Question 1: After using an AED to shock someone, you should:

• check a pulse
• let the AED reanalyze the rhythm
• Start CPR, beginning with chest compressions (Correct answer)
• give a rescue breath

Correct answer: Start CPR, beginning with chest compressions

After delivering a shock with an automated external defibrillator (AED), the immediate next step is to resume chest compressions without delay. This is because even if the shock successfully terminates the lethal rhythm, the heart may still be stunned and require circulatory support. Interrupting compressions to check a pulse or reanalyze wastes critical time and reduces perfusion.

Question 2: The compression-to-ventilation ratio during CPR when there is no advanced airway in place is:

• 10:1
• 20:2
• 30:2 (Correct answer)
• 5:1

Correct answer: 30:2

For adult CPR without an advanced airway, the recommended compression-to-ventilation ratio is 30 compressions followed by 2 breaths. This ratio applies to both single rescuer and two-rescuer CPR. This standard ensures adequate blood flow to vital organs while minimizing interruptions for ventilations.

Question 3: Which of the following statements about CPR once an advanced airway has been established is true:

• Chest compressions should be stopped while giving breaths
• One breath every 6 seconds should be given (Correct answer)
• The breaths should be synchronized with the chest compressions
• The goal is 20 or greater breaths per minute

Correct answer: One breath every 6 seconds should be given

Once an advanced airway (like an ET tube or LMA) is in place, chest compressions should be continuous without pauses for ventilations. Breaths are given asynchronously at a rate of one breath every 6 seconds, which translates to approximately 10 breaths per minute. This allows for uninterrupted chest compressions, maximizing coronary and cerebral perfusion.

Question 4: Suctioning attempts in ACLS scenarios should typically be:

• no more than 30 seconds
• 5 seconds or less
• ten seconds or less (Correct answer)
• 20 seconds or less

Correct answer: ten seconds or less

Suctioning removes oxygen from the airway, potentially leading to hypoxemia and bradycardia. Therefore, suctioning attempts should be brief, typically limited to 10 seconds or less for adults. This minimizes interruptions to ventilation and oxygenation, which are critical during resuscitation.

Question 5: Rescue breaths should be given at a rate of one breath every __ seconds to patients who are having respiratory arrest with a perfusing rhythm.

• 6 seconds (Correct answer)
• 5-6 seconds
• 8 to 10 seconds
• 10 seconds

Correct answer: 6 seconds

For an adult patient in respiratory arrest with a pulse, rescue breaths should be delivered at a rate of one breath every 6 seconds. This translates to approximately 10 breaths per minute. This rate provides adequate ventilation without causing hyperventilation, which can lead to complications like gastric inflation and decreased cardiac output.

Question 6: Any resuscitation attempt's success is based on:

• defibrillation when required by the patients ECG rhythm (Correct answer)
• high quality CPR (Correct answer)
• neither defibrillation when required by the patients ECG rhythm or high quality CPR
• none of the above

Correct answer: defibrillation when required by the patients ECG rhythm

For patients in sudden cardiac arrest with a shockable rhythm (Ventricular Fibrillation or Pulseless Ventricular Tachycardia), timely and effective defibrillation is the most critical intervention for restoring a perfusing rhythm. While high-quality CPR is essential to maintain perfusion until defibrillation can occur, defibrillation is the definitive treatment that can terminate the lethal arrhythmia and is therefore a cornerstone of successful resuscitation when indicated by the patient's ECG rhythm.

Question 7: For adult resuscitation, the most crucial algorithm to understand is:

• PEA
• Cardiac Arrest (Correct answer)
• Bradycardia
• Tachycardia

Correct answer: Cardiac Arrest

The Cardiac Arrest Algorithm is the overarching framework for managing adult patients in cardiac arrest, encompassing the assessment, interventions, and treatment pathways for all arrest rhythms (VF/pVT, asystole, PEA). While PEA, Bradycardia, and Tachycardia are specific algorithms, they address particular clinical scenarios, whereas the Cardiac Arrest Algorithm guides the initial and ongoing management of the most critical life-threatening event.

Question 8: Which of the subsequent procedures takes place prior to the BLS Assessment?

• Activate EMS and, if available, procure an AED.
• Are you okay? ask the victim as you tap them on the shoulder.
• Ensure the safety of the scene. (Correct answer)
• All of the above

Correct answer: Ensure the safety of the scene.

Before initiating any patient assessment or intervention, the very first step in any emergency situation is to ensure scene safety. Rescuers must protect themselves from hazards before approaching a victim. Only after confirming the scene is safe can the BLS assessment (checking responsiveness, activating EMS, etc.) begin.

Question 9: Which of the following statements regarding supplemental oxygen administration is true regarding the Primary Assessment's evaluation of (B)breathing? (Select any that apply.)

• For ACS keep O2 sat ≥ 90%
• Give cardiac and respiratory arrest patients 100% oxygen (Correct answer)
• Give oxygen to the patient in order to get a pulse oximetry O2 saturation value of 95–98%, excluding cardiac and respiratory arrest.
• Keep O2 at 92–98% for post-cardiac arrest treatment.

Correct answer: Give cardiac and respiratory arrest patients 100% oxygen

In cardiac and respiratory arrest, maximizing oxygen delivery to vital organs is paramount. Therefore, 100% supplemental oxygen should be administered to these patients. While other scenarios might aim for specific SpO2 targets to avoid hyperoxia, the immediate priority in arrest is full oxygenation to support cellular function.

Question 10: Which of the following describes the proper order for BLS CPR?

• Airway, breathing, circulation
• Chest compressions, airway, breathing (Correct answer)
• Circulation, airway, breathing
• Access care early, begin CPR, check pulse

Correct answer: Chest compressions, airway, breathing

The current BLS sequence for CPR is C-A-B: Chest compressions, Airway, then Breathing. This change prioritizes immediate chest compressions to maintain vital organ perfusion, as interruptions to compressions significantly reduce survival rates. Airway and breathing follow after the initial compressions.

Question 11: All of the following—with the exception of—are instances of advanced airway adjuncts:

• Laryngeal tube
• Laryngeal mask airway
• Oropharyngeal airway (Correct answer)
• Combitube
• Endotracheal tube

Correct answer: Oropharyngeal airway

Advanced airway adjuncts are devices that provide a definitive, secure airway, often isolating the trachea and requiring specific training for placement. Laryngeal tubes, LMAs, Combitubes, and Endotracheal tubes all fall into this category. An oropharyngeal airway (OPA), however, is a basic airway adjunct used to maintain an open airway by preventing the tongue from obstructing the pharynx, and it does not provide the same level of airway control as advanced devices.

Question 12: Which statement regarding the oropharyngeal airway (OPA) is false:

• Throughout bag-mask ventilation, the OPA maintains the airway open.
• The OPA can make you gag and cough.
• On a patient who is aware, the OPA should only be applied. (Correct answer)
• The patient's ability to bite on an ET tube can be stopped by the OPA.

Correct answer: On a patient who is aware, the OPA should only be applied.

The statement that an OPA should *only* be applied to an aware patient is false. In fact, an OPA should *not* be used in a conscious or semiconscious patient with an intact gag reflex, as it can induce gagging, vomiting, and aspiration. It is primarily used in unconscious patients to prevent tongue obstruction and facilitate ventilation.

Question 13: Which of the following is FALSE while doing BLS/ACLS to a patient with a known or suspected cervical spine injury when trying to access the airway?

• Use a head stabilizer to immobilize the body. (Correct answer)
• Use the jaw thrust without extending the head to open the airway.
• If the jaw thrust doesn't work, try a head tilt-chin lift.
• Utilize a physical restraint to keep the head still.

Correct answer: Use a head stabilizer to immobilize the body.

When managing an airway in a patient with suspected cervical spine injury, the primary goal is to minimize neck movement. The jaw-thrust maneuver is the preferred method as it opens the airway without extending the head. While cervical spine immobilization is crucial, using a 'head stabilizer to immobilize the body' is not the correct terminology or approach; immobilization focuses on the head and neck, not the entire body for airway access, and physical restraints are not the primary method for C-spine immobilization during airway management.

Question 14: The following questions should be made during the Primary Assessment's Airway Assessment section:

• Is the airway patent?
• Is an advanced airway indicated?
• Does the patient have a pulse?
• both 1 and 2 (Correct answer)

Correct answer: both 1 and 2

During the Airway (A) component of the Primary Assessment, the rescuer assesses if the airway is open and clear (patent). Simultaneously, based on the patient's condition and the patency of the airway, a decision is made regarding the need for an advanced airway device. Checking for a pulse (C) is part of the Circulation assessment, not the Airway assessment.

Question 15: The following tasks are completed during the (C) circulation phase of the Primary Assessment:

• Observe, hear, and feel
• Obtain IV access, administer oxygen therapy, maintain the advanced airway, and administer IV/IO fluids as necessary.
• Pulse check, heart rate monitoring, and CPR if necessary
• Get IV access, Connect ECG leads, check rhythm, administer drugs to control rhythm, and administer IV/IO fluids as necessary. (Correct answer)

Correct answer: Get IV access, Connect ECG leads, check rhythm, administer drugs to control rhythm, and administer IV/IO fluids as necessary.

The Circulation (C) phase of the Primary Assessment in ACLS involves critical interventions to assess and support the patient's circulatory status. This includes establishing vascular access (IV/IO), monitoring cardiac rhythm with ECG, identifying and treating arrhythmias with appropriate medications, and managing fluid status. While pulse checks and CPR are part of initial BLS, the ACLS 'C' phase expands to these advanced interventions.

Question 16: (True or False) Healthcare professionals should do the Primary Assessment initially for aware patients who may require more sophisticated assessment and management techniques?

• TRUE
• FALSE

The Primary Assessment (A-B-C-D-E) is a rapid, systematic approach used for *all* critically ill or injured patients, regardless of their level of consciousness. It quickly identifies and addresses life-threatening conditions. Even aware patients can have underlying critical issues requiring advanced assessment and management, making the Primary Assessment a crucial initial step.