ACLS FINAL EXAM STUDY GUIDE
QUESTIONS WITH DETAILED VERIFIED
ANSWERS
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? - correct
answer- 2-3 minutes
A 28-year-old pregnant patient who resides in transitional
housing presents to the emergency department with
complaints of feeling feverish and very faint. The patient
tells the emergency nurse that she does not know when
she became pregnant. Upon palpation, the fundus is not
at or above the umbilicus. The patient's condition quickly
deteriorates and she goes into cardiac arrest. If available
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? -
correct answer- Point of care US
,- Gestational age is an important consideration when
determining the approach to a pregnant patient in cardiac
arrest. If the gestational age is not known and point-of-
care ultrasound is available and able to be performed
without impeding or delaying the resuscitation effort, it
can be used to quickly estimate gestational age and guide
decision-making.
A 30-year-old patient has been brought to the emergency
department in cardiac arrest. The cardiac monitor shows
the following rhythm- V FIB. Interpretation of this rhythm
would suggest which of the following as a possible
precipitating factor? - correct answer-
Electrocution
- The rhythm is ventricular fibrillation. Precipitating causes
of ventricular fibrillation include electrocution, myocardial
ischemia or infarction, shock, stimulant overdose and
ventricular tachycardia
A 35-year-old female patient's ECG is consistent with
STEMI. The ECG reveals a new ST-segment elevation at
the J point in leads V2 and V3 of at least which size? -
correct answer- 0.15 mV
, -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.
A 42-year-old woman presents to the emergency
department with complaints of fatigue, shortness of
breath, back pain and nausea. A 12-lead ECG is obtained
and shows ST-segment depression in leads II, III, and aVF
and intermittent runs of nonsustained ventricular
tachycardia. Cardiac serum markers are elevated. These
findings suggest which condition? - correct
answer- High-risk non-ST-segment elevation ACS
(NSTE-ACS)
- The 12-lead ECG findings of ST-segment depression in
three contiguous leads along with elevated cardiac serum
biomarkers are consistent with high-risk non-ST-segment
elevation ACS (NSTE-ACS). The presence of intermittent
runs of ventricular tachycardia also places this patient at
high risk. In ST-segment elevation myocardial infarction
(STEMI), cardiac serum markers would be elevated, but
this patient's ECG findings are not consistent with STEMI.
Patients with intermediate- or low-risk NSTE-ACS show
nondiagnostic ST-segment or T-wave changes on ECG, or
no changes at all.
QUESTIONS WITH DETAILED VERIFIED
ANSWERS
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? - correct
answer- 2-3 minutes
A 28-year-old pregnant patient who resides in transitional
housing presents to the emergency department with
complaints of feeling feverish and very faint. The patient
tells the emergency nurse that she does not know when
she became pregnant. Upon palpation, the fundus is not
at or above the umbilicus. The patient's condition quickly
deteriorates and she goes into cardiac arrest. If available
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? -
correct answer- Point of care US
,- Gestational age is an important consideration when
determining the approach to a pregnant patient in cardiac
arrest. If the gestational age is not known and point-of-
care ultrasound is available and able to be performed
without impeding or delaying the resuscitation effort, it
can be used to quickly estimate gestational age and guide
decision-making.
A 30-year-old patient has been brought to the emergency
department in cardiac arrest. The cardiac monitor shows
the following rhythm- V FIB. Interpretation of this rhythm
would suggest which of the following as a possible
precipitating factor? - correct answer-
Electrocution
- The rhythm is ventricular fibrillation. Precipitating causes
of ventricular fibrillation include electrocution, myocardial
ischemia or infarction, shock, stimulant overdose and
ventricular tachycardia
A 35-year-old female patient's ECG is consistent with
STEMI. The ECG reveals a new ST-segment elevation at
the J point in leads V2 and V3 of at least which size? -
correct answer- 0.15 mV
, -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.
A 42-year-old woman presents to the emergency
department with complaints of fatigue, shortness of
breath, back pain and nausea. A 12-lead ECG is obtained
and shows ST-segment depression in leads II, III, and aVF
and intermittent runs of nonsustained ventricular
tachycardia. Cardiac serum markers are elevated. These
findings suggest which condition? - correct
answer- High-risk non-ST-segment elevation ACS
(NSTE-ACS)
- The 12-lead ECG findings of ST-segment depression in
three contiguous leads along with elevated cardiac serum
biomarkers are consistent with high-risk non-ST-segment
elevation ACS (NSTE-ACS). The presence of intermittent
runs of ventricular tachycardia also places this patient at
high risk. In ST-segment elevation myocardial infarction
(STEMI), cardiac serum markers would be elevated, but
this patient's ECG findings are not consistent with STEMI.
Patients with intermediate- or low-risk NSTE-ACS show
nondiagnostic ST-segment or T-wave changes on ECG, or
no changes at all.
