ACLS Recertification Test, updated 2022.

ACLS Recertification Test A pt with STEMI has ongoing chest dicomfort. Heparin 4000 units IV bolus and heparin infusion of 1000 units/hr are being administered. The pt did not take ASA because he has a hx of gastritis ...

ACLS Recertification Test A pt with STEMI has ongoing chest dicomfort. Heparin 4000 units IV bolus and heparin infusion of 1000 units/hr are being administered. The pt did not take ASA because he has a hx of gastritis, which was tx 5 years ago. What is the next action? A. Give ASA 160 to 325 mg to chew B. Give clopidogrel 300 mg PO C. Give enteric-coated ASA 75 mg PO D. Give enteric-coated ASA 325 mg rectally A pt is in pulseless ventricular tachycardia. 2 shocks and 1 dose of epinephrine have been given. Which drug should be given next? A. Adenosine 6 mg B. Amiodarone 300 mg C. Epinephrine 3 mg D. Lidocaine 0.5 mg/kg A pt is in cardiac arrest. V fib has been refractory to an initial shock. If no pathway for medication administration is in place, which method is preferred A. Central line B. Endotracheal tube C. External Jugular vein D. IV or IO What is the indicatio for the use of Mg in cardiac arrest? A. V tach associated with a normal QT interval B. shock-refractory monomorphic v tach C. Pulseless v tach-associated torsades de pointes D. shock-refractory v fib You arrive on the scene with the code team. CRP is in progess. An AED previously advised "no shock indicated." A rhythm chec now finds asystole. After resuming compressions, which action do you take next? A. Call for a pulse check B. establish IV or IO access C. Insert a laryneal airway D. Perform endotracheal intubation A pt is in cardiac arrest. V fib has been refractory to a second shock. Which drug should be administered first? A. Atropine 1 mg IV/IO B. epinephrine 1 mg IV/IO C. Lidocaine 1 mg/kg IV/IO D. Sodium bicarbonate 50 mEq IV/IO A pt with sinus bradycardia and a HR of 42/min has diaphoresis and a BP of 80/60 mg. What is the initial dose of atropine? A. 0.1 mg B. 0.5 mg C. 1 mg D. 3 mg A pt is in refractory V fib. CRP is in progess. One dose of epinephrine was given after the second shock. An antiarrhythimic drug was given immediate after the thirst shock. You are the team leader. Which med do you order next? A. Epinephrine 1 mg B. epinephrine 3 mg C. Sodium bicarbonate 50 mEq D. a second dose of the antiarrhythmic drug A monitored pt in the ICU developed a sudden onset of narrow-complex tachycardia at 220/min. The pt BP is 128/58. The PETCO2 is 38 mm Hg, and the puse Ox is 98%. There is a vascular access in the L arm, and the pt has not been given any vasoactive drugs. An ECG confirms supraventricular tachycardia with no evidence of ischemia or infarction. The HR has not responsed to vagal maneuvers. What is the next action? A. Administer adenosine 6 mg IV push B. Administer amiodarone 300 mg IV push C. perform synchronized cardioversion at 50 J D. perform synchronized cardioversion at 200 J A pt has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asx with a BP of 110/70. PMHx of angina. What action is recommended next? A. Give adenosine 6 mg IV bolus B. Give lidocaine 1 to 1.5 mg IV bolus C. performing synchronized cardioversion D. Seeking expert consultation at 61yoM suddenly experienced difficulty speaking and L sided weakness. HE meet initial criteria for fibrinolytic therapy, and a CT scan of the brain is ordered. Which best describes the guidelines for anti-platelet and fibrinolytic therapy? A. give ASA 160-325 to be chewed immediately B. give ASA 160 mg and clopidogrel 75 mg orally C. Give heparin if the CT scan is negative for hemorrhage D. Hold ASA for at least 24 hours if rtPA is administered Which intervention is most appropriate for the tx of a pt in asystole? A. atropine B. defibrillation C. epinephrine D. transcutaneous pacing you are caring for a 66 yo M with hx of a large ICH 2 months ago. He is being evaluated for another acute stroke. The CT scan is neg. for hemorrhage. The pt is getting O2 via nasal cannula at 2 L/min and has an IV. His BP is 180/100. Which drug do you anticipate giving the pt? A. ASA B. glucose C. nicardipine D. rtPA Pt in refractory v fib and has gotten multiple debribillations, epinephrine 1 mg IV x 2 and amiodarone 300 mg IV x 1. Pt is intubated. Which best describes the recommended 2nd dose of amiodarone? A. 1 mg/kg IV push B. 1 to 2 mg/min infusion C. 150 mg IV push D. 300 mg IV push 57yoW with palpitations, chest discomfort and tachycardia. Monitor shows regular wide-complex QRS of 180/min. She becomes diaphrotic and her BP is 80/60. What is next action? A. establish IV/IO B. obtain a 12 lead EKG C. perform electrical cardioversion D. seek expert consultation A pt is in cardiac arrest. CRP are performed. Pt is intubated and has IV access. Rhythm is asystole. What is the first drug? A. Atropine 0.5 mg IV/IO B. Atropine 1 mg IV/IO C. Dopamine 2 to 20 mcg/kg per minute IV/IO D. epinephrine 1 mg IV/IO 35yoW w/ palpitations, light-headedness and a stable tachy. Monitor shows regular narrow-complex QRS at 180/min/ Vagal maneuvers have not been effective. Has IV access. What drug? A. Adenosine 6 mg B. Atropine 0.5 mg C. epinephirne 2 to 10 mcg/kg per minutes D. lidocaine 1 mg/kg PT with possible STEMI has ongoing chest discomfort. What contraindication to nitrate? A. Anterior wall MI B. HR < 90 C. SBP > 180 D. use of phosphodiesterase inhibitors within previous 24 hrs When does bradycardia need tx? A. 12-lead ECG with NSR B. hypotension C. DBP > 90 D. SBP > 100 PT has sinus brady with HR 36. Atropine administered to a total dose of 3 mg. A trancutaneous pacemaker has failed to capture. Pt is confused and BP is 88/56. What therapy is now indicated? A. atropine 1 mg B. epinephrine 2 t0 10 mcg/min C. adenosine 6 mg D. NS 250 mL to 500 mL bolus What is the recommended depth of chest compressions for an adult victim? A. at least 1.5 inches B. at least 2 inches C. at least 2.5 inches D. at least 3 inches Your patient is not responsive and is not breathing. You can palpate the carotid pulse. Which action do you take next? A. apply and AED B. Obtain a 12-lead ECG C. Start an IV D. Start rescue breathing How often should you switch chest compressions to avoid fatigue? A. about every 2 minutes B. about every 3 minutes C. about every 4 minutes D. about every 5 minutes How does complete chest recoil contribute to effective CPR? A. Allows maximum blood return to the heart B. Reduces rescuer fatigue C. Reduces the risk of rib fractures D. increases the rate of chest compressions EKG shows STEMI. When pt arrives to ED, the pt has resolution of moderate (5/10) chest pain after 3 doses of Nitro SL. BP is 104/70. Which intervention is most important in reducing this pt's in-hospital day mortality rate? A. application of transcutaneous pacemaker B. Atropine administration C. Nitro D. Reperfusion therapy What action minimizes the risk of air entering the victim's stomach during bag-mask ventilation? A. ventilating until you see chest rise B. ventilating as quickly as you can C. squeezing the bag w both hands D. delivering the largest breath you can If someone has symptomatic bradycardia what medication do you give first? (dose too) - Atropine 0.5 mg IV A pt has been resuscitated from cardiac arrest. During post-ROSC tx, the pt becomes unresponsive and has v fib. Which action is indicated next? A. Give an immediate unsynchronized high-energy shock (defibrillation dose) B. Give lidocaine 1 to 1.5 mg/kg IV C. Perform sychronized cardioversion D. Repeat amiodarone 300 mg IV 45yoW w Hx of palpitations gets light-headed and has palpitations. She has received adenosine 6 mg IV for the SVTs without conversion of the rhythm. She is not apprehensive. BP is 128/70. What is the next intervention? A. Adenosine 12 mg IV B. unsynchronized cardioversion C. vagal maneuvers D. Synchronized cardioversion What is the recommended compression rate for high-quality CPR? A. 50 to 60 compressions/minute B. 70 to 80 compressions/minute C. 90 to 100 compressions/minute D. 100 to 120 compressions/minute You arrive to find a pt with CPR in progress. On next rhythm check you see NSR. Team members tell you that the pt was well but reported chest discomfort and then collapsed. She has no pulse or respirations. Bag mask ventilations are producing visible chest rise and IO access has been established. Which intervention would be your next action? A. Atropine 1 mg B. Dopamine at 10 to 20 mcg/kg per min C. Epinephrine 1 mg D. Intubation and administration of 100% O2 bag valve mask ventilations are about every ______ seconds? What action should you take immediately after providing an AED shock? A. Check pulse rate B. prepare to deliver a second shock C. Resume chest compressions D. Start rescue breathing What is the max interval for pausing chest compressions? A. 10 sec B. 15 sec C. 20 sec D. 25 sec What are the 2 shockable rhythms that a defibrillator will work on?