DHA Nursing Critical Care & Emergency 2 — Questions and Answers
Question 1: What is the maximum single recommended dose of adrenaline (epinephrine) administered IV during adult cardiac arrest?
- 1 mg IV every 3–5 minutes (Correct answer)
- 5 mg IV bolus every 2 minutes
- 0.1 mg IV every minute
- 10 mg IV once only
Correct answer: 1 mg IV every 3–5 minutes
Current ACLS guidelines recommend 1 mg of IV epinephrine every 3–5 minutes during adult cardiac arrest to maintain coronary and cerebral perfusion pressure.
Question 2: A mechanically ventilated patient develops sudden hypotension and absent breath sounds on one side. What complication should the nurse suspect?
- Tension pneumothorax (Correct answer)
- Pulmonary embolism
- Aspiration pneumonia
- Ventilator-associated pneumonia
Correct answer: Tension pneumothorax
Sudden hypotension with unilateral absent breath sounds in a ventilated patient is the hallmark presentation of tension pneumothorax, a life-threatening emergency.
Question 3: The Glasgow Coma Scale (GCS) assesses which three patient responses?
- Eye opening, verbal response, motor response (Correct answer)
- Pupil size, pain response, breathing
- Pulse, pressure, pupils
- Orientation, memory, reflexes
Correct answer: Eye opening, verbal response, motor response
The GCS evaluates eye opening (4 points), verbal response (5 points), and motor response (6 points) to objectively quantify level of consciousness.
Question 4: Which ECG finding is the hallmark of ST-elevation myocardial infarction (STEMI)?
- ST segment elevation of ≥1 mm in two or more contiguous leads (Correct answer)
- Prolonged PR interval
- Widened QRS complex only
- T-wave inversion in one lead
Correct answer: ST segment elevation of ≥1 mm in two or more contiguous leads
STEMI is diagnosed by ST elevation of ≥1 mm in two or more anatomically contiguous leads, indicating complete occlusion of a coronary artery requiring urgent reperfusion.
Question 5: A patient in the ICU develops acute respiratory distress syndrome (ARDS). Which ventilator strategy is recommended?
- Low tidal volume ventilation (lung-protective ventilation, 6 mL/kg ideal body weight) (Correct answer)
- High tidal volume ventilation to maximise oxygenation
- Spontaneous breathing without ventilator support
- Continuous positive pressure at 20 cmH2O
Correct answer: Low tidal volume ventilation (lung-protective ventilation, 6 mL/kg ideal body weight)
Lung-protective ventilation using low tidal volumes (6 mL/kg IBW) reduces ventilator-induced lung injury and is the evidence-based standard for ARDS management.
Question 6: What is the correct sequence for defibrillation using an AED?
- Power on, attach pads, analyse rhythm, deliver shock if advised, resume CPR (Correct answer)
- Attach pads, shock immediately without analysis, then assess
- Assess pulse first, then attach pads, shock if pulseless
- Start CPR, shock after 5 cycles, then attach AED
Correct answer: Power on, attach pads, analyse rhythm, deliver shock if advised, resume CPR
AED use follows: power on, attach pads to dry skin, allow rhythm analysis, deliver the shock if advised, then immediately resume CPR for 2 minutes.
DHA Nursing Critical Care & Emergency 2
What is the maximum single recommended dose of adrenaline (epinephrine) administered IV during adult cardiac arrest?