ACLS test

Your patient is in cardiac arrest and has been intubated. To assess CPR quality, which should you do?

Monitor the patient’s PETCO 2

Which facility is the most appropriate EMS destination for a patient with sudden cardiac arrest who achieved return of spontaneous circulation in the field?

Coronary reperfusion-capable medical center

Which of the following signs is a likely indicator of cardiac arrest in an unresponsive patient?

Agonal gasps

To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag?

Once every 5 to 6 seconds

In addition to clinical assessment, which is the most reliable method to confirm and monitor correct placement of an endotracheal tube?

Continuous waveform capnography

You are caring for a patient with a suspected stroke whose symptoms started 2 hours ago. The CT scan was normal, with no signs of hemorrhage. The patient does not have any contraindications to fibrinolytic therapy. Which treatment approach is best for this patient?

Start fibrinolytic therapy as soon as possible

What is the recommended range from which a temperature should be selected and maintained constantly to achieve targeted temperature management after cardiac arrest?

32°C to 36°C

Which is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation?

300 mg

Which is the primary purpose of a medical emergency team or rapid response team?

Improving patient outcomes by identifying and treating early clinical deterioration

Which is the recommended next step after a defibrillation attempt?

Resume CPR, starting with chest compressions

EMS providers are treating a patient with suspected stroke. According to the Adult Suspected Stroke Algorithm, which critical action performed by the EMS team will expedite this patient’s care on arrival and reduce the time to treatment?

Alert the hospital

Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive. Which is the next step in your assessment and management of this patient?

Check the patient’s breathing and pulse

Which best describes the length of time it should take to perform a pulse check during the BLS Assessment?

5 to 10 seconds

You instruct a team member to give 0.5 mg atropine IV. Which response is an example of closed-loop communication?

"I’ll draw up 0.5 mg of atropine."

What is an effect of excessive ventilation?

Decreased cardiac output

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?

Address the team member immediately

For STEMI patients, which best describes the recommended maximum goal time for emergency department door-to-balloon inflation time for percutaneous coronary intervention?

90 minutes

Which is the maximum interval you should allow for an interruption in chest compressions?

10 seconds

Which is one way to minimize interruptions in chest compressions during CPR?

Continue CPR while the defibrillator charges

Which best describes an action taken by the team leader to avoid inefficiencies during a resuscitation attempt?

Clearly delegate tasks

Which is an acceptable method of selecting an appropriately sized oropharyngeal airway?

Measure from the corner of the mouth to the angle of the mandible

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?

Obtaining a 12-lead ECG

During post-cardiac arrest care, which is the recommended duration of targeted temperature management after reaching the correct temperature range?

At least 24 hours

Three minutes into a cardiac arrest 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 mm Hg. Which is the significance of this finding?

Chest compressions may not be effective

Which is the recommended oral dose of aspirin for a patient with a suspected acute coronary syndrome?

160 to 325 mg

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?

Ask for a new task or role

As the team leader, when do you tell the chest compressors to switch?

About every 2 minutes

You are performing chest compressions during an adult resuscitation attempt. Which rate should you use to perform the compressions?

C. 100 to 120/min

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 from the team member?

"I have an order to give 500 mg of amiodarone IV. Is this correct?"

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?

12mg

Which of these tests should be performed for a patient with suspected stroke within 25 minutes of hospital arrival?

Noncontrast CT scan of the head

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?

90mmHg

(Six part question 1 of 6) A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

1.Based on this patient’s initial presentation, which condition do you suspect led to the cardiac arrest?

Acute coronary syndrome

(Six part question 2 of 6) A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

2.In addition to defibrillation, which intervention should be performed immediately?

Chest compressions

(Six part question 3 of 6) A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

3.Despite 2 defibrillation attempts, the patient remains in ventricular fibrillation. Which drug and dose should you administer first to this patient?

Epinephrine 1 mg

(Six part question 4 of 6) A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

4.Despite the drug provided above and continued CPR, the patient remains in ventricular fibrillation. Which other drug should be administered next?

Amiodarone 300 mg

(Six part question 5 of 6) A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

5.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?

Initiate targeted temperature management

(Six part question 6 of 6) A 45-year-old man had coronary artery stents placed 2 days ago. Today, he is in severe distress and is reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation.

6.Which would you have done first if the patient had not gone into ventricular fibrillation?

Performed synchronized cardioversion

(4 part question 1 of 4) A 68-year-old woman presents with light-headedness, nausea, and chest discomfort. Your assessment finds her awake and responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready, and fast. You are unable to obtain a blood pressure. She has no obvious dependent edema, and her neck veins are flat. Her lung sounds are equal, with moderate rales present bilaterally. The cardiac monitor shows the rhythm seen here.

Photo shows ECG rhythm strip with ventricular tachycardia

1.Based on this patient’s initial assessment, which adult ACLS algorithm should you follow?

Tachycardia

(4 part question 2 of 4) A 68-year-old woman presents with light-headedness, nausea, and chest discomfort. Your assessment finds her awake and responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready, and fast. You are unable to obtain a blood pressure. She has no obvious dependent edema, and her neck veins are flat. Her lung sounds are equal, with moderate rales present bilaterally. The cardiac monitor shows the rhythm seen here.

2.The patient’s pulse oximeter shows a reading of 84% on room air. Which initial action do you take?

Apply oxygen

(4 part question 3 of 4) A 68-year-old woman presents with light-headedness, nausea, and chest discomfort. Your assessment finds her awake and responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready, and fast. You are unable to obtain a blood pressure. She has no obvious dependent edema, and her neck veins are flat. Her lung sounds are equal, with moderate rales present bilaterally. The cardiac monitor shows the rhythm seen here.

3.After your initial assessment of this patient, which intervention should be performed next?

Synchronized cardioversion

(4 part question 4 of 4) A 68-year-old woman presents with light-headedness, nausea, and chest discomfort. Your assessment finds her awake and responsive but ill-appearing, pale, and grossly diaphoretic. Her radial pulse is weak, thready, and fast. You are unable to obtain a blood pressure. She has no obvious dependent edema, and her neck veins are flat. Her lung sounds are equal, with moderate rales present bilaterally. The cardiac monitor shows the rhythm seen here.

4.If the patient became apneic and pulseless but the rhythm remained the same, which would take the highest priority?

Perform defibrillation

A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the lead II ECG rhythm shown here. Which is the appropriate treatment?

ECG shows unstable supraventricular tachycardia

Performing synchronized cardioversion

A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm. Which is the appropriate treatment?

ECG shows V-tach

Defibrillation

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. Which do you do next?

ECG shows Pulseless Electrical Activity

Give epinephrine 1 mg IV