Quiz on Cardiac Procedures PDF

1\. Which of the following factors affecting transthoracic impedance is false? Distance between the paddles. Energy setting of the defibrillator. Contact material between the paddle and skin. Types of defibrillator (monophasic/biphasic). Amount of pressure the paddles are applied to t...

1\. Which of the following factors affecting transthoracic impedance is false? Distance between the paddles. Energy setting of the defibrillator. Contact material between the paddle and skin. Types of defibrillator (monophasic/biphasic). Amount of pressure the paddles are applied to the chest. Answer: Types of defibrillator (monophasic/biphasic). 2\. A patient with PEA was intubated. 3 minutes after IV Adrenaline 1 mg is given, PEA continues at 50 bpm. Which of the following actions should be done next? Administer IV Atropine 0.6mg. Initiate transcutaneous pacing at a rate of 60bpm. Start an IV Dopamine at 15 mcg/kg/min. Administer IV Adrenaline 1 mg of 1:10 000. Prepare for cardioversion. Answer: Start an IV Dopamine at 15 mcg/kg/min. 3\. Which of the following statements regarding arrhythmia management is false? Electrical cardioversion is necessary for patients with SVT. Sinus bradycardia of 56 beats per minute in a fit young athlete requires no treatment. IV Amiodarone is recommended in PEA and asystole. Exclude underlying causes of cardiac arrest. Repeat emergency drug administration every 3-5 minutes interval. Answer: IV Amiodarone is recommended in PEA and asystole. 4\. Initial assessment reveals that the patient is pulseless and apneic. What is the immediate action? Defibrillate immediately, CPR, establish IV access and intubate. Perform synchronized shock, CPR, establish IV access, and intubate. Defibrillate immediately, CPR, establish IV access and administer a rapid bolus IV Amiodarone 150mg. Continue CPR, establish IV access, administer a rapid bolus IV 1 mg adrenaline and intubate. Continue CPR, establish IV access, administer bolus IV Amiodarone 300mg and intubate. Answer: Continue CPR, establish IV access, administer a rapid bolus IV 1 mg adrenaline and intubate. 5\. Which of the following statements on defibrillation is true? The correct defibrillation pads position is one pad just below the right clavicle and the other pad to the left of the nipple in the mid-axillary line. The recommended energy level of the shock in a patient with ventricular fibrillation (VF) is 160J. The presence of a pacemaker is an absolute contraindication to defibrillation. Ensure synchronized mode is turned On. Unsynchronized defibrillation is indicated for VT with a pulse. Answer: The correct defibrillation pads position is one pad just below the right clavicle and the other pad to the left of the nipple in the mid-axillary line. 6\. Which of the following statements regarding chest compression post defibrillation is false? CPR should be started immediately post defibrillation. Post defibrillation, ECG shows SR, continue CPR for another 2 minutes. Post defibrillation, ECG shows VF, continue CPR for another 2 minutes. Post defibrillation and upon completion of 2 minutes CPR, ECG shows SR, proceed to check pulse. Upon return of spontaneous circulation (ROSC) post defibrillation, continue chest compression for another 2 minutes. Answer: Upon return of spontaneous circulation (ROSC) post defibrillation, continue chest compression for another 2 minutes. 7\. After an advanced airway is inserted, compressions are delivered at what rate? A ratio of 15 compressions to 2 breaths. A ratio of 30 compressions to 2 breaths. A rate of 100-120 per minute and ventilations at 10-12 per minute. A rate of 100 per minute and ventilations at 10 per minute. Depth of at least 5 cm without interruption for ventilations. Answer: A rate of 100-120 per minute and ventilations at 10-12 per minute. 8\. In the Singapore Resuscitation and First Aid Council guidelines for resuscitation, which of the following is true? Initial head-tilt chin-lift maneuver is omitted. Check breathing and pulse within 5 seconds. Chest compression landmark is upper mid sternum. Continue CPR for 1 minute post defibrillation. Answer: Initial head-tilt chin-lift maneuver is omitted. 9\. Synchronized cardioversion should be considered in which of the following rhythms? VT with pulse. Asystole. Symptomatic sinus bradycardia. Ventricular fibrillation. PEA. Answer: VT with pulse. 10\. In considering the need for an electrocardiogram (ECG) in a 40-year-old man presenting with any of these symptoms, which of the following is false? Breathlessness. Acute confusion. Syncope. Iliac fossa pain. Epigastric discomfort. Answer: Iliac fossa pain. 11\. The 3 key parameters used to evaluate a patient with AMI are: Clinical history, treadmill test and ECG. Chest x-ray, cardiac markers and ECG. Clinical history, cardiac markers and ECG. Physical examination, chest x-ray and 2D echo. Clinical history, 2D echo and cardiac markers. Answer: Clinical history, cardiac markers and ECG. 12\. Morphine: Which statements are correct? i. Is the recommended opioid analgesic in AMI. ii. Is useful in the treatment of pulmonary edema. iii. Should be given together with an IV anti-emetic. iv. Reversal agent is flumazenil. Answer: i and iii. 13\. Aspirin: Which statements are correct? i. Is indicated in patients with AMI who have no NSAID allergy. ii. Should be used with caution in patients with a past history of peptic ulcer disease. iii. Is best given intravenously in AMI. iv. Should be given together with an IV anti-emetic. Answer: i and ii. 14\. During an endotracheal intubation of a collapsed patient, the patient's SpO2 has dropped to 85%. What should be the most appropriate action? Quickly intubate before the SpO2 drops further. Stop intubation and bag-valve-mask the patient with 100% oxygen before the next intubation attempt. Give IV Adrenaline and continue intubation. Perform suctioning to clear airway and continue intubation. Ensure chest compression is not interrupted and continue intubation. Answer: Stop intubation and bag-valve-mask the patient with 100% oxygen before the next intubation attempt. 15\. Patient with the following ECG rhythm may (See attached ECG image). i. Be hemodynamically stable. ii. Have a seizure attack. iii. Complain of palpitations. iv. Have a syncopal attack. i and ii. ii and iii. i and iv. ii, iii and iv. i, ii, iii, and iv. Answer: i, ii, iii, and iv. 16\. In the management of acute myocardial infarction (AMI), it is important to avoid intramuscular injections for the following reasons: i. Poor absorption. ii. Muscular hematoma. iii. Altered cardiac markers. iv. Increased risk of arrhythmias. i and ii. i and iv. ii and iii. i, ii, and iii. i, iii, and iv. Answer: i, ii, and iii. 17\. Upon the arrival of the code team, nurse 1 should: Prepare drugs. Attach monitor leads and check ECG rhythm. Assess responsiveness. Continue chest compression. Give a brief verbal report to Doctor 1. Answer: Give a brief verbal report to Doctor 1. 18\. In a patient who has just achieved Return of Spontaneous Circulation (ROSC) after a cardiac event, what should be maintained? Blood glucose level should be maintained at ≤10mmol/L. Glasgow coma scale should be maintained at ≤8. SaO2 should be maintained at 100%. Mean arterial pressure should be maintained at 60mmHg. Temperature should be maintained at 34-36°C for 12-24 hours. Answer: Blood glucose level should be maintained at ≤10mmol/L. 19\. Which of the following statements is true? A child can be pronounced dead if there is no response to continuous resuscitation after 30 minutes. It is safe to discharge a patient from the Emergency Department after successful resuscitation following a near-drowning episode. There is an increased risk of regurgitation and pulmonary aspiration in a pregnant woman in her third trimester who requires resuscitation. The correct landmark for the Heimlich maneuver in a pregnant woman is 2 finger breadths above the umbilicus. "In an unconscious patient with suspected insecticide poisoning, gastric lavage should be performed prior to endotracheal intubation." Answer: There is an increased risk of regurgitation and pulmonary aspiration in a pregnant woman in her third trimester who requires resuscitation. 20\. Early CPR with \_\_\_\_\_\_ is most likely to improve survival rates for out-of-hospital cardiac arrest patients. Early intubation. Early defibrillation. Advanced cardiac life support. Early access to EMS early warning. Answer: Early defibrillation. 21\. In the chain of survival, which of the following is false? Early CPR. Advance cardiac life support. Early intubation. Emergency medical services. Early defibrillation. Answer: Early intubation. 22\. When approaching an unconscious casualty, which of the following measures is false? Check for danger and ensure it is safe to approach the victim. Perform head tilt chin lift. Assess for level of consciousness. Activate EMS if there is no response. Assess for spontaneous breathing. Answer: Perform head tilt chin lift. 23\. The most lethal arrhythmia in acute myocardial infarction is: Ventricular couplets. Ventricular fibrillation. Atrial fibrillation. Supraventricular tachycardia. Wenkebach phenomenon. Answer: Ventricular fibrillation. 24\. The drug of choice in the management of Torsades de Pointe is: Adrenaline. Atropine. Lignocaine. Amiodarone. Magnesium sulfate. Answer: Magnesium sulfate. 25\. Which of the following statements regarding Lignocaine is false? May cause seizures if given in overdose. Can be used for the treatment of persistent ventricular tachycardia. Can be used to control premature ventricular contractions. Is administered as bolus neat, 1-1.5mg/kg in cardiac collapse. Can be used for the treatment of atrial fibrillation. Answer: Can be used for the treatment of atrial fibrillation.