ACLS Final Exam (Written Test) American Heart Association Standards Aligned | 2026/2027 Update | Questions and Correct Answers | 100% correct solutions

1/ 8 ACLS Final Exam (Written Test) American Heart Association Standards Aligned | 2026/2027 Update | Questions and Correct Answers | 100% correct solutions A patient experiences cardiac arrest, and the resuscitation team initiates ventilations using a bag-valve-mask (BVM) resuscitator. The development of which condition during the provision of care would lead the team to suspect that improper BVM technique is being used? Hypertension Esophageal injury Pneumothorax Rib fracture Pneumothorax Complications can occur with the use of a BVM resuscitator due to improper technique. Delivering excessive volume or ventilating too fast creates excessive pressure that can damage the airways, lungs and other organs. Excessive volume can lead to tension pneumothorax. A person suddenly collapses while sitting in the sunroom of a healthcare facility. A healthcare provider observes the event and hurries over to assess the situation. The healthcare provider performs which assessment first? Rapid assessment Basic life support assessment Secondary assessment Primary assessment Rapid assessment A systematic approach to assessment is necessary. The healthcare provider should first perform a rapid assessment. A rapid assessment is a visual survey to ensure safety, form an initial impression about the patient's condition (including looking for life-threatening bleeding), and determine the need for additional resources. This would be followed by a primary assessment and then a secondary assessment. A patient is receiving ventilation support via bag-valve- mask (BVM) resuscitator. Capnography is established and a blood gas is obtained to evaluate the adequacy of the ventilations. Which arterial carbon dioxide (PaCO2) value signifies adequate ventilations? 10 to 15 mmHg 20 to 25 mmHg 25 to 30 mmHg 35 to 45 mmHg 35 to 45 mmHg Arterial carbon dioxide (PaCO2) values in the range of 35 to 45 mmHg confirm adequacy of ventilation. A resuscitation team is debriefing following a recent event. "We provided chest compressions at a rate of 100 to 120 compressions per minute A patient experienced cardiac arrest, and advanced life while giving 1 ventilation every 6 seconds without pausing compressions." support was initiated. The patient required the placement of an advanced airway to maintain airway patency. Which When an advanced airway has been placed in a patient who is in cardiac arrest, statement indicates that the team performed high-quality compressions should be delivered continuously (100 to 120 per minute) with no CPR? pauses for ventilations. "We initiated chest compressions at a rate of 100 to 110 per minute to a depth of 2.4 inches and then gave 1 ventilation every 10 seconds." "We provided chest compressions at a rate of 100 to 120 compressions per minute while giving 1 ventilation every 6 seconds without pausing compressions." "We provided chest compressions at a rate of 80 to 120 per minute to a depth of at least 2 inches and gave 1 ventilation every 6 seconds without pausing compressions." "We kept the rate of chest compressions to around 100 per minute but adjusted their depth to 1.5 inches while giving 1 ventilation every 3 seconds without pausing compressions." Assessment of a patient reveals an ETCO2 level of 55 mmHg and an arterial oxygen saturation (SaO2) level of 88%. The provider would interpret these findings as indicative of which condition? Respiratory failure Respiratory arrest Cardiac arrest Respiratory distress Respiratory failure An SaO2 level of less than 90% (PaO2 of less than 50 mmHg) accompanied by ETCO2 values greater than 50 mmHg is indicative of respiratory failure. A responsive patient is choking. What method should the Back blows provider use first to clear the obstructed airway? To clear an obstructed airway in a responsive adult, first provide up to 5 back blows Back blows to clear the obstruction. Abdominal thrusts Magill forceps extraction Chest compressions 2/ 8 A patient arrives at the emergency department complaining Assisted ventilation with BVM resuscitator of shortness of breath. The patient has a long history of chronic obstructive pulmonary disease. Assessment Patients who cannot ventilate adequately despite an open airway or who have reveals respiratory failure. Which action would be the initial insufficient respiratory effort require assisted ventilation initially provided via a BVM priority to address the respiratory failure? resuscitator. Establishment of vascular access Delivery of supplemental oxygen via nasal cannula Assisted ventilation with BVM resuscitator Initiation of capnography A 20-year-old man with respiratory depression is brought to the emergency department by his parents. Opioid overdose is suspected, and an initial dose of naloxone is administered at 10 p.m. The patient does not respond to this initial dose. The team would expect to administer a second dose after how many minutes? 2 minutes 4 minutes 6 minutes 8 minutes 2 minutes The dose of naloxone may be repeated after 2 to 3 minutes. Assessment of a patient in the emergency department reveals that the patient is experiencing respiratory compromise. From the assessment, the team identifies that the patient is in the earliest stage of this condition. Which stage would this be? Respiratory distress Respiratory failure Respiratory arrest Respiratory acidosis Respiratory distress Respiratory compromise occurs along a continuum, beginning with respiratory distress, progressing to respiratory failure and then to respiratory arrest. The following capnogram is from a patient experiencing respiratory distress. At which point in the waveform would the patient's ETCO2 level be measured? B C D E D The ETCO2 value is measured at the end of exhalation (point D), which represents the peak level. A patient is experiencing respiratory distress secondary to an exacerbation of chronic obstructive pulmonary disease. The patient begins to exhibit signs and symptoms of worsening respiratory function and experiences respiratory arrest. The team intervenes, delivering ventilations via BVM resuscitator. The team should provide ventilations at a rate of 1 ventilation: Every 3 seconds Every 6 seconds Every 8 seconds Every 10 seconds Every 6 seconds The team would deliver 1 ventilation every 6 seconds. Each ventilation should last about 1 second and make the chest begin to rise. A patient enters the emergency department in respiratory Respiratory distress compromise. The team is monitoring the patient using capnography and identifies that ETCO2 levels are initially Capnography can objectively assess the severity of a patient's respiratory distress. 33 mmHg and later 40 mmHg. From these readings, the Early on, the patient will often hyperventilate, leading to hypocapnia that is reflected team identifies that the patient is progressing in what stage by a low ETCO2 value (less than 35 mmHg). As respiratory distress increases, and of respiratory compromise? 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 Respiratory arrest will increase to greater than 45 mmHg, which indicates hypoventilation. Respiratory failure Respiratory distress Respiratory acidosis A patient is in cardiac arrest. The underlying cause is Naloxone should be administered as soon as possible but is not a priority over high- thought to be opioid toxicity. Which statement accurately quality CPR and AED use. describes the use of naloxone for this patient? High-quality CPR and AED use are the priority interventions for cardiac arrest Naloxone should be administered immediately as the first caused by suspected or known opioid toxicity. When opioid toxicity is the suspected action in resuscitation at a dose of 0.4 to 2 mg and then or known cause of cardiac arrest, naloxone should be administered as soon as repeated every 2 to 3 min as needed. 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 Naloxone has not been shown to be effective for opioid 3 minutes as needed. A continuous naloxone infusion may be considered if there is toxicity once cardiac arrest has occurred. 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 Naloxone administered via continuous IV infusion should indicated in the immediate treatment of suspected or known opioid toxicity 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. 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 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. 3/ 8 4/ 8 a A patient with dyspnea, inadequate blood pressure and a Atropine 1 mg every 3 to 5 minutes change in mental status arrives at the emergency department. The healthcare team completes the necessary The ECG strip is showing bradycardia. Atropine is an anticholinergic drug that assessments and begins to care for the patient, including increases sinoatrial node firing by counteracting vagus nerve action to increase the initiating cardiac monitoring and pulse oximetry; providing heart rate. It is the first-line therapy for symptomatic bradycardia. A 1-mg bolus is supplemental oxygen and ensuring adequate ventilation; given intravenously every 3 to 5 minutes, up to a maximum dose of 3 mg. 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 A patient comes to the emergency department complaining Atrial flutter of palpitations and "some shortness of breath." Cardiac monitoring is initiated and reveals the following ECG In atrial flutter, atrial contraction occurs at such a rapid rate that discrete P waves rhythm strip. The provider interprets this strip as indicating separated by a flat baseline cannot be seen on the strip. Instead, the baseline which arrhythmia? 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 Atrial fibrillation volume of atrial impulses, the AV node allows only some of the impulses to pass Atrial flutter through to the ventricles. In atrial flutter, a 2:1 ratio is the most common (i.e., for Ventricular fibrillation every two flutter waves, only one impulse passes through the AV node to generate Ventricular tachycardia QRS complex). Ratios of 3:1 and 4:1 are also frequently seen. The ECG rhythm strip of a patient who arrived in the igoxin emergency department complaining of dizziness, syncope and shortness of breath reveals sinus bradycardia. When Metoprolol reviewing the patient's medication history, the healthcare provider identifies which agent(s) as a potential cause of Verapamil the patient's current condition? Medications associated with causing sinus bradycardia include β-blockers (such as Digoxin metoprolol), calcium channel blockers (such as verapamil) and digoxin. Losartan Metoprolol Verapamil Quinapril A patient with bradycardia and signs of hemodynamic Transcutaneous pacing compromise does not respond to atropine. Which Epinephrine or dopamine infusion interventions could the healthcare provider use next? Second-line therapies for symptomatic bradycardia include transcutaneous pacing Transcutaneous pacing or an epinephrine or dopamine infusion. Carotid massage Epinephrine or dopamine infusion Synchronized cardioversion A patient's ECG reveals a narrow QRS complex with a Vagal maneuvers regular rhythm, indicating a narrow-complex supraventricular tachyarrhythmia. The patient is not For a patient who is not showing signs of hemodynamic compromise and is showing signs of hemodynamic compromise. Which experiencing a narrow-complex supraventricular tachyarrhythmia, vagal maneuvers intervention would be initiated first if it does not delay other are attempted first. If ineffective, adenosine is given. interventions? Synchronized cardioversion Adenosine administration Vagal maneuvers Sedation An ECG strip of a patient in the emergency department Absence of discrete P waves and presence of irregularly irregular QRS complexes reveals the following rhythm. Which feature would the healthcare provider interpret as indicating atrial fibrillation? The two key features of atrial fibrillation on ECG are the absence of discrete P waves and the presence of irregularly irregular QRS complexes. Presence of wide QRS complexes that are bizarrely and consistently shaped Presence of flutter waves and sawtooth patterns Absence of discrete P waves and presence of irregularly irregular QRS complexes Narrow QRS complex with PP interval constant or slightly irregular Cardiac monitoring indicates that a patient has a Consider an antiarrhythmic medication ventricular tachyarrhythmia. The patient has a pulse and is not showing any signs of hemodynamic compromise. A 12- For a patient with a wide-complex tachyarrhythmia and no signs of hemodynamic lead ECG reveals an irregular rhythm with QRS complexes compromise, consider an antiarrhythmic medication (procainamide, amiodarone or greater than 0.12 second in duration. Which action would sotalol). be appropriate at this time? Defibrillation Synchronized cardioversion Atropine Consider an antiarrhythmic medication 5/ 8 a A patient is brought into the emergency department. The Ventricular tachycardia patient does not have a pulse. The cardiac monitor shows the following rhythm. The team interprets this as which The cardiac monitor reveals ventricular tachycardia. In pulseless ventricular condition? tachycardia, the ventricular rate is usually greater than 180 beats per minute, and the QRS complexes are very wide. Ventricular tachycardia Torsade de pointes Asystole Ventricular fibrillation A patient with acute renal failure experiences cardiac Hyperkalemia arrest. Just before the cardiac arrest, the patient's ECG showed peaked T waves. What might be causing the Suspect hyperkalemia in all patients with acute or chronic renal failure who exhibit patient's cardiac arrest? wide-complex ventricular rhythm or tall, peaked T waves on an ECG before cardiac arrest. Hypoxia Hypothermia Hyperkalemia Acidosis A member of the resuscitation team is preparing to 120 to 200 joules defibrillate a patient in cardiac arrest using a biphasic defibrillator. The team member would set the energy dose When using a biphasic defibrillator, the energy dose should be set at 120 to 200 according to the manufacturer's recommendations, which joules. is usually: 75 to 100 joules 120 to 200 joules 300 joules 360 joules A member of the resuscitation team is preparing to 10 to 20 mL administer medications intravenously to a patient in cardiac arrest. The team member should follow each When administering medications during a cardiac arrest, all medications peripherally administered drug dose with a normal saline administrated through the IV or intraosseous infusion route should be followed by a flush. How much would the team member give? 10- to 20-mL normal saline flush. 5 to 10 mL 10 to 20 mL 20 to 30 mL 30 to 40 mL A 30-year-old patient has been brought to the emergency Electrocution department in cardiac arrest. The cardiac monitor shows the following rhythm. Interpretation of this rhythm would The rhythm is ventricular fibrillation. Precipitating causes of ventricular fibrillation suggest which of the following as a possible precipitating include electrocution, myocardial ischemia or infarction, shock, stimulant overdose factor? and ventricular tachycardia. Hemorrhage Antibiotic use Electrocution Cardiac tamponade Cardiac monitoring of a patient in cardiac arrest reveals Defibrillation. ventricular fibrillation. In addition to high-quality CPR, what intervention should be a priority for the team? The cardiac monitor is showing ventricular fibrillation, which is a shockable rhythm. The team's priority should be to continue to provide high-quality CPR and Perform a pulse check. defibrillation. Insert an advanced airway. Defibrillation. Initiate capnography. The resuscitation team suspects that hyperkalemia is the Wide-complex ventricular rhythm and tall, peaked T waves cause of cardiac arrest in a patient brought to the emergency department. Which finding on a 12-lead ECG In hyperkalemia, the patient's 12-lead ECG will show a wide-complex ventricular would confirm this suspicion? rhythm and tall, peaked T waves. Narrow-complex ventricular tachycardia Flat T waves, prominent U waves and possibly prolonged QT intervals ST-segment changes, T-wave inversion Wide-complex ventricular rhythm and tall, peaked T waves A patient has experienced return of spontaneous Tension pneumothorax circulation (ROSC) after cardiac arrest. The healthcare team is conducting a secondary assessment to determine Prearrest signs of tension pneumothorax in the advanced stage include jugular the possible cause of the patient's cardiac arrest. Before venous distension, cyanosis, apnea and hyperresonance on percussion. Difficulty the arrest, the patient exhibited jugular venous distension, ventilating the patient may also be a sign of tension pneumothorax. cyanosis, apnea and hyperresonance on percussion. The patient was also difficult to ventilate during the response. The team would most likely suspect which condition as the cause? Hypothermia Cardiac tamponade Acidosis Tension pneumothorax 6/ 8 A patient in cardiac arrest experiences return of SaO2 90% spontaneous circulation. As part of post-cardiac arrest care, the patient is receiving mechanical ventilation at an PaCO2 48 mmHg initial rate of 10 breaths/min and a fraction of inspired oxygen (FiO2) of 0.30. Which finding(s) would indicate the ETCO2 55 mmHg need for change in the ventilator settings to optimize the patient's ventilation and oxygenation? Mechanical ventilation should be started at a rate of 10 breaths per minute and adjusted as necessary to keep carbon dioxide levels in physiologic range (PaCO2 SaO2 96% between 35 and 45 mmHg or monitored using ETCO2). The minimum fraction of SaO2 90% inspired oxygen necessary to maintain an SaO2 of 94% to 99% is used. PaCO2 48 mmHg ETCO2 55 mmHg ETCO2 40 mmHg After cardiac arrest and successful resuscitation, the Giving an ice-cold IV fluid bolus patient has a return of spontaneous circulation. The patient Applying cooling blankets to the patient's body is unable to follow verbal commands. Targeted Using an endovascular catheter temperature management is initiated. Which method(s) would be appropriate for the resuscitation team to use? For targeted temperature management, various methods of inducing hypothermia may be used, including administering an ice-cold IV fluid bolus (30 mL/kg), using Administering cool-mist oxygen therapy endovascular catheters or applying surface cooling strategies (e.g., cooling Giving an ice-cold IV fluid bolus blankets, ice packs). Applying a cool compress to the patient's forehead Applying cooling blankets to the patient's body Using an endovascular catheter A patient with suspected acute coronary syndromes (ACS) 93% has a pulse oximetry reading of 86% and is given supplemental oxygen. The provider determines that the A patient with potential acute coronary syndromes (ACS) and an oxygen saturation supplemental oxygen dose is correct based on which of less than 90% should have oxygen administered to maintain an SaO2 greater SaO2 level? than 90% and less than or equal to 99%. 87% 89% 93% 100% A 35-year-old female patient's ECG is consistent with 0.15 mV STEMI. The ECG reveals a new ST-segment elevation at the J point in leads V2 and V3 of at least which size? New ST-segment elevation at the J point in leads V2 and V3 of at least 0.15 mV (1.5 mm) in women 40 years or younger is considered diagnostic of STEMI. 0.10 mV 0.15 mV 0.2 mV 0.25 mV A patient with STEMI is experiencing chest pain that is 90 mmHg refractory to sublingual nitroglycerin. Intravenous nitroglycerin is prescribed. When administering this In patients with STEMI, IV nitroglycerin may be used when chest pain or discomfort medication, it would be titrated to maintain which systolic is recurrent or refractory to nitroglycerin administered sublingually or by spray. The blood pressure? IV nitroglycerin should be titrated to maintain a systolic blood pressure of 90 mmHg or more. 60 mmHg 70 mmHg 80 mmHg 90 mmHg A patient is admitted to the emergency department of a Within 90 minutes of the patient's first medical contact large medical center. The patient is diagnosed with STEMI. The facility is capable of administering PCI. To achieve the Reperfusion should be administered within 90 minutes of the patient's first medical best outcomes, therapy should be administered to this contact if the patient does not need to be transferred to another facility. patient within what time frame? Within 30 minutes of the patient's arrival Within 60 minutes of the patient's first medical contact Within 90 minutes of the patient's first medical contact Within 3 hours of the onset of symptoms A patient is being treated in the emergency department Ventricular tachycardia and is determined to have NSTE-ACS. Invasive management is planned based on which finding? An early invasive strategy should be considered for patients with high-risk NSTE- ACS, which would be indicated by ventricular tachycardia. Atrial tachycardia Ventricular tachycardia Atrial fibrillation Hypoxia A patient is admitted to the emergency department with Within 20 minutes signs and symptoms of stroke. The stroke team should complete a comprehensive neurologic assessment and The stroke team should complete a comprehensive neurologic assessment and obtain brain imaging results within what time frame? obtain brain imaging results within 20 minutes. Within 10 minutes Within 20 minutes Within 30 minutes Within 40 minutes 7/ 8 Which areas are evaluated using the National Institutes of Facial palsy Health Stroke Scale (NIHSS)? Language deficits Visual function Facial palsy Level of consciousness Hearing Language deficits The National Institutes of Health Stroke Scale (NIHSS) evaluates level of Visual function consciousness, best gaze, visual fields, facial palsy, motor function (arm and leg), Level of consciousness limb ataxia, sensation, language deficits and extinction and inattention. The stroke team is assessing a patient with a suspected Atrial fibrillation stroke. The patient is alert and able to carry on a conversation, although the patient has difficulty getting the Between 15 and 20 percent of embolic strokes are caused by atrial fibrillation. words out. Testing confirms that the patient has had an ischemic stroke. Based on the patient's medical history, a history of which arrhythmia would alert the team to the patient's increased risk for stroke? Atrial fibrillation Atrial tachycardia Ventricular fibrillation Bradycardia A patient with suspected stroke arrives at the emergency Within 1 hour of the patient's arrival department. The patient is diagnosed with acute ischemic stroke and is a candidate for fibrinolytic therapy. To For patients with ischemic stroke who meet the eligibility criteria, fibrinolytic therapy achieve the best outcomes, this therapy should be initiated is the first-line treatment. Administration of IV recombinant tissue plasminogen within what time frame? activator (rtPA) within 1 hour of the patient's arrival and within 3 hours of the onset of signs and symptoms is optimal. Within 30 minutes of the patient's arrival Within 1 hour of the patient's arrival Within 2 hours of the patient's arrival Within 3 hours of the patient's arrival Which statement accurately reflects the management of Resuscitative cesarean delivery (RCD) should be performed within 5 minutes from cardiac arrest in a pregnancy of 26 weeks' gestation? the time of arrest. Fetal monitoring should be immediately initiated after Resuscitative cesarean delivery (RCD) should be performed within 5 minutes from pulselessness is determined. the time of arrest in a pregnant patient if the gestational age is known to be equal to Resuscitative cesarean delivery (RCD) should be or greater than 20 weeks or if the fundus is at or above the umbilicus. In a pregnant performed within 5 minutes from the time of arrest. patient, intravenous access should be obtained above, not below, the level of the Targeted temperature management (TTM) is diaphragm. To keep the focus on the pregnant patient, during arrest fetal monitoring contraindicated in the post-cardiac arrest pregnant patient. should be removed. Targeted temperature management (TTM) is a viable Intravenous access should be placed below the level of consideration for post-cardiac arrest care in a pregnant patient. the diaphragm. A 28-year-old pregnant patient who resides in transitional Point-of-care ultrasound housing presents to the emergency department with complaints of feeling feverish and very faint. The patient Gestational age is an important consideration when determining the approach to a tells the emergency nurse that she does not know when pregnant patient in cardiac arrest. If the gestational age is not known and point-of- she became pregnant. Upon palpation, the fundus is not at care ultrasound is available and able to be performed without impeding or delaying or above the umbilicus. The patient's condition quickly the resuscitation effort, it can be used to quickly estimate gestational age and guide deteriorates and she goes into cardiac arrest. If available decision-making. and able to be used without impeding or delaying the resuscitation effort, what diagnostic tool could be used to guide decision-making in the care of this patient? Fetal echocardiogram Abdominal radiograph Point-of-care ultrasound Fetal monitoring What is the priority intervention for a patient with a narrow- Perform immediate synchronized cardioversion complex tachycardia (160 bpm) and a blood pressure of 72/48 mmHg? Immediate synchronized cardioversion is recommended for a patient with signs of hemodynamic compromise and a supraventricular tachycardia. A vagal maneuver, Perform immediate synchronized cardioversion such as carotid massage, is recommended for a patient with a narrow-complex Administer amiodarone, 150 mg IV over 10 minutes tachycardia if the rhythm is regular and there are no signs of hemodynamic Administer adenosine, 6 mg via rapid IV push compromise. Adenosine may be considered for this patient, but immediate Perform carotid massage cardioversion should be performed without delay. Amiodarone may be considered if this patient's rhythm is refractory. Cardiac monitoring reveals a tachyarrhythmia. The patient "I've had a terrible cold with a horrible cough for the past week and today I is hemodynamically stable and has a regular heart rate developed a fever." ranging from 120 to 135 beats per minute. Which statements by the patient could the team interpret as "I've been so anxious lately because I just lost my job." contributing to the tachyarrhythmia? "I've been vomiting for the past 2 days from a gastrointestinal bug." "I've had a terrible cold with a horrible cough for the past week and today I developed a fever." If the heart rate is between 100 and 150 beats per minute, the rhythm is likely sinus "I've been so anxious lately because I just lost my job." tachycardia. The underlying cause is most likely a systemic one, such as anxiety, "I had the first shot of the COVID-19 vaccine over a week dehydration or infection. That condition is treated first. If the heart rate is 150 beats ago." per minute or more, the tachycardia is likely caused by a cardiac arrhythmia, rather "I've been vomiting for the past 2 days from a than a systemic condition. If vaccines cause fever, they usually do so in the first 1 to gastrointestinal bug." 3 days. A patient is in cardiac arrest. The cardiac monitor shows Administering epinephrine as early as possible asystole. In addition to providing continuous high-quality CPR, what is the other priority intervention for this patient? For cardiac arrest with a nonshockable rhythm, epinephrine (1 mg IV/IO) should be administered as early as possible and repeated every 3 to 5 minutes. Although Administering epinephrine as early as possible inserting an advanced airway may be considered for this patient, this is not a priority Inserting an advanced airway intervention. Defibrillation and amiodarone are not appropriate interventions for Defibrillating with 360 joules when available asystole. Administering amiodarone as early as possible 1/ 8 . A 42-year-old woman presents to the emergency High-risk non-ST-segment elevation ACS (NSTE-ACS) department with complaints of fatigue, shortness of breath, back pain and nausea. A 12-lead ECG is obtained and The 12-lead ECG findings of ST-segment depression in three contiguous leads shows ST-segment depression in leads II, III, and aVF and along with elevated cardiac serum biomarkers are consistent with high-risk non-ST- intermittent runs of nonsustained ventricular tachycardia. segment elevation ACS (NSTE-ACS). The presence of intermittent runs of Cardiac serum markers are elevated. These findings ventricular tachycardia also places this patient at high risk. In ST-segment elevation suggest which condition? myocardial infarction (STEMI), cardiac serum markers would be elevated, but this patient's ECG findings are not consistent with STEMI. Patients with intermediate- or High-risk non-ST-segment elevation ACS (NSTE-ACS) low-risk NSTE-ACS show nondiagnostic ST-segment or T-wave changes on ECG, Low-risk non-ST-segment elevation ACS (NSTE-ACS) or no changes at all. Intermittent-risk non-ST-segment elevation ACS (NSTE- ACS) ST-segment elevation myocardial infarction (STEMI) Which statements accurately reflect the recommendations Arterial blood gases may be used to guide ventilation and oxygenation in the post- for post-cardiac arrest patient care? cardiac arrest patient. Prophylactic anticonvulsants should be administered to Perfusion should be assessed and maintained to ensure the best outcome for the patients who remain comatose after cardiac arrest to post-cardiac arrest patient. prevent seizures. Arterial blood gases may be used to guide ventilation and Priorities for the post-cardiac arrest patient include managing hemodynamics to oxygenation in the post-cardiac arrest patient. ensure and maintain adequate perfusion and optimizing ventilation and Targeted temperature management (TTM) should not be oxygenation. Arterial blood gases may be used to ensure ventilation and initiated in a post-cardiac arrest patient who is receiving oxygenation levels are in the physiologic range. Prophylactic anticonvulsant therapy mechanical circulatory support. has not been shown to be of benefit for preventing seizures or for improving other Perfusion should be assessed and maintained to ensure clinical outcomes and is not recommended in the care of the post-cardiac arrest the best outcome for the post-cardiac arrest patient. patient. Mechanical circulatory support can be initiated concurrently with targeted temperature management (TTM). For a patient with third-degree atrioventricular (AV) block Administer atropine and a blood pressure of 70/48 mmHg, what interventions should be considered? Initiate transcutaneous pacing Administer atropine Initiate a dopamine infusion Initiate transcutaneous pacing Initiate a dopamine infusion For a patient with third-degree atrioventricular (AV) block and signs of hemodynamic Administer adenosine compromise, first-line therapy is with atropine. Second-line therapies include transcutaneous pacing and β-adrenergic agonists, such as dopamine. Second-line therapies should be considered immediately if the patient has third-degree AV block Adenosine is not used in the treatment of bradyarrhythmia. What is the correct technique for performing left uterine Position yourself on the patient's left side. Reach across the patient, place both displacement (LUD) for a pregnant patient in cardiac arrest hands on the right side of the uterus and pull the uterus to the left and up. whose fundus is at or above the umbilicus? To provide left uterine displacement from the patient's left side, reach across the Position yourself at the patient's feet. Place both hands patient, place both hands on the right side of the uterus and pull the uterus to the underneath the uterus and push the uterus to the left and left and up. Alternatively, to provide left uterine displacement from the patient's right up. side, place both hands on the right side of the uterus and push the uterus to the left Position yourself on the patient's left side. Reach across and up. the patient, place both hands on the right side of the uterus and pull the uterus to the left and up. Position yourself at the patient's head. Reach down and over the patient, place both hands to each side of the uterus, and pull the uterus to the left and up. Position yourself at the patient's feet. Reach up and over the patient, place both hands on the fundus and pull the uterus to the left and down. Which statements accurately reflect the recommendations Post-cardiac arrest neuroprognostication should be multimodal. for post-cardiac arrest neuroprognostication? Decision-making related to the continuation or withdrawal of life-sustaining Brain imaging studies do not provide useful information for treatments should be delayed until 72 hours after return of spontaneous circulation predicting neurologic outcome in the post-cardiac arrest (ROSC) and following return to normothermia. patient. Status epilepticus can be used to accurately predict a poor neurologic outcome. Post-cardiac arrest neuroprognostication should be multimodal. Decision-making related to the continuation or withdrawal of life-sustaining treatments should be delayed until 72 hours after return of spontaneous circulation (ROSC) and following return to normothermia.