ACLS Practice Questions
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Which of the following constitute elements of quality CPR?
The best answer is: all of the above
“High-quality CPR” is identified in the most recent Guidelines for CPR as: compression rate of 100-120/minute; 2-2.4 inch compression depth; complete chest recoil following each compression; minimizing interruptions to chest compressions, and, avoiding excessive ventilation.
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Every patient developing a "flatline" ECG is usually irreversibly dead.
The best answer is: false
"Asystole" is a clinical diagnosis, not simply an ECG pattern. Patients whose hearts stop secondary to sepsis, heart failure or other untreatable conditions are unlikely to survive. However, long pauses are usually treatable. These patients are not dying. They have a focal conduction/pacemaker problem. Pacing and/or atropine are usually effective.
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When managing pain caused by transcutaneous cardiac pacing (TCP), which of the following is the most effective?
The best answer is: morphine sulfate
Many practitioners mistakenly reach for benzodiazepam agents such as diazepam or midazolam. Neither of these drugs provide analgesia for the patient. The TCP produces significant pain in many patients, thus, the use of carefully titrated IV narcotic analgesia is recommended. In unstable patients, oral drugs should not be given.
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Although most treatment algorithms include epinephrine for the treatment of pulseless electrical activity (PEA), its success is unlikely. The primary goal when confronted with a PEA arrest should be to?
The best answer is: rapidly attempt to determine the cause of the PEA
The more rapidly a practitioner can identify a cause, the more rapidly a targeted intervention can occur. There is a small window of time when certain causes of PEA are treatable. The longer a patient stays in arrest, the less likely survival is. -
When treating narrow QRS tachycardia suspected to be caused by hypovolemia:
The best answer is: fluid boluses are administered
When a patient has narrow QRS tachycardia and signs of hypovolemia, rapid administration of fluid is indicated. Usually 100 ml boluses of 0.9% saline are given until improvement is observed, or until the heart rate increases and/or signs of CHF occur.
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Quality CPR includes which of the following?
- 1. push hard and fast
- 2. make sure there is full chest recoil with each compression
- 3. minimize interruptions to CPR (no longer than 10 seconds)
- 4. hyperventilate (give 1 breath for every 2 compressions)
The best answer is: (1,2,3)
“Quality CPR” includes providing compressions “hard and fast” at the rate of 100/minute; allowing the chest to fully recoil between each delivered compression; AVOID hyperventilation; and avoid or minimize interruptions to CPR.
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The recommended approach to fluid resuscitation is:
The best answer is: 20 ml/kg boluses of fluid
Infusing fluids using a “wide-open” IV system through a small IV device rarely provides adequate fluid volume in a timely manner. While 500 ml boluses might be appropriate for a hypovolemic adult, this rapid amount is not appropriate for small patients. That is why 20 ml/kg boluses are recommended. They can be repeated aggressively until improvement is observed. Oral fluids are never administered to an unstable patient.
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Albuterol can be delivered:
- 1. via small volume nebulizer
- 2. using a continuous nebulizer system
- 3. using a gas-operated inhaler
- 4. via intraosseous infusion
The best answer is: (1,2,3 only)
The most common delivery device used when administering albuterol is the small-volume nebulizer, and can be used with a continuous nebulizer in monitored units. It is also available as an inhaler. It is not given via an intraosseous injection.
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Patients requiring continuous positive airway pressure therapy (mechanical ventilation and/or CPAP) should:
The best answer is: all of the above
Critically ill or unstable patients receiving ventilatory support should be transferred to an intensive care setting where the staff is trained and capable of managing this higher level patient. All patients receiving positive airway pressure are at risk for life-threatening events like the development of a tension pneumothorax. The staff needs to be able to rapidly diagnose and treat this problem to prevent a bad outcome for the patient.
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Which of the following signs and symptoms would describe a patient with a “stable” tachyarrhythmia?
- 1. decreased level of consciousness associated with a breathing problem
- 2. cyanosis
- 3. good perfusion
- 4. alert, oriented, and cooperative
The best answer is: (3,4 only)
Patients with tachycardia who are “stable” show no signs of respiratory or perfusion abnormalities. In other words, the arrhythmia is causing no life-threatening or potentially life-threatening events.
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The correct compression ventilation ratio for CPR for an adult is:
The best answer is: 30 compressions to 2 ventilations
30 compressions to 2 ventilations
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When there are two rescuers on the scene of an unresponsive infant or child, which compression-ventilation ratio should be used?
The best answer is: 15:2
15:2
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When rescue breaths are given without compressions (support ventilation) to a victim with a pulse, how many breaths per minute should be given to an infant or child? (increase respiratory frequency if the heart rate is slow)
The best answer is: 12 to 20
12 to 20
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Healthcare providers should first verify that the victim is unresponsive after witnessing a sudden collapse.
The best answer is: True
True
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CPR can double or triple the victim’s chance of survival when performed immediately after collapse from ventricular fibrillation sudden cardiac arrest.
The best answer is: True
True
