ACLS Cardiac Arrest Final Exam Study Guide Questions and Answers
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Course
Cardiac Arrest
Institution
Cardiac Arrest
A patient in cardiac arrest experiences return of spontaneous circulation. As part of post-cardiac arrest care, the patient is receiving mechanical ventilation at an initial rate of 10 breaths/min and a fraction of inspired oxygen (FiO2) of 0.30. Which finding(s) would indicate the need for change ...
ACLS Cardiac Arrest Final Exam Study
Guide Questions and Answers
A patient in cardiac arrest experiences return of spontaneous circulation. As part of
post-cardiac arrest care, the patient is receiving mechanical ventilation at an initial rate
of 10 breaths/min and a fraction of inspired oxygen (FiO2) of 0.30. Which finding(s)
would indicate the need for change in the ventilator settings to optimize the patient's
ventilation and oxygenation? - Answer-ETCO2 55mmHg
PaCO2 48 mmHg
SaO2 90%
- Mechanical ventilation should be started at a rate of 10 breaths per minute and
adjusted as necessary to keep carbon dioxide levels in physiologic range (PaCO2
between 35 and 45 mmHg or monitored using ETCO2). The minimum fraction of
inspired oxygen necessary to maintain an SaO2 of 94% to 99% is used.
A 28-year-old pregnant patient who resides in transitional housing presents to the
emergency department with complaints of feeling feverish and very faint. The patient
tells the emergency nurse that she does not know when she became pregnant. Upon
palpation, the fundus is not at or above the umbilicus. The patient's condition quickly
deteriorates and she goes into cardiac arrest. If available and able to be used without
impeding or delaying the resuscitation effort, what diagnostic tool could be used to
guide decision-making in the care of this patient? - Answer-Point of care US
- Gestational age is an important consideration when determining the approach to a
pregnant patient in cardiac arrest. If the gestational age is not known and point-of-care
ultrasound is available and able to be performed without impeding or delaying the
resuscitation effort, it can be used to quickly estimate gestational age and guide
decision-making.
A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a
narrow-complex supraventricular tachyarrhythmia. The patient is not showing signs of
hemodynamic compromise. Which intervention would be initiated first if it does not delay
other interventions? - Answer-Vagal Maneuver
- For a patient who is not showing signs of hemodynamic compromise and is
experiencing a narrow-complex supraventricular tachyarrhythmia, vagal maneuvers are
attempted first. If ineffective, adenosine is given.
A patient is in cardiac arrest. The underlying cause is thought to be opioid toxicity.
Which statement accurately describes the use of naloxone for this patient? - Answer-
Naloxone should be administered as soon as possible but is not a priority over high-
quality CPR and AED use.
- High-quality CPR and AED use are the priority interventions for cardiac arrest caused
by suspected or known opioid toxicity. When opioid toxicity is the suspected or known
cause of cardiac arrest, naloxone should be administered as soon as possible without
disrupting or delaying high-quality CPR and AED use. The recommended dose of
, naloxone is 0.4 to 2 mg IV/IO/IM/IN/SC, repeated every 2 to 3 minutes as needed. A
continuous naloxone infusion may be considered if there is the potential for recurrence
of respiratory depression (for example, if the cause of the opioid toxicity was an
extended-release or long-acting opioid) but is not indicated in the immediate treatment
of suspected or known opioid toxicity.
For a patient with third-degree atrioventricular (AV) block and a blood pressure of 70/48
mmHg, what interventions should be considered? - Answer-Atropine
Dopamine infusion
Transcut. Pacing
- For a patient with third-degree atrioventricular (AV) block and signs of hemodynamic
compromise, first-line therapy is with atropine. Second-line therapies include
transcutaneous pacing and β-adrenergic agonists, such as dopamine. Second-line
therapies should be considered immediately if the patient has third-degree AV block.
Adenosine is not used in the treatment of bradyarrhythmia.
A 20-year-old man with respiratory depression is brought to the emergency department
by his parents. Opioid overdose is suspected, and an initial dose of naloxone is
administered at 10 p.m. The patient does not respond to this initial dose. The team
would expect to administer a second dose after how many minutes? - Answer-2-3
minutes
A patient is in cardiac arrest. The cardiac monitor shows asystole. In addition to
providing continuous high-quality CPR, what is the other priority intervention for this
patient? - Answer-Administer Epi ASAP
- For cardiac arrest with a non-shockable rhythm, epinephrine (1 mg IV/IO) should be
administered as early as possible and repeated every 3 to 5 minutes. Although inserting
an advanced airway may be considered for this patient, this is not a priority intervention.
Defibrillation and amiodarone are not appropriate interventions for asystole.
Which areas are evaluated using the National Institutes of Health Stroke Scale
(NIHSS)? - Answer-LOC
Facial Palsy
Orientation
Visual deficits
Language
- The National Institutes of Health Stroke Scale (NIHSS) evaluates level of
consciousness, best gaze, visual fields, facial palsy, motor function (arm and leg), limb
ataxia, sensation, language deficits and extinction and inattention.
The ECG rhythm strip of a patient who arrived in the emergency department
complaining of dizziness, syncope and shortness of breath reveals sinus bradycardia.
When reviewing the patient's medication history, the healthcare provider identifies which
agent(s) as a potential cause of the patient's current condition? - Answer-Metoprolol
Verapamil
Digoxin
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