival Which statement accurately reflects the management of cardiac arrest in a pregnancy of 26 weeks' gestation? ------CORRECT ANSWER--------------- Resuscitative cesarean delivery (RCD) should be performed within 5 minutes from the time of arrest. A 28-year-old pregnant patient who resides in transitional housing presents to the emergency department with complaints of feeling feverish and very faint. The patient tells the emergency nurse that she does not know when she became pregnant. Upon palpation, the fundus is not at or above the umbilicus. The patient's condition quickly deteriorates and she goes into cardiac arrest. If available and able to be used without impeding or delaying the resuscitation effort, what diagnostic tool could be used to guide decision-making in the care of this patient? ------CORRECT ANSWER------- --------Point-of-care ultrasound (POC-US_ What is the priority intervention for a patient with a narrow-complex tachycardia (160 bpm) and a blood pressure of 72/48 mmHg? ------ CORRECT ANSWER---------------Perform immediate synchronized cardioversion Cardiac monitoring reveals a tachyarrhythmia. The patient is hemodynamically stable and has a regular heart rate ranging from 120 to 135 beats per minute. Which statements by the patient could the team interpret as contributing to the tachyarrhythmia? ------CORRECT ANSWER- --------------"I've been vomiting for the past 2 days from a gastrointestinal bug." "I've been so anxious lately because I just lost my job."
"I've had a terrible cold with a horrible cough for the past week and today I developed a fever." A patient is in cardiac arrest. The cardiac monitor shows asystole. In addition to providing continuous high-quality CPR, what is the other priority intervention for this patient? ------CORRECT ANSWER--------------- Administering epinephrine as early as possible A 42-year-old woman presents to the emergency department with complaints of fatigue, shortness of breath, back pain and nausea. A 12- lead ECG is obtained and shows ST-segment depression in leads II, III, and aVF and intermittent runs of nonsustained ventricular tachycardia. Cardiac serum markers are elevated. These findings suggest which condition? ------CORRECT ANSWER---------------High-risk non-ST-segment elevation ACS (NSTE-ACS) What is the correct technique for performing left uterine displacement (LUD) for a pregnant patient in cardiac arrest whose fundus is at or above the umbilicus? ------CORRECT ANSWER---------------Position yourself on the patient's left side. Reach across the patient, place both hands on the right side of the uterus and pull the uterus to the left and up. Which statements accurately reflect the recommendations for post-cardiac arrest neuroprognostication? ------CORRECT ANSWER--------------- Decision-making related to the continuation or withdrawal of life-sustaining treatments should be delayed until 72 hours after return of spontaneous circulation (ROSC) and following return to normothermia. Post-cardiac arrest neuroprognostication should be multimodal.
indicating which arrhythmia? ------CORRECT ANSWER---------------Atrial flutter A healthcare provider initiates ventilations to ensure adequate breathing and oxygenation. While ventilations are being performed, capnography is established to evaluate the adequacy of the ventilations. The healthcare provider determines that ventilations are adequate based on which end- tidal carbon dioxide (ETCO2) value? ------CORRECT ANSWER--------------- 35 - 45 mmHg A healthcare provider is establishing cardiac monitoring using a five- electrode system. The healthcare provider demonstrates proper use of the system by placing the green electrode in which location? ------CORRECT ANSWER---------------Lower right abdomen A patient with suspected acute coronary syndromes (ACS) is placed on a cardiac monitor. The patient is complaining of dyspnea and is given supplemental oxygen. The provider determines that the supplemental oxygen dose is correct based on which SaO2 level? ------CORRECT ANSWER---------------95% A patient's capnogram reveals the following waveform. Which segment would the healthcare provider interpret as reflecting the beginning of exhalation? ------CORRECT ANSWER---------------A-B (the flat line before a sharp rise towards the peaked plateau) Assessment of a patient in the emergency department reveals that the patient is experiencing respiratory compromise. From the assessment, the team identifies that the patient is in the earliest stage of this condition.
Which stage would this be? ------CORRECT ANSWER--------------- Respiratory distress After cardiac arrest and successful resuscitation, the patient has a return of spontaneous circulation. The patient is unable to follow verbal commands. Targeted temperature management is initiated. Which method(s) would be appropriate for the resuscitation team to use? ------CORRECT ANSWER---- -----------Giving ice-cold IV fluid bolus Applying cooling blankets Using an endovascular catheter A patient with a suspected stroke arrives at the emergency department at 7:10 p.m. The stroke team ensures that a comprehensive neurologic assessment using the National Institutes of Health Stroke Scale (NIHSS) is completed and that brain imaging is performed by which time? - ----- CORRECT ANSWER---------------7:30pm A 30-year-old patient has been brought to the emergency department in cardiac arrest. The cardiac monitor shows the following rhythm. Interpretation of this rhythm would suggest which of the following as a possible precipitating factor? (EKG strip shows ventricular fibrillation) ------CORRECT ANSWER------------ ---Electrocution A patient presents to the emergency department with suspected ACS. Electrocardiogram and cardiac biomarkers show the patient has ST- segment elevation myocardial infarction (STEMI). Physical examination reveals signs of left ventricular dysfunction. Which finding(s) would support this? ------CORRECT ANSWER---------------Crackles
the patient is experiencing a condition that mimics a stroke? ------ CORRECT ANSWER---------------Hypoglycemia A patient's ECG reveals a tachyarrhythmia. The patient is hemodynamically stable and has a heart rate ranging from 120 to 135 beats per minute. Based on the findings of the secondary assessment, which statement(s) by the patient would the team interpret as a possible contributing cause? ------ CORRECT ANSWER---------------"I've been so anxious lately because I just lost my job." "I've had a terrible cold with a horrible cough and fever the past week." "I've been vomiting for the past two days from a gastrointestinal bug." A resuscitation team is debriefing following a recent event. A patient experienced cardiac arrest, and advanced cardiac life support was initiated. The patient required the placement of an advanced airway to maintain airway patency. Which statement indicates that the team performed high- quality CPR? ------CORRECT ANSWER---------------"We delivered 1 ventilation every 6 seconds and chest compressions at a rate of 100 to 120 compressions per minute." A patient is experiencing respiratory distress secondary to an exacerbation of chronic obstructive pulmonary disease. The patient begins to exhibit signs and symptoms of worsening respiratory function and experiences respiratory arrest. The team intervenes, delivering ventilations via BVM resuscitator. The team would deliver 1 ventilation at which interval? ------ CORRECT ANSWER---------------Every 5-6 seconds A patient with a diagnosis of ACS is experiencing cardiogenic shock. Which adjunct therapy would be contraindicated? ------CORRECT ANSWER-------- -------β-Blockers
A patient with acute renal failure experiences cardiac arrest. Just before the cardiac arrest, the patient's ECG showed peaked T waves. What might be causing the patient's cardiac arrest? ------CORRECT ANSWER--------------- Hyperkalemia Cardiac monitoring of a patient in cardiac arrest reveals ventricular fibrillation. What intervention would the team perform next? ------CORRECT ANSWER---------------Administer one shock A patient is brought to the emergency department by their spouse. The spouse says, "I think it's a stroke." The stroke team assesses the patient using the National Institutes of Health Stroke Scale (NIHSS). Which area(s) would the team include in this assessment? ------CORRECT ANSWER------ ---------Visual function Language deficits Level of conciousness A 20-year-old man with respiratory depression is brought to the emergency department by his parents. The parents state that "[They] found him at home with various needles and syringes around him, but [they] have no idea what he took." Opioid overdose is suspected, and an initial dose of naloxone is administered at 10 p.m. The patient does not respond to this initial dose. The team would expect to administer a second dose after how many minutes? ------CORRECT ANSWER---------------4 minutes A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a narrow-complex supraventricular tachyarrhythmia. The patient
strip as indicating which arrhythmia? ------CORRECT ANSWER--------------- Third-degree AV Block A patient with an ischemic stroke arrives at the emergency department at 2 a.m. The patient's symptoms started about 12:30 a.m. After completing the necessary assessments, the healthcare team diagnoses an ischemic stroke, and the patient is determined to be a candidate for fibrinolytic therapy. To achieve the best outcomes, the team should initiate therapy for this patient no later than by which time? ------CORRECT ANSWER----------- ----3:00am A patient is brought into the emergency department with a suspected opioid overdose. The patient is in cardiac arrest. Which action would be the team's priority? ------CORRECT ANSWER---------------Initiating high-quality CPR A patient enters the emergency department in respiratory compromise. The team is monitoring the patient using capnography and identifies that ETCO2 levels are initially 33 mmHg and later 40 mmHg. From these readings, the team identifies that the patient is progressing in what stage of respiratory compromise? ------CORRECT ANSWER---------------Respiratory distress A patient with STEMI is experiencing chest pain that is refractory to sublingual nitroglycerin. Intravenous nitroglycerin is prescribed. When administering this medication, it would be titrated to maintain which systolic blood pressure? ------CORRECT ANSWER---------------90 mmHg A person suddenly collapses while sitting in the sunroom of a healthcare facility. A healthcare provider observes the event and hurries over to
assess the situation. The healthcare provider performs which assessment first? ------CORRECT ANSWER---------------Rapid assessment Assessment of a patient reveals an ETCO2 level of 55 mmHg and an arterial oxygen saturation (SaO2) level of 88%. The provider would interpret these findings as indicative of which condition? ------CORRECT ANSWER---------------Respiratory failure A 40-year-old patient in the waiting room of the primary care provider's office approaches a staff member and says, "I'm having really severe, crushing chest pain that is moving to both my arms." The patient is diaphoretic and dyspneic. Which action would be appropriate for the staff member to take? ------CORRECT ANSWER---------------Activate EMS A patient has experienced return of spontaneous circulation (ROSC) after cardiac arrest. The healthcare team is conducting a secondary assessment to determine the possible cause of the patient's cardiac arrest. The history reveals that before the arrest, the patient exhibited jugular venous distension, cyanosis, apnea and hyper-resonance on percussion. The patient was also difficult to ventilate during the response. The team would most likely suspect which condition as the cause? ------CORRECT ANSWER---------------Tension pneumothorax The stroke team is assessing a patient with a suspected stroke. The patient is alert and able to carry on a conversation, although the patient has difficulty getting the words out. Testing confirms that the patient has had an ischemic stroke. Based on the patient's medical history, a history of which arrhythmia would alert the team to the patient's increased risk for stroke? -- ----CORRECT ANSWER---------------Atrial fibrillation
