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3. How often should a patient be ventilated if they are experiencing respiratory arrest?
a. Once every 7 to 8 seconds or 10 to 12 times per minute
b. Once every 8 to 9 seconds or 8 to 10 times per minute
c. Once every 5 to 6 seconds or 10 to 12 times per minute
d. Once every 2 to 3 seconds or 15 to 17 times per minute
4. What are the risks associated with Hyperventilation?
a. Decreased venous return to the heart
b. Diminished cardiac outpu
c. Increases intrathoracic pressure
d. All of the above
5. The target oxygen saturation that should be maintained is ____________ .
a. 90%
b. 85%
c. 95%
d. 97%
6. Which basic airway skill is the most commonly used method for providing positivepressure ventilation?
a. Mouth-to-mouth
b. Mouth-to-barrier device
c. Bag-mask ventilation
d. Jaw thrust without head extension
7. A Rigid Catheter type is more effective than a Soft Catheter type for which of the following
uses:
a. More effective suctioning of the oropharynx
b. Aspiration of thin secretions from the oropharynx and nasopharynx
c. Performing intratracheal suctioning
d. Suctioning through an in-place airway to access the back of the pharynx in a patient
with clenched teeth
8. One cycle of CPR consists of ___________.
a. 30 compressions then 2 breaths
b. 20 compressions then 2 breaths
c. 30 compressions then 3 breaths
d. 20 compressions then 3 breath
9. When using a monophasic defibrillator, how many joules should be delivered for one
shock?
a. 270-J
b. 320-J
c. 360-J
d. 390-J
10. When using a monophasic defibrillator, how many joules should be delivered for one
shock?
a. 270-J
b. 320-J
c. 360-J
d. 390-J
10. Which one of the following is not a common cause of PEA?
a. Hypoxia
b. Thoracic damage
c. Toxins
d. Thrombosis
11. Which of the following are the two most easily reversible causes of PEA?
a. Hypovolemia and Trauma
b. Thrombosis and Trauma
c. Hypoglycemia and Hypoxia
d. Tension pneumothorax and Hypoxia
12. Cardiac arrest rhythm associated with no discernible electrical activity on the ECG is
a. Acute Coronary Syndrome
b. Bradycardia
c. Pulseless Electric Activity
d. Aystole
13. Which of the following is (are) an Acute Coronary Syndrome?
a. Plaque pupture
b. Microemboli
c. Unstable angina
d. All of the above
14. Which of the following is not a recommended agent to be administered to patients under
evaluation for ACS?
a. Morphine
b. Epinephrine
c. Aspirin
d. Nitroglycerin
15. Which of the following is a standard treatment procedure for patients with STEMI?
a. Reperfusion therapy
b. Use of a soft catheter
c. Defibrillation
d. Administration of morphin
16. A rhythm disorder with a heart rate of less than 60 bpm is ____________ .
a. Acute Coronary Syndrome
b. Bradycardia
c. Pulseless Electric Activity
d. Ventricular Fibrillation
17. What is an adverse sign of bradycardia?
a. Congestive heart failure
b. Hypertension
c. Chest pain
d. Impaired speech
18. TCP is not a recommended treatment for which of the following?
a. Standby pacing
b. Bracycardia with escape rhythms
c. Asystole
d. Hemodynamically significant bradyarrhythmia
19. A rhythm disorder with a heart rate of greater than 100 bpm is __________.
a. Acute Coronary Syndrome
b. Bradycardia
c. Ventricular Fibrillation
d. Tachyarrthythmia
20. Which of the following is a recommended agent to be administered to patients under
evaluation for unstable tachycardia?
a. No agents are recommended
b. Morphine
c. Oxygen
d. Aspirin
21. Which of the following is not a symptom of unstable tachycardia?
a. Shortness of breath
b. Blurred vision
c. Altered mental status
d. Fatigue
that the woman has gone 12 minutes without any bystander CPR. What actions should you
the EMTs take next?
a. resume CPR, supplement with 100% 02, continue until paramedics arrive
b. allow the AED to charge and shock
c. resume CPR, supplement with 100% 02 for 3 minutes, reanalyze, shock if indicated
d. resume CPR, contact medical control, request permission to stop resuscitative efforts
35) When using vasopressin on a patient who remains in persistent VF arrest.. Which
of the following guidelines for use of vasopressin is true?ue?
a. give vasopressin 40 U every 3 to 5 minutes
b. give vasopressin for better vasoconstriction and -adrenergic; stimulation than
provided by
epinephrine
c. give vasopressin as an alternative to epinephrine in shock-refractory VF
d. give vasopressin as the first-line pressor agent for clinical shock caused by
hypovolemia
36) A patient presents to your unit. CPR continues with ventilations provided through a
endotracheal tube inserted in the hallway. Chest compressions produce a femoral pulse that
disappears during a "stop compressions" pause. During the pause the cardiac monitor shows
narrow QRS complexes at a rateof 67 bpm. What is the next action you should take?
a. check for tracheal tube dislodgment and improper tube placement
b. start an IV, administer atropine 1 mg IV push
c. start an IV, send blood samples for measurement of serum electrolytes and a toxic drug
screen
d. analyze arterial blood gases to check for acidosis, hypoxia, and hypoventilation
37) Your patient presents with PEA. You auscultate excellent bilateral breath sounds, and you
see excellent bilateral chest rise. Two minutes after epinephrine 1 mg IV is given, PEA
continues at 30 bpm. What action would you take next?
a. administer atropine 1 mg IV
b. initiate transcutaneous pacing at a rate of 60 bpm
c. start a doparnine IV infusion at 15 to 20 pg/kg per minute
d. give epinephrine (1 mL of 1:10 000 solution) IV bolus
38) Your patient presents with PEA. When would sodium bicarbonate therapy (1 mEq/kg) be
most
effective?
a. a patient with hypercarbic acidosis due to a tension pneumothorax
b. a patient with a brief arrest interval
c. a patient with documented severe hyperkalemia
d. a patient with documented severe hypokalemia
39) An unresponsive, pulseless, apnec patient arrives in your unit in PEA at 30 bpm. CPR
continues, ET tube placement is confirmed, and IV access is secured. Which of the following
medications would you give next?
a. calcium chloride 5 mL of 10% solution IV
b. epinephrine 1 mg IV
c. synchronized cardioversion at 200 J
d. sodium bicarbonate 1 mEq/kg IV
40) What drug-dose combination is recommended as the first line medication to give to a
patient in asystole?
a. epinephrine 3 mg IV
b. atropine 3 mg IV
when
improvement in neurologic signs is noted
46) An acute stroke may exhibit signs and symptoms of which of the following conditions?
a. acute insulin-induced hypoglycemia
b. acute hypoxia
c. isotonic dehydration and hypovolemia
d. acute vasovagal or orthostatic hypotension
47) For which of the following rhythms would transcutaneous cardiac pacing be indicated?
a. sinus bradycardia with no symptoms
b. normal sinus rhythm with hypotension and shock
c. complete heart block with pulmonary edema
d. asystole that follows 6 or more defibrillation shocks
48) A man with a HR of 30 to 35 bpm complains of SOB, cool clammy extremities, and
dizziness
with minimal exercise. What drug would be indicated first to treat this patient?
a. atropine 0.5 to I mg
b. epinephrine 1 mg IV push
c. isoproterenol infusion 2 to 10 4min
d. adenosine 6 mg rapid IV push
49) Syncronized cardioversion is indicated for which of the following patients?
a. a 78-year-old woman with fever, pneumonia, chronic congestive heart failure, and sinus
tachycardia at 125 bpm
b. a 55-year-old man with multifocal atrial tachycardia at 125 bpm, respiratory rate of 12
breaths/minute, and BP of 134/86 mm Hg
c. a 69-year-old woman with a history of coronary artery disease, chest pain, a 2-mm ST
elevation, and sinus tachycardia at 130 bpm
d. a 62-year-old man with a history of rheumatic mitral valve disease, obvious shortness
of breath,
HR of 160 bpm, and BP of 80/50 mm Hg
50) In which of the senerio's below would you not cardiovert a patient with stable
tachycardia
a. a 25-year-old wheezing asthmatic woman who has pneumonia on chest x-ray, who is
taking
albuterol, and who has the following vital signs: temp = 101.2'F, HR = 140 bpm, resp =
20
breaths/min
b. a 55-year-old man with diaphoresis, bilateral rales, and the following vital signs: HR =
140 bpm,
BP = 90/55 mrn Hg, resp = 18 breaths/min, rhythm = rapid atrial flutter
c. a 62-year-old man with a wide-complex tachycardia at a rate of 140 bpm, chest pain,
shortness of breath, and palpitations
d. a 55-year-old woman with chest pain, shortness of breath, extreme weakness and
dizziness, BP of 88/54 mm Hg, and a narrow-complex tachycardia at a rate of 145 bpm
51) You prepare to cardiovert an unstable 44-year-old tachycardic man with the
monitor/defibrillator in"synchronization" mode. He suddenly becomes unresponsive and
pulseless as the rhythm changes to a VF-like pattern. You charge the defibrillator to 200 J
and press the SHOCK button,but the defibrillator fails to deliver a shock. Why?
59) Which patient below is most likely to present with vague signs and symptoms of an
atypical AMI?
a. a 65-year-old woman with moderate coronary artery disease recently confirmed by
angiography
b. a 56-year-old man who smokes 3 packs per day but has no history of heart disease
c. a 45-year-old woman diagnosed with type I diabetes 22 years ago
d. a 48-year-old man in the ICU after coronary artery bypass surgery
60) A 50-year-old woman (weight = 60 kg) with recurrent VF has converted to a wide
complex
perfusing rhythm after epinephrine 1 mg IV and a 4th shock (HR = 70 bpm, BP = 92/62 mm
Hg). Which drug therapy is most appropriate to give next?
a. amiodarone 300 mg IV push
b. adenosine 6 mg rapid IV push
hyperthermia
Answer hyperthermia
The most recent ECC Guidelines list hypovolemia; hypoxia; hypothermia;
tension pneumothorax; cardiac tamponade; toxins; and, thrombosis as
potentially reversible causes of PEA. The clinical reality is that patient should
never die of an undetected/untreated tension pneumothorax. Treatment is
simple and straight-forward. The others on the list are often too massive to
treat fast enough to achieve return of spontaneous circulation.
63) All patients with bradycardia (adult with a heart rate < 60/minute) must
receive treatment to accelerate the heart rate.
true
false
IV fluid administration
fever reduction
pain relief
all of the above
Answer all of the above. Because sinus tachycardia is not an arrhythmia per
se, but a response to a physiologic stimulus, the treatment is reversing fever,
hypovolemia, severe anxiety and pain. Adenosine can be used to
differentiate ST from SVT when the history is unclear. If adenosine converts
the narrow QRS tachycardia, ST is ruled-out
66) While treating a patient in persistent ventricular fibrillation, you consider
using vasopressin. Which of the following guidelines for the use of
vasopressin is true?
a) Give vasopressin 40 U IV every 3 to 5 minutes.
b) Give vasopressin as an alternative to epinephrine.
c) Give vasopressin rather than epinephrine, because vasopressin is a better
vasoconstrictor.
d) Give vasopressin as an antiarrhythmic to attempt to convert the ventricular
waveform.
67) A man in his 20s, who was a spectator at a sporting event, has collapsed in the
restroom. He is unresponsive and has no pulse or respirations. As you enter the room,
someone reports having just called 911 and another person races out to obtain an AED just
down the hall. What is indicated next?
a) Give the man 2 rescue breaths and begin CPR.
b) Keep the man comfortable while waiting for the AED.
c) Ask if anyone knows the mans medical history.
d) Look for evidence of drug use.
68) What is the intrinsic pacemaker rate of ventricular cells?
a) Greater than 80 beats per minute.
b) 60 to 80 beats per minute.
c) 40 to 60 beats per minute.
d) Less than 40 beats per minute.
69) Paroxysmal atrial tachycardia is characterized by a heart rate of.
a) Of 100 beats per minute.
b) Between 100 and 150 beats per minute.
c) Between 150 and 250 beats per minute.
d) Greater than 250 beats per minute.
70) First degree AV block is characterized by
79) What is the sequence in the basic life support (BLS) primary survey?
a) Check pulse, start CPR, assess reparations, start rescue breathing and activate
EMS.
b) Open the airway, start rescue breathing, check heart rhythm, provideshocks as
indicated.
c) Open the airway, assess breathing, give rescue breaths, check pulse, start CPR.
d) Activate EMS, check breathing, give two rescue breaths, check pulse, start CPR.
80) To ensure the best possible chance for your patient to survive an arrest the resuscitation
team should ensure that:
a) Family members are not present during the resuscitation effort.
b) Every attempt is made to check for signs of life.
c) Interruptions in CPR are minimized.
d) The team follows the ACLS guidelines perfectly.
81) What is the ACLS secondary survey composed of?
a) Assess airway, assess oxygenation, confirm circulation, start an IV.
b) Assess airway, assess breathing, insert an advanced airway if needed,
confirm proper placement, assess rhythm, start IV, treat abnormal rhythm.
c) Assess airway, assess pulse, treat arrhythmia, confirm properplacement
of an advanced airway, start IV, give fluids if needed.
d) Assess airway, intubate, insert a central line, shock patient.
82) What is the rate of rescue breathing for an adult?
a) 1 breath every 5 to 6 seconds or 10 to 12 breaths per minute.
b) 2 breaths to every 30 compressions.
c) 1 breath every 6 seconds or 14 breaths per minute.
d) 12 to 16 breaths per minute.
83) What is the most common cause of airway obstruction?
a) Food getting stuck in the esophagus.
b) The tongue.
c) People trying to swallow objects.
d) Eating to fast and talking at the same time.
84) How do you open the airway of a suspected neck injury patient?
a) Head tilt-chin lift.
b) Jaw thrust maneuver.
c) You do not open the airway because it will damage the spinal cord.
d) You ventilate the nose instead.
85) What is an OPA?
a) Oropharyngeal airway.
b) Oraesphageal airway.
c) Oral pharyngeal airway.
d) Oral patient airway.
86) Which statement about a nasopharyngeal airway is correct?
a) Provides an airway between the nares and the pharynx.
b) It is called a trumpet and it is used for frequent suctioning.
c) Cannot be used on a patient with an intact cough and gag reflex.
d) Will not cause laryngospasm and vomiting.
87) Immediately after delivering a shock you should have a team member.
a) Deliver another shock if the rhythm is still ventricular fibrillation.
108) What is the initial dose of atropine for the treatment of asystole?
a) 3 mg.
b) 1 mg. And repeat in 3 to 5 minutes if no response.
c) 0.5 mg.
d) 1 to 2 mg.
109) Which is the better treatment for asystole?
a) CPR, IV, intubate, epinephrine, pace.
b) CPR, IV, epinephrine or vasopressin, pace.
c) CPR, IV, epinephrine, atropine.
d) CPR, IO, intubate, epinephrine, defibrillate or pace.
110) What is ROSC?
a) Return of Spontaneous Circulation.
b) Review of Stroke Scale.
c) Reevaluation of Sudden Confusion.
d) Report of Observance of Standards and Codes.
111) Which of the following is not a contributing factor to an arrest.
a) Exercise.
b) Taking doubling the prescription dose.
c) Developing a pneumothorax.
d) Being the passenger in a motor vehicle accident.
112) What is considered the first treatment for hypotension?
a) Start a low dose dopamine infusion.
b) Administer a bolus of normal saline.
c) Administer a vasoconstrictor by the IV route.
d) Stop all blood pressure medication.
113) What are the signs and symptoms of an unstable patient?
a) A patient who complains all of the time.
b) A patient who demonstrates tachycardia, fever, and sweats.
c) A patient who reports pain.
d) A patient who reports chest pain, or shortness of breath, or has
hypotension.
114) What are the two most common causes of PEA?
a) Hypothermia and hypoxia.
b) Hypovolemia and thrombosis.
c) Hypovolemia and hypoxia.
d) Hypothermia and aneurysm.
115) MACE is all of the following except.
a) Death or nonfatal MI.
b) Urgent revascularization.
c) Major adverse cardiac events.
d) Unstable cardiac rhythms.
116) Which of the following is not a potential cause of chest pain?
a) Aortic dissection.
b) Pulmonary embolism.
c) Pericardial effusion.
d) Atherosclerosis.
a) 30 minutes.
b) 20 minutes.
c) One hour.
d) Until they are exhausted.
126) Prolonged resuscitation efforts may be indicated for patients who
a) Have a diagnosis of terminal cancer.
b) Suffered a massive MI.
c) Drowned.
d) Are hypothermic or overdosed on drugs.
127) Classification of acute coronary syndromes is based on
a) ECG and cardiac enzymes.
b) ECG.
c) History.
d) History and ECG.
128) Patients are instructed to chew an aspirin if
a) They have no allergy to aspirin.
b) They have a recent gastrointestinal bleed.
c) History of gastritis or peptic ulcer.
d) They are not having a heart attack.
129) Nitroglycerin can be safely administered to a patient with
a) An inferior MI with RV involvement.
b) Recent consumption of Viagra, Cialis or Levetra.
c) Systolic blood pressure < 90 mmHg.
d) Congestive heart failure.
130) What is the infusion rate of epinephrine?
a) 2 to 10 mcg/min.
b) 2 to 10 mcg/kg/min.
c) 2 to 10 mg/min.
d) 2 to 10 units/min.
131) What is the infusion rate of dopamine?
a) 2 to 10 mcg/kg/min.
b) 2 to 10 mg/min.
c) 2 to 10 units/min.
d) 2 to 10 mcg/min.
132) Which patient do you need to be cautious of giving atropine to?
a) The patient who was just given benadryl.
b) A patient with a second degree block.
c) A patient with a pacemaker.
d) A patient with Mobitz type II block.
133) What should you do before you pace a semicontious patient?
a) Ensure proper placement of the pacing patches.
b) Consult a cardiologist.
c) Administer pain medication and sedation.
d) Let the monitor technician know that you are going to pace the patient.
134) Which of the following is not a precaution for transcautaneous pacing?
a) It is contraindicated in severe hypothermia.
d) 0.2 mcg/kg/min.
170) Which of the following are considered vagal maneuvers?
a) Valsalva maneuver or carotid sinus massage.
b) Valsalva maneuver.
c) Carotid sinus massage.
d) A deep breath.
171) What do you do if the patient does not respond to vagal maneuvers?
a) Bolus with cardizem and start a cardizem drip.
b) Consult a cardiologist.
c) Prepare to administer 12 mg of adenosine.
d) Prepare to administer 6 mg of adenosine.
172) The first drug and dosage for Ventricular Fibrillation (other than
Oxygen) is what?
A.
Epinephrine .5 mg Q 3-5 minutes
B.
Epinephrine 1 mg Q 3-5 minutes
C.
Lidocaine 1-1.5 mg/KG
2
173)During VF, which drug and dosage may be used in
.place of Epinephrine?
A.
Vasopressin 20 units
B.
Vasopressin 40 units
C.
Lodocaine 1-1.5 mg/KG
174) For significant adult bradycardia with poor perfusion, which drugs
would you use and in what doses?
A.
Epi 0.01 mg/kg followed by Atropine 0.5 mg or Dopamine 5-10
mcg/kg/min
B.
Atropine .5 mg followed by Dopamine 2-10 mcg/kg/min or Epi 2-10
mcg/min
C.
Atropine 1 mg followed by Epi 0.01 mg/kg or Dopamine 5-10
mcg/kg/min
4
175) Which statement is true about Atropine when used for
.symptomatic bradycardia?
A.
(Max 3 mg) (0.02 mg/KG)
B.
(MAX 2 mg) (0.04 mg/kg)
C.
(MAX 3 mg) (0.04 mg/kg)
5
176) What is another treatment (in addition to Atropine) that might be used
.for symptomatic bradycardia?
A.
Isoproterenol
B.
C.
TCP
Both Isoproterenol and TCP
6
177) What drugs might be
.used with PEA?
A.
EPINEPHRINE 1 mg IV PUSH Q 3-5 MIN
B.
Lidocaine .5 mg/kg/min
C.
Atropine .2mg IVP, repeat Q 3-5
7
.178)A useful acronym for handling
asystole is what?
A.
TAE, Transcutaneous Pacing, Atropine, Epinephrine
B.
ATE, Atropine, Transcutaneous Pacing, Epinephrine
C.
TEA, Transcutaneous Pacing, Epinephrine, Atropine
8
.179) What is a useful acronym in remembering the drugs that may be
administered down an ET tube?
A.
MAN - Magnesium, Atropine, Naloxone
B.
SAN - Sodium Bicarbonate, Atropine, Naloxone
C.
LEAN - Lidocaine, Epinephrine, Atropine, Naloxone
9
180)Doses administered down an ET tube
.should be cut in half.
A.
True
B.
False
1
0
181)Which drug should not be administered as a bolus (i.e.,
.continuous infusion only)?
A.
Procainamide
B.
Amiodarone
C.
Lidocaine
1
182)A drug that might be used in place of Epi when dealing
1
with VF is what?
.
A.
Atropine .5 mg Q 3-5 min
B.
Lidocaine 1-1.5 mg/kg
C.
Vasopressin 40 Units IVP
1
183)Vasopressin may only be
2
administered once.
.
A.
True
B.
False
1
184)Vasopressin and Epi may be administered simultaneously
3
when dealing with VF.
.
A.
True
B.
False
1
4
.
185)A useful drug in dealing with persistent tachyarrhythmia causing
hypotension is what?
A.
Adenosine
B.
Bretillium
C.
Narcan
1
186) Adenosine IV initial
5
dosage is 6 mg.
.
A.
True
B.
False
1
187)Which statement about
6
Adenosine is true?
.
A.
Rapid push is indicated
B.
Second dose is 12 mg (if required)
C.
Both rapid push and 12 mg (second
dose) are indicated
1
7
188) Which statement is true concerning
.synchronized cardioversion?
A.
Narrow regular: 50-100J, Wide regular: 100 J
B.
Narrow regular: 100J, Wide regular: 50-100 J
C.
Narrow irregular: 200 biphasic or 300J monophasic
1
8
189) What is the normal dose of
.Amiodarone?
A.
6 mg initial followed by 12 mg in five minutes
B.
300 mg IV initially, followed by second dose of 150 mg IV in five
minutes
C.
1-1.5 mg/kg/min
1
190)Amiodarine is used in
9
pulseless VF.
.
A.
True
B.
False
2
191) The first drug normally used in cardiac
0
arrest is what?
.
A.
Atropine
B.
Lidocaine
C.
Epinephrine