ACLS-Pretest

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2nd degree AV block: Mobitz II

2nd degree AV block: Mobitz II
2nd degree AV block: Wenebach
2nd degree AV block: Wenebach
3rd degree AV block
Atrial fibrillation
Atrial flutter
Asystole
Monomorphic ventricular tachycardia
Normal sinus
Pulseless electrical activity
Polymorphic ventricular tachycardia
Sinus bradycardia
Sinus bradycardia
Sinus tachycardia
Supraventricular tachycardia
Supraventricular tachycardia
Ventricular fibrillation
Ventricular fibrillation
Ventricular fibrillation
You arrive on the scene with the code
team. High-quality CPR is in progress,
An AED has previously advised 'no
shock indicated.' A rhythm check now establish IV/IO access
finds asystole. After resuming high-qual-
ity compressions, what is the next action
you take?
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A patient has a rapid irregular wide-com-
plex tachycardia. The ventricular rate is
138 bpm. He is asymptomatic, with a
seeking expert consultation
blood pressure of 110/70. He has a his-
tory of angina. What action is recom-
mended next?
What is the indication for the use of mag- Pulseless VT-associated torsades de
nesium in cardiac arrest? pointes
A patient with possible STEMI has on-
going chest discomfort. What is a con- use of PDE-i within the previous 24 hrs
traindication to nitrate administration?
A patient is in cardiac arrest. High-qual-
ity chest compressions are being given.
The patient is
epi 1mg IV/IO
intubated and an IV has been started.
The rhythm is asystole. Which is the first
drug/dose to administer?
A patient is in pulseless ventricular
tachycardia. Two shocks and 1 dose
amiodarone 300mg
of epinephrine have been given. Which
drug should be given next?
A patient with STEMI has ongoing chest
discomfort. Heparin 4000 units IV bolus
and a heparin infusion of 1000 units/hr
are being administered. The patient did ASA 160-325mg to chew
not take aspirin because he has a history
of gastritis, which was treated 5 years
ago. What is your next action?
A 57-year-old woman has palpitations,
chest discomfort, and tachycardia. The
monitor shows a regular wide-complex
perform electrical cardioversion
QRS at a rate of 180 bpm. She becomes
diaphoretic, and her BP is 80/60 mmHg.
Which action do you take next?
What is a situation in which bradycardia
hypotension
requires treatment?

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A monitored patient in the ICU devel-
oped a sudden onset of narrow-complex
tachycardia at a rate of 220 bpm. The
patient's BP is 128/58 mmHg, the PET-
CO2 is 38 mmHg, and the pulse ox is
98%. There is vascular access in the L
adenosine 6mg IV push
arm, and the patient has not been given
any vasoactive drugs. A 12-lead EKG
confirms an SVT with on evidence of
ischemia or infarction. The rate has not
responded to vagal maneuvers. What is
your next action?
A patient is in refractory vfib and has
received multiple appropriate defibrilla-
tion shocks, epi 1mg IV 2x, and an ini-
150mg IV push
tial dose of amiodarone 300mg IV. The
patient is intubated. How should the 2nd
dose of amiodarone be given?
A patient is in refractory vfib. High-quality
CPR is in progress. One dose of epi was
given after the 2nd shock. An antiarrhyth-
epi 1 mg
mic drug was given immediately after
the 3rd shock. You are the team leader.
Which medication do you order next?
A 35-year-old woman has palpitations,
lightheadedness, and a stable tachycar-
dia. The monitor shows a regular nar-
row-complex QRS at a rate of 180 bpm.
adenosine 6mg
Vagal maneuvers have not been effec-
tive in terminating the rhythm. An IV has
been established. What drug should be
administered?
A patient is in cardiac arrest. Vfib has
been refractory to an initial shock. If no
IV/IO
pathway for medication administration is
in place, what is the preferred method?

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A patient is in cardiac arrest. Vfib has
been refractory to a 2nd shock. Which epi 1mg IV/IO
drug should be administered 1st?
A patient has sinus bradycardia with a
HR of 36 bpm. Atropine has been ad-
ministered to a total dose of 3mg. A
transcutaneous pacemaker has failed to epi 2-10 mcg/min
capture. The patient is confused, and her
BP is 88/56 mmHg. What therapy is now
indicated?
What intervention is most appropriate for
epi
the treatment of a patient in asystole?
A 62-year-old man suddenly experi-
enced difficulty speaking and L-sided
weakness. He meets initial criteria for hold ASA for at least 24hrs if rtPA is
fibrinolytic therapy, and a CT of the brain administered
is ordered. What is a guideline for an-
tiplatelet and fibrinolytic therapy?
A patient with sinus bradycardia and a
HR of 42 bpm has diaphoresis and a BP
0.5 mg
of 80/60 mmHg. What is the initial dose
of atropine?
You are caring for a 66-year-old man with
a history of a large intracerebral hemor-
rhage 2 months ago. He is being evaluat-
ed for another acute stroke. The CT scan
is negative for hemorrhage. The patient ASA
is receiving oxygen via nasal cannula at
2 L/min and an IV has been established.
His BP is 180/100 mmHg. What drug do
you anticipate giving to this patient?
How often should you switch chest com-
~q2mins
pressors to avoid fatigue?
A patient's 12-lead ECG is transmitted
by the paramedics and shows a STEMI.
When the patient arrives in the ED, the

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rhythm shown here is seen on the car-
diac monitor. The patient has resolution
of 5/10 chest pain after 3 doses of SL reperfusion therapy
NTG. BP is 104/70 mmHg. What inter-
vention is most important in reducing this
patient's in-hospital and 30-day mortality
rate?
What is the recommended compression
100-120/min
rate for high-quality CPR?
A patient was in refractory vfib; the
rhythm shown here is on the cardiac resume high-quality chest compressions
monitor. A 3rd shock has just been ad-
ministered. Your team looks to you for
instructions. What is your next action?
What action should you take immediate-
resume chest compressions
ly after providing an AED shock?
Your patient is not responsive and is
not breathing. You can palpate a carotid start rescue breathing
pulse. What action do you take next?
You are providing bag-mask ventilations
to a patient in respiratory arrest. How ~q5-6 secs
often should you provide ventilations?
What is the recommended depth of
at least 2 in
chest compressions for an adult victim?
A patient has been resuscitated from
cardiac arrest. During post-ROSC treat- give immediate unsynchronized high-en-
ment, the patient becomes unrespon- ergy shock (defibrillation dose)
sive, with the rhythm shown here. What
action is indicated next?
Your patient becomes unresponsive. You
are uncertain if a faint pulse is present.
The rhythm shown here is seen on the start high-quality CPR
cardiac monitor. An IV is in place. What
action do you take next?
After initiation of CPR and 1 shock for
vfib, this rhythm is present on the next
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rhythm check. A 2nd shock is given, and
chest compressions are resumed imme-
diately. An IV is in place, and no drugs epi 1mg IV/IO
have been given. Bag-mask ventilations
are producing visible chest rise. What is
your next intervention?
A 45-year-old woman with a history
of palpitations develops light-headed-
ness and palpitations. She has received
adenosine 6mg IV for the rhythm shown adenosine 12mg IV
here, without conversion of the rhythm.
She is now extremely apprehensive. Her
BP is 128/70 mmHg. What is the next
appropriate intervention?
What action is likely to cause air to enter
the victim's stomach (gastric inflation) ventilating too quickly
during bag-mask ventilation?
Your patient is a 56-year-old woman with
a history of DM2 who reports feeling
dizzy. She is pale and diaphoretic. Her
BP is 80/60 mmHg. The cardiac moni- atropine 0.5mg IV
tor documents the rhythm shown here.
She is receiving oxygen at 4 L/min by
nasal cannula, and an IV has been es-
tablished. What do you administer next?
What action minimizes the risk of air
entering the victim's stomach during ventilating until you see chest rise
bag-mask ventilation?
What is the maximum interval for paus-
15 sec
ing chest compressions?
A 35-year-old woman presents with a
CC of palpitations. She has no chest dis- vagal maneuvers
comfort, SOB, or light-headedness. Her
BP is 120/78 mmHg. What intervention
is indicated 1st?

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How does complete chest recoil con- allows maximal blood to return to the
tribute to effective CPR? heart
You are the code team leader and arrive
to find a patient with CPR in progress.
On the next rhythm check, you see the
rhythm shown here. Team members tell
you that the patient was well but re- epi 1mg
ported chest discomfort and then col-
lapsed. She has no pulse or respirations.
Bag-mask ventilations are producing vis-
ible chest rise, and IO access has been
established. What intervention would be
your next action?
You arrive on the scene to find CPR in
progress. Nursing staff report the patient
was recovering from a PE and suddenly
epi 1mg IV
collapsed. Two shocks have been deliv-
ered, and an IV has been initiated. What
do you administer now?

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