D. Start Chest Compressions at A Rate of at Least 100/min

 

Advanced Cardiovascular Life Support Exam Version A (50 questions) Please do not mark on this exam. Record the best answer on the separate answer sheet.

1. You find an unresponsiv unresponsive e patient patient who is not breathing breathing.. After After activati activating ng the emergency response system, you determine that there is no pulse. What is your  next action?  A. B. C. D.

Open the airway with a head tilt–chin tilt–chin lift. Administ Administer er epinep epinephrin hrine e at a dose dose of 1 mg/kg. mg/kg. Deliver Deliver 2 rescue rescue breat breaths hs each each over over 1 second. second. Startt chest compre Star compressio ssions ns at a rate of at least least 100/min. 100/min.

2. You are evaluating a 58-year-old 58-year-old man with chest pain. The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most important now?  A. PETCO2 B. Chest xx-ra ray y C. Labo Laborat ratory ory testin testing g D. Ob Obtai tainin ning g a 12-l 12-lea ead d ECG ECG 3. What is the preferred method of access for epinephrine administration administration during cardiac arrest in most patients?  A. B. C. D.

Intraosseous Intraosseous En Endo dotr trac ache heal al Centr Central al in intra traven venou ous s Perip Pe riphe heral ral intra intrave veno nous us

4. An activated AED does not promptly analyze analyze the rhythm. What is your next action?  A. B. C. D.

Begin chest chest compressions. compressions. Disconti Discontinue nue the the resusci resuscitati tation on at attemp tempt. t. Check Check all AED AED connecti connections ons and and reanal reanalyze. yze. Rotate Rotate AED electro electrodes des to an alterna alternate te position position..

 

5. You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm below, and the patient has no pulse. Another member of your team resumes chest compressions, and an IV is in place. What management step is your next priority?

 A. B. C. D.

Give 0.5 mg mg of atropine. atropine. Ins Insert ert an an advan advance ced d airway airway.. Administ Admi nister er 1 mg of of epinep epinephrin hrine. e. Administ Administer er a dopamin dopamine e in infusi fusion. on.

6. Durin During g a pa paus use e in CPR, CPR, you see see this this le lead ad II ECG ECG rhythm rhythm on the monito monitor. r. The patient has no pulse. What is the next action?

 A. B. C. D.

Establish vascular vascular access. access. Obtain Obtain the patient patient’s ’s history. history. Resume Resu me ches chestt comp compress ressions ions.. Terminat Terminate e the resuscita resuscitative tive effort. effort.

7. What is a common but sometimes fatal mistake in cardiac arrest manag management? ement?  A. B. C. D.

Failure to obtain vascular vascular access access Prolong Prolonged ed perio periods ds of of no ventilat ventilations ions Failure Failure to perform perform endotr endotrache acheal al intubati intubation on Prolong Prol onged ed interrupt interruption ions s in chest compressi compressions ons

8. Which action is a component of high-quality chest chest compressions? complete chest chest recoil  A. Allowing complete B. Chest Chest compres compression sions s withou withoutt ventilat ventilation ion C. 60 to 100 100 compress compression ions s per minute minute with a 15:2 15:2 ratio ratio D. Uninterru Uninterrupted pted compre compressio ssions ns at a depth of of 1½ inches inches

 

9. Which action increases increases the chance of successful successful conversion of ventricular fibrillation? fibrillation?  A. Pausing chest chest compressions compressions immediately immediately after after a defibrillation defibrillation attempt attempt B. Administe Administering ring 4 quick quick ventilations ventilations immediately immediately before a defibrillation defibrillation attempt attempt C. Using man manual ual defibrillator defibrillator paddles paddles with with light light pressure against the chest chest D. Providing quality compressions compressions immediate immediately ly before a defibrillation defibrillation attempt attempt 10. Which situation BEST describes pulseless electrical electrical activity?  A. B. C. D.

Asystole without without a pulse pulse Sinus Sin us rhyt rhythm hm with withou outt a pulse pulse Torsade Torsades s de pointes pointes w with ith a puls pulse e Ventricu Ventricular lar tachyc tachycardi ardia a with a pulse pulse

11. What is the BEST strategy for performing high-quality high-quality CPR on a patient with an advanced airway in place?  A. B. C. D.

Provide compression compressions s and ventilations ventilations with with a 15:2 ratio. Provide compressions compressions and and ventilation ventilations s with a 30:2 30:2 ratio. ratio. Provide a single ventilation ventilation every every 6 seconds seconds during the compression compression pause. pause. Provide continuous continuous chest compressions compressions without without pauses pauses and 10 ventilations ventilations per minute.

12. Three minutes after witnessing a cardiac arrest, one member of your team inserts an endotracheal tube while another performs continuous chest compressions. During subsequent ventilation, you notice the presence of a waveform on the capnography screen and a PETCO2 level of 8 mm Hg. What is the significance of this finding?  A. B. C. D.

Chest compressions compressions may may not be effective. The endotr endotrache acheal al tube tube is no long longer er in the trach trachea. ea. The p patient atient meets the criteria criteria for terminatio termination n of efforts. The tea team m is ventilating ventilating the the patient patient too often (hyperventilation). (hyperventilation).

13. The use of quantitative capnography capnography in intubated patients  A. B. C. D.

allows for monitoring monitoring of of CPR quality. quality. measures measures oxyge oxygen n levels levels at the the alveoli alveoli level. level. determine determines s inspired inspired carbon carbon dioxide dioxide rela relating ting to cardiac output. detects electrolyte abnormalities abnormalities early early in code management. management.

 

14. For the past 25 minutes, an EMS crew has attempted resuscitation resuscitation of a patient who originally presented in ventricular fibrillation. After the first shock, the ECG screen displayed asystole, which has persisted despite 2 doses of epinephrine, a fluid bolus, and high-quality CPR. What is your next treatment?  A. Apply a transcutaneous  pacemaker. B. Administ Administer er 1 mg of intrav intraveno enous us atropi atropine. ne. C. Administ Administer er 40 units units of intraveno intravenous us vasopres vasopressin. sin. D. Conside Considerr terminatin terminating g resuscitative resuscitative efforts efforts after after consulting consulting medical medical control. control. 15. Which is a safe and effective practice within the defibrillatio defibrillation n sequence?  A. Stop chest chest compressions compressions as you you charge the defibrillator. defibrillator. B. Be sure oxygen oxygen is not not blowing blowing over the patient’s chest chest during during the shock. shock. C. Assess fo forr the presence of a pulse pulse immediately immediately after after the shock. D. Commandi Commandingly ngly announce announce “clear” “clear” after after you deliver deliver the defibrillation defibrillation shock. 16. During your assessment, your patient suddenly loses consciousne consciousness. ss. After calling for help and determining that the patient is not breathing, you are unsure whether the patient has a and pulse. is your next action?  A. Leave an d getWhat an AED. B. Be Begin gin ches chestt compre compressi ssion ons. s. C. Deliver Deliver 2 quick quick ventilat ventilation ions. s. D. Check th the e patient’s patient’s mouth mouth for the the presence presence of a foreign foreign body. body. 17. What is an advantage of using hands-free defibrillation pads instead instead of defibrillation paddles?  A. Hands-free pads deliver deliver more energy energy than paddles. paddles. B. Hands-fr Hands-free ee pads pads increa increase se electri electrical cal arc. arc. C. Han Hands-fr ds-free ee pads pads allow for a more rapid rapid defibri defibrillat llation. ion. D. Hands-free pads have have universal universal adaptors adaptors that can work with any any machine. machine. 18. 18. What What ac acti tion on is re reco comm mmen ende ded d compressions during CPR?  A. B. C. D.

to help help min minim imiz ize e

Continue CPR while charging charging the the defibrillator. defibrillator. Perform Perform pulse pulse checks checks immediatel immediately y after defi defibril brillatio lation. n. Administe Administerr IV medications medications only only when when delivering delivering breaths. breaths. Continue to use an an AED even even after the the arrival of of a manual manual defibrillator. defibrillator.

19. Which action is included in the BLS Survey?  A. B. C. D.

inte interr rrup upti tion ons s

Early defibrillation defibrillation Ad Adva vance nced d airway airway manag manageme ement nt Rapid Rapid medic medicatio ation na admin dministra istration tion Preparat Preparation ion for for therapeu therapeutic tic hypoth hypothermia ermia

in ch ches estt

 

20. Which drug and dose are recommended recommended for the management management of a patient in refractory ventricular fibrillation?  A. Atropine 2 mg B. Am Amio ioda daro rone ne 300 300 mg C. Va pressi ssin 1 mg/kg mg D. Vaso Dopa Dosopre pamin mine e 2n mg/kg mg/ kg/kg per per minute minute 21. What is the appropriate interval interval for an interruption in chest compressions? compressions?  A. B. C. D.

10 seconds seconds or less 10 to 15 seco second nds s 15 to 20 seco second nds s Interrup Interruption tions s are neve neverr acce acceptab ptable le

22. Which of the following is a sign of effective effective CPR?  A. PETCO2 ≥10 mm Hg B. Measured Measured urine urine output output of of 1 mL/kg mL/kg per per hour  hour  C. Patient Patient tempe temperatu rature re >32°C >32°C ((89.6 89.6°F) °F) D. Diastoli Diastolic c intra-arte intra-arterial rial pressu pressure re