ACLS Certification Practical Application Practice Test Results

Question 1
80% answer correctly
A patient with an acute MI on a 12-lead ECG transmitted by the paramedics has the above findings on a rhythm strip when a monitor is placed in the ED. The patient had resolution of moderate (5/10) chest pain with three doses of sublingual nitroglycerine. BP is 104/70 mm Hg. Which intervention below is most important, reducing in-hospital and 30-day mortality?
intravenous nitroglycerin for 24 hours
atropine 0.5 mg IV, total dose 2 mg as needed
Temporary pacing
reperfusion therapy
atropine 1 mg IV, total dose 3 mg as needed
Question 2
60% answer correctly
You are evaluating a patient with a 15-minute duration of chest pain during transportation to the emergency department. He is receiving oxygen, and 2 sublingual nitroglycerin tablets have relieved his chest discomfort. He has no complaints but appears anxious. BP is 130/70 mm Hg. You observe the above rhythm on the monitor and your next action is:
continue monitoring patient, prepare for TCP
administer nitroglycerine 0.4 mg SL
initiate transcutaneous pacing (TCP)
give atropine 0.5 mg IV
start epinephrine 2 to 10 ụg/kg per minute and titrate
Question 3
65% answer correctly
A patient in the ED develops recurrent chest discomfort (8/10) suspicious for ischemia. His monitored rhythm becomes irregular as seen above. Oxygen is being administered by NC at 4 L/min and an IV line is patent. Bp is 160/96. There are no allergies or contraindications to any meds. You would first order:
Nitroglycerin 0.4 mg SL
Morphine sulfate 2-4 mg IV
lidocaine 1 mg/kg and infusion 2 mg/min
Amiodarone 150 mg IV
IV nitroglycerine initiated at 10 ụg/min and titrated