ACLS COMPLETE 2024 solution
complete update A+ graded
This is a good starting point for Jose (big Megacode at end):
https://www.stuvia.com/doc/4279620/test-bank-lehnes-pharmacology-for-nursing-care-11th-
edition-by-jacqueline-burchum-laura-rosenthal-chapter-1-112complete-guide-a
In which situation does bradycardia require treatment? Hypotension
Which intervention is most appropriate for the treatment of a patient in asystole? Epinephrine
You arrive on the scene with the code team. High-quality CPR is in progress. An AED has
previousy advised "no shock indicated." A rhythm check now finds asystole. After resuming
high-quality compressions, which action do you take next? Establish IV or IO access
A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a
rate of 220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38mm Hg, and
the pulse oximetry reading is 98%. There is vascular access in the left arm, and the patient has
not been given any vasoactive drugs. A 12-lead ECG confirm a supraventricular tachycardia with
no evidence of ischemia or infarction. The heart rate has not responded to vagal maneuvers. what
is your next action? Administer adenosine 6mg IV push
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a
toal does of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused,
and her blood pressure is 88/56 mm Hg. Which therapy is now indicated? Epinephrine 2 to 10
mcg/min
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock.
Which drug should be administered first? Epinephrine 1 mg IV/IO
A 62-year-old man suddenly experienced difficulty speaking and left-sided weakness. He meets
initial criteria for fibrinolytic therapy, and a CT scan of the brain si ordered. Which best
describes the guidelines for antiplatelet and fibrinolytic therapy? Hold aspirin for at least 24
hours if rtPA is administered
,A patient is in refractory ventricular fibrillation and has received multiple appropriate
defribillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300mg IV.
The patient is intubated. Which best describe the recommended second does of amiodarone for
this patient? 150 mg IV push
A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure
of 80/60mm Hg. What is the initial does of atropine? 0.5mg
A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor
shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been
effective in terminating the rhythm. An IV has been established. Which drug should be
administered? Adenosine 6mg
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. If no
pathway for medication administration is in place, which method is preferred? IV or IO
What is the indication for the use of magnesium in cardiac arrest? Pulseless ventricular
tachycardia-associated torsades de pointes
A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is
asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. What action
is recommended next?Seeking expert consultation
A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is
intubated, and an IV has been started. The rhythm is asystole. What is the first drug/dose to
administer? Epinephrine 1mg IV/IO
A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One does of
epinephrine was given after the second shock. An antiarrhythmic drug was given immediately
after the third shock. You are the team leader. Which medication do you order next.
Epinephrine 1 mg
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to
nitrate administration? Use of a phosphodiestrase inhibitor within the previous 24 hours
A 57-year-old woman has palpitation, chest discomfort, and tachycardia. The monitor shows a
regular wide-QRS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60
mm HG/ Which action do you take next? Perform electrical cordioversion
A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin
infusion of 1000 units per hour are being administered. The patient did not take aspirin because
he has a history of gastritis, with was treated 5 years ago. What is your next action? Give
aspirin 160-325 mg to chew
You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage 2 months
ago. He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The
, patient is receiving oxygen via nasal cannula at 2L/min, and an IV has been established. His
blood pressure is 180/100mm Hg. Which drug do you anticipate giving to this patient? Aspirin
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have
been given. Which drug should be given next? Amiodarone 300mg
What is the maximum interval for pausing chest compressions? 10 seconds
Your patient is a 56-year-old woman with a history of type 2 diabetes who reports feeling dizzy.
She is pale and diaphoretic. Her blood pressure is 80/66mm Hg. The cardiac monitor documents
the rhythm shown here. She is receiving oxygen at 4L/min by nasal cannula, and an Iv has been
established. What do you administer next? Atropine 0.5mg IV
A 35-year-old woman presents with a chief complaint of palpitations. She has no chest
discomfort, shortness of breath, or light-headedness. Her blood pressure is 120/78mm Hg. Which
intervention is indicated first?Vagal maneuvers
Which action should you take immediately after providing an AED shock?Resume chest
compressions
What action minimizes the risk of air entering the victim's stomach during-bag mask ventilation?
Ventilating until you see the chest rise
You are providing bag-mask ventilations to a patient in respiratory arrest. How often should you
provide ventilation? About every 5-6 seconds
After initiation of CPR and 1 shock for ventricular fibrillation, this rhythm is present on the next
rhythm check. A second shock is given, and chest compressions are resumed immediately. An
IV is in place, and no drugs have been given. Bag-mask ventilations are producing visible chest
rise. What is your next intervention? Give epinephrine 1mg IV/IO
A patient's 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the patient
arrives in the emergency department, the rhythm shown here is seen on the cardiac monitor. The
patient has resolution of moderate (5/10) chest pain after 3 doses of sublingual nitroglycerin.
Blood pressure is 104/70mm Hg. Which intervention is most important in reducing this patient's
in-hospital and 30-day mortality rate? Repersfusion therapy
A patient was in refractory ventricular fibrillation. A thrid shock has just been administered.
Your team looks to you for instructions. What is your next action? Resume high quality chest
compressions
Which action is likely to cause air to enter the victim's stomach (gastric inflation) during bag-
mask ventilation? Ventilating too quickly
A 45-year-old woman with a history of palpitations develops light-headedness and palpitations.
She has received adensoine 6mg IV for the rhythm shown here (SVT), without conversion of the
complete update A+ graded
This is a good starting point for Jose (big Megacode at end):
https://www.stuvia.com/doc/4279620/test-bank-lehnes-pharmacology-for-nursing-care-11th-
edition-by-jacqueline-burchum-laura-rosenthal-chapter-1-112complete-guide-a
In which situation does bradycardia require treatment? Hypotension
Which intervention is most appropriate for the treatment of a patient in asystole? Epinephrine
You arrive on the scene with the code team. High-quality CPR is in progress. An AED has
previousy advised "no shock indicated." A rhythm check now finds asystole. After resuming
high-quality compressions, which action do you take next? Establish IV or IO access
A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a
rate of 220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38mm Hg, and
the pulse oximetry reading is 98%. There is vascular access in the left arm, and the patient has
not been given any vasoactive drugs. A 12-lead ECG confirm a supraventricular tachycardia with
no evidence of ischemia or infarction. The heart rate has not responded to vagal maneuvers. what
is your next action? Administer adenosine 6mg IV push
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a
toal does of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused,
and her blood pressure is 88/56 mm Hg. Which therapy is now indicated? Epinephrine 2 to 10
mcg/min
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock.
Which drug should be administered first? Epinephrine 1 mg IV/IO
A 62-year-old man suddenly experienced difficulty speaking and left-sided weakness. He meets
initial criteria for fibrinolytic therapy, and a CT scan of the brain si ordered. Which best
describes the guidelines for antiplatelet and fibrinolytic therapy? Hold aspirin for at least 24
hours if rtPA is administered
,A patient is in refractory ventricular fibrillation and has received multiple appropriate
defribillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300mg IV.
The patient is intubated. Which best describe the recommended second does of amiodarone for
this patient? 150 mg IV push
A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure
of 80/60mm Hg. What is the initial does of atropine? 0.5mg
A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor
shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been
effective in terminating the rhythm. An IV has been established. Which drug should be
administered? Adenosine 6mg
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. If no
pathway for medication administration is in place, which method is preferred? IV or IO
What is the indication for the use of magnesium in cardiac arrest? Pulseless ventricular
tachycardia-associated torsades de pointes
A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is
asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. What action
is recommended next?Seeking expert consultation
A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is
intubated, and an IV has been started. The rhythm is asystole. What is the first drug/dose to
administer? Epinephrine 1mg IV/IO
A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One does of
epinephrine was given after the second shock. An antiarrhythmic drug was given immediately
after the third shock. You are the team leader. Which medication do you order next.
Epinephrine 1 mg
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to
nitrate administration? Use of a phosphodiestrase inhibitor within the previous 24 hours
A 57-year-old woman has palpitation, chest discomfort, and tachycardia. The monitor shows a
regular wide-QRS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60
mm HG/ Which action do you take next? Perform electrical cordioversion
A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin
infusion of 1000 units per hour are being administered. The patient did not take aspirin because
he has a history of gastritis, with was treated 5 years ago. What is your next action? Give
aspirin 160-325 mg to chew
You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage 2 months
ago. He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The
, patient is receiving oxygen via nasal cannula at 2L/min, and an IV has been established. His
blood pressure is 180/100mm Hg. Which drug do you anticipate giving to this patient? Aspirin
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have
been given. Which drug should be given next? Amiodarone 300mg
What is the maximum interval for pausing chest compressions? 10 seconds
Your patient is a 56-year-old woman with a history of type 2 diabetes who reports feeling dizzy.
She is pale and diaphoretic. Her blood pressure is 80/66mm Hg. The cardiac monitor documents
the rhythm shown here. She is receiving oxygen at 4L/min by nasal cannula, and an Iv has been
established. What do you administer next? Atropine 0.5mg IV
A 35-year-old woman presents with a chief complaint of palpitations. She has no chest
discomfort, shortness of breath, or light-headedness. Her blood pressure is 120/78mm Hg. Which
intervention is indicated first?Vagal maneuvers
Which action should you take immediately after providing an AED shock?Resume chest
compressions
What action minimizes the risk of air entering the victim's stomach during-bag mask ventilation?
Ventilating until you see the chest rise
You are providing bag-mask ventilations to a patient in respiratory arrest. How often should you
provide ventilation? About every 5-6 seconds
After initiation of CPR and 1 shock for ventricular fibrillation, this rhythm is present on the next
rhythm check. A second shock is given, and chest compressions are resumed immediately. An
IV is in place, and no drugs have been given. Bag-mask ventilations are producing visible chest
rise. What is your next intervention? Give epinephrine 1mg IV/IO
A patient's 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the patient
arrives in the emergency department, the rhythm shown here is seen on the cardiac monitor. The
patient has resolution of moderate (5/10) chest pain after 3 doses of sublingual nitroglycerin.
Blood pressure is 104/70mm Hg. Which intervention is most important in reducing this patient's
in-hospital and 30-day mortality rate? Repersfusion therapy
A patient was in refractory ventricular fibrillation. A thrid shock has just been administered.
Your team looks to you for instructions. What is your next action? Resume high quality chest
compressions
Which action is likely to cause air to enter the victim's stomach (gastric inflation) during bag-
mask ventilation? Ventilating too quickly
A 45-year-old woman with a history of palpitations develops light-headedness and palpitations.
She has received adensoine 6mg IV for the rhythm shown here (SVT), without conversion of the
