ACLS Precourse Self Assessment Answers

1) A 48-year-old man became unresponsive shortly after presenting to you with nausea and generalized chest discomfort. You observe gasping breathing and are unsure if you feel a pulse. You should now:

2) Which of the following is the most likely complication of inferior wall myocardial infarction (MI)?

3) A 52-year-old man is complaining of palpitations that came on suddenly after walking up a short flight of stairs. His symptoms have been present for about 20 minutes. He denies chest pain and is not short of breath. His skin is warm and dry; breath sounds are clear. His blood pressure (BP) is 144/88 millimeters of mercury (mm Hg), his heart rate is 186 beats per minute (beats/min), and his ventilatory rate is 18 breaths/min. The cardiac monitor reveals the rhythm here. Vascular access has been established. Which of the following medications is most appropriate in this situation?

4) Your general impression of a 78-year-old woman reveals that her eyes are closed, she is not moving, you can see no rise and fall of her chest or abdomen, and her skin color is pale. When you arrive at the patient’s side, you confirm that she is unresponsive. Your best action in this situation will be to:

5) A 60-year-old woman has suffered a cardiac arrest. A healthcare professional trained in endotracheal intubation has intubated the patient. Which of the following findings would indicate inadvertent esophageal intubation?

6) Hypotension (ie, a systolic BP of less than 90 mm Hg) after the return of spontaneous circulation (ROSC) may necessitate the use of:

7) Which of the following is incorrect with regard to a postevent debriefing?

8) Assuming there are no contraindications, which of the following can be performed as an initial intervention for a stable but symptomatic patient with the rhythm shown?

9) A 62-year-old man received IV tissue plasminogen activator (tPA) 2 hours ago after a diagnosis of acute ischemic stroke. While assessing the patient’s vital signs, you observe swelling of the patient’s lips and tongue. Your best course of action will be to:

10) During a cardiac arrest, multiple attempts to establish a peripheral IV have proved unsuccessful. Your best course of action at this time will be to:

11) Synchronized cardioversion:

12) An 84-year-old man presents with an acute onset of altered mental status. The cardiac monitor shows the rhythm here. The patient’s BP is 58/30 mm Hg and his ventilatory rate is 14 breaths/min. His skin is cool, moist, and pale. His blood oxygen saturation level (SpO 2 ) on room air is 95%. An IV has been established.

On the basis of the information provided, your best course of action will be to:

13) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

Which of the following actions performed at the scene is most likely to reduce subsequent treatment delays at the hospital?

14) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

The patient rates his discomfort 9/10. His BP is 126/72 mm Hg and ventilations 14 breaths/min. His SpO 2 on room air is 95%. The cardiac monitor shows a sinus rhythm at 60 beats/min. Immediate management of this patient should include:

15) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

Current guidelines recommend obtaining an initial 12-lead ECG within ____ of patient contact when an acute coronary syndrome (ACS) is suspected

16) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

When the patient’s 12-lead ECG is reviewed, the results should be used to classify the patient into one of three groups. Which of the following correctly reflects these categories?

17) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

A 12-lead ECG has been obtained.

18) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

To be considered significant, ECG findings, such as STE or STD, need to be viewed in two or more contiguous leads. Which of the following are contiguous leads?

19) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

The patient’s 12-lead ECG findings suggest a(n) _____ MI

20) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

On the basis of the patient’s 12-lead ECG findings:

21) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

Vascular access has been established. The patient’s BP is 130/70 mm Hg, his pulse is 60 beats/min, and his ventilatory rate is 14 breaths/min. Assuming there are no contraindications for any of the following medications, which of the following would be appropriate for this patient at this time?

22) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

NTG has been ordered for administration to this patient. NTG:

23) Questions 13 through 23 pertain to the following scenario:

Paramedics are on the scene with a 55-year-old man who is complaining of severe chest discomfort. He describes his discomfort as a “heavy pressure” in the middle of his chest that has been present for about 1 hour.

The patient’s chest discomfort was unrelieved after the maximum recommended dosage of NTG tablets. Morphine sulfate was ordered and a 4 mg dose was given IV. The patient’s BP is now 80/60 mm Hg and his skin is cool, moist, and pale. His breath sounds are clear. You should:

24) Which of the following is not recommended when performing defibrillation?

25) Atypical symptoms of ACSs are more common in:

26) A 53-year-old woman is unresponsive. The cardiac monitor initially showed a narrow-QRS tachycardia at 220 beats/min. Her BP was 50 mm Hg by palpation and her ventilatory rate was 10 breaths/min. Supplemental oxygen therapy was initiated and an IV established before the patient’s collapse. You promptly delivered a synchronized shock. Reassessment reveals the patient is not breathing and has no pulse. The cardiac monitor now reveals the rhythm shown. What course of action should you take at this time?

27) An unstable patient with a narrow-QRS tachycardia requires electrical therapy. You have a biphasic defibrillator available to you. Which of the following correctly reflects the recommended energy dose that should be delivered in this situation?

28) The preferred method used to verify the proper placement of an endotracheal tube is:

29) Which of the following is incorrect with regard to the events of a typical resuscitation effort?

30) Which of the following statements is correct about the use of medications during cardiac arrest?