ACLS Final Exam (2023/ 2024 Update) Questions and 100% Correct Verified Answers
QUESTION
A patient enters the emergency department in respiratory compr... [Show More] omise. The team is monitoring the patient using capnography and identifies that ETCO2 levels are initially 33 mmHg and later 40 mmHg. From these readings, the team identifies that the patient is progressing in what stage of respiratory compromise?
Respiratory arrest
Respiratory failure
Respiratory distress
Respiratory acidosis
Answer:
Respiratory distress
Capnography can objectively assess the severity of a patient's respiratory distress. Early on, the patient will often hyperventilate, leading to hypocapnia that is reflected by a low ETCO2 value (less than 35 mmHg). As respiratory distress increases, and the patient begins to tire, the ETCO2 value may return to the normal range (35 to 45 mmHg). However, if the patient progresses to respiratory failure, the ETCO2 level will increase to greater than 45 mmHg, which indicates hypoventilation.
QUESTION
A patient is in cardiac arrest. The underlying cause is thought to be opioid toxicity. Which statement accurately describes the use of naloxone for this patient?
Naloxone should be administered immediately as the first action in resuscitation at a dose of 0.4 to 2 mg and then repeated every 2 to 3 min as needed.
Naloxone has not been shown to be effective for opioid toxicity once cardiac arrest has occurred.
Naloxone administered via continuous IV infusion should be considered for short-acting opioid toxicity.
Naloxone should be administered as soon as possible but is not a priority over high-quality CPR and AED use.
Answer:
Naloxone should be administered as soon as possible but is not a priority over high-quality CPR and AED use.
High-quality CPR and AED use are the priority interventions for cardiac arrest caused by suspected or known opioid toxicity. When opioid toxicity is the suspected or known cause of cardiac arrest, naloxone should be administered as soon as possible without disrupting or delaying high-quality CPR and AED use. The recommended dose of naloxone is 0.4 to 2 mg IV/IO/IM/IN/SC, repeated every 2 to 3 minutes as needed. A continuous naloxone infusion may be considered if there is the potential for recurrence of respiratory depression (for example, if the cause of the opioid toxicity was an extended-release or long-acting opioid) but is not indicated in the immediate treatment of suspected or known opioid toxicity
QUESTION
A patient in the telemetry unit is receiving continuous cardiac monitoring. The patient has a history of myocardial infarction. The patient's ECG rhythm strip is shown in the following figure. The provider interprets this strip as indicating which arrhythmia?
Sinus tachycardia
Third-degree AV block
First-degree atrioventricular (AV) block
Second-degree AV block
Answer:
Third-degree AV block
In third-degree AV block, no electrical communication occurs between the atria and ventricles, thus no relationship between P waves and QRS complexes exists. The RR interval is constant. The PP interval is constant or slightly irregular, as with sinus arrhythmia. If pacemaker cells in the AV junction simulate ventricular contraction, the QRS complexes will be narrow (less than 120 milliseconds in duration). Impulses that originate in the ventricles produce wide QRS complexes. This arrhythmia may result from damage caused by myocardial infarction.
QUESTION
A patient with dyspnea, inadequate blood pressure and a change in mental status arrives at the emergency department. The healthcare team completes the necessary assessments and begins to care for the patient, including initiating cardiac monitoring and pulse oximetry; providing supplemental oxygen and ensuring adequate ventilation; and obtaining vascular access. The team reviews the patient's ECG rhythm strip, as shown in the following figure. Which agent would the team most likely administer?
Epinephrine 2 to 10 mcg/min
Dopamine 5 to 10 mcg/min
Atropine 1 mg every 3 to 5 minutes
Amiodarone 150 mg over 10 minutes
Answer:
Atropine 1 mg every 3 to 5 minutes
The ECG strip is showing bradycardia. Atropine is an anticholinergic drug that increases sinoatrial node firing by counteracting vagus nerve action to increase the heart rate. It is the first-line therapy for symptomatic bradycardia. A 1-mg bolus is given intravenously every 3 to 5 minutes, up to a maximum dose of 3 mg.
QUESTION
A patient comes to the emergency department complaining of palpitations and "some shortness of breath." Cardiac monitoring is initiated and reveals the following ECG rhythm strip. The provider interprets this strip as indicating which arrhythmia?
Atrial fibrillation
Atrial flutter
Ventricular fibrillation
Ventricular tachycardia
Answer:
Atrial flutter
In atrial flutter, atrial contraction occurs at such a rapid rate that discrete P waves separated by a flat baseline cannot be seen on the strip. Instead, the baseline continually rises and falls, producing the "flutter" waves. In leads II and III, the flutter waves may be quite prominent, creating a "sawtooth" pattern. Because of the volume of atrial impulses, the AV node allows only some of the impulses to pass through to the ventricles. In atrial flutter, a 2:1 ratio is the most common (i.e., for every two flutter waves, only one impulse passes through the AV node to generate a QRS complex). Ratios of 3:1 and 4:1 are also frequently seen.
QUESTION
The ECG rhythm strip of a patient who arrived in the emergency department complaining of dizziness, syncope and shortness of breath reveals sinus bradycardia. When reviewing the [Show Less]