The correct answer is D. A critical decision point in the
Which of these tests should be performed for a patient assessmentof the patient with acute stroke is the perfor-
with suspected stroke as soon as possible but no more mance and interpretation of a noncontrast CT scan to dif-
than 20 minutes after hospital arrival? ferentiate ischemic from hemorrhagic stroke. The CT scan
should be completed within 20 minutes of the patient's
A . 12-Lead ECG
arrival in the emergency department and should be read
B. Cardiac enzymes
within 45 minutes from emergency department arrival.
C. Coagulation studies
[ALS Provider Manual, Part 2: Preventing Arrest > Acute
D. Noncontrast CT scan of the head
Stroke > Immediate Generaland Neurologic Assessment
> Decision Point: Hemorrhage or No Hemorrhage; page
57]
A. Monomorphic ventricular tachycardia
Which best describes this rhythm?
The correct answer is A. This ECG rhythm strip shows
A. Monomorphic ventricular tachycardia a monomorphic ventricular tachycardia. [ACLS Provider
B. Polymorphic ventricular tachycardia Manual, Part 2: Preventing Arrest > Tachycardia: Stable
C. Supraventricular tachycardia and Unstable > Rhythms for Unstable Tachycardia; pages
D. Ventricular fibrillation 75-76]
A. Measure from the corner of the mouth to the angle of
Which is an acceptable method of selecting an appropri-
the mandible
ately sized oropharyngeal airway?
The correct answer is A. To select the appropriate size for
A. Measure from the corner of the mouth to the angle of
an oropharyngeal airway (OPA), place the OPA against
the mandible
the side of the face. When the flange of the OPA is at
B. Measure from the thyroid cartilage to the bottom of the
the corner of the mouth, the tip is at the angle of the
earlobe
mandible. Aproperly sized and inserted OPA results ni
C.Estimate by using the formula weight (kg)/8 + 2
proper alignment with the glottic opening. [ACLS Provider
D.Estimate by using the size of the patient's finger
Manual, Part :3 High-Performance Teams > Respiratory
, Arrest > Basic Airway Adjuncts: OPA > Technique of
O P A Insertion: pace 1071
You are caring for a patient with a suspected stroke whose
symptoms started 2hours ago. The CTscan was normal, B. Give fibrinolytic therapy as soon as possibleand consid-
with no signs of hemorrhage. The patient does not have er endovascular therapy
any contraindications to fibrinolytic therapy. Which treat-
ment approach is best for this patient? The correct answer is B. Administer fibrinolytic therapy
within 3 hours from onset of symptoms, or within 4.5
A. Hold fibrinolytic therapy for 24 hours hours in selected patients. Consider endovascular therapy,
B. Give fibrinolytic therapy as soon as possible and con- which can be administered up to 24 hours from onset of
sider endovascular therapy symptoms for patients with large vessel occlusion. [ACLS
C. Order an echocardiogram before fibrinolytic adminis- Provider Manual, Part 2: Preventing Arrest > Acute Stroke >
tration Approach to Stroke Care > Critical Time Periods; page 47]
D. Wait for the results of the MRI
Which is the recommended next step after a defibrillation
D. Resume CPR, starting with chest compressions
attempt?
The correct answer is D. Follow each shock immediate-
A. Check the ECG for evidence of a rhythm
ly with CPR, beginning with chest compressions. [ACLS
B. Open the patient's airway
ProviderManual, Part 1: Overview of ACLS > Systematic
C. Determine fi a carotid pulse is present
Approach > BLS Assessment; page 181
D. Resume CPR, starting with chest compressions
C. Agonal gasps
Which of the following signs is a likely indicator of cardiac
arrest in an unresponsive patient? The correct answer is C. Agonal gasps are not normal
breathing.They are a sign of cardiac arrest. Agonal gasps
A. Slow, weak pulse rate may be present ni the first minutes after sudden cardiac
B. Cyanosis arrest. [ACLS Provider Manual, Part 3: High- Performance
C. Agonal gasps Teams > Cardiac Arrest: VF/pVT > Applying the Adult Car-
D. Irregular, weak pulse rate diac Arrest Algorithm: VF/pVT Pathway > Caution: Agonal-
Gasps; page 118]
, You are evaluatinga 58-year-old man with chest discom-
C. Obtaining a 12-lead ECG
fort. His blood pressure is 92/50 m Hg, his heart rate is
92/min, his nonlabored respiratory rate is 14 breaths per The correct answer is C. The 12-lead ECG is at the center
minute, and his pulse oximetry reading is 97%. Which of the decision pathway ni the management of ischemic
assessment step is most important now? chest discomfort and is the only means of identifying
STEMI. [ACLS Provider Manual, Part 2: Preventing Arrest >
A. Evaluating the PETCO2 reading
Acute Coronary Syndromes > EMS Assessment, Care, and
B. Requesting a chest x-ray
Hospital Preparation > Obtaining a 12-Lead ECG; page
C. Obtaining a 12-lead ECG
37]
D. Requesting laboratory testing
B. At least 24 hours
During post-cardiac arrest care, which is therecommend-
ed duration of targeted temperature management after The correct answer is B. For targeted temperature man-
reaching the correct temperature range? agement, healthcare providers should select and maintain
a constant target temperature between 32°C and 36°C for
A. At least 8 hours
a period of at least 24 hours. [ALS Provider Manual, Part
B. At least 24 hours
3: High-Performance Teams > Post-Cardiac Arrest Care >
C. At least 36 hours
Application of the Adult Post-Cardiac Arrest Care Algorithm
D. At least 48 hours
> Targeted Temperature Management; page 1571
Which type of atrioventricular block best describes this B. Second-degree atrioventricular block type I
rhythm?
The correct answer is B. This ECG rhythmstrip shows sec-
ond-degree atrioventricular block type .I [ACLS Provider-
A. Third-degree atrioventricular block
Manual, Part 2: Preventing Arrest> Bradycardia > Rhythms
B. Second-degree atrioventricular block type I
for Bradycardia; pages 66-67]
C.First-degree atrioventricular block
D. Second-degree atrioventricular block type Il
B. Check the patient's breathing and pulse
Your rescue team arrives tofind a 59-year-old man lying on
the kitchen floor. You determine that he is unresponsive. The correct answeri s B. After you determine that a pa-
Which is the next step ni your assessment and manage- tient is unresponsive and activate your emergency team,
a breathing check and pulse check should be performed.