ACLS Post Test
ACLS Post Test
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termine whether is pale. When you arrive at the patient's side, you confirm
she has a pulse. that she is unresponsive. Your best action in this situation
will be to:
A. Open her airway and give two breaths.
B. Apply an automated external defibrillator (AED).
C. Assess breathing and determine whether she has a
pulse.
D. Prepare the necessary equipment to insert an ad-
vanced airway.
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8. B. Vagal maneu- Assuming there are no contraindications, which of the
vers following can be performed as an initial intervention for a
stable but symptomatic patient with the rhythm shown?
A. Defibrillation
B. Vagal maneuvers
C. Administration of intravenous (IV) diltiazem
D. Administration of IV epinephrine
12.
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A. Prepare An 84-year-old man presents with an acute onset of al-
for transcuta- tered mental status. The cardiac monitor shows the rhythm
neous pacing. here. The patient's BP is 58/30 mm Hg andhis ventilatory
rate is 14 breaths/min. His skin is cool, moist, and pale. His
blood oxygen saturation level (SpO2) on room air is 95%.
An IV has been established.
13. B. Obtaining a Paramedics are on the scene with a 55-year-old man who
12-lead is complaining of severe chest discomfort. He describes
electrocardio- his discomfort as a "heavy pressure" in the middle of his
gram (ECG) chest that has been present for about 1 hour.
Which of the following actions performed at the scene is
most likely to reduce subsequent treatment delays at the
hospital?
A. Giving aspirin
B. Obtaining a 12-lead electrocardiogram (ECG)
C. Assessing vital signs and oxygen saturation
D. Assessing the patient's degree of discomfort
14. B. Establishing Paramedics are on the scene with a 55-year-old man who
IV access and is complaining of severe chest discomfort. He describes
giving aspirin. his discomfort as a "heavy pressure" in the middle of his
chest that has been present for about 1 hour.
The patient rates his discomfort 9/10. His BP is 126/72 mm
Hg and ventilations 14 breaths/min. His SpO2 on room air
is 95%. The cardiac monitor shows a sinus rhythm at 60
beats/min. Immediate management of this patient should
include:
A. Giving aspirin and NTG.
B. Establishing IV access and giving aspirin.
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C. Administering oxygen and establishing IV access.
D. Administering oxygen and obtaining a targeted history.
15. A. 10 minutes Paramedics are on the scene with a 55-year-old man who
is complaining of severe chest discomfort. He describes
his discomfort as a "heavy pressure" in the middle of his
chest that has been present for about 1 hour.
Current guidelines recommend obtaining an initial 12-lead
ECG within ____ of patient contact when an acute coro-
nary syndrome (ACS) is suspected.
A. 10 minutes
B. 30 minutes
C. 45 minutes
D. 60 minutes
16. D. STE, STD, nor- Paramedics are on the scene with a 55-year-old man who
mal or nondiag- is complaining of severe chest discomfort. He describes
nostic ECG his discomfort as a "heavy pressure" in the middle of his
chest that has been present for about 1 hour.
When the patient's 12-lead ECG is reviewed, the results
should be used to classify the patient into one of three
groups.Which of the following correctly reflects these cat-
egories?
A. ST elevation (STE), normal ECG, Q waves
B. Q waves, ST depression (STD), inconclusive ECG
C. STD, normal ECG, inconclusive ECG
D. STE, STD, normal or nondiagnostic ECG
17. C. STE in leads I, Paramedics are on the scene with a 55-year-old man who
aVL, and V2 to V6. is complaining of severe chest discomfort. He describes
his discomfort as a "heavy pressure" in the middle of his
chest that has been present for about 1 hour.
A 12-lead ECG has been obtained.
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18. B. V2, V3, and V4 Paramedics are on the scene with a 55-year-old man who
is complaining of severe chest discomfort. He describes
his discomfort as a "heavy pressure" in the middle of his
chest that has been present for about 1 hour.
To be considered significant, ECG findings, such as STE
or STD, need to be viewed in two or more contiguous
leads. Which of the following are contiguous leads?
A. V1, V4, and V5
B. V2, V3, and V4
C. III, aVF, and V1
D. I, II, III, and aVL
19. C. Anterolateral Paramedics are on the scene with a 55-year-old man who
is complaining of severe chest discomfort. He describes
his discomfort as a "heavy pressure" in the middle of his
chest that has been present for about 1 hour.
The patient's 12-lead ECG findings suggest a(n) _____
MI.
A. Posterior
B. Inferolateral
C. Anterolateral
D. Non-ST elevation
20. B. The patient Paramedics are on the scene with a 55-year-old man who
should be clas- is complaining of severe chest discomfort. He describes
sified as having his discomfort as a "heavy pressure" in the middle of his
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an ST elevation chest that has been present for about 1 hour.
MI (STEMI) and On the basis of the patient's 12-lead ECG findings:
should be eval- A. The patient should be classified as having a nondiag-
uated for imme- nostic ECG and discharged with follow-up instructions.
diate reperfusion B. The patient should be classified as having an ST eleva-
therapy. tion MI (STEMI) and should be evaluated for immediate
reperfusion therapy.
C. The patient should be classified as having a normal
ECG; serial ECGs should be obtained at 30-minute inter-
vals to detect the development of ST elevation.
D. The patient should be classified as having a non-ST
elevation ACS (NSTE-ACS) and should be admitted to a
monitored bed for further evaluation.
21. A. Aspirin and Paramedics are on the scene with a 55-year-old man who
NTG is complaining of severe chest discomfort. He describes
his discomfort as a "heavy pressure" in the middle of his
chest that has been present for about 1 hour.
Vascular access has been established. The patient's BP
is 130/70 mm Hg, his pulse is 60 beats/min, and his
ventilatory rate is 14 breaths/min. Assuming there are
nocontraindications for any of the following medications,
which of the following would be appropriate for this patient
at this time?
A. Aspirin and NTG
B. Aspirin and a nonsteroidal antiinflammatory drug
(NSAID)
C. An oral beta-blocker and an NSAID
D. Aspirin and a calcium channel blocker (CCB)
22. A. Is contraindi- Paramedics are on the scene with a 55-year-old man who
cated in hypoten- is complaining of severe chest discomfort. He describes
sive patients. his discomfort as a "heavy pressure" in the middle of his
chest that has been present for about 1 hour.
NTG has been ordered for administration to this patient.
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NTG:
A. Is contraindicated in hypotensive patients.
B. Should be administered via the IV route for maximum
benefit.
C. Should be used with caution in patients with anterior
infarction.
D. Should be given every 15 to 20 minutes until chest
discomfort is relieved.
23. C. Give a 250 mL Paramedics are on the scene with a 55-year-old man who
IV fluid bolus of is complaining of severe chest discomfort. He describes
normal saline. his discomfort as a "heavy pressure" in the middle of his
chest that has been present for about 1 hour.
The patient's chest discomfort was unrelieved after the
maximum recommended dosage of NTG tablets. Mor-
phine sulfate was ordered and a 4 mg dose was given IV.
The patient's BP is now 80/60 mm Hg and his skin is cool,
moist, and pale. His breath sounds are clear. You should:
A. Prepare a lidocaine infusion at 1 to 4 mg/min.
B. Prepare an epinephrine infusion at 2 mcg/min.
C. Give a 250 mL IV fluid bolus of normal saline.
D. Prepare a dopamine infusion at 2 to 10 mcg/kg/min.
24. A. Check for a Which of the following is not recommended when perform-
pulse immediate- ing defibrillation?
ly after defibrilla- A. Check for a pulse immediately after defibrillation to
tion to determine determine next steps.
next steps. B. Visually check and ensure that everyone is clear of the
patient before shock delivery.
C. Remove transdermal medication patches or ointment
from the patient's chest before the procedure.
D. All team members with the exception of the chest com-
pressor should clear the patient as the machine charges.
25. A. Older adults, Atypical symptoms of ACSs are more common in:
women, and dia- A. Older adults, women, and diabetic individuals.
betic individuals. B. Men, older adults, and individuals who have liver dis-
ease.
C. Women, diabetic individuals, and individuals who have
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liver disease.
D. Men, patients who have a history of coronary artery
disease, and patients who have a history of hypertension.
A. Defibrillate immediately.
B. Perform cardiopulmonary resuscitation (CPR) for 2 min-
utes and then prepare to defibrillate.
C. Place an advanced airway and then begin transcuta-
neous pacing.
D. Press the "Sync" control and deliver another synchro-
nized shock.
28. B. Using contin- The preferred method used to verify the proper placement
uous waveform of an endotracheal tube is:
capnography. A. Obtaining a chest radiograph.
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B. Using continuous waveform capnography.
C. Auscultating the presence of bilateral breath sounds.
D. Observing adequate chest rise with positive pressure
ventilation.
29. B. The team Which of the following is incorrect with regard to the events
leader should of a typical resuscitation effort?
encourage a A. The team leader should state his or her instructions one
respectful ex- at a time.
change of ideas. B. The team leader should encourage a respectful ex-
change of ideas.
C. Team members must be knowledgeable about current
resuscitation algorithms.
D. Team members should be encouraged to confer among
themselves throughout the resuscitation effort.
30. C. Epinephrine Which of the following statements is correct about the use
should be giv- of medications during cardiac arrest?
en as soon as A. Amiodarone is the drug of choice for cardiac arrest
feasible after the resulting from asystole.
onset of cardiac B. Lidocaine is contraindicated in cardiac arrest associat-
arrest associated ed with a shockable rhythm.
with a nonshock- C. Epinephrine should be given as soon as feasible after
able rhythm. the onset of cardiac arrest associated with a nonshockable
rhythm.
D. Vasopressin can be substituted for either the first or
second dose of epinephrine in the treatment of cardiac
arrest.
31. B. STE is present This 12-lead ECG is from a 50-year-old man complaining
in leads V1 to V4. of chest discomfort.
An anterior STE-
MI is suspected. Which of the following is true regarding this 12-lead ECG?
A. This 12-lead reveals no significant findings.
B. STE is present in leads V1 to V4. An anterior STEMI is
suspected.
C. STE is present in leads I, aVR, and V6. A lateral STEMI
is suspected.
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D. STD is present in leads III and aVF. An inferior STEMI
is suspected.
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You have started an IV and placed the patient on the
cardiac monitor, which reveals the following rhythm:
41. B. 40% to 60% A BMD that is used with supplemental oxygen set at a flow
rate of 10 to 15 L/min delivers about _____oxygen to the
patient when a reservoir is not used.
A. 21%
B. 40% to 60%
C. 60% to 90%
D. 90% to 100%
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C. Administer 12 mg of adenosine rapid IV push.
D. Administer diltiazem 0.25 mg/kg IV over 2 minutes.
44. C. The patient If a patient wakes from sleep or is found with symptoms of
was last known a stroke, the time of onset of symptoms is defined as the
to be symp- time:
tom-free. A. Of awakening.
B. The patient retired for sleep.
C. The patient was last known to be symptom-free.
D. The patient was last seen by a health care professional.
46. A. CPR and defib- A 49-year-old man is found unresponsive, not breathing,
rillation. and pulseless. The cardiac monitor reveals monomorphic
ventricular tachycardia. The most important actions in the
management of this patient are:
A. CPR and defibrillation.
B. Defibrillation and resuscitation medications.
C. CPR and prompt insertion of an advanced airway.
D. Synchronized cardioversion and resuscitation medica-
tions.
49. B. Make sure What precautions should be taken before giving NTG?
there is no ev- A. Make sure the patient's heart rate is at least 70
idence of a beats/min.
right ventricular B. Make sure there is no evidence of a right ventricular
infarction. infarction.
C. Make sure the patient's systolic BP is more than 140
mm Hg.
D. Make sure the patient has not used a diuretic or an
antihypertensive medication in the past 24 hours.
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