Assessment Flashcard 7
Rationale
D. Rationale: Pericardial tamponade is a reversible condition. Treatment includes emergency thoracotomy when cardiac tamponade is significant in size and volume, such as in the case of trauma. Pericardiocentesis is the treatment for mild tamponade. Other treatments for pericardial tamponade include volume infusion with a crystalloid solution.
Question
Pericardial tamponade:
a. Is a reversible cause of cardiac arrest
b. Can be treated by pericardiocentesis or thoracotomy
c. Should be treated with volume infusion with a crystalloid solution
d. All of the above
Answer
d. All of the above
Rationale
B. Rationale: Pericardial tamponade is a reversible condition. Treatment includes pericardiocentesis for mild tamponade and emergency thoracotomy when significant in size and volume, as in the case of trauma. Other treatments for pericardial tamponade include volume infusion with a crystalloid solution. (The Secondary Assessment: Hs and Ts table)
Question
Pericardial tamponade:
a. Is an irreversible cause of cardiac arrest
b. Can be treated by pericardiocentesis or thoracotomy
c. Is treated by inserting a large-bore needle into the second intercostal space
d. Is usually caused by a choking event
Answer
b. Can be treated by pericardiocentesis or thoracotomy
Rationale
C. Rationale: On ECG, electrical activity can indicate the heart is contracting normally. If there is not enough blood to eject, then each contraction of the ventricles will not produce a pulse; a severely diminished preload will have this effect. Certain medical conditions can cause a significant reduction in preload, such as pulmonary embolism, hypovolemia, and severe pneumothorax.
Question
Pulseless electrical activity can be caused by diminished preload wherein the ventricles are contracting normally, but there is not enough blood to produce sufficient cardiac output. Which one of the following conditions does NOT produce a diminished preload?
a. Pulmonary embolism
b. Hypovolemia
c. Peripheral artery disease
d. Pneumothorax
Answer
c. Peripheral artery disease
Rationale
C. Rationale: Removal of clothing to perform a physical examination, looking for obvious signs of trauma, bleeding, burns, unusual markings, or medical alert bracelets is part of the primary assessment.
Question
Removal of the patient’s clothing to perform a physical examination, looking for obvious signs of trauma, bleeding, burns, unusual markings, or medical alert bracelets is part of the:
a. Tertiary assessment
b. Secondary assessment
c. Primary assessment
d. BLS assessment
Answer
c. Primary assessment
Rationale
B. Rationale: Potassium is primarily excreted by our kidneys. Patients with renal failure have difficulty excreting potassium and thus are prone to hyperkalemia. When the potassium level is significantly increased, there is a chance the patient will experience cardiac arrest. The definitive treatment for hyperkalemia is hemodialysis.
Question
Renal failure patients are likely to develop cardiac arrest due which one of the following reversible causes?
a. Pulmonary effusion
b. Hyperkalemia
c. Thromboembolism
d. Hypovolemia
Answer
b. Hyperkalemia
Rationale
C. Rationale: The secondary assessment is taking a focused medical history and performing a targeted physical examination to come up with a differential diagnosis that led to the patient’s current emergency situation. This guides rescuers to interventions needed to prevent the patient from deteriorating while awaiting transfer to a healthcare institution.
Question
Taking a focused medical history and performing a targeted physical examination to identify the cause of a patient’s urgent situation, such as cardiopulmonary distress, is which part of the Systematic Approach?
a. BLS Assessment
b. Primary Assessment
c. Secondary Assessment
d. All of the above
Answer
c. Secondary Assessment
Rationale
C. Rationale: Trauma has been removed from the ACLS list of Hs and Ts.
Question
The Hs and Ts include all of the following except:
a. Hypovolemia
b. Tension pneumothorax
c. Trauma
d. Cardiac tamponade
Answer
c. Trauma
Rationale
A. Rationale: Sinus tachycardia is a normal rhythm in response to a physical stimulus such as exertion or anxiety. However, it can also occur in response to conditions such as hypovolemia or anemia.
Question
The Hs and Ts should be considered when a patient presents with sinus tachycardia and a pulse.
a. True
b. False
Answer
a. True
Rationale
D. Rationale: The primary assessment must be performed until the patient is transferred to a higher level of care.
Question
The primary assessment must be performed until:
a. Return of spontaneous circulation
b. A shockable rhythm is detected
c. The patient’s relatives are contacted
d. The patient is transferred to a higher level of care
Answer
d. The patient is transferred to a higher level of care
Rationale
B. Rationale: The BLS sequence was altered following research showing that the “look, listen, and feel” step in the BLS sequence led to a delay in the initiation of chest compressions for patients with cardiac arrest.
Question
The Rationale for the removal of the “look, listen, and feel” step that used to be part of the initial BLS survey was based on:
A. Knowledge that lay rescuers prefer to avoid performing mouth to mouth ventilations
B. Promoting earlier initiation of chest compressions in patients with cardiac arrest
C. The ease of performing chest compressions rather than ventilations
D. Facial trauma in patients injured in motor vehicle collisions
Answer
B. Promoting earlier initiation of chest compressions in patients with cardiac arrest