ACLS

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  1. Success of any resuscitation attempt is built on:

    A) defibrillation when required by the patients ECG rhythm
    B) neither A or B
    C) high quality CPR
    D) both A and B
    D) both A and B

    high quality CPR
    (this multiple choice question has been scrambled)
  2. The most important algorithm to know for adult resuscitation is:

    A) Tachycardia
    B) Cardiac Arrest
    C) PEA
    D) Bradycardia
    B) Cardiac Arrest
    (this multiple choice question has been scrambled)
  3. The systematic approach with a person in cardiac arrest should include the BLS survey and ACLS survey?

    A) True
    B) False
    A) True
  4. While conducting the BLS Survey, you should do all of the following except:

    A) active emergency response system
    B) check patient responsiveness
    C) get an AED
    D) open the airway
    D) open the airway
    (this multiple choice question has been scrambled)
  5. According to new 2010 Guidelines for CPR, which of the following is in the correct order for the patient with sudden cardiac arrest?

    A) open airway, provide ventilations, give 30 chest compressions, attach AED as soon as possible
    B) open airway, check breathing, check pulse, attach AED as soon as possible
    C) give 30 compressions, open airway, provide ventilation, attach AED as soon as possible
    D) none of the above
    C) give 30 compressions, open airway, provide ventilation, attach AED as soon as possible
    (this multiple choice question has been scrambled)
  6. After providing a shock with an AED you should:

    A) let the AED reanalyze the rhythm
    B) check pulse
    C) give a rescue breath
    D) Start CPR, beginning with chest compressions
    D) Start CPR, beginning with chest compressions
    (this multiple choice question has been scrambled)
  7. During CPR with no advanced airway in place the compression-to-ventilation ratio is:

    A) 20:2
    B) 5:1
    C) 30:2
    D) 10:1
    C) 30:2
    (this multiple choice question has been scrambled)
  8. During CPR after an advanced airway is in place, which of the following is true:

    A) Chest compressions should be stopped while giving breaths
    B) One breath every 6 to 8 seconds should be given
    C) The goal is 20 or greater breaths per minute
    D) The breaths should be synchronized with the chest compressions.
    B) One breath every 6 to 8 seconds should be given
    (this multiple choice question has been scrambled)
  9. The most important intervention with witnessed sudden cardiac arrest is:

    A) effective chest compressions
    B) early defibrillation
    C) rapid use of resuscitation drugs
    D) early activation of EMS
    B) early defibrillation
    (this multiple choice question has been scrambled)
  10. Typically, suctioning attempts in ACLS situations should be:

    A) ten seconds or less
    B) 20 seconds or less
    C) 5 seconds or less
    D) no more than 30 seconds
    A) ten seconds or less
  11. What is the drug of first choice for symptomatic bradycardia?

    A) atropine
    B) lidocaine
    C) vasopressin
    D) epinephrine
    A) atropine
    (this multiple choice question has been scrambled)
  12. Which ECK rhythm is commonly associated with bradycardia?

    A) ventricular fibrillation
    B) PEA
    C) sinus rhythm
    D) Morbitz II
    D) Morbiz II
    (this multiple choice question has been scrambled)
  13. What is generally considered the most important and clinically significant degree block?

    A) type I (Mobitz I)
    B) type II (Mobitz II)
    C) third-degree AV block
    D) first-degree AV block
    C) third-degree AV block
    (this multiple choice question has been scrambled)
  14. Which drugs are involved in the Bradycardia Algorithm?

    A) atropine, norepinephrine, dopamine
    B) atropine, epinephrine, lidocaine
    C) atropine, epinephrine, dopamine
    D) atropine, lidocaine, adenosine
    C) atropine, epinephrine, dopamine
    (this multiple choice question has been scrambled)
  15. Bradyarrhythmia is defined as:

    A) any symptomatic rhythm disorder with a heart rate less than 50 beats per minute
    B) any rhythm disorder with a heart rate less than 40 beats per minute
    C) any rhythm disorder with a heart rate less than 60 beats per minute
    D) any rhythm disorder with a heart rate less than 50 beats per minute
    C) any rhythm disorder with a heart rate less than 60 beats per minute
    (this multiple choice question has been scrambled)
  16. Symptomatic bradycardia exists when ____.

    A) the heart rate is slow
    B) the patient has symptoms
    C) the symptoms are due to a slow heart rate
    D) all of the above are needed for symptomatic bradycardia to exist
    D) all of the above are needed for symptomatic bradycardia to exist
  17. Symptoms of bradycardia can include chest discomfort or pain, shortness of breath, decreased level of consciousness, weakness, fatigue, lightheadedness, dizziness, and presyncope or syncope. 

    A) True
    B) False
    A) True
  18. Signs of symptomatic bradycardia include hypotension, orthostatic hypotension, diaphoresis, pulmonary congestion, runs of PVC's or VT.

    A) True
    B) False
    A) True
  19. The primary decision point in the bradycardia algorithm is the determination of:  

    A) adequate perfusion
    B) heart rate
    C) rhythm
    D) blood pressure
    A) adequate perfusion
    (this multiple choice question has been scrambled)
  20. After it is determined that the patient does not have adequate perfusion your first step is to:
    A) use defibrillator set at 200 J
    B) give atropine while awaiting transcutaneous pacer
    C) observe and monitor the patient
    D) prepare for transcutaneous pacing
    B) give atropine while awaiting transcuataneous pacer
    (this multiple choice question has been scrambled)
  21. The correct dose of atropine given in the bradycardia algorithm is:

    A) 1 mg atropine, may repeat up to 4 mg
    B) 1 mg atropine, may repeat up to 3 mg
    C) 0.5 mg atropine, may repeat up to 3 mg
    D) 0.5 mg atropine, may repeat up to 2 mg
    C) 0.5 mg atropine, may repeat up to 3 mg
    (this multiple choice question has been scrambled)
  22. The correct dose of epinephrine given in the bradycardia algorithm is:

    A) 5-10 mcg/min
    B) 1-5 mcg/min
    C) 2-10 mcg/min
    D) 2-8 mcg/min
    C) 2-10 mcg/min
    (this multiple choice question has been scrambled)
  23. The correct dose of dopamine given in the bradycardia algorithm is:

    A) 1-5 mcg/kg/min infusion
    B) 5-10 mcg/kg/min infusion
    C) 2-10 mcg/kg/min infusion
    D) 2-8 mcg/kg/min infusion
    C) 2-10 mcg/kg/min infusion
    (this multiple choice question has been scrambled)
  24. The key clinical question when determining steps to take for the patient with symptomatic bradycardia is:

    A) Are the symptoms caused by bradycardia or some other illness?
    B) Is the bradycardia reversible?
    C) Does the patient respond to medications?
    D) Is the pateint a DNR?
    A) Are the symptoms caused by bradycardia or some other illness?
    (this multiple choice question has been scrambled)
  25. The treatment sequence for bradycardia with poor perfusion is:
    A) start IV drip of dopamine or epinephrine, if ineffective begin transcutaneous pacing, and if this is not effective, give atropine
    B) give epinephrine, if ineffective give atropine, if atropine is ineffective start transcutaneous pacing
    C) prepare for transcuataneous pacing, consider atropine while preparing TCP, use epinephrine or dopamine while awaiting pacemaker or if pacing is ineffective.
    D) begin cpr, give epinephrine, give atropine, defibrillate, repeat epinephrine if needed
    C) prepare for transcutaneous pacing, consider atropine while preparing TCP, use epinephrine or dopamine while awaiting pacemaker or if pacing is ineffective.
    (this multiple choice question has been scrambled)
  26. Transcutaneous pacing should be started immediately if:

    A) there is no response to atropine
    B) atropine is unlikely to be effective or if IV access cannot be quickly established
    C) the pateint is severely symptomatic
    D) all of the above
    D) all of the above
  27. If transcutaneous pacing is ineffective for symptomatic bradycardia, the next step would be to prepare for:
    A) begin CPR
    B) prepare for transvenous pacing
    C) prepare for pacemaker placement
    D) give repeat doses of atropine
    B) prepare for transvenous pacing
    (this multiple choice question has been scrambled)
  28. Atropine doses of less than 0.5 mg may paradoxically result in further slowing of the heart rate.

    A) True
    B) False
    A) True
  29. For bradycardia unresponsive to atropine, what other drug should be considered?

    A) epinephrine
    B) magnesium sulfate
    C) vasopressin
    D) all of the above
    A) epinephrine
    (this multiple choice question has been scrambled)
  30. The treatment of choice for symptomatic bradycardia with signs of poor perfusion is ____.

    A) CPR
    B) transcutaneous pacing
    C) pacemaker placement
    D) none of the above
    B) transcutaneous pacing
    (this multiple choice question has been scrambled)
  31. Transcutaneous pacing is contraindicated in the patient with ___.

    A) severe hypothermia
    B) chest pain
    C) hypokalemia
    D) all of the above
    A) severe hypothermia
    (this multiple choice question has been scrambled)
  32. For transcutaneous pacing, the current millamperes (mA) output should be:

    A) set at 30 mA
    B) set 2 mA above capture dose
    C) set 4 mA avoe capture dose
    D) set no higher than capture dose
    B) set 2 mA above capture dose
  33. For transcutaneous pacing, the demand rate should be set at:

    A) started at 60/min with adjustment based on clinical response
    B) no higher than 60/min
    C) started at 100/min and reduced to minimum for clinical response
    D) started at 80/min with adjustment based on clinical response
    A) started at 60/min with adjustment based on clinical reponse
    (this multiple choice question has been scrambled)
  34. Transcutaneous pacing is not recommended for which of the following?

    A) asystole
    B) both a and B
    C) complete block
    D) 2nd degree block type II
    A) asystole
    (this multiple choice question has been scrambled)
  35. Preparation for transcutaneous pacing should be made for which of the following?

    A) unstable sinus bradycardia
    B) third degree AV block
    C) Mobitz type II second-degree AV block
    D) all of the above
    D) all of the above
  36. What is the infusion rate for epinephrine in the bradycardia algorithm?

    A) 0.5 mg, every 3-5 min
    B) 2-10 micrograms/min
    C) 1 mg, every 5 min
    D) 2-5 micrograms/min
    B) 2-10 micrograms/min
    (this multiple choice question has been scrambled)
  37. Identify the following rhythm.

    Image Upload 1

    A) second degree block
    B) sinus bradycardia
    C) sinus rhythm
    D) complete block
    B) sinus bradycardia
    (this multiple choice question has been scrambled)
  38. If transcutaneous pacing and drugs fail, what would be your next intervention?

    A) defibrillation
    B) synchronized cardioversion
    C) transvenous pacing
    D) CPR
    C) transvenous pacing
    (this multiple choice question has been scrambled)
  39. The following rhythm is complete block. Which definition of complete block is correct. 

    Image Upload 2

    A) The impulse generated in the SA node in the atrium does not propagate to the ventricles and there is no apparent relationship between P waves and QRS complexes.
    B) There is no impulse generated from the SA note in the atrium but the ventricles contract from random locations below the AV Node.
    C) One or more (but not all) of the atrial impulses fail to conduct to the ventricles due to impaired conduction.
    D) The impulse conducting from atria to ventricles through the AV node is delayed and travels slower than normal PR interval is lengthened beyond 0.20 seconds.
    A) The impulse generated in the SA node in the atrium does not propagate to the ventricles and there is no apparent relationship between P waves and QRS complexes.
    (this multiple choice question has been scrambled)
  40. Which of the following is not correct?

    A) Wenckenbach = Mobitz I
    B) second degree AV block type 1 = Wenckebach
    C) complete block = third degree AV block
    D) second degree AV block type II = Mobitz I
    D)  second degree AV block type II = Mobitz I
    (this multiple choice question has been scrambled)
  41. PEA is defined as:

    A. Any rhythm organized or unorganized that does not have a pulse.
    B. All rhythms which do not have a palpable pulse
    C. Any organized rhythm without a palpable pulse
    D. Any organized rhythm including VT without a palpable pulse.
    C. Any organized rhythm without a palpable pulse
    (this multiple choice question has been scrambled)
  42. The two most important aspects to treating PEA are:

    A. Provide effective CPR and check pulses regularly
    B. Provide effective CPR and correct the underlying cause of the rhythm
    C. Provide effective CPR and promptly use core drugs.
    D. Provide effective CPR and timely transcutaneous pacing of the patient
    B. Provide effective CPR and correct the underlying cause of the rhythm.
    (this multiple choice question has been scrambled)
  43. Some common causes of PEA are:

    A. Hyovolemia, Hypoxia, and Hydrogen Ion (Acidosis)
    B. Hypovolemia and Hypothermia
    C. Hypothermia and Hyperkalemia
    D. All of the above
    D. All of the above
  44. In PEA, advanced airway placement is a priority over establishing IV/IO access.

    A. True
    B. False
    B. False
  45. All resuscitation team members must simultaneously conduct a search for an underlying and treatable cause of the PEA in addition to their roles.

    A. True
    B. False
    A. True
  46. As soon as IV/IO access is available, the patient should be given:

    A. 1 mg ephinephrine
    B. 6 mg adenosine
    C. 1 mg atropine
    D. 2 mg epinephrine
    A. 1 mg ephinephrine
    (this multiple choice question has been scrambled)
  47. When hypoxia is the primary cause of PEA what clues may be noted on assessment?

    A. slow rate on ECG
    B. rapid rate on ECG
    C. normal blood gas
    D. wide QRS complex on ECG
    A. slow rate on ECG
    (this multiple choice question has been scrambled)
  48. During PEA, what step occurs after CPR and medication administration?

    A. rhythm check
    B. defibrillation
    C. 5 cycles of CPR
    D. transcutaneous pacing
    A. rhythm check
    (this multiple choice question has been scrambled)
  49. The H's and T's that are possible causes of PEA include all the following except:


    A. hypovolemia, toxins, thrombosis
    B. hypoxia, thrombocytopenia, hypoglycemia
    C. hypothermia, tension pneumothorax, hydrogen ion (acidosis)
    D. hydrogen ion, hypokalemia, tamponade
    B. hypoxia, thrombocytopenia, hypoglycemia`
    (this multiple choice question has been scrambled)
  50. When hypovolemia is the primary cause of PEA what clues may be noted on assessment?

    A. narrow complex rapid rate on ECG
    B. flat neck veins
    C. dropping blood pressure prior to PEA
    D. all of the above
    D. all of the above
  51. Some clues for PEA caused by acidosis (hydrogen ion) would be all of the below except:

    A. history of diabetes
    B. smaller-amplitude QRS complexes
    C. renal failure
    D. recent trauma
    D. recent trauma
    (this multiple choice question has been scrambled)
  52. Recommended treatment to reverse PEA caused by acidosis is:

    A. sodium bicarbonate
    B. normal saline bolus
    C. both A and B
    D. adequate ventilation
    C. both A and B

    adequate ventilation and sodium bicarbonate
    (this multiple choice question has been scrambled)
  53. PEA caused by HYPERkalemia may present with which of the following rhythm changes?

    A. wide QRS complex, taller P-waves, and T-waves taller and peaked
    B. narrow QRS complex, smaller P-waves, and T-waves smaller and rounded
    C. narrow QRS complex, smaller P-waves, and T-waves taller and peaked
    D. wide QRS complex, smaller P-waves, and T-waves taller and peaked
    D. wide QRS complex, smaller P-waves, and T-waves taller and peaked
    (this multiple choice question has been scrambled)
  54. Patients that you might more commonly see with PEA caused by HYPERkalemia are all the following except which one?

    A. elderly
    B. diabetes
    C. dialysis recipient
    D. renal failure
    A. elderly
    (this multiple choice question has been scrambled)
  55. Reversing Hyperkalemia is done using which of the following medications?

    A. sodium bicarbonate
    B. glucose and insulin
    C. albuterol
    D. any of the above
    D. any of the above
  56. PEA caused by HypOkalemia may present with which if the following symptoms?

    A. peaked T-waves, non-visible U waves, wide QRS, prolonged QT
    B. peaked T-waves, prominent U waves, narrow QRS, prolonged QT
    C. flattened T-waves, prominent U waves, wide QRS, prolonged QT
    D. flattened T-waves, prominent U waves, narrow QRS, shortened QT
    C. flattened T-waves, prominent U waves, wide QRS, prolonged QT
    (this multiple choice question has been scrambled)
  57. Patients that you might more commonly see with PEA caused by HypOkalemia are:

    A. patients with chest pain
    B. diabetic patients
    C. patients using diuretics
    D. all of the above
    C. patients using diuretics
    (this multiple choice question has been scrambled)
  58. Life threatening hypokalemia is uncommon but can occur in the setting of gastrointestinal and renal losses and is associated with hyomagnesemia. Treatment with magnesium may help during cardiac arrest.

    A. True
    B. False
    A. True
  59. The "T" that represents drug overdose and chemical exposure among frequent causes of PEA stands for:

    A. tension pneumothroax
    B. toxins
    C. thrombosis
    D. tamponade
    B. toxins
    (this multiple choice question has been scrambled)
  60. A clue that PEA could be caused by drug overdose "Toxins" is:

    A. narrow QRS complex
    B. tachycardia
    C. prolonged QT interval
    D. tracheal deviation
    C. prolonged QT interval
    (this multiple choice question has been scrambled)
  61. In patients with PEA/cardiac arrest and without known pulmonary embolism (PE), routine fibrinolytic treatment given during CPR shows no benefit and is not recommended.

    A. True
    B. False
    A. True
  62. Reversing PEA caused by Tamponade is performed by:

    A. pericardiocentesis
    B. emergency surgery
    C. chest tube placement
    D. needle decompression
    A. pericardiocentesis
    (this multiple choice question has been scrambled)
  63. Tension pneumothroax which can be a cause of PEA may be recognized by all of the following symptoms except:

    A. neck vein distension
    B. tracheal deviation
    C. unequal breath sounds
    D. wide QRS complex on ECG
    D. wide QRS complex on ECG
    (this multiple choice question has been scrambled)
  64. The "T" in PEA representing Acute MI or massive pulmonary embolism stands for  ____.

    A. thoracic
    B. tamponade
    C. tension pneumothroax
    D. thrombosis
    D. thrombosis
    (this multiple choice question has been scrambled)
  65. Pulmonary Thrombosis (massive pulmonary embolism) induced PEA may manifest itself with which symptoms?

    A. no pulse with CPR
    B. distended neck veins
    C. narrow QRS complex on ECG
    D. all of the above
    D. all of the above
  66. Hypvolemia Which is a common cause of PEA can be rapidly reversed by _____.

    A. fluid resuscitation
    B. epinephrine
    C. increase core temperature
    D. all of the above
    A. fluid resuscitation
    (this multiple choice question has been scrambled)
  67. Which cause of PEA is least likely to benefit from treatment?

    A. hypovolemia
    B. tamponade
    C. thrombosis (pulmonary/coronary)
    D. tension pneumothroax
    C. thrombosis (pulmonary/coronary)
    (this multiple choice question has been scrambled)
  68. the two most common and easily reversible causes of PEA are:

    A. hypovolemia and hypoxia
    B. trauma and hypoxia
    C. hypovolemia and hypothermia
    D. trauma and hydrogen ion (acidosis)
    A. hypovolemia and hypoxia
    (this multiple choice question has been scrambled)
  69. For a patient in asystole which has the higher priority?

    A. defibriillation
    B. all are of equal importance
    C. advanced airway management
    D. IV/IO access
    D. IV/IO access
    (this multiple choice question has been scrambled)
  70. According to the 2015-2020 guidelines, drugs used in the asystole include:

    A. amiodarone, lidocaine
    B. atropine, epinephrine, vasopressin
    C. epinephrine, vasopressin
    D. epinephrine
    D. epinephrine
    (this multiple choice question has been scrambled)
  71. What must be ruled out before a patient's rhythm can be classified as "true asystole"?

    A. causes of PEA
    B. if the patient is a DNR
    C. other causes of isoelectric ECG
    D. all of the above
    C. other causes of isoelectric ECG
    (this multiple choice question has been scrambled)
  72. What are some causes of isoeletric ECG (false asystole)?

    A. loose leads or leads not connected to the patient
    B. no power to the monitor
    C. low signal gain on the ECG monitor
    D. all of the above
    D. all of the above
  73. What are 4 reasons that BLS and ACLS should be stopped or withheld?

    A. DNR, CPR lasting longer than 12 minutes, patient has terminal cancer, rigor mortis
    B. rigor mortis, DNR status, living will directives, threat to safety of rescuers
    C. CPR lasts longer than 10 minute, DNR status, patient has MRSA, physician is tired
    D. None of the above
    B. rigor mortis, DNR status, living will directives, threat to safety of rescuers
    (this multiple choice question has been scrambled)
  74. The first drug to be used in the pulseless arrest-PEA/asystole branch is ________.

    A. adenosine
    B. atropine
    C. epinephrine
    D. any of the above
    C. epinephrine
    (this multiple choice question has been scrambled)
  75. The therapy pathway for asystole/PEA is designed around _______.

    A. early intubation and use of IV access
    B. rapid defibrillation
    C. periods of uninterrupted (5 cycles or 2 minutes), high quality CPR
    D. first considering treatable symptoms
    C. periods of uninterrupted (5 cycles or 2 minutes), high quality CPR
    (this multiple choice question has been scrambled)
  76. Which of the following is a consideration for a patient is asystole?

    A. underlying causes for the asystole
    B. external pacing
    C. both A. and B.
    D. possibility of termination of CPR
    C. both A. and B. 

    underlying causes for the asystole & possibility of termination of CPR
    (this multiple choice question has been scrambled)
  77. All of the following are important in the asystole pathway of the cardiac arrest algorithm. Which is the correct order of importance?

    A. High quality CPR, gain IV/IO access, advance airway
    B. advanced airway, gain IV/IO access, high quality CPR
    C. advanced airway, high quality CPR, gain IV/IO access
    D. gain IV/IO access, advanced airway, high quality CPR
    A. High quality CPR, gain IV/IO access, advance airway
    (this multiple choice question has been scrambled)
  78. When starting an IV or administering drugs during CPR, do not stop CPR

    A. True
    B. False
    A. True
  79. Fine Ventricular Fibrillation may appear as asystole. If this is unclear an initial attempt at defibrillation may be warranted.

    A. True
    B. False
    A. True
  80. Interruption of chest compressions to conduct a rhythm check should not exceed ___ seconds.

    A. fifteen
    B. five
    C. ten
    D. eight
    C. ten
    (this multiple choice question has been scrambled)
  81. Drugs used in the VF/Pulseless VT Algorithm included:  

    A. epinephrine, vasopressin, amiodarone, lidocaine, magnesium sulfate
    B. epinephrine, vasopressin, atropine, and magnesium sulfate
    C. epinephrine, amiodarone, lidocaine, and magnesium sulfate
    D. epinephrine, amiodarone, lidocane, and atropine
    C. epinephrine, amiodarone, lidocaine, and magnesium sulfate
    (this multiple choice question has been scrambled)
  82. The primary ACLS traetment for VF and Pulseless VT is:

    A. epinephrine
    B. lidociane
    C. high-energy unsynchronized shocks
    D. synchronized shocks
    C. high-energy unsynchronized shocks
    (this multiple choice question has been scrambled)
  83. If an AED is on the patient and a manual defibrillator is available you should ____________.

    A. use the AED because it reduces user error
    B. replace the AED only after delivery of three shocks
    C. replace the AED because continued use of the AED may result in unnecessary  prolonged interruptions in chest compression for rhythm analysis and shock administration
    D. do not replace is the AED because replacing the AED with the manual defibrillator will interrupt chest compressions for to long
    C. replace the AED because continued use of the AED may result in unnecessary  prolonged interruptions in chest compression for rhythm analysis and shock administration
    (this multiple choice question has been scrambled)
  84. Even a 5 to 10 second pause in chest compressions can reduce the chance that a shock will terminate VF.

    A. True
    B. False
    A. True
  85. Chest compressions should be continued while the defibrillator is charging.

    A. True
    B. False
    A. True
  86. For VF/Pulseless VT how many shocks should initially be given?

    A. 1 shock
    B. none, shocks are not indicated
    C. it depends whether the rhythm is VF or VT
    D. 3 stacked shocks
    A. 1 shock
    (this multiple choice question has been scrambled)
  87. The initial energy dose delivered in Pulseless Arrest (VF/VT) with biphasic defibrillator is typically _______.

    A. 180-240 J
    B. 150-220 J
    C. 90-110 J
    D. 120-200 J
    D. 120-200 J
    (this multiple choice question has been scrambled)
  88. After the first shock for pulseless VF/VT you should:

    A. give 1mg epinephrine IV/IO
    B. immediately resume CPR
    C. check for pulse
    D. check for rhythm
    B. immediately resume CPR
    (this multiple choice question has been scrambled)
  89. If using a monophasic defibrillator for Pulseless VF/VT the first dose and all subsequent doses should be _____J.

    A. 360
    B. 200
    C. 260
    D. 300
    A. 360
    (this multiple choice question has been scrambled)
  90. If you do not know the effective biphasic dose range for the defibrillator that you are using, you should deliver a first shock and all subsequent shocks at ____.

    A. the maximal energy dose that is available
    B. 120
    C. 200
    D. the lowest energy dose that is available
    A. the maximal energy dose that is available
    (this multiple choice question has been scrambled)
  91. The drug Vasopressin can be used as a substitute for epinephrine for the first or second dose during resuscitation

    a. true
    b. false
    a. true
  92. If VF is initially terminated by a shock but recurs later in the resuscitation attempt you should:  

    A. shock at the previously successful energy level
    B. use medications to reverse VF
    C. increase energy level 20J for subsequent shocks
    D. increase energy level to maximum dose that defibrillator can deliver
    A. shock at the previously successful energy level
    (this multiple choice question has been scrambled)
  93. Select the sequence that is in the correct order?

    A. give 1 shock, 5 cycles CPR, check rhythm, give 1 shock, 5 cycles CPR, after 2nd shock give 40 U Vasopressin IV push
    B. give 1 shock, 3 cycles CPR, check rhythm, give 1 shock, 3 cycles CPR, after 2nd shock give 1mg epinephrine IV push
    C. give 1 shock, 5 cycles CPR, check rhythm, give 1 shock, 5 cycles CPR, check rhythm after 2nd shock give 1mg epinephrine IV PUSH
    D. give 1 shock, check rhythm, 5 cycles CPR, give 1 shock, check rhythm, 5 cycles CPR, after 2nd shock give 1mg epinephrine IV push
    C. give 1 shock, 5 cycles CPR, check rhythm, give 1 shock, 5 cycles CPR, check rhythm after 2nd shock give 1mg epinephrine IV PUSH
    (this multiple choice question has been scrambled)
  94. You have given a patient the 1st shock and CPR 5 cycles, your next step is to _____

    A. give a second shock
    B. give the patient epinephrine 1mg IV
    C. check rhythm
    D. check breathing
    C. check rhythm
    (this multiple choice question has been scrambled)
  95. You have given a patient the 1st shock, CPR for 5 cycles, and now they have an organized rhythm. Your next step is to __________. 

    A. place the patient in rescue position
    B. search for possible causes for the VF/VT
    C. palpate for a pulse
    D. start the patient on an antiarrhythmic drug
    C. palpate for a pulse
    (this multiple choice question has been scrambled)
  96. If during VF/VT after a shock, the rhythm check reveals a __________ rhythm and _________, you then should proceed with the asystole/PEA pathway of the ACLS Pulseless Arrest.

    A. nonshockable, no pulse
    B. ventricular, no pulse
    C. shockable, strong pulse
    D. slow, weak pulse
    A. nonshockable, no pulse
    (this multiple choice question has been scrambled)
  97. The appropriate dosage for the 2nd administration of amiodarone in the left branch of the cardiac arrest algorithm is _____.

    A. 100 mg
    B. 150 mg 
    C. 200 mg
    D. 300 mg
    B. 150 mg
    (this multiple choice question has been scrambled)
  98. Five cycles of CPR should take about _____ minutes. 

    A. 2
    B. 3
    C. 1
    D. 4
    A. 2
    (this multiple choice question has been scrambled)
  99. You have shocked the patient, given 5 cycles of CPR and have done a rhythm check. Now, the patient remains in VT with no pulse. What should you do next:

    A. continue CPR for 5 cycles
    B. consider giving antiarrhythmics
    C. give the patient a second shock
    D. give the patient 1 mg epinephrine
    C. give the patient a second shock
    (this multiple choice question has been scrambled)
  100. The maximum time chest compressions should be interrupted is ____ seconds.

    A. 8 seconds
    B. 15 seconds
    C. 5 seconds
    D. 10 seconds
    D. 10 seconds
    (this multiple choice question has been scrambled)
  101. The initial energy dose used during defibrillation is dependent upon ______. 

    A. whether the defibrillator is monophasic or biphasic
    B. whether the patient has an internal pacemaker
    C. whether the arrest was witness or unwitnessed
    d. none of the above
    A. whether the defibrillator is monophasic or biphasic
    (this multiple choice question has been scrambled)
  102. Prior to defibrillation which of the following should be done?

    a. ensure all team members are clear
    b. charge the defibrillator
    c. minimize time delay between chest compressions and shock delivery
    d. all of the above
    d. all of the above
  103. Epinephrine is used during resuscitation primarily for its alpha-adrenergic effects. Alpha-adrenergic effects include:

    A. increased renal blood flow resulting from vasoconstriction
    B. increase in coronary blood flow resulting from vasoconstriction
    C. increased oxygenation resulting from bronchoconstriction
    D. increase cerebral blood flow resulting from vasodilation
    B. increase in coronary blood flow resulting from vasoconstriction
    (this multiple choice question has been scrambled)
  104. Vasopressin was completely removed from the 2015-2020 Cardiac Arrest Algorithm for the treatment of pulseless VT and VF.

    a. true
    b. flase
    a. true
  105. When treating pulseless VF/VT remember to ______. 

    a. ensure full chest recoil
    b. push hard and fast (100/min)
    c. search for treatable contributing factors (H and T's)
    d. all of the above
    d. all of the above
  106. The H's of treatable contributing factors are:

    A. hemophilia, hypoxia, hydrogen ion, hypo-/hyperkalemia, hypoglycemia
    B. hypovolemia, hypoxia, hydrogen ion, hypo-/hyperkalemia, hypothermia
    C. hypovolemia, hydrogen ion, hypo-/hyperkalemia, hyperglycemia, hypothermia
    D. hypovolemia, hypoxia, hydrogen ion, hypo-hypercalcemia, hypoglycemia, hypothermia
    B. hypovolemia, hypoxia, hydrogen ion, hypo-/hyperkalemia, hypothermia
    (this multiple choice question has been scrambled)
  107. After the third shock during CPR in the pulseless VF/VT algorithm, you should ______.

    A. check for a pulse
    B. consider giving antiarrhythmic drugs
    C. get a different defibrillator
    D. consider giving a beta-blocker
    B. consider giving antiarrhythmic drugs
    (this multiple choice question has been scrambled)
  108. Four important aspects to the Pulseless VF/VT algorithm are: 

    A. use only biphasic defibrillator, avoid hyperventilation, establish IV/IO access, CPR immediately after shock
    B. early defibrillation, atropine after first shock, consider antiarrhythmic use, establish IV/IO access
    C. early defibrillation, effective CPR (hard and fast), secure the airway, establish IV/IO access
    D. stacked shocks with defibrillation, minimize delay in CPR, establish IV/IO access, avoid hyperventilation
    C. early defibrillation, effective CPR (hard and fast), secure the airway, establish IV/IO access
    (this multiple choice question has been scrambled)
  109. For the pulseless VF/VT algorithm, the proper first dose of IV Amiodarone is ___________.

    A. 100 mg
    B. 300 mg
    C. 200 mg
    D. 150 mg
    B. 300 mg
    (this multiple choice question has been scrambled)
  110. A second dose of ________ IV Amiodarone can be given.

    A. 150 mg
    B. 300 mg
    C. 200 mg
    D. 100 mg
    A. 150 mg
    (this multiple choice question has been scrambled)
  111. A tachyarrhythmia is defines as "any rhythm other than sinus tachycardia with a rate greater than _________."

    A. 100
    B. 80
    C. 60
    D. 150
    A. 100
    (this multiple choice question has been scrambled)
  112. Unstable tachycardia exists when the heart rate is too fast for the patient's clinical condition and the excessive heart rate causes symptoms

    a. true
    b. false
    a. true
  113. Symptoms that may be due to tachycardia include all the following except:

    A. altered mental status
    B. facial droop
    C. chest pain
    D. shortness of air
    B. facial droop
    (this multiple choice question has been scrambled)
  114. Serious signs or symptoms of tachycardia can include which of the following:

    a. hypotension
    b. poor peripheral perfusion
    c. acutely altered mental status
    d. acute heart failure
    e. all of the above
    e. all of the above
  115. Heart rates from ____ to ___ (per minute) usually are the result of an underlying process (fever, anemia, blood loss, etc.) and are generally sinus tachycardia.

    A. 90-150
    B. 150-200
    C. 100-130
    d. none of the above
    C. 100-130
    (this multiple choice question has been scrambled)
  116. The higher the rate, the more likely symptoms are due to tachyarrhythmia and not an underlying comorbidity.

    a. true
    b. false
    a. true
  117. The decision point for performing immediate synchronized cardioversion is:

    A. Adenosine does not convert the patient's rhythm
    B. the patient is unstable and no other reversible causes are identified
    C. advised by expert consultation
    D. the patient's heart rate is greater than 150
    B. the patient is unstable and no other reversible causes are identified
    (this multiple choice question has been scrambled)
  118. Tacyarrhthmias respond to cardioversion. Sinus tachycardia will not respond to cardioversion. What wil often occur if a shock is delivered with sinus tachycardia?

    A. heart rate decreases
    B. venticular fibrillation
    C. heart rate increases
    D. asystole
    C. heart rate increases
    (this multiple choice question has been scrambled)
  119. Which of the following would be considered a tachyarrhythmia if the ventricular rate is greater than 100?

    a. atrial flutter
    b. atrial fibrillation
    c. supraventricular tachycardia
    d. all of the above
    d. all of the above
  120. When performing synchronized electrical cardioversion on a patient, the shock will occur at the exact time that you press the "deliver shock button."

    a. true
    b. false
    b. false
  121. Which of the following is not an appropriate initial intervention when addressing tachycardia with a pulse?

    A. monitor ECG, blood pressure, and oximetry
    B. identify and treat reversible causes
    C. give oxygen (if hypoxemic)
    D. attempt vagal maneuvers
    D. attempt vagal maneuvers
    (this multiple choice question has been scrambled)
  122. Tachycardia rates less than 150 per minute usually do not cause serious signs or symptoms

    a. true
    b. false
    a. true
  123. Which of the following are key questions that should be addressed during the assessment and management of a patient with tachycardia?

    a. Are symptoms present or absent?
    b. Is the patient stable?
    c. Is the QRS narrow or wide?
    d. Is the rhythm regular or irregular?
    e. All of the above
    e. All of the above
  124. With tachycardia, if a patient is seriously ill or has significant underlying heart disease or other conditions, symptoms may be present at a lower heart rate?

    a. true
    b. false
    a. true
  125. If a tachyarrhythmia is causing a patient to become unstable what is the most important intervention?

    A. expert consultation
    B. antiarrhythmic medications
    C. IV fluids
    D. cardioversion
    D. cardioversion
    (this multiple choice question has been scrambled)
  126. Unstable Monomorphic VT and Polymorphic VT are treated with the same interventions?

    a. true
    b. false
    b. false
  127. Which is the correct treatment for unstable polymorphic VT?

    A. treat with medication only
    B. treat with 3 stacked shocks
    C. treat as VF with high-energy unsynchronized shocks
    D. treat with synchronized cardioversion and an initial shock 100J
    C. treat as VF with high-energy unsynchronized shocks
    (this multiple choice question has been scrambled)
  128. Which is the correct treatment of unstable monomorphic VT with a pulse?

    A. treat with 3 stacked shocks
    B. treat with medications only
    C. treat with synchronized cardioversion and an initial shock of 100J
    D. treat as VF with high-energy unsynchronized shocks
    C. treat with synchronized cardioversion and an initial shock of 100J
    (this multiple choice question has been scrambled)
  129. If there is any doubt about whether an unstable patient has monomorphic or polymorphic VT what should you do?

    A. treat with synchronized cardioversion and an initial shock of 100J
    B. treat with high-energy unsynchronized shocks
    C. treat with 3 stacked shocks
    D. treat with medications only
    B. treat with high-energy unsynchronized shocks
    (this multiple choice question has been scrambled)
  130. If the patient is unstable with a narrow-complex SVT what IV medications can be given as you prepare for immediate synchronized cardioversion? (not shown in unstable pathway but can be given)

    A. amiodarone 150 mg IV
    B. adenosine 6 mg rapid IV push
    C. atropine 1 mg IV
    D. epinephrine 1 mg IV
    B. adenosine 6 mg rapid IV push
    (this multiple choice question has been scrambled)
  131. Which is the correct definition of unsynchronized shock?

    a. The electrical shock is delivered as soon as the operator pushed the SHOCK button to discharge the machine. The shock can fall randomly anywhere within the cardiac cycle.
    b. The electrical shock is delivered with a peak of the R wave in the QRS Complex thus avoiding the delivery of a shock during cardiac repolarization (t-wave).
    a. The electrical shock is delivered as soon as the operator pushed the SHOCK button to discharge the machine. The shock can fall randomly anywhere within the cardiac cycle.
  132. Synchronized cardioversion uses a higher energy level than used with unsynchronized cardioversion (defibrillation).

    a. true
    b. false
    b. false
  133. Low-energy shocks are always delivered synchronized due to the fact that low energy shocks have the potential to produce which rhythm if delivered unsynchronized?

    A. Atrial flutter
    B. VF
    C. Asystole
    D. VT
    B. VF
    (this multiple choice question has been scrambled)
  134. Which of the following cases is unsynchronized shock not advised?

    A. for a patient who has unstable tachycardia with a pulse
    B. for the patient who is unstable and you are unsure what type of VT exists
    C. for the patient who is pulseless
    D. for a patient who is unstable with polymorphic VT
    A. for a patient who has unstable tachycardia with a pulse
    (this multiple choice question has been scrambled)
  135. How many doses of adenosine rapid IV push can be give with the tachycardia algorithm?

    A. 4
    B. 3
    C. 2
    D. 5
    C. 2
    (this multiple choice question has been scrambled)
  136. Two interventions that can be performed for a regular narrow-complex tachyarrhythmias are vagal maneuvers and adenosine administration?

    a. true
    b. false
    a. true
  137. Adenosine can be given 2 times to attempt conversion of tachyarrhythmia. What is the recommended dosing schedule?

    A. 12mg, if no conversion then 6mg
    B. 6mg, if no conversion then 6mg
    C. 12mg, if no conversion then 12mg
    D. 6mg, if no conversion then 12mg
    D. 6mg, if no conversion then 12mg
    (this multiple choice question has been scrambled)
  138. Cardioversion is contraindicated for sinus tachycardia because the increased heart rate is being caused by an external influence such as fever, blood loss, or exercise.

    a. true
    b. false
    a. true
  139. With sinus tachycardia, the goal is to identify and treat the underlying systemic causes.

    a. true
    b. false
    a. true
  140. Adenosine can be considered for the diagnosis and treatment of stable undifferentiated wide-complex tachycardia when the rhythm is regular and the QRS waveform is monomorphic.

    a. true
    b. false
    a. true
  141. Immediate assessments and actions for a patient presenting with symptoms suggestive of ACS include:

    a. oxygen
    b. aspirin
    c. nitroglycerin
    d. morphine
    e. 12-lead ECG
    f. all of the above
    g. only a and e
    h. only b and e
    f. all of the above
  142. Once a patient has arrived in the emergency department with ACS symptoms, the goal is to analyze the ECG within ____ minutes of arrival.

    A. 10 mins
    B. 5 mins
    C. 20 mins
    D. 30 mins
    A. 10 mins
    (this multiple choice question has been scrambled)
  143. What is the primary focus of treatment of a patient with ACS?

    A. early reperfusion of the STEMI patient
    B. assessing family history of coronary artery disease
    C. early use of medications to prevent plaque formation
    D. early hospital arrival
    A. early reperfusion of the STEMI patient
    (this multiple choice question has been scrambled)
  144. Which rhythm is most commonly caused by acute myocardial ischemia and is the leading cause of sudden cardiac death?

    A. SVT
    B. VT
    C. VF
    D. Bradycardia
    C. VF
    (this multiple choice question has been scrambled)
  145. Reperfusion therapy may involve which of the following:

    A. PCI (percutaneous coronary intervention)
    B. heparin
    C. both a and b
    D. fibrinolytic therapy
    e. all of the above
    C. both a and b

    PCI and fibrinolytic therapy
    (this multiple choice question has been scrambled)
  146. Which of the following drugs are used in the initial treatment of ACS (acute coronary syndrome)?

    A. aspirin, fibrinolytics, ACE inhibitors
    B. aspirin, morphine, nitroglycerin
    C. simvastatin, labetalol, oxygen
    D. heparin, metoprolol, aspirin
    B. aspirin, morphine, nitroglycerin
    (this multiple choice question has been scrambled)
  147. Which of the following is essential to the risk and treatment stratification process in the ACS algorithm?

    A. assessing pain level
    B. obtaining a family history
    C. using symptoms to identify an MI
    D. obtaining a 12-lead ECG
    D. obtaining a 12-lead ECG
    (this multiple choice question has been scrambled)
  148. What is the most common symptom of myocardial ischemia and infarction?

    A. discomfort in the upper back between the shoulder blades
    B. jaw pain
    C. discomfort in the retrosternal chest
    D. radiating left arm pain
    C. discomfort in the retrosternal chest
    (this multiple choice question has been scrambled)
  149. Other life-threatening conditions that may cause acute chest discomfort are:

    a. aortic dissections, acute PE
    b. acute pericardial effusion with tamponade
    c. tension pneumothorax
    d. all of the above
    d. all of the above
  150. EMS/ED providers should administer oxygen if the oxyhemoglobin saturation is <(less than) ____%.

    A. 90
    B. 95
    C. 92
    D. 94
    D. 94
    (this multiple choice question has been scrambled)
  151. There is insufficient evidence to support the routine use of oxygen in uncomplicated ACS without signs of hypoxemia and heart failure or both.

    a. true
    b. false
    a. true
  152. What arrhythmia is most likely to develop in the first 4 hours after onset of acute coronary syndrome?

    A. VT
    B. PEA
    C. Atrial Flutter
    D. VF
    D. VF
    (this multiple choice question has been scrambled)
  153. For the patient with chest pain, nitroglycerine should be administered if the patient's systolic blood pressure remains > (greater than) _____ and the heart rate is 50-100/min.

    A. 90
    B. 120
    C. 100
    D. 80
    A. 90
    (this multiple choice question has been scrambled)
  154. Which pain medication is indicated in STEMI when chest discomfort is unresponsive to nitrates?

    A. motrin
    B. dilaudid
    C. hydrocodone
    D. morphine
    D. morphine
    (this multiple choice question has been scrambled)
  155. For the patient with acute coronary syndrome, use of Non-steroidal anti-inflammatory drugs (NSAIDs) are contraindicated (except for aspirin) and should be discontinued.

    a. true
    b. false
    a. true
  156. Response to nitroglycerine (nitrate therapy) is not diagnostic for acute coronary syndrome.

    a. true
    b. false
    a. true
  157. One of the goals of reperfusion therapy is to perform PCI (percutaneous coronary intervention) within ___ mins of arrival in the ED.

    A. 120 mins
    B. 60 mins
    C. 90 mins
    D. 30 mins
    C. 90 mins
    (this multiple choice question has been scrambled)
  158. What is the major contraindication to aspirin administration?

    a. true aspirin allergy
    b. recent GI bleed
    c. hypotension
    d. fever > 100 F (37.7 C)
    e. all of the above
    f. both a and b
    f. both a and b

    true aspirin allergy and recent GI bleed
  159. Fibrinolytic agents or "clot busters" are effective in about ____% of the patients given these drugs.

    A. 70
    B. 40
    C. 50
    D. 20
    C. 50
    (this multiple choice question has been scrambled)
  160. Fibrin specific agents include which of the following?

    a. rtPA
    b. reteplase
    c. tenecteplase
    d. all of the above
    d. all of the above
  161. What is the recommended dosage of oral aspirin to be given within the ACS protocol?

    A. 300mg
    B. 120-200mg
    C. 80-120mg
    D. 160-325mg
    D. 160-325mg
    (this multiple choice question has been scrambled)
  162. Which item(s) below can be used to identify a STEMI?

    A. troponin
    B. 12-lead EKG
    C. retrosternal chest pain
    d. all of the above
    B. 12-lead EKG
    (this multiple choice question has been scrambled)
  163. One goal of reperfusion therapy is to give fibrinolytics within ___ mins of arrival.

    A. 60
    B. 90
    C. 30
    D. 20
    C. 30
    (this multiple choice question has been scrambled)
  164. Morphine is recommended for patients suspected of having ischemic chest discomfort that does not respond to nitrates.

    a. true
    b. false
    a. true
  165. consultation with a cardiologist should take place before treatment of STEMI.

    a. true
    b. false
    b. false
  166. Patients with suspected ACS should have oxygen administered if the patient is ______.

    a. dyspneic
    b. hypoxemic
    c. oxyhemaglobin saturation is <94%
    d. any of the above
    d. any of the above
  167. The 4 agents that are routinely recommended for consideration in patients with ischemic-type chest discomfort are:

    A. ibuprofen, morphine, nitroglycerine, and oxygen if hypoxemic (O2 < 94%)
    B. aspirin, nitroglycerin, morphine, and oxygen if hypoxemic (O2 < 94%)
    C. epinephrine, dopamine, morphine, and oxygen if hypoxemic (O2 < 94%)
    D. aspirin, nitroglycerin, dilaudid, and metoprolol
    B. aspirin, nitroglycerin, morphine, and oxygen if hypoxemic (O2 < 94%)
    (this multiple choice question has been scrambled)
  168. What is the major contraindication to administration of nitroglycerine and morphine?

    A. chest pain
    B. recent bleeding
    C. changes in level of consciousness
    D. hypotension
    D. hypotension
    (this multiple choice question has been scrambled)
  169. For cases in which fibrinolytics are contraindicated, what intervention should be performed?

    A. heparin therapy
    B. observation
    C. bypass surgery
    D. PCI (percutaneous coronary intervention)
    D. PCI (percutaneous coronary intervention)
    (this multiple choice question has been scrambled)
  170. Routine use of IV nitroglycerine is not indicated for STEMI and has not been shown to significantly reduce mortality in STEMI.

    a. true
    b. false
    a. true
  171. Indications for the use of intravenous nitroglycerine in STEMI are:

    a. recurrent or continuing chest pain unresponsive to sublingual or spray nitroglycerine
    b. pulmonary edema complicating STEMI
    c. hypertension complicating STEMI
    d. all of the above
    d. all of the above
  172. Which is a contraindication for the use of nitroglycerin in the ACS protocol?

    a. right ventricular infarction
    b. hypotension
    c. recent phosphodiesterase inhibitor use
    d. all of the above
    d. all of the above
  173. The most common form of stroke is:

    A. hemorrhagic
    B. ischemic
    C. cardiogenic
    D. neurogenic
    B. ischemic
    (this multiple choice question has been scrambled)
  174. Hemorrhagic stroke occurs when a blood Bessel in the brain suddenly ruptures into surrounding cerebral tissue.

    a. true
    b. false
    a. true
  175. Hemorrhagic strokes are potentially eligible for fibrinolytic therapy.

    a. true
    b. false
    b. false
  176. Upon arrival to the ED, how soon should a suspected stroke patient receive an assessment and order for a non-contrast CT scan?

    A. within 5 mins
    B. within 20 mins
    C. within 15 mins
    D. within 10 mins
    D. within 10 mins
    (this multiple choice question has been scrambled)
  177. A neurological assessment and CT scan should be completed within ____ mins of ED arrival.

    A. 30
    B. 15
    C. 20
    D. 25
    D. 25
    (this multiple choice question has been scrambled)
  178. Interpretation of the CT scan should be completed within ____ mins of ED arrival.

    A. 40
    B. 25
    C. 45
    D. 30
    C. 45
    (this multiple choice question has been scrambled)
  179. For patients who qualify for fibrinolytic therapy, it should be initiated within ___mins of hospital arrival.

    A. 60
    B. 45
    C. 50
    D. 55
    A. 60
    (this multiple choice question has been scrambled)
  180. The correct order of the 8 D's of stroke care is:

    A. dispatch, detection, door, delivery, data, decision, drug, disposition
    B. detection, dispatch, delivery, door, data, decision, drug, disposition
    C. decision delivery, data, dispatch, detection, drug, door, disposition
    D. detection, decision, dispatch, disposition, drug, delivery, door, data
    B. detection, dispatch, delivery, door, data, decision, drug, disposition

    Detection: rapid recognition of stroke symptoms
    Dispatch: early activation and dispatch of emergency medical services (EMS) system by calling 911
    Delivery: rapid EMS identification, management, and transport
    Door: appropriate triage to stroke center
    Data: rapid triage, evaluation, and management within the emergency department (ED)
    Decision: stroke expertise and therapy selection
    Drug: fibrinolytic therapy, intra-arterial strategies
    Disposition: rapid admission to stroke unit, critical-care unit
    (this multiple choice question has been scrambled)
  181. The Cincinnati Prehospital Stroke Scale identifies a stroke on the basis of these three physical findings:

    A. vision changes, arm drift, abnormal speech
    B. headache, arm drift, abnormal speech
    C. dizziness, facial droop, arm drift
    D. facial droop, arm drift, abnormal speech
    D. facial droop, arm drift, abnormal speech
    (this multiple choice question has been scrambled)
  182. From the time of onset of symptoms for ischemic stroke, how long do you generally have to initiate fibrinolytic therapy?

    A. 5 hours
    B. 3 hours
    C. 60 mins
    D. 90 mins
    B. 3 hours
    (this multiple choice question has been scrambled)
  183. The critical decision point in the assessment of the patient with acute stroke is the performance and interpretation of a _________.

    A. non-contrast CT scan
    B. ECG
    C. EEG
    D. Cincinnati Stroke Scale
    A. non-contrast CT scan
    (this multiple choice question has been scrambled)
  184. What should not be given until intracranial hemorrhage has been ruled out?

    a. aspirin
    b. heparin
    c. rtPA
    d. all of the above
    d. all of the above
  185. If hemorrhage is not present on the initial CT scan and the patient is not a candidate for fibrinolytics for other reasons, consider giving what medication?

    A. heparin
    B. metoprolol
    C. aspirin
    D. enoxaparin
    C. aspirin
    (this multiple choice question has been scrambled)
  186. Which of the following will exclude someone from the use of fibrinolytic therapy?

    a. head trauma or prior stroke in previous 3 months
    b. elevated systolic blood pressure > 185 or diastolic > 110
    c. evidence of active bleeding
    d. all of the above
    d. all of the above
  187. For inclusion of fibrinolytic therapy, the onset of symptoms must be less than ___ hours before beginning treatment.

    A. 4
    B. 2.5
    C. 3
    D. 3.5
    C. 3
    (this multiple choice question has been scrambled)
  188. The minimum age for inclusion of fibrinolytic therapy is ____years of age.

    A. 25
    B. 20
    C. 12
    D. 18
    D. 18
    (this multiple choice question has been scrambled)
  189. Anticoagulants or antiplatelet treatment should not be administered for ____hrs after administration of rtPA.

    A. 48
    B. 36
    C. 12
    D. 24
    D. 24
    (this multiple choice question has been scrambled)
  190. In certain instances, the time allowed for consideration of treatment can be pushed back to ___ hrs after onset of symptoms.

    A. 5
    B. 4.5
    C. 5.5
    D. 4
    B. 4.5
    (this multiple choice question has been scrambled)
  191. Intra-arterial administration of rtPA, which is not yet approved by the FDA, can be given within the first ___hrs after onset of symptoms and has been documented to improve functional outcomes.

    A. 7
    B. 6
    C. 5
    D. 4
    B. 6
    (this multiple choice question has been scrambled)
  192. During rtPA treatment, blood pressure should be monitored every ____ mins for 2 hrs from the start of rtPA therapy.

    A. 30
    B. 60
    C. 10
    D. 15
    D. 15
    (this multiple choice question has been scrambled)
  193. What does ROSC stand for:

    A. return of spontaneous compression
    B. return of strong circulation
    C. repeat of shock and compressions
    D. return of spontaneous circulation
    D. return of spontaneous circulation
    (this multiple choice question has been scrambled)
  194. In the post-cardiac arrest phase, you should maintain oxygen saturation levels at

    A. 90-95%
    B. ≥ 90%
    C. ≥ 94%
    D. 100%
    C. ≥ 94%
    (this multiple choice question has been scrambled)
  195. In the post arrest phase hypotension is considered _____ .

    A. SBP < 85
    B. SBP < 90
    C. SBP < 80
    D. SBP < 100
    B. SBP < 90
    (this multiple choice question has been scrambled)
  196. The most reliable method of confirming and monitoring correct placement of an ET tube is _____.

    A. oxygen saturation monitor
    B. continuous waveform capnography
    C. x-ray
    D. end-tidal CO2 detector
    B. continuous waveform capnography
    (this multiple choice question has been scrambled)
  197. Which of the following is the only post-resuscitation intervention that has been demonstrated to improve neurologic recovery after cardiac arrest?

    A. therapeutic hypothermia (Now called Targeted Temperature Management)
    B. vasopressor infusion
    C. continuous waveform capnography
    D. maintaining an oxygen saturation >94%
    A. therapeutic hypothermia (Now called Targeted Temperature Management)
    (this multiple choice question has been scrambled)
  198. The teratment of hypotension during the post-cardiac arrest will often include IV bolus of fluids. What is the recommended amount of NS or lactated Ringer's that should be given?

    A. 1-2 L
    B. 500mL
    C. 1 L
    D. 500mL -1L
    A. 1-2 L
    (this multiple choice question has been scrambled)
  199. If Targeted Temperature Management is indicated in the post-resuscitation phase, what is the recommended temperature fluids should be cooled to?

    A. 10° C
    B. 8° C
    C. 0° C
    D. 4° C
    D. 4° C
    (this multiple choice question has been scrambled)
  200. Three medications recommended for the treatment of hypotension in the post-resuscitation phase are:

    A. epinephrine, dopamine, sotalol
    B. epinephrine, norepinephrine, and amiodarone
    C. epinephrine, norepinephrine, and dopamine
    D. labetalol, dopamine, amiodarone
    C. epinephrine, norepinephrine, and dopamine
    (this multiple choice question has been scrambled)
  201. The medications used for the treatment of hypotension in the previous question should be titrated to keep the SBP >  ___ mmHg or a mean arterial pressure of >___mmHg

    A. 90, 65
    B. 95, 70
    C. 100, 75
    D. 85, 60
    A. 90, 65
    (this multiple choice question has been scrambled)
  202. The medications used for the treatment of hypotension during the post-arrest phase including epinephrine, dopamine, and norepinephrine all use weight based doses?

    a. true
    b. fasle
    a. true
  203. In the post resusciation phase, what is the decision point for the use of Targeted Temperature Management?

    A. arrest phase was > than 10 mins
    B. defibrillation occurred during resuscitation.
    C. The patient fails to follow commands
    D. The patient's tempeature is > 37 °C
    C. The patient fails to follow commands
    (this multiple choice question has been scrambled)
  204. To induce hypothermia for Targeted Temperature Management, health care providers should cool patients to a single target temperature of __-__.

    A. 28-32° C
    B. 30-32° C
    C. 30-35° C
    D. 32-36° C
    D. 32-36° C
    (this multiple choice question has been scrambled)
  205. How long should cooling measures persist during the post-arrest phase?

    A. 12-24 hrs
    B. < 12 hrs
    C. 5-10 hrs
    D. At least 24 hrs
    D. At least 24 hrs
    (this multiple choice question has been scrambled)
  206. The purpose of Targeted Temperature Management is to:

    A. slow the heart rate
    B. protect the brain and other organs
    C. reduce chances of reoccurrence of cardiac arrest
    D. improve the effectiveness of medications
    B. protect the brain and other organgs
    (this multiple choice question has been scrambled)
  207. Which of the following are considered safe and effective for indcution of Targeted Temperature Management?

    a. rapid IV infusion of ice-cold, isotonic, non-glucose-containing fluid (30mL/kg)
    b. surface cooling devices
    c. endovascular catheter infusion of ice-cold, isotonic, non-glucose-containing fluid
    d. all of the above
    d. all of the above
  208. In comatose patient who spontaneously develop a mild degree of hypthermia (>32° C) after resuscitation from cardiac arrest, avoid active rewarming during the first 12-24 hrs after ROSC.

    a. true
    b. false
    a. true
  209. Axillary temperatures are adequate for measurment of core temperature during the post-resusciation phase.

    a. true
    b. false
    b. false
  210. Which of the following is considered adequate for monitoring core temperatures in the post-arrest phase?

    a. esophageal thermometer
    b. bladder catheter in nonanuric patients
    c. pulmonary artery catheter
    d. all of the above
    d. all of the above
  211. What does PCI mean?

    A. premature coronary intervention
    B. possible cardiac incident
    C. post-cardiac interventions
    D. percutaneous cornoary intervention
    D. percutaneous coronary intervention
    (this multiple choice question has been scrambled)
  212. In the Post-Cardiac Arrest Algorithm flowchart, you are instructed "DO NOT" do one thing. What is it?
    A. hyperventilate
    B. induce hypothermia
    C. hypoventilate
    d. none of the above
    A. hyperventilate
    (this multiple choice question has been scrambled)
  213. Health care providers should consider induced hypothermia for comatose adult patients with ROSC after in-hospital cardiac arrest from ventricular fibrillation only.

    a. true
    b. false
    b. false
  214. Waveform capnography measures which of the following:

    A. PetCO2
    B. PaCO2
    C. PaO2
    D. PCO2
    A. PetCO2
    (this multiple choice question has been scrambled)
  215. In the post-resuscitation phase when using continuous waveform capnography, you should titrate breaths per minute to achieve PetCO2 (partial end-tidal carbon dioxide) of __________.

    A. 35-40 mmHg
    B. 25-30 mmHg
    C. 15-25 mmHg
    D. 5-10 mmHg
    A. 35-40mmHg
    (this multiple choice question has been scrambled)
  216. In the post-resuscitation phase when evaluating an arterial blood gas, you should titrate breaths per minute to achieve PaCO2 (partial pressure of carbon dioxide) of _____.

    A. 50-60 mmHg
    B. 35-45 mmHg
    C. 40-45mmHg
    D. 30-40 mmHg
    C. 40-45 mmHg
    (this multiple choice question has been scrambled)
  217. In the post-resuscitiation phase what is a reasonable goal for the mean arterial blood pressure?

    A. 55-65 mmHg
    B. 65-70 mmHg
    C. ≥65 mmHg
    D. ≥ 85 mmHg
    C. ≥65 mmHg
    (this multiple choice question has been scrambled)
  218. There are now 2 "Chanis of Survival" that are used for ACLS. These two chains include:

    A. cardiac arrest from ventricular tachycardia and ventricular fibrillation
    B. Out-of-Hospital and In-Hospital Cardiac Arrest
    C. Hands only CPR and CPR with chest compressions and rescue breaths
    D. the right branch and the left branch of the Cardiac Arrest Algorithm
    B. Out-of-Hospital and In-Hospital Cardiac Arrest
    (this multiple choice question has been scrambled)
  219. At what point in both chains of survival do the interventions converge?

    A. in the cath lab
    B. post-arrest ICU
    C. in the emergency room
    D. with the lay rescuer
    A. in the cath lab
    (this multiple choice question has been scrambled)
  220. Rapid Response Teams (RRT) or Medical Emergency Teams (MET) can be effective for reducing the incidence of cardiac arrest.

    a. true
    b. false
    a. true
  221. The recommended sequence for CPR has been confirmed and will remain the same. What is the recommended sequence for single recuer CPR?

    A. C-A-B (Circualtion, Airway, Breathing)
    B. Establish unresponsiveness, provide 2 rescue breaths, begin chest compressions
    C. Activate EMS, open the airway, begin CPR, defibrillation
    D. A-B-C (Airway, Breathing, Circulation)
    A. C-A-B (Circualtion, Airway, Breathing)
    (this multiple choice question has been scrambled)
  222. During CPR a compression depth of at least ___ is requried in adults.

    A. 2 inches
    B. 2 ½ inches
    C. 1½ inches
    D. 1 ½-2 inches
    A. 2 inches
    (this multiple choice question has been scrambled)
  223. High qulaity CPR includes all of the following except:

    A. allowing for complete chest recoil after each compression
    B. avoiding excessive ventilation
    C. minimizing interruptions in chest compressions
    D. ensuring a 15:2 compression to ventilation ratio
    D. ensuring a 15:2 compression to ventilation ratio
    (this multiple choice question has been scrambled)
  224. Prior to 2010, when the A-B-C (airway-breathing-circulation) sequence was used for CPR, which of the following would often delay chest compressions?

    a. opening the airway to give rescue breaths
    b. retrieving a barrier device
    c. assembling ventilation equipment
    d. all of the above
    d. all of the above
  225. During CPR, the recommended chest compressions rate is ___ per minute.

    A. at least 100/min
    B. at least 110/min
    C. 100-120/min
    D. 90-100/min
    C. 100-120/min
    (this multiple choice question has been scrambled)
  226. The recommendation for chest comprssion depth for adults is at least 2 inches (5cm) but not greater than ___ inches.

    A. 2.5 inches
    B. 2.4 inches
    C. 2.2 inches
    D. 3 inches
    B. 2.4 inches
    (this multiple choice question has been scrambled)
  227. What is now recommended to be implemented in public access locations where there is a relatively high liklihood of witnessed cardiac arrest?

    A. oral barrier devices for assisted breathing
    B. Public access defibrillators
    C. Written BLS instrucitons
    D. public health nurses
    B. Public access defibrillators
    (this multiple choice question has been scrambled)
  228. Compressions-only CPR is recommended for singel-rescuer health care providers

    a. true
    b. false
    b. false
  229. When CPR is first initiated, how many chest compressions should be administered before giving 2 rescue breath.

    A. 100
    B. 15
    C. 100-120
    D. 30
    D. 30
    (this multiple choice question has been scrambled)
  230. One important aspect of chest compressions is allow for complete chest recoil after each chest compression. What is one common error that can prevent full chest recoil.

    A. placing your hands on top of each other
    B. hyperventilation during CPR
    C. misplaced defibrillator pads
    D. leaning on the chest between compressions
    D. leaning on the chest between compressions
    (this multiple choice question has been scrambled)
  231. Chest compression fraction is a measurement of the proportion of total resuscitation time that compressions are performed. (True or False) The optimal target for the chest compression fractions should be at least 50%.

    a. true
    b. false
    b. false
  232. The simple single rate fo rthe delivery of ventilations during cardiac arrest when an advanced airway is in place is __breath(s) every __ seconds.

    A. 2 breaths every 15 seconds
    B. 2 breaths every 10 seconds
    C. 1 breath every 8 seconds
    D. 1 breath every 6 seconds
    D. 1 breath every 6 seconds
    (this multiple choice question has been scrambled)
  233. Vasopressin has been removed from the cardiac arrest algorithm.

    a. true
    b. false
    a. true
  234. It is now considered reasonable to administer what medication as soon as feasibly possible after the onset of cardiac arrest due to an initial nonshockable rhythm?

    A. vasopressin
    B. epinephrine
    C. potassium
    D. atropine
    B. epinephrine
    (this multiple choice question has been scrambled)
  235. The routine use of lidocaine after cardiac arrest is not indicated, but providers may consider lidocaine when amiodarone is not available.

    a. true
    b. false
    a. true
  236. Within the post-cardiac arrest algorithm, the term therapeutic hypothermia has been changed to _____.

    A. targeted Hypothermia Managemtn (THM)
    B. Hypothermic Temperature Management (HTM)
    C. Therapeutic Temperature Control (TTC)
    D. Targeted Temperature Management (TTM)
    D. Targeted Temperature Management (TTM)
    (this multiple choice question has been scrambled)
  237. For post-cardiac arrest (TTM) targeted temperature management, a target temperature between __ and __ °C should be selected, achieved, and maintained constantly for at least 24 hrs.

    A. 32 and 36
    B. 32 and 38
    C. 30 and 40
    D. 30 and 35
    A. 32 and 36
    (this multiple choice question has been scrambled)
  238. After 24 hrs of (TTM) targeted temperture management in the comatose post-cardiac paatient, it is recommended to activly prevent fevers.

    a. true
    b. false
    a. true
  239. The routine prehospital cooling of patients with rapid infusion of cold IV fluids after ROSC is now recommended.

    a. true
    b. false
    b. false
  240. During post-cardiac arrest care, the goal for adequate blood pressure should be to maintain a systolic BP (SBP) greater than ___mmHg and a mean arterial pressure (MAP) greater than ____mmHG.

    A. 100 and 65
    B. 100 and 62
    C. 95 and 60
    D. 90 and 65
    D. 90 and 65
    (this multiple choice question has been scrambled)
  241. In the out-of-hospital or ER setting, trained non-physicians may now perform ECG interpretation to determine whether or not the ECG shows evidence of STEMI.

    a. true
    b. false
    a. true
  242. Oxygen should be started on all suspected ACS (Acute Coronary Syndorme) patients regardless of oxygen saturation or respiratory condition.

    a. true
    b. false
    b. false
  243. How long should cooling measures persist during the post-arrest phase?

    A. 5-10 hrs
    B. at least 24 hrs
    C. 12-24 hrs
    D. < 12 hrs
    B. at least 24 hrs
    (this multiple choice question has been scrambled)
Author
ID
280253
Card Set
ACLS
Description
advance cardiac life support
Updated
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