ACLS Exam Version A,B and ACLS: FINAL TEST - Advanced Cardiovascular Life Support (50 ques | Exams Nursing | Docsity (2024)

Download ACLS Exam Version A,B and ACLS: FINAL TEST - Advanced Cardiovascular Life Support (50 ques and more Exams Nursing in PDF only on Docsity! 1 ACLS Exam Version A,B and ACLS: FINAL TEST - Advanced Cardiovascular Life Support (50 questions each) With Most Verified Solutions for Best Score> Advanced Cardiovascular Life Support Exam Version A (50 questions)2024. . Please do not mark on this exam. Record the best answer on the separate answer sheet. 1. You find an unresponsive patient who is not breathing. After activating the emergency response system, you determine that there is no pulse. What is your next action? A. Open the airway with a head tilt–chin lift. B. Administer epinephrine at a dose of 1 mg/kg. C. Deliver 2 rescue breaths each over 1 second. D. Start chest compressions at a rate of at least 100/min. 2. 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 is most important now? A. PETCO2 B. Chest x-ray C. Laboratory testing D. Obtaining a 12-lead ECG 3. What is the preferred method of access for epinephrine administration during cardiac arrest in most patients? A. Intraosseous B. Endotracheal C. Central intravenous D. Peripheral intravenous 4. An activated AED does not promptly analyze the rhythm. What is your next action? A. Begin chest compressions. B. Discontinue the resuscitation attempt. C. Check all AED connections and reanalyze. D. Rotate AED electrodes to an alternate position. 1 1 14.For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who originally presented in ventricular fibrillation. After the first shock, the ECG screen displayed asystole, which has persisted despite 2 doses of epinephrine, a fluid bolus, and high-quality CPR. What is your next treatment? A. Apply a transcutaneous pacemaker. B. Administer 1 mg of intravenous atropine. C. Administer 40 units of intravenous vasopressin. D. Consider terminating resuscitative efforts after consulting medical control. 15. Which is a safe and effective practice within the defibrillation sequence? A. Stop chest compressions as you charge the defibrillator. B. Be sure oxygen is not blowing over the patient’s chest during the shock. C. Assess for the presence of a pulse immediately after the shock. D. Commandingly announce “clear” after you deliver the defibrillation shock. 16.During your assessment, your patient suddenly loses consciousness. After calling for help and determining that the patient is not breathing, you are unsure whether the patient has a pulse. What is your next action? A. Leave and get an AED. B. Begin chest compressions. C. Deliver 2 quick ventilations. D. Check the patient’s mouth for the presence of a foreign body. 17. What is an advantage of using hands-free defibrillation pads instead of defibrillation paddles? A. Hands-free pads deliver more energy than paddles. B. Hands-free pads increase electrical arc. C. Hands-free pads allow for a more rapid defibrillation. D. Hands-free pads have universal adaptors that can work with any machine. 18.What action is recommended to help minimize interruptions in chest compressions during CPR? A. Continue CPR while charging the defibrillator. B. Perform pulse checks immediately after defibrillation. C. Administer IV medications only when delivering breaths. D. Continue to use an AED even after the arrival of a manual defibrillator. 19. Which action is included in the BLS Survey? A. Early defibrillation B. Advanced airway management C. Rapid medication administration D. Preparation for therapeutic hypothermia 1 20.Which drug and dose are recommended for the management of a patient in refractory ventricular fibrillation? A. Atropine 2 mg B. Amiodarone 300 mg C. Vasopressin 1 mg/kg D. Dopamine 2 mg/kg per minute 21. What is the appropriate interval for an interruption in chest compressions? A. 10 seconds or less B. 10 to 15 seconds C. 15 to 20 seconds D. Interruptions are never acceptable 22. Which of the following is a sign of effective CPR? A. PETCO2 ≥10 mm Hg B. Measured urine output of 1 mL/kg per hour C. Patient temperature >32°C (89.6°F) D. Diastolic intra-arterial pressure <20 mm Hg 23.What is the primary purpose of a medical emergency team (MET) or rapid response team (RRT)? A. Identifying and treating early clinical deterioration B. Rapidly intervening with patients admitted through emergency department triage C. Responding to patients during a disaster or multiple-patient situation D. Responding to patients after activation of the emergency response system 24.Which action improves the quality of chest compressions delivered during a resuscitation attempt? A. Observe ECG rhythm to determine depth of compressions. B. Do not allow the chest to fully recoil with each compression. C. Compress the upper half of the sternum at a rate of 150 compressions per minute. D. Switch providers about every 2 minutes or every 5 compression cycles. 25.What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse rate of 80/min? A. 1 breath every 3 to 4 seconds B. 1 breath every 5 to 6 seconds C. 2 breaths every 5 to 6 seconds D. 2 breaths every 6 to 8 seconds 1 26.A patient presents to the emergency department with new onset of dizziness and fatigue. On examination, the patient’s heart rate is 35/min, the blood pressure is 70/50 mm Hg, the respiratory rate is 22 breaths/min, and the oxygen saturation is 95%. What is the appropriate first medication? A. Atropine 0.5 mg B. Oxygen 12 to 15 L/min C. Epinephrine 0.5 mg D. Aspirin 160 mg chewed 27.A patient presents to the emergency department with dizziness and shortness of breath with a sinus bradycardia of 40/min. The initial atropine dose was ineffective, and your monitor/defibrillator is not equipped with a transcutaneous pacemaker. What is the appropriate dose of dopamine for this patient? A. 2 to 10 mg/min B. 2 to 10 mcg/kg per minute C. 10 to 15 mg/min D. 10 to 15 mcg/kg per minute 28.A patient has sudden onset of dizziness. The patient’s heart rate is 180/min, blood pressure is 110/70 mm Hg, respiratory rate is 18 breaths/min, and pulse oximetry reading is 98% on room air. The lead II ECG is shown below: What is the next appropriate intervention? A. Vagal maneuvers B. Metoprolol 5 mg IV C. Adenosine 6 mg IV D. Normal saline 1 L bolus 1 38.What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in place? A. 4 to 6 breaths per minute B. 8 to 10 breaths per minute C. 12 to 14 breaths per minute D. 16 to 18 breaths per minute 39.A 62-year-old man in the emergency department says that his heart is beating fast. He says he has no chest pain or shortness of breath. The blood pressure is 142/98 mm Hg, the pulse is 200/min, the respiratory rate is 14 breaths/min, and pulse oximetry is 95% on room air. What intervention should you perform next? A. Obtain a 12-lead ECG. B. Give 150 mg of amiodarone. C. Administer 160 mg of aspirin. D. Administer 6 mg of adenosine. 40.You are evaluating a 48-year-old man with crushing substernal chest pain. The patient is pale, diaphoretic, cool to the touch, and slow to respond to your questions. The blood pressure is 58/32 mm Hg, the heart rate is 190/min, the respiratory rate is 18 breaths/min, and the pulse oximeter is unable to obtain a reading because there is no radial pulse. The lead II ECG displays a regular wide-complex tachycardia. What intervention should you perform next? A. Procedural sedation B. 12-lead ECG C. Amiodarone administration D. Synchronized cardioversion 41. What is the initial priority for an unconscious patient with any tachycardia on the monitor? A. Review the patient’s home medications. B. Evaluate the breath sounds. C. Determine whether pulses are present. D. Administer sedative drugs. 42. Which rhythm requires synchronized cardioversion? A. Unstable supraventricular tachycardia B. Atrial fibrillation C. Sinus tachycardia D. NSR on monitor but no pulse 1 43.What is the recommended second dose of adenosine for patients in refractory but stable narrow-complex tachycardia? A. 3 mg B. 6 mg C. 9 mg D. 12 mg 44.What is the usual post–cardiac arrest target range for PETCO2 when ventilating a patient who achieves return of spontaneous circulation (ROSC)? A. 30 to 35 mm Hg B. 35 to 40 mm Hg C. 40 to 45 mm Hg D. 45 to 50 mm Hg 45.Which condition is a contraindication to therapeutic hypothermia during the post–cardiac arrest period for patients who achieve return of spontaneous circulation ROSC? A. Initial rhythm of asystole B. Responding to verbal commands C. Patient age greater than 60 years D. Desire to provide coronary reperfusion (eg, PCI) 46.What is the potential danger of using ties that pass circumferentially around the patient’s neck when securing an advanced airway? A. May interfere with effective ventilation B. Places the patient’s cervical spine at risk C. Obstruction of venous return from the brain D. Does not adequately secure the airway device 47.What is the most reliable method of confirming and monitoring correct placement of an endotracheal tube? A. 5-point auscultation B. Colorimetric capnography C. Continuous waveform capnography D. Use of esophageal detection devices 48.What is the recommended IV fluid (normal saline or Ringer’s lactate) bolus dose for a patient who achieves ROSC but is hypotensive during the post–cardiac arrest period? A. 250 to 500 mL B. 500 to 1000 mL C. 1 to 2 L D. 2 to 3 L 1 49.What is the minimum systolic blood pressure one should attempt to achieve with fluid, inotropic, or vasopressor administration in a hypotensive post–cardiac arrest patient who achieves ROSC? A. 90 mm Hg B. 85 mm Hg C. 80 mm Hg D. 75 mm Hg 50. What is the first treatment priority for a patient who achieves ROSC? A. Coronary reperfusion B. Therapeutic hypothermia C. Maintaining blood glucose <185 mg/dL D. Optimizing ventilation and oxygenation Advanced Cardiovascular Life Support Exam Version B (50 questions).2024 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. Perform pulse checks only after defibrillation. B. Continue CPR while the defibrillator is charging. C. Administer IV medications only when breaths are given. D. Continue to use AED even after the arrival of a 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 of a pulse, you initiate CPR with adequate bag-mask ventilation. The patient’s lead II ECG appears below. What is your next action? 1 10. What is the recommended next step after a defibrillation attempt? A. Open the patient’s airway. B. Determine if a carotid pulse is present. C. Check the ECG for evidence of a rhythm. D. Begin CPR, starting with chest compressions. 11. Which of the following is the recommended first choice for establishing intravenous access during the attempted resuscitation of a patient in cardiac arrest? A. Subclavian vein B. Antecubital vein 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. 1 mg B. 1 mg/kg C. 1 mEq/kg D. 300 mg 13. IV/IO drug administration during CPR should be A. given rapidly during compressions. B. administered slowly during the pause for a pulse check. C. given by infusion. D. given before any defibrillation attempts. 14. How often should the team leader switch chest compressors during a resuscitation attempt? A. Every minute B. Every 2 minutes C. Every 3 minutes D. Every 4 minutes 15. Which finding is a sign of ineffective CPR? A. PETCO2 <10 mm Hg B. Patient temperature >32°C (89.6°F) C. Diastolic intra-arterial pressure ≥20 mm Hg D. Measured patient urine output of 1 mL/kg per hour 1 1 16. A team leader orders 1 mg of epinephrine, and a team member verbally acknowledges when the medication is administered. What element of effective resuscitation team dynamics does this represent? A. Clear messages B. Knowing one’s limitations C. Closed-loop communication D. Clear roles and responsibilities 17. How long should it take to perform a pulse check during the BLS Survey? A. 1 to 5 seconds B. 5 to 10 seconds C. 10 to 15 seconds D. 15 to 20 seconds 18. Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive and notice that he is taking agonal breaths. What is the next step in your assessment and management of this patient? A. Apply the AED. B. Check the patient’s pulse. C. Open the patient’s airway. D. Check for the presence of breathing. 19. Which treatment or medication is appropriate for the treatment of a patient in asystole? A. Atropine B. Epinephrine C. Defibrillation D. Transcutaneous pacing 20. An AED advises a shock for a pulseless patient lying in snow. What is the next action? A. Place a backboard beneath the patient and administer the shock. B. Move the patient off the snow to bare ground and deliver the shock. C. Remove any snow beneath the patient and then administer the shock. D. Administer the shock immediately and continue as directed by the AED. 21. What is the minimum depth of chest compressions for an adult in cardiac arrest? A. 1 inch B. 1½ inches C. 2 inches D. 2½ inches 1 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 rate is 16 breaths/min, and the pulse oximetry reading is 96%. The lead II ECG is displayed below. A patent peripheral IV is in place. What is the next action? A. Acquisition of a 12-lead ECG B. Vagal maneuvers C. Procedural sedation D. Immediate defibrillation 28. 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 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What is the next action? A. Administer an additional dose of aspirin. B. Administer an additional nitroglycerin tablet. C. Administer high-flow oxygen via an oxygen mask. D. Administer 2 to 4 mg of morphine by slow IV bolus. 29. 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/min and 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 is the next action after establishing an IV and obtaining a 12-lead ECG? A. Administration of IV epinephrine B. Seeking expert consultation C. Procedural sedation D. Synchronized cardioversion 30. A postoperative patient in the ICU reports new chest pain. What actions have the highest priority? A. Administer an IV fluid bolus and obtain arterial blood gas. B. Start dopamine at 2 mcg/kg per minute and obtain a chest x-ray. C. Send blood to the laboratory for chemistry and cardiac enzymes. 1 D. Obtain a 12-lead ECG and administer aspirin if not contraindicated. 1 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 II ECG is below. After you start an IV, what is the next action? A. Give an IV fluid bolus. B. Give atropine and monitor for changes in mental status. C. Start an epinephrine infusion and titrate to patient response. D. Conduct a problem-focused history and physical examination. 32. What is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes? A. 2 to 4 mg B. 80 to 120 mg C. 160 to 325 mg D. 400 to 600 mg 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, and a heart rate of 190/min. The patient’s lead II ECG is displayed below. Which of the following terms best describes this patient? A. Sinus tachycardia B. Perfusing ventricular tachycardia C. Stable supraventricular tachycardia D. Unstable supraventricular tachycardia 1 39. A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the following lead II ECG rhythm: What is the appropriate next intervention? A. Defibrillation B. Amiodarone 150 mg IV C. Adenosine 6 mg IV push D. Synchronized cardioversion 40. A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm: What is the appropriate next intervention? A. Defibrillation B. Adenosine 6 mg IV push C. Epinephrine 1 mg IV push D. Synchronized cardioversion 41. What is the recommended energy dose for biphasic synchronized cardioversion of atrial fibrillation? A. 50 to 75 J B. 75 to 100 J C. 120 to 200 J D. 200 to 300 J 10 1 42. Which of the following is an acceptable method of selecting an appropriately sized oropharyngeal airway (OPA)? A. Estimate by using the size of the patient’s thumb. B. Estimate by using the formula Weight (kg)/8 + 2. C. Measure from the thyroid cartilage to the angle of the mandible. D. Measure from the corner of the mouth to the angle of the mandible. 43. Which is a contraindication to nitroglycerin administration in the management of acute coronary syndromes? A. Heart rate greater than 80/min B. Right ventricular infarction and dysfunction C. Phosphodiesterase inhibitor use more than 72 hours ago D. Systolic blood pressure greater than 100 mm Hg 44. What is the recommended initial intervention for managing hypotension in the immediate period after return of spontaneous circulation (ROSC)? A. Atropine bolus B. Administration of IV or IO fluid bolus C. Placement of a central line to monitor pulmonary wedge pressure D. Phenylephrine hydrochloride titrated to keep systolic blood pressure >100 mm Hg 45. Which is an appropriate and important intervention to perform for a patient who achieves ROSC during an out-of-hospital resuscitation? A. Initiate an antiarrhythmic infusion. B. Transport the patient to a facility capable of performing PCI. C. Replace any supraglottic airway with an endotracheal tube. D. Place a central venous catheter for hemodynamic monitoring. 46. What is the immediate danger of excessive ventilation during the post–cardiac arrest period for patients who achieve ROSC? A. Oxygen toxicity B. Pulmonary hypertension C. Decreased cerebral blood flow D. Ventilation/perfusion mismatch 47. What is the recommended target temperature range for achieving therapeutic hypothermia after cardiac arrest? A. 26C to 28C B. 29C to 31C C. 32C to 34C D. 35C to 37C 1 48. What is the recommended duration of therapeutic hypothermia after reaching the target temperature? A. 0 to 12 hours B. 12 to 24 hours 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? A. Potential oxygen toxicity B. Adverse hemodynamic effects C. Decrease in cerebral blood flow D. Increased intrathoracic pressure 50. What is the recommended dose of epinephrine for the treatment of hypotension in a post– cardiac arrest patient who achieves ROSC? A. 2 to 10 mg/min IV infusion B. 0.1 to 0.5 mcg/kg per minute IV infusion C. 1 mg IV push every 3 to 5 minutes D. 10 mg IV push every 3 to 5 minutes 12 1 management of this patient? - Correct answerB) Check the patient's breathing and pulse. 17. Which best describes the length of time it should take to perform a pulse check during the BLS assessment? - Correct answerB) 5 to 10 seconds 18. You instruct a team member to give 1 mg Atropine IV. Which is the best example of closed-loop communication? - Correct answerC) I'll draw up 1 mg of Atropine. 19. What is an effect of excessive ventilation? - Correct answerA) Decreased cardiac output. 20. If a team member is about to make a mistake during a resuscitation attempt, which best describes the action that the team leader or other team members should take? - Correct answerC) Address the team members immediately. 21. Which best describes this rhythm? - Correct answerA) Monomorphic ventricular tachycardia. 22. For STEMI patient, which best describes the recommended maximum goal time for emergency department door-to-balloon inflation time for percutaneous coronary intervention? - Correct answerD) 90 minutes. 23. Which is the maximum interval you should allow for an interruption in chest compressions? - Correct answerA) 10 seconds. 24. Which is the one way to minimize interruptions in chest compressions during CPR? - Correct answerD) Continue CPR while the defibrillator charges. 25. Which best describes an action taken by the team leader to avoid insufficiencies during a resuscitation attempt? - Correct answerC) Clearly delegate tasks. 26. Which is an acceptable method of selecting an appropriately sized oropharyngeal airway? - Correct answerA) Measure the corner of the mouth to the angle of the mandible. 27. You are evaluating a 58-year-old man with chest discomfort. His blood pressure is 92/50 mm Hg, his heart rate is 92/min, his nonlabored respiratory rate is 14 breaths/min, and his pulse oximetry reading is 97%. Which assessment step is most important now? - Correct answerC) Obtaining a 12-lead ECG. 28. A patient in respiratory distress and with a blood pressure of 70/50 mmHg presents with the lead IIECG rhythm shown here. Which is the appropriate treatment? - Correct answerB) Performing synchronized cardioversion. 1 29. During post-cardiac arrest care, which is the recommended duration of targeted temperature management after reaching the correct temperature range? - Correct answerB) At least 24 hours. 30. Three minutes into a cardiac resuscitation attempt, one member of your team inserts an endotracheal tube while another performs chest compressions. Capnography shows a persistent waveform and a PETCO2 of 8 mmHg. Which is the significance of this finding? - Correct answerA) Chest compressions may not be effective. 31. Which is the recommended oral dose of aspirin for a patient with a suspected acute coronary syndrome? - Correct answerC) 160 to 325 mg. 32. 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 answerA) Ask for a new task or role. 33. As the team leader, when do you tell the chest compressors to switch? - Correct answerB) About every 2 minutes. 34. You are performing chest compressions during an adult resuscitation attempt. Which rate should you use to perform the compressions? - Correct answerC) 100 to 120/min. 35. A patient is being resuscitated in a very noisy environment. A team member thinks he heard an order for 500 mg of amiodarone IV. Which is the best response? - Correct answerD) I have an order to give 500 mg of amiodarone IV. 36. A patient in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the first dose of adenosine. Which dose would you administer next? - Correct answerB) 12 mg. 37. A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm. Which is the appropriate treatment? - Correct answerC) Defibrillation 38. Which of these tests should be performed for a patient with suspected stroke within 25 minutes of hospital arrival? - Correct answerD) Noncontrast CT scan of the head. 39. What is the minimum systolic blood pressure one should attempt to achieve with fluid administration or vasoactive agents in a hypotensive post-cardiac arrest patient who achieves return of spontaneous circulation? - Correct answerD) 90 mm Hg. 40. You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm shown here, and the patient has no pulse. Another member of your team resumes chest compressions, and an IV is in place. What do you do next? - Correct answerC) Give epinephrine 1 mg IV. 1 41. Based on this patient's initial presentation, which condition do you suspect led to the cardiac arrest? - Correct answerA) Acute Coronary Syndrome. 42. In addition to defibrillation, which intervention should be performed immediately? - Correct answerC) Chest Compressions. 43. Despite 2 Defibrillation attempts, the patient remains in ventricular fibrillation. Which drug and dose should you administer first to this patient? - Correct answerA) Epinephrine 1 mg. 44. Despite the drug provided above and continued CPR, the patient remains in ventricular fibrillation. Which other drug should be administered next? - Correct answerD) Amiodarone 300 mg. 45. The patient has return of spontaneous circulation and is not able to follow commands. Which immediate post-cardiac arrest care intervention do you choose for this patient? - Correct answerA) Initiate targeted temperature management. 46. Which would you have done first if the patient had not gone into ventricular fibrillation? - Correct answerD) Performed synchronized cardioversion. 47. Based on this patient's initial assessment, which adult ACLS algorithm should you follow? - Correct answerB) Tachycardia. 48. The patient's pulse oximeter shows a reading of 84% on room air. Which initial action do you take? - Correct answerC) Apply oxygen. 49. After your initial assessment of this patient, which intervention should be performed next? - Correct answerA) Synchronized cardioversion. 50. If the patient became apneic and pulseless but the rhythm remained the same, which would take the highest priority? - Correct answerD) Perform defibrillation.