CEN CARDIOVASCULAR EMERGENCIES

• | Page

CEN CARDIOVASCULAR EMERGENCIES

UPDATED ACTUAL EXAM WITH CORRECT

SOLUTIONS.

Preload refers to:

• The volume of blood entering the left side of the heart
• The volume of blood entering the right side of the heart
• The pressure in the venous system that the heart must

overcome to pump the blood

• The pressure in the arterial system that the heart must

overcome to pump the blood - correct answer- b. 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?

• Less than 5 seconds
• Less than 10 seconds
• Less than 20 seconds
• Less than 30 seconds - correct answer- B. 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.

• / 3

• | Page

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?

• Do nothing; this is normal.
• Increase the amount of oxygen being delivered.
• Attempt to improve the quality of CPR.
• Decrease the amount of oxygen being delivered. - correct

answer- C. 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?

• It should only be done on children under the age of 16.
• It is preferred over the IV route of drug administration.
• It should only be attempted after all other routes have been

attempted.

• Any drug or fluid can be administered via the IO route. -

correct answer- D. Any drug that can be given via the IV route 2 / 3

• | Page

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:

• Do CPR for a 2-minute cycle.
• Obtain an ECG to determine the rhythm.
• Defibrillate again at a higher dose.
• Give IV Epinephrine. - correct answer- A. 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?

• Oxygen, Aspirin, Nitroglycerin, Morphine
• Aspirin, Oxygen, Nitroglycerin, Morphine
• Nitroglycerin, Oxygen, Aspirin, Morphine
• Aspirin, Oxygen, Morphine, Nitroglycerin - correct answer- A.

Oxygen should be the first drug given for the patient with ACS.Aspirin is the front line drug for dissolving clots associated with

• / 3