ACLS Written Test Flashcards

Questions and Answers

What is your next action after finding an unresponsive patient who is not breathing and has no pulse?

Start chest compressions of at least 100 per minute.

What is the most important assessment step for a 58-year-old man with chest pain and low blood pressure?

Obtaining a 12 lead ECG.

What is the preferred method of access for epinephrine administration during cardiac arrest?

Peripheral IV.

What should you do if an AED does not promptly analyze a rhythm?

Begin chest compressions. Signup and view all the answers

What management step is your next priority after 2 minutes of CPR and no pulse?

Administer 1 mg of epinephrine. Signup and view all the answers

What should be your next action during a pause in CPR if you see a narrow complex rhythm on the monitor and the patient has no pulse?

Resume compressions. Signup and view all the answers

What is a common but sometimes fatal mistake in cardiac arrest management?

Prolonged interruptions in chest compressions. Signup and view all the answers

Which action is a component of high-quality chest compressions?

Allowing complete chest recoil. Signup and view all the answers

What action increases the chance of successful conversion of ventricular fibrillation?

Providing quality compressions immediately before a defibrillation attempt. Signup and view all the answers

Which situation best describes PEA?

Sinus rhythm without a pulse. Signup and view all the answers

What is the best strategy for performing high-quality CPR on a patient with an advanced airway in place?

Provide continuous chest compressions without pauses and 10 ventilations per minute. Signup and view all the answers

What does the presence of a waveform on the capnography screen and a PETCO2 of 8 mm Hg indicate during ventilation?

Chest compressions may not be effective. Signup and view all the answers

What does quantitative capnography in intubated patients allow for?

Monitoring CPR quality. Signup and view all the answers

What should you consider after 25 minutes of unsuccessful resuscitation of a patient with V-FIB?

Consider terminating resuscitative efforts after consulting medical control. Signup and view all the answers

What is a safe and effective practice within the defibrillation sequence?

Be sure oxygen is NOT blowing over the patient's chest during shock. Signup and view all the answers

What is your next action upon determining a patient suddenly loses consciousness and is not breathing?

Begin chest compressions. Signup and view all the answers

What is an advantage of using hands-free defibrillation pads instead of defibrillation paddles?

Hands-free allows for more rapid defibrillation. Signup and view all the answers

What action is recommended to help minimize interruptions in chest compressions during CPR?

Continue CPR while charging the defibrillator. Signup and view all the answers

Which action is included in the BLS survey?

Early defibrillation. Signup and view all the answers

Which drug and dose are recommended for the management of a patient in refractory V-FIB?

Amiodarone 300 mg. Signup and view all the answers

What is the appropriate interval for an interruption in chest compressions?

10 seconds or less. Signup and view all the answers

Which of the following is a sign of effective CPR?

PETCO2 = or > 10 mm Hg. Signup and view all the answers

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

Identifying and treating early clinical deterioration. Signup and view all the answers

Which action improves the quality of chest compressions delivered during resuscitation attempts?

Switch providers about every 2 minutes or every 5 compression cycles. Signup and view all the answers

What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse of 80 beats/min?

1 breath every 5-6 seconds. Signup and view all the answers

What is the appropriate first medication for a patient presenting with dizziness and fatigue?

Atropine 0.5 mg. Signup and view all the answers

What is the appropriate dose of dopamine for a patient with ineffective initial atropine dose?

2-10 mcg/kg/min. Signup and view all the answers

What is the next intervention for a patient with a narrow complex tachycardia and dizziness?

Vagal maneuver. Signup and view all the answers

What is the next intervention for a monitored patient developing a narrow complex tachycardia with no ischemia on 12 lead?

Adenosine 12 mg IV. Signup and view all the answers

What should you do if a patient's CT scanner is broken and they may be having a stroke?

Divert the patient to a hospital 15 minutes away with CT capabilities. Signup and view all the answers

What is an appropriate indication to stop or withhold resuscitative efforts?

Evidence of rigor mortis. Signup and view all the answers

What is the most appropriate next action for a patient with persistent epigastric pain after taking antacids?

Obtain a 12 lead ECG. Signup and view all the answers

What intervention has the highest priority for a patient in respiratory failure who becomes apneic?

Simple airway maneuvers and assisted ventilations. Signup and view all the answers

What is the appropriate procedure for ET suctioning after the catheter is selected?

Suction during withdrawal, but not for longer than 10 seconds. Signup and view all the answers

What is the next step for a patient with bradycardia and low blood pressure?

Atropine 0.5 mg. Signup and view all the answers

What would be your next action for a female patient with sudden onset of right arm weakness?

Cincinnati Stroke Scale. Signup and view all the answers

What is the next step for a patient with a positive stroke assessment?

Head CT scan. Signup and view all the answers

What is the proper ventilation rate for a patient in cardiac arrest with an advanced airway in place?

8-10 breaths per minute. Signup and view all the answers

What should be the next evaluation for a patient reporting a fast heartbeat with no other symptoms?

Obtain a 12 lead ECG. Signup and view all the answers

What intervention should be next for a patient with crushing sub-sternal pain and wide complex tachycardia?

Synchronized cardioversion. Signup and view all the answers

What is the initial priority for an unconscious patient with any tachycardia on the monitor?

Determine if a pulse is present. Signup and view all the answers

Which rhythm requires synchronized cardioversion?

Unstable SVT. Signup and view all the answers

What is the recommended dose for adenosine for patients in refractory, stable narrow complex tachycardia?

12 mg. Signup and view all the answers

What is the usual post-cardiac arrest target range for PETCO2 who achieves return of spontaneous circulation (ROSC)?

35-40 mm Hg. Signup and view all the answers

What condition is a contraindication to therapeutic hypothermia during the post-cardiac arrest period?

Responding to verbal commands. Signup and view all the answers

What is the potential danger of using ties that pass circumferentially around the patient's neck when securing an advanced airway?

Obstruction of venous return from the brain. Signup and view all the answers

What is the most reliable method of confirming and monitoring correct placement of an ET tube?

Continuous waveform capnography. Signup and view all the answers

What is the recommended IV fluid bolus dose for a patient who achieves ROSC but is hypotensive?

1 to 2 Liters. Signup and view all the answers

What is the minimum systolic BP one should attempt to achieve with fluid, inotropic, or vasopressor administration in a hypotensive post-cardiac arrest patient?

90 mm Hg. Signup and view all the answers

What is the first treatment priority for a patient who achieves ROSC?

Optimizing ventilation and oxygenation. Signup and view all the answers

Study Notes

Cardiac Arrest Response

Upon confirming unresponsiveness and lack of breathing, activate emergency response and start chest compressions at a rate of at least 100 per minute.
In cases of chest pain with hypotension (BP 92/50), priority assessment is obtaining a 12-lead ECG.

Medication Administration

Preferred route for epinephrine during cardiac arrest is via a peripheral IV.
Administer 1mg epinephrine promptly after 2 minutes of CPR if PEA is present and no pulse is detected.

CPR Quality and Techniques

Avoid prolonged interruptions in chest compressions to reduce fatal mistakes in cardiac arrest management.
High-quality chest compressions require complete chest recoil between compressions.
Continuous chest compressions without pauses are essential for patients with an advanced airway, incorporating 10 ventilations per minute.

Rhythm Management

If an AED fails to analyze a rhythm, immediately resume chest compressions.
The presence of a narrow complex rhythm with no pulse necessitates a quick return to compressions.
Quality of chest compressions should be checked via quantitative capnography in intubated patients to monitor CPR effectiveness.

Advanced Interventions

If asystole persists despite multiple interventions, consider terminating resuscitation efforts after consulting medical control.
Safe defibrillation practices include ensuring no oxygen flow over the patient during the shock.

Post-Arrest Care

Optimize ventilation and oxygenation as the first treatment priority for those achieving return of spontaneous circulation (ROSC).
Maintain a minimum systolic BP of 90mm Hg with fluid or medication support in post-arrest hypotensive patients.

Stroke Assessment and Management

When suspecting a stroke, utilize the Cincinnati Stroke Scale for initial assessment, followed by a CT scan if available.

Bradycardia and Tachycardia Management

For symptomatic bradycardia, administer atropine 0.5mg; consider dopamine (2-10 mcg/kg/min) if atropine is ineffective.
In narrow complex tachycardia, initiate vagal maneuvers; for refractory cases, adenosine 12mg IV is indicated.

Endotracheal Intubation and Confirmation

Proper suctioning technique during ET tube management includes suctioning during withdrawal for no longer than 10 seconds.
Confirm correct ET tube placement via continuous waveform capnography, as it's the most reliable method.

Fluid Resuscitation

Administer a fluid bolus (1 to 2 liters) for hypotensive patients achieving ROSC during post-cardiac arrest care.

Preservation of Neurological Function

Avoid therapeutic hypothermia in patients who are responsive to verbal commands following cardiac arrest.

Cardioversion Criteria

Unstable SVT requires synchronized cardioversion as a management protocol.

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Description

Prepare for the ACLS (Advanced Cardiovascular Life Support) written test with these flashcards. Each card presents critical scenarios and questions that test your knowledge of emergency response protocols and assessments for patients in cardiac distress.