1. D. Noncontrast CT scan of the head
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The correct answer is D. A critical decision point in the assessmentof the
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patient with acute stroke is the performance and interpretation of a non-
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contrast CT scan to differentiate ischemic from hemorrhagic stroke. The CT
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scan should be completed within 20 minutes of the patient's arrival in the
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emergency department and should be read within 45 minutes from
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emergencydepartment arrival. [ALS Provider Manual, Part 2: Preventing
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Arrest > Acute Stroke > Immediate Generaland Neurologic Assessment >
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Decision Point: He-morrhage or No Hemorrhage;page 57]: Which of these tests
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should be performedfor a patient with suspected stroke as soon as possible but no more
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than 20 minutesafter hospital arrival?
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A . 12-Lead ECG
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B. Cardiac enzymes nk
C. Coagulation studies nk
D. Noncontrast CT scan of the head nk nk nk nk nk
2. A. Monomorphic ventricular tachycardia
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The correct answer is A. This ECG rhythm strip shows a monomorphic
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ventricular tachycardia. [ACLS Provider Manual, Part 2: Preventing Arrest >
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Tachycardia: Stable and Unstable > Rhythms for UnstableTachycardia;
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k
pages75-76]: Which best describes this rhythm?
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A. Monomorphic ventricular tachycardia nk nk
B. Polymorphic ventricular tachycardia nk nk
C. Supraventricular tachycardia nk
D. Ventricular fibrillation nk
3. A. Measure from the corner of the mouth to the angle of the mandible
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The correct answer is A.To select the appropriate size for an
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,oropharyngealairway (OPA), place the OPA against the side of the face.When
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k
the flange
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of the OPA is at the corner of the mouth, the tip is at the angle of the
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mandible. Aproperly sized and inserted OPA results ni proper alignment
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withthe glottic opening. [ACLS Provider Manual, Part :3 High-Performance
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Teams
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> Respiratory Arrest > Basic Airway Adjuncts: OPA >Technique of
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O P A Insertion: pace 1071: Which is an acceptable method of selecting
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anappropriately sized oropharyngeal airway?
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, A. Measure from the corner of the mouth to the angle of the mandible nk nk nk nk nk nk nk nk nk nk nk nk
B. Measure from the thyroid cartilage to the bottom of the earlobe nk nk nk nk nk nk nk nk nk nk
C. Estimate by using the formula weight (kg)/8 + 2 nk nk nk nk nk nk nk nk
D.Estimate by using the size of the patient's finger nk nk nk nk nk nk nk nk
4. B. Give fibrinolytic therapy as soon as possibleand consider
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endovasculartherapy
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The correct answer is B. Administer fibrinolytic therapy within 3 hours from
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onset of symptoms, or within 4.5 hours in selected patients. Consider en-
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dovascular therapy, which can be administered up to 24 hours from onset
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ofsymptoms for patients with large vessel occlusion. [ACLS Provider
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Manual, Part 2: Preventing Arrest > Acute Stroke > Approach to Stroke Care >
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CriticalTime Periods; page 47]: You are caring for a patient with a suspected
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stroke whose symptoms started 2hours ago. The CTscan was normal, with no
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signs of hemorrhage.The patient does not have any contraindications to fibrinolytic
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therapy.Which treatment approach is best for this patient?
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A. Hold fibrinolytic therapy for 24 hours nk nk nk nk nk
B. Give fibrinolytic therapy as soon as possible and consider endovascular therapy
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C. Order an echocardiogram before fibrinolytic administration nk nk nk nk nk
D. Wait for the results of the MRI nk nk nk nk nk nk
5. D. Resume CPR, starting with chest compressions
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The correct answer is D. Follow each shock immediately with CPR,
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beginning with chest compressions. [ACLS ProviderManual, Part 1: Overview
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of ACLS > Systematic Approach > BLS Assessment; page 181: Which is the
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recommendednext step after a defibrillation attempt?
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A. Check the ECG for evidence of a rhythm nk nk nk nk nk nk nk
B. Open the patient's airway nk nk nk
C. Determine fi a carotid pulse is present nk nk nk nk nk nk
D. Resume CPR, starting with chest compressions nk nk nk nk nk
6. C. Agonal gasps nk nk
The correct answer is C. Agonal gasps are not normal breathing.They are
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a sign of cardiac arrest. Agonal gasps may be present ni the first minutes
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after sudden cardiac arrest. [ACLS Provider Manual, Part 3: High- Perfor-
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manceTeams > Cardiac Arrest:VF/pVT > Applying the Adult Cardiac Arrest
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Algorithm:VF/pVT Pathway > Caution: AgonalGasps; page 118]: Which of the n
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