ACLS Post-Cardiac Arrest Care 4

Question 1

Which EEG pattern in a post-cardiac arrest patient is most strongly associated with poor neurological prognosis?

Accepted Answer

Burst suppression with identical bursts (generalized suppression pattern)

Answer

Burst suppression with identical bursts (suppression-burst ratio >50%) is a malignant EEG pattern indicating severe cortical injury post-arrest.

Question 2

During targeted temperature management, a patient develops bradycardia at a rate of 48 bpm with stable blood pressure. What is the most appropriate action?

Accepted Answer

Continue TTM; bradycardia is an expected physiologic response to cooling

Answer

Bradycardia during TTM is a normal physiological response to hypothermia and does not require treatment as long as hemodynamics remain stable.

Question 3

What is the recommended rewarming rate during the rewarming phase of targeted temperature management?

Accepted Answer

0.25°C per hour

Answer

Slow controlled rewarming at 0.25°C/hour minimizes risks of hemodynamic instability, seizures, and electrolyte shifts associated with rapid temperature changes.

Question 4

NSE (neuron-specific enolase) levels greater than 60 μg/L at 48–72 hours post-arrest indicate:

Accepted Answer

High likelihood of poor neurological outcome when combined with other predictors

Answer

Elevated NSE is a biomarker of neuronal injury; levels >60 μg/L combined with other clinical findings support a poor prognosis but should not be used in isolation.

Question 5

Post-arrest hyperthermia (temperature >37.7°C) in the 48 hours after ROSC is associated with:

Accepted Answer

Worse neurological outcomes due to increased cerebral metabolic demand

Answer

Fever after cardiac arrest increases cerebral metabolic demand and excitotoxicity, worsening neurological injury and outcomes.

ACLS Practice Test

ACLS Practice Test

ACLS Post-Cardiac Arrest Care 4