ACLS Written Exam
Question:
A 49-year-old man has retrosternal chest pain radiating into the left arm.The patient is diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. The patient's 12-lead ECG shows ST-segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What is the next action?
Answer:
Administer 2 to 4 mg of morphine by slow IV bolus.
Question:
A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing. The blood pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95%. The lead II ECG displays a wide-complex tachycardia. What is the next action after establishing an IV and obtaining a 12-lead ECG?
Answer:
Seeking expert consultation
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Question:
A postoperative patient in the ICU reports new chest pain. What actions have the highest priority?
Answer:
Obtain a 12-lead ECG and administer aspirin if not contraindicated.
Question:
An 80-year-old woman presents to the emergency department with dizziness. She now states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She is alert and oriented. Her lead II ECG is below. After you start an IV, what is the next action?
Answer:
Conduct a problem-focused history and physical examination.
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Question:
A responder is caring for a patient with a history of congestive heart failure.The patient is experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of 190/min. The patient's lead II ECG is displayed below.
Answer:
stable supraventricular tachycardia
Question:
What is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes?
Answer:
160 to 325 mg 3 / 4
Question:
What is the most appropriate intervention for a rapidly deteriorating patient who has this lead II ECG?
Answer:
Synchronized cardioversion
Question:
What is the purpose of a medical emergency team (MET) or rapid response team (RRT)?
Answer:
Improving patient outcomes by identifying and treating early clinical deterioration
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