CEN Cardiovascular Emergencies 36
Questions With Correct Answers.
Preload refers to:
a. The volume of blood entering the left side of the heart
b. The volume of blood entering the right side of the heart
c. The pressure in the venous system that the heart must overcome to pump the blood
d. The pressure in the arterial system that the heart must overcome to pump the blood -
Answerb. Preload is the volume of blood that enters the right side of the heart. This
volume stretches the fibers in the heart prior to contraction. Preload is commonly
measured as atrial pressure.
When suctioning during a cardiac arrest, suctioning should be limited to which of the
following?
a. Less than 5 seconds
b. Less than 10 seconds
c. Less than 20 seconds
d. Less than 30 seconds - AnswerB. According to the 2010 BLS and ACLS guidelines,
suctioning for longer than 10 seconds may result in pulling too much oxygen out of the
airways resulting in hypoxemia.
You are caring for a 65 year old who collapsed outside of the hospital and was brought
in to the emergency department. During CPR, quantitative waveform capnography
shows a PETCO2 level < 10 mm HG. Which of the following is the correct response to
this finding?
a. Do nothing; this is normal.
b. Increase the amount of oxygen being delivered.
c. Attempt to improve the quality of CPR.
d. Decrease the amount of oxygen being delivered. - AnswerC. Quantitative waveform
capnography provides a good indication of the quality of CPR. Levels < 10 mm HG
indicate either a problem with the quality of CPR or with the placement of the ETT.
EtCO2 levels of ≤10 mmHg predicted death in adult patients with cardiac arrest.
Measurement of EtCO2 varies directly with the cardiac output produced by chest
compression . Goal is 35-45mmg HG or 5-6% CO2.
You are caring for an 85 year old and are having trouble establishing an intravenous
line. The ED physician asks for an intraosseous needle to establish an IO line for
medication administration. Which of the following is TRUE about the intraosseous route
of drug administration?
a. It should only be done on children under the age of 16.
b. It is preferred over the IV route of drug administration.
c. It should only be attempted after all other routes have been attempted.
, d. Any drug or fluid can be administered via the IO route. - AnswerD. Any drug that
can be given via the IV route can also be given via the IO route. Although commonly
thought of in reference to pediatric patients, an IO route can be established on any age
person. IO access is the preferred route over the ETT but not IV route; it is often the
easiest route to establish while CPR is being done.
You have defibrillated the patient in ventricular fibrillation. The appropriate action to take
next is:
a. Do CPR for a 2-minute cycle.
b. Obtain an ECG to determine the rhythm.
c. Defibrillate again at a higher dose.
d. Give IV Epinephrine. - AnswerA. The 2010 ACLS guidelines no longer recommend
the stacked defibrillation. Instead, a 2-minute cycle of CPR should be done as the
defibrillator is charging.
A 55-year-old patient is diagnosed with Acute Coronary Syndrome (ACS). The ED
nurse should expect to give medications to relieve pain and prevent clots. Assuming
oxygen is needed, what is the correct sequence for these frontline drugs?
a. Oxygen, Aspirin, Nitroglycerin, Morphine
b. Aspirin, Oxygen, Nitroglycerin, Morphine
c. Nitroglycerin, Oxygen, Aspirin, Morphine
d. Aspirin, Oxygen, Morphine, Nitroglycerin - AnswerA. Oxygen should be the first
drug given for the patient with ACS. Aspirin is the front line drug for dissolving clots
associated with ACS. Nitroglycerine is typically readily available and should be
administered third. Finally, for continued pain, morphine may be necessary. During the
initial assessment phase, the following steps should be accomplished for any patient at
significant risk for ACS:
•Airway, breathing, and circulation assessed
•Preliminary history and examination obtained
•12-lead ECG interpreted
•Resuscitation equipment brought to the bedside
•Cardiac monitor attached to patient
•Oxygen given
•IV access and blood work obtained
•Aspirin 162 to 325 mg given
•Nitrates and morphine given (unless contraindicated)
A 75-year-old patient has the rhythm on the right. He is short of breath, lethargic and
has a systolic blood pressure of 80 mm Hg. What is the most appropriate first step in
treatment for this patient?
a. Obtain an EKG to determine the rhythm.
b. Give Adenosine 6 mg IV rapid push.
c. Perform immediate synchronized cardioversion.
d. Give Amiodarone 150 mg over 10 minutes. - AnswerC. The rhythm is tachycardia
and can be further classified as unstable due to the fact that the patient is short of
Questions With Correct Answers.
Preload refers to:
a. The volume of blood entering the left side of the heart
b. The volume of blood entering the right side of the heart
c. The pressure in the venous system that the heart must overcome to pump the blood
d. The pressure in the arterial system that the heart must overcome to pump the blood -
Answerb. Preload is the volume of blood that enters the right side of the heart. This
volume stretches the fibers in the heart prior to contraction. Preload is commonly
measured as atrial pressure.
When suctioning during a cardiac arrest, suctioning should be limited to which of the
following?
a. Less than 5 seconds
b. Less than 10 seconds
c. Less than 20 seconds
d. Less than 30 seconds - AnswerB. According to the 2010 BLS and ACLS guidelines,
suctioning for longer than 10 seconds may result in pulling too much oxygen out of the
airways resulting in hypoxemia.
You are caring for a 65 year old who collapsed outside of the hospital and was brought
in to the emergency department. During CPR, quantitative waveform capnography
shows a PETCO2 level < 10 mm HG. Which of the following is the correct response to
this finding?
a. Do nothing; this is normal.
b. Increase the amount of oxygen being delivered.
c. Attempt to improve the quality of CPR.
d. Decrease the amount of oxygen being delivered. - AnswerC. Quantitative waveform
capnography provides a good indication of the quality of CPR. Levels < 10 mm HG
indicate either a problem with the quality of CPR or with the placement of the ETT.
EtCO2 levels of ≤10 mmHg predicted death in adult patients with cardiac arrest.
Measurement of EtCO2 varies directly with the cardiac output produced by chest
compression . Goal is 35-45mmg HG or 5-6% CO2.
You are caring for an 85 year old and are having trouble establishing an intravenous
line. The ED physician asks for an intraosseous needle to establish an IO line for
medication administration. Which of the following is TRUE about the intraosseous route
of drug administration?
a. It should only be done on children under the age of 16.
b. It is preferred over the IV route of drug administration.
c. It should only be attempted after all other routes have been attempted.
, d. Any drug or fluid can be administered via the IO route. - AnswerD. Any drug that
can be given via the IV route can also be given via the IO route. Although commonly
thought of in reference to pediatric patients, an IO route can be established on any age
person. IO access is the preferred route over the ETT but not IV route; it is often the
easiest route to establish while CPR is being done.
You have defibrillated the patient in ventricular fibrillation. The appropriate action to take
next is:
a. Do CPR for a 2-minute cycle.
b. Obtain an ECG to determine the rhythm.
c. Defibrillate again at a higher dose.
d. Give IV Epinephrine. - AnswerA. The 2010 ACLS guidelines no longer recommend
the stacked defibrillation. Instead, a 2-minute cycle of CPR should be done as the
defibrillator is charging.
A 55-year-old patient is diagnosed with Acute Coronary Syndrome (ACS). The ED
nurse should expect to give medications to relieve pain and prevent clots. Assuming
oxygen is needed, what is the correct sequence for these frontline drugs?
a. Oxygen, Aspirin, Nitroglycerin, Morphine
b. Aspirin, Oxygen, Nitroglycerin, Morphine
c. Nitroglycerin, Oxygen, Aspirin, Morphine
d. Aspirin, Oxygen, Morphine, Nitroglycerin - AnswerA. Oxygen should be the first
drug given for the patient with ACS. Aspirin is the front line drug for dissolving clots
associated with ACS. Nitroglycerine is typically readily available and should be
administered third. Finally, for continued pain, morphine may be necessary. During the
initial assessment phase, the following steps should be accomplished for any patient at
significant risk for ACS:
•Airway, breathing, and circulation assessed
•Preliminary history and examination obtained
•12-lead ECG interpreted
•Resuscitation equipment brought to the bedside
•Cardiac monitor attached to patient
•Oxygen given
•IV access and blood work obtained
•Aspirin 162 to 325 mg given
•Nitrates and morphine given (unless contraindicated)
A 75-year-old patient has the rhythm on the right. He is short of breath, lethargic and
has a systolic blood pressure of 80 mm Hg. What is the most appropriate first step in
treatment for this patient?
a. Obtain an EKG to determine the rhythm.
b. Give Adenosine 6 mg IV rapid push.
c. Perform immediate synchronized cardioversion.
d. Give Amiodarone 150 mg over 10 minutes. - AnswerC. The rhythm is tachycardia
and can be further classified as unstable due to the fact that the patient is short of
