Within the first 10 minutes, on the basis of the patient showing symptoms suggestive of myocardial ischemia, what will your first actions include (if not
... [Show More] completed by EMS before arrival)?
o Obtain a 12-lead electrocardiogram (ECG)
o Administer a blood thinner
o Administer aspirin and establish IV access
o Activate the ST-segment elevation myocardial infarction (STEMI) team
o If SPO2 is less than 90%, start oxygen
o Assess airway, breathing, and circulation (ABCs)
o Administer epinephrine 1 mg IV
o Consider nitroglycerin, morphine and a P2Y inhibitor
o Obtain a 12-lead electrocardiogram (ECG)
o Administer aspirin and establish IV access
o Activate the ST-segment elevation myocardial infarction (STEMI) team
o If SPO2 is less than 90%, start oxygen
o Assess airway, breathing, and circulation (ABCs)
o Consider nitroglycerin, morphine and a P2Y inhibitor
His initial vital signs are HR 120/min, BP 135/88 mm Hg, RR 23/min, SpO2 87%, and temperature 37.3C. When considering oxygen saturation, what is your course of action?
o Intubate the patient immediately
o Administer albuterol nebulizer
o Do not start oxygen
o Start oxygen at 4L/min via nasal cannula
o Start oxygen at 4L/min via nasal cannula
What additional question help you determine next steps?
o Do you take any medication?
o Do you have any allergies?
o When was the last time you went to the doctor?
o When did the symptoms start?
o Have you had any recent falls?
o Do you take any medication?
o Do you have any allergies?
o When did the symptoms start?
Your patient continues to say that he has chest discomfort. What treatment can you repeat as long as it is not contradicted by vital signs?
o Morphine sublingual every 1 to 3 minutes
o Morphine IV every 1 to 3 minutes
o Nitroglycerine sublingual or translingual every 3 to 5 minutes
o Nitroglycerine every 1 to 3 minutes
o Nitroglycerine sublingual or translingual every 3 to 5 minutes
What is your interpretation of the patient's ECG tracing?
o Anterior ST-segment elevation of myocardial infarction (STEMI)
o Ventricular tachycardia
o Posterior ST-segment elevation myocardial infarction (STEMI)
o Normal sinus rhythm with premature ventricular contractions
o Anterior ST-segment elevation of myocardial infarction (STEMI)
With the diagnosis of STEMI, what is the most probable treatment?
o Release to home
o Admission to an intensive car unit
o Admission for observation
o Admission for PCI or fibrinolysis
o Admission for PCI or fibrinolysis
What is your goal for PCI when treating this patient?
o Door-to-balloon inflation time of 30 minutes
o First medical contact-to-balloon inflation time of 90 minutes
o Door-to-needle time of 90 minutes
o First medical contact-to-needle time of 30 minutes
o First medical contact-to-balloon inflation time of 90 minutes
The patient's vital signs show HR 92/min, RR 14/min, BP 130/86 mm Hg, SpO2 97%, and atrial fibrillation on the monitor. What additional assessment and stabilization activities should be completed with the first 10 minutes after the patient's arrival?
o Establish IV access
o Order an emergent CT scan or MRI of the brain and review patient history
o Monitor for worsening symptoms
o Activate the stroke team
o Complete neurologic screening
o Check glucose
o Administer O2
o Establish IV access
o Order an emergent CT scan or MRI of the brain and review patient history
o Activate the stroke team
o Complete neurologic screening
o Check glucose
What needs to be completed for this patient within 20 minutes after hospital arrival?
o Neurologic assessment
o Admission to a monitored bed
o Interpretation of the emergent CT scan or MRI of the brain
o Administration of fibrinolytic therapy
o Neurologic assessment
As part of the neurologic assessment, you perform a physical and neurologic examination. What are some of the general questions you need to ask?
o What other symptoms do you have?
o Has your wife been sick as well?
o Do you take any medications?
o Did you eat anything today?
o When did the symptoms start?
o Do you have any allergies?
o What other symptoms do you have?
o Do you take any medications?
o When did the symptoms start?
o Do you have any allergies?
Within 45 minutes, the neuroimaging interpretation of the CT scan of the brain suggests an acute ischemic infarction. There are no signs of hemorrhage or mass lesions. Is this patient a potential candidate for fibrinolytic therapy?
o Yes
o No
o Yes
To determine whether the patient is a candidate for fibrinolytic therapy, what actions should be taken?
o Repeat the neurologic exam
o Determine family stroke history
o Order a 12-lead ECG
o Obtain an MRI of the brain for confirmation of hemorrhage
o Repeat the neurologic exam
You find the patient's neurologic function is rapidly improving. Is this patient still a candidate for fibrinolytic therapy?
o Yes
o No
o Not enough information
o No
Because this patient is no longer a candidate for fibrinolytic therapy, what are your next steps for him?
o Consider giving adenosine
o Administer O2
o Support airway, breathing, and circulation (ABCs_
o Begin the stroke pathway
o Admit the patient to an intensive care unit
o Order an emergent x-ray
o Order an emergent CT scan
o Support airway, breathing, and circulation (ABCs_
o Begin the stroke pathway
o Admit the patient to an intensive care unit
As Team Leader, you conduct the primary assessment, including rhythm analysis, while high-quality BLS continues. What type of rhythm is being displayed on the monitor?
o Ventricular tachycardia
o Asystole
o Supraventricular tachycardia
o Ventricular fibrillation
o Ventricular fibrillation
Based on the patient's condition, what is your next action?
o Pause CPR to establish IV/IO access
o Continue CPR while you establish IV/IO access
o Shock immediately
o Continue CPR while delivering shock
o Shock immediately
After a shock is delivered, CPR resumes immediately. What actions also needs to be performed at this time?
o Establish IV/IO access
o Administer amiodarone or lidocaine
o Consider an advanced airway
o Perform a second rhythm check
o Establish IV/IO access
After 2 minutes, the team pauses CPR for a rhythm check. What rhythm is now being demonstrated by the patient?
o Ventricular tachycardia
o Pulseless electric activity
o Ventricular fibrillation
o Asystole
o Ventricular tachycardia [Show Less]