Question

In: Nursing

Your hospitalized patient is in ventricular fibrillation with no pulse and no respiratory effort. The code...

Your hospitalized patient is in ventricular fibrillation with no pulse and no respiratory effort. The code team has been called and a defibrillator is on the way. You should immediately:
Administer atropine
Administer epinephrine
Begin high-quality CPR
Administer vasopressin

Your patient is in cardiac arrest and you are doing CPR on him. The cardiac monitor shows he is in ventricular tachycardia. You have just delivered a shock without the desired rhythm conversion. Before you defibrillate again, do CPR for:
2 minutes
3 minutes
30 seconds
5 minutes

Your patient arrives to the ED with a pulse rate of 72 but no respiratory effort. You may do all of the following EXCEPT:
Give 1 rescue breath every 6 seconds
Initiate chest compressions
Insert an airway
Administer oxygen
What is the treatment for acute cardiac tamponade?
Pericardiocentesis
Thoracostomy with chest tube
Epinephrine
Surgical embolectomy

You are in an ambulance caring for a man with cardiac chest pain. Which of the following ECG findings would prompt you to activate the cardiac catheterization lab?
Third degree heart block
Supraventricular tachycardia
Elevation of the segment between the S and T waves
Asystole

Your patient in the emergency department is having a cardiopulmonary emergency and is unconscious. You should:
Perform the BLS Assessment first
Perform the ACLS Assessment first
Perform the assessments simultaneously

You do not need to perform either assessment
During CPR, correct compression depth for an adult is:
Between 2 and 2.4 inches
1 inch for females and 2 inches for males
1.5 inches
At least 2 inches

The rate for compressions for an adult is:
60-80 compressions per minute (normal adult heart rate)
80-100 compressions per minute
At least 100 compressions per minute
Between 100 and 120 compressions per minute

Before beginning CPR, check for a pulse for:
No longer than 10 seconds
At least 20 seconds
30 seconds
Take as much time as needed to definitively feel a pulse

The patient in bradycardia begins to have chest pain and her blood pressure is 90/50. The correct drug and dosage for this patient is:
Atropine 0.5 mg IV push
Atropine 1 mg IV push
Epinephrine 2 mcg/min drip
Epinephrine 2 mg/min drip

Your patient has a heart rate of 50 with strong pulses and no other symptoms. The correct intervention is:
Monitor and observe
Atropine at 0.5 mg IV bolus
Transcutaneous pacing
Dopamine infusion at 2-10 mcg/kg/minute

Your patient is bradycardic with a systolic blood pressure of 80 mm Hg. You gave one dose of atropine (0.5 mg IV push) that was not effective. The patient is still unstable, but conscious. The next treatment is to:
Try a second dose of atropine
Begin an epinephrine infusion at 10-20 mcg/min
Provide transcutaneous pacing (TCP)
Monitor and observe

Which of the following rhythms is most likely to convert to cardiac arrest?
Atrial fibrillation
1st degree heart block
2nd degree heart block
3rd degree heart block3rd degree heart block

Your patient is unresponsive with no pulse and a flat line on the monitor. As the team leader you know that you should continue doing high-quality CPR and:
Defibrillate the patient as soon as possible
Perform synchronized cardioversion
Administer atropine 1.0 mg IV
Review the H's and T's to determine if there is a reversible cause for the asystole

You are doing CPR on a patient with pulseless ventricular tachycardia. You should check for a pulse:
Never
After each cycle of CPR
After 2 minutes of CPR
After 10 minutes of CPR

Which of the following should NOT be treated with a fibrinolytic (i.e. tPA)?
Ischemic stroke
Hemorrhagic stroke
ST-segment elevation myocardial infarction
Pulmonary embolism

Therapeutic hypothermia may be recommended for:
Hypothermia is never recommended following resuscitation
Only patients with head injury and successful CPR
All patients after resuscitation

Comatose patients with return of spontaneous circulation (ROSC) after cardiac arrest
You are taking care of a hemodynamically stable patient with a narrow QRS complex supraventricular tachycardia. Which of the following interventions should you provide first?
Amiodarone
Adenosine
Atropine
Synchronized cardioversion

Your patient has tachycardia with a heart rate of 200 beats per minute with pulses; his systolic blood pressure is 80 mm Hg; he is lethargic. Of the options provided, which is the best first step?
Perform immediate unsynchronized cardioversion
Give adenosine 6 mg IV rapid push
Give amiodarone 150 mg IV
Obtain an ECG to determine the specific rhythm

A patient began to have cardiac chest pain at 6am on Friday. She came to the emergency department at 8am on Saturday because she still wasn’t feeling well. Her 12-lead EKG is consistent with an ST elevation myocardial infarction but she is stable. How should this patient be managed?
STEMI Algorithm: Emergent PCI.
Unstable Angina Algorithm: Admit to hospital and monitor. Give statins and control blood pressure.
Non-STEMI Algorithm: Admit to hospital and monitor. Give anti-platelets and anticoagulants.
Stable Angina: Discharge from ED with follow-up with primary care doctor.

The immediate general assessment of a possible stroke victim by the stroke team or physician should be done:
Within 1 minute of arrival to the ED
Within 10 minutes of arrival to the ED
Within 30 minutes of arrival to the ED
Within 60 minutes of arrival to the ED

Which if the following drugs can be used to rapidly reverse the effects of opioids?
Epinephrine
Caffeine
Naloxone
Methadone

As of 2015, what agents are no longer recommended for routine post-cardiac arrest care?
Lidocaine
Beta-blockers
Atropine
Both lidocaine and beta-blockers

Solutions

Expert Solution

1) C. Begin high- quality CPR immediately.Ventricular fibrillation means impiluses fom many irritable foci in the ventricles fire in totally disorganized manner .It is fatal if not successfully terminated withi 3 to 5 minutes.Initate CPR until a defbrillator is available.The other need to do after CPR.

2) A.2 minutes.CPR is continued for 2 minutes and the cardiac rhythm is reassessed to dtermine need for further countershock.The other options are eliminated.

3)B.Initate chest compression.In this pulse rate is good and chest compression is need in patient with no respiratory rate and need to think of ventillation.

4)B.Supraventricular tachcardia.It is defined as heart beat is beating faster than normal.The patient with supraventricular tachycardia will go through a procedure konwn as catheter ablation and it is done ib cardiac catherterization.The other options are eliminated because In case third degree block the management is same as heart failure

5)A.Perform BLS ssessment.The BLS is the first and foremost step need to do when emergency occur .Firstly check whether the victim is unresponsive and then activate emergency system after that check for respiration and heart rate .If pulse is not felt begin CPR after that start the assessment based on ACLS.


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