ACLS Final Exam Second try questions with answers 2021/2022

check_circle Question 1 Points 1 / 1 Bradycardia in a healthy adult patient is defined as: Feedback Bradycardia is defined as a resting heart rate below 60 beats per minute. cancel Question 2 Points 0 / 1 While working a code in the ED, the respiratory therapist inserts an endotracheal tube for airway control, while continuous chest compressions are being accomplished and ACLS is being continued. During subsequent ventilations, the presence of a waveform is noticed on the capnography screen as well as a PETCO2 level of 7 mmHg. What is the significance of this finding? Feedback Monitor the quality of CPR using intra-arterial pressure (attempt to improve quality of CPR if diastolic blood pressure is 20 mmHg) or quantitative waveform capnography (attempt to improve quality of CPR if PETCO2 is 10 mmHg). check_circle Question 3 Points 1 / 1 A patient presents to you in the field in new-onset rapid A-fib on the monitor. His BP is 142/88, heart rate 182 and irregular and respirations 18, non-labored with an oxygen saturation of 98% on low-flow oxygen. Which of the following drugs can be given to aid in controlling the patient's rate? Feedback Medications that are used in the treatment of new onset atrial fibrillation include Cardizem (diltiazem), a calcium channel blocker, or metoprolol, a beta blocker. These medications are given to control rate. check_circle Question 4 Points 1 / 1 Working on the telemetry floor, you are summoned to the bedside of a patient who has suddenly gone into ventricular tachycardia on rhythm interpretation and is found to be unconscious. What is your first priority for this patient? Feedback When responding to an unresponsive patient, first ensure scene safety and then perform a carotid pulse check. check_circle Question 5 Points 1 / 1 PETCO2 levels that should be achieved in the ventilated post cardiac arrest patient are: Feedback Avoid excessive ventilation. Administer 10 to 12 breaths per minute to maintain a PETCO2 of 35 to 40 mmHg or PaCO2 of 40 to 45 mmHg. cancel Question 6 Points 0 / 1 A 51-year-old man presented to the ED triage complaining of severe dizziness. He is immediately brought to your room where the monitor reveals a second-degree AV block, type II. His blood pressure is 50/23 with a heart rate of 34. There has been no attempt at an IV. Which of the following should be performed immediately? Feedback Prepare for TCP if the patient has a high-degree atrioventricular block. Start TCP immediately if you have trouble obtaining IV access, or there is delay in establishing IV access. check_circle Question 7 Points 2 / 2 Use the following scenario for the next 2 questions: As a paramedic, you are caring for a 78-year-old female with a history of congestive heart failure. She called you due to extreme dyspnea that has been constant all night. check_circle SubQuestion 1 Identify the rhythm: Student Answer: Supraventricular tachycardia Correct Answer: Supraventricular tachycardia Feedback By definition, supraventricular tachycardia is any tachycardic rhythm that originates above the ventricles in the atria or AV node. However, the term SVT is usually reserved for atrioventricular nodal reentrant tachycardia (AVNRT), which is one of the more common types of SVT and results from a re-entry circuit that forms in the AV node or just next to it. AVNRT can be indentified by: rate – 150 to 250 beats per minute, typically 170 to 250 beats per minute; rhythm – regular atrial and ventricular rhythm; P waves – P waves are hidden in the QRS complex; when the ventricles are stimulated first followed by the atria, an inverted P wave will appear after the QRS in leads II, III, and aVF; if the atria are depolarized after the ventricles, the end of the QRS complex will be distorted by the P wave; PR interval – not measurable due to the lack of P waves before the QRS complex; QRS duration – 0.10 second or less, barring an intraventricular conduction delay. check_circle SubQuestion 2 The patient presents with a blood pressure of 134/60. However you note she is using all accessory muscles to breath and has an SPO2 of 74% with a PETCO2 of 20 mmHg and central cyanosis. Based on this information, the best treatment of choice for her cardiac presentation is: Student Answer: Synchronized cardioversion Correct Answer: Synchronized cardioversion Feedback If persistent tachycardia is causing significant signs or symptoms, then the patient is unstable. Signs that the tachycardic patient is unstable may include: hypotension, an acutely altered mental state, signs of shock, ongoing chest pain/discomfort/shortness of breath, acute heart failure, lightheadedness or loss of consciousness (presyncope or syncope). Cardioversion is administered to unstable tachycardic patients. Feedback cancel Question 8 Points 0 / 1 Use this rhythm strip for the following question(s): cancel SubQuestion 1 Identify the rhythm: Student Answer: 2nd degree – Mobitz Type II Correct Answer: 3rd degree AV block Feedback A complete failure of the AV node to conduct any impulses from the atria to the ventricles is the main feature of a third-degree AV block. There is AV dissociation and escape rhythms that may be junctional or ventricular that represent perfusing rhythms. Feedback check_circle Question 9 Points 1 / 1 In order to meet criteria for an ECG tracing to be called a STEMI, the provider must find: Feedback ST Segment Elevation Myocardial Infarction (STEMI) is diagnosed if there is ST segment elevation greater than 1 mm (0.1 mV) in 2 or more contiguous precordial leads (2 mm in leads V2 and V3) or two or more adjacent limb leads, or by new (or presumed new) left bundle branch block. check_circle Question 10 Points 1 / 1 Use this rhythm strip for the following question(s): check_circle SubQuestion 1 Identify the rhythm: Student Answer: 2nd degree AV block – Mobitz Type I Correct Answer: 2nd degree AV block – Mobitz Type I Feedback Mobitz Type I (also known as Wenckebach) occurs when there is an intermittent conduction block within the AV node that results in a failure to conduct an impulse from the atria into the ventricles. The impaired nodal conduction is progressive to the point that there is a total block. This causes an absent impulse into the ventricles, reflected by the disappearance of the QRRS complex in the ECG. Feedback