RQI 2025 ACLS HEALTHCARE PROVIDER WITH ANSWERS
1. Within the first 10 minutes, on the basis of the pa-
tient showing symptoms suggestive of myocardial
ischemia, what will your first actions include (if not
completed by EMS before arrival)?
o Obtain a 12-lead electrocardiogram (ECG)
o Administ...
1. Within the first 10 minutes, on the basis of the pa- o Obtain a
tient showing symptoms suggestive of myocardial 12-lead electro-
ischemia, what will your first actions include (if not cardiogram (ECG)
completed by EMS before arrival)? o Administer as-
o Obtain a 12-lead electrocardiogram (ECG) pirin and establish
o Administer a blood thinner IV access
o Administer aspirin and establish IV access o Activate the
o Activate the ST-segment elevation myocardial in- ST-segment eleva-
farction (STEMI) team tion myocardial in-
o If SPO2 is less than 90%, start oxygen farction (STEMI)
o Assess airway, breathing, and circulation (ABCs) team
o Administer epinephrine 1 mg IV o If SPO2 is less
o Consider nitroglycerin, morphine and a P2Y in- than 90%, start
hibitor oxygen
o Assess airway,
breathing, and cir-
culation (ABCs)
o Consider nitro-
glycerin, morphine
and a P2Y inhibitor
2. His initial vital signs are HR 120/min, BP 135/88 mm o Start oxygen at
Hg, RR 23/min, SpO2 87%, and temperature 37.3C. 4L/min via nasal
When considering oxygen saturation, what is your cannula
course of action?
o Intubate the patient immediately
o Administer albuterol nebulizer
o Do not start oxygen
o Start oxygen at 4L/min via nasal cannula
3. What additional question help you determine next o Do you take any
steps? medication?
o Do you take any medication? o Do you have any
o Do you have any allergies? allergies?
o When was the last time you went to the doctor? o When did the
o When did the symptoms start? symptoms start?
o Have you had any recent falls?
4.
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, RQI 2025 ACLS HEALTHCARE PROVIDER WITH ANSWERS
Your patient continues to say that he has chest dis- o Nitroglycer-
comfort. What treatment can you repeat as long as it ine sublingual or
is not contradicted by vital signs? translingual every
o Morphine sublingual every 1 to 3 minutes 3 to 5 minutes
o Morphine IV every 1 to 3 minutes
o Nitroglycerine sublingual or translingual every 3 to
5 minutes
o Nitroglycerine every 1 to 3 minutes
5. What is your interpretation of the patient's ECG trac- o Anterior ST-seg-
ing? ment elevation of
o Anterior ST-segment elevation of myocardial infarc- myocardial infarc-
tion (STEMI) tion (STEMI)
o Ventricular tachycardia
o Posterior ST-segment elevation myocardial infarc-
tion (STEMI)
o Normal sinus rhythm with premature ventricular
contractions
6. With the diagnosis of STEMI, what is the most proba- o Admission for
ble treatment? PCI or fibrinolysis
o Release to home
o Admission to an intensive car unit
o Admission for observation
o Admission for PCI or fibrinolysis
7. What is your goal for PCI when treating this patient? o First med-
o Door-to-balloon inflation time of 30 minutes ical contact-to-bal-
o First medical contact-to-balloon inflation time of 90 loon inflation time
minutes of 90 minutes
o Door-to-needle time of 90 minutes
o First medical contact-to-needle time of 30 minutes
8. The patient's vital signs show HR 92/min, RR 14/min, o Establish IV ac-
BP 130/86 mm Hg, SpO2 97%, and atrial fibrillation on cess
the monitor. What additional assessment and stabi- o Order an emer-
lization activities should be completed with the first gent CT scan or
10 minutes after the patient's arrival? MRI of the brain
o Establish IV access and review patient
o Order an emergent CT scan or MRI of the brain and history
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