Deck 10: Rapid Response Teams and Code Management

Question 1

The nurse knows that in advanced cardiac life support,the secondary survey includes steps A-B-C-D,in which "D" refers to:

A) defibrillate.
B) differential diagnosis.
C) diltiazem intravenous push.
D) do not resuscitate.

Answer 1

differential diagnosis.

Question 2

The code team has just defibrillated a patient in ventricular fibrillation.Following CPR for 2 minutes,what is the next action to take?

A) Administer amiodarone.
B) Administer lidocaine.
C) Assess rhythm and pulse.
D) Prepare for transcutaneous pacing.

Answer 2

Assess rhythm and pulse.

Question 3

It is determined that the patient needs a transcutaneous pacemaker until a transvenous pacemaker can be inserted.What is the most appropriate nursing intervention?

A) Apply conductive gel to the skin.
B) Provide adequate sedation and analgesia.
C) Recheck leads to make sure that the rhythm is asystole.
D) Set the milliamperes to 2 mA below the capture level.

Answer 3

Provide adequate sedation and analgesia.

Question 4

During cardioversion,the nurse would synchronize the electrical charge to coincide with which wave of the ECG complex?

A) P
B) R
C) S
D) T

Question 5

The monitor technician notifies the nurse "stat" that the patient has a rapid,chaotic rhythm that looks like ventricular tachycardia.What is the nurse's first action?

A) Call a code overhead.
B) Check the patient immediately.
C) Go to the nurses' station and look at the rhythm strip.
D) Take the crash cart to the room.

Question 6

During a code situation,the nurse would prepare to use which preferred intravenous fluid?

A) 5% dextrose in 0.45% normal saline
B) 5% dextrose in water
C) Dopamine infusion
D) Normal saline

Question 7

Laypersons should use which device to treat lethal ventricular dysrhythmias that occur outside a hospital setting?

A) Automatic external defibrillator
B) Carbon dioxide detector
C) Pocket mask
D) Transcutaneous pacemaker

Question 8

The patient is diagnosed with abrupt onset of supraventricular tachycardia (SVT).The nurse prepares which medication to administer to the patient?

A) Adenosine
B) Amiodarone
C) Diltiazem
D) Procainamide

Question 9

When doing manual ventilations during a code,the nurse would administer ventilations following which guideline?

A) Approximately 8 to 10 breaths per minute
B) During the fifth chest compression
C) Every 3 seconds or 20 times per minute
D) While compressions are stopped

Question 10

The patient has pulseless electrical activity ( PEA ).What action by the nurse takes priority?

A) Begin high-quality CPR.
B) Assist with chest tube placement.
C) Prepare equipment for a pericardiocentesis.
D) Attach the patient to a transcutaneous pacemaker.

Question 11

The nurse needs to evaluate arterial blood gases before the administration of which drug?

A) Calcium chloride
B) Magnesium sulfate
C) Potassium
D) Sodium bicarbonate

Question 12

The patient's monitor shows bradycardia (heart rate of 40 beats/min)and frequent premature ventricular contractions (PVCs)with a measured blood pressure of 85/50 mm Hg.The nurse anticipates the use of which drug?

A) Atropine 0.5 to 1 mg intravenous push
B) Dopamine drip-continuous infusion
C) Lidocaine 1 mg/kg intravenous push
D) Transcutaneous pacemaker

Question 13

A patient is admitted to the coronary care unit with an inferior wall myocardial infarction and develops symptomatic bradycardia with premature ventricular contractions every third beat (trigeminy).The nurse knows to prepare to administer which drug?

A) Amiodarone
B) Atropine
C) Lidocaine
D) Magnesium

Question 14

A nursing home patient is admitted to the critical care unit with a severe case of pneumonia.No living will or designation of health care surrogate is noted on the chart.In the event this patient needs intubation and/or cardiopulmonary resuscitation,what should be the nurse's action?

A) Activate the code team, but initiate a "slow" code.
B) Call the nursing home to determine the patient's or family's wishes.
C) Code the patient for 5 minutes and then cease efforts.
D) Initiate intubation and/or cardiopulmonary resuscitation efforts.

Question 15

The patient has been admitted to a critical care unit with a diagnosis of acute myocardial infarction.Suddenly the monitor alarms and the screen shows a flat line.What action should the nurse take first?

A) Administer epinephrine by intravenous push.
B) Begin chest compressions.
C) Check patient for unresponsiveness.
D) Defibrillate at 360 J.

Question 16

Which rhythm would be an emergency indication for the application of a transcutaneous pacemaker?

A) Asystole
B) Bradycardia (heart rate 40 beats/min), normotensive and alert
C) Bradycardia (heart rate 50 beats/min) with hypotension and syncope
D) Supraventricular tachycardia (heart rate 150 beats/min), hypotensive

Question 17

A patient is brought to the critical care unit after a motor vehicle crash.On admission,the patient reports dyspnea and chest pain.Upon examination,the nurse notes a lack of breath sounds on the left side and a tracheal shift.The patient suddenly experiences cardiac arrest.What assessment by the nurse takes priority?

A) Heart tones
B) Lung sounds
C) Peripheral pulses
D) Neurological status

Question 18

During a code,the nurse would place paddles for anterior defibrillation in what locations?

A) Second intercostal space, left sternal border and fourth intercostal space, left midclavicular line
B) Second intercostal space, right sternal border and fourth intercostal space, left midaxillary line
C) Second intercostal space, right sternal border and fifth intercostal space, left midclavicular line
D) Fourth intercostal space, right sternal border and fifth intercostal space, left midclavicular line

Question 19

A patient develops frequent ventricular ectopy.The nurse prepares to administer which drug?

A) Adenosine
B) Atropine
C) Lidocaine
D) Magnesium

Question 20

The nurse chooses which method and concentration of oxygen administration until intubation is established in a patient who has sustained a cardiopulmonary arrest?

A) Bag-valve-mask at FiO₂ of 100%
B) Bag-valve-mask at FiO₂ of 50%
C) Mouth-to-mask ventilation with supplemental oxygen
D) Non-rebreather mask at FiO₂ of 100%

Question 21

Which code drugs can be given safely through an endotracheal tube? (Select all that apply)

A) Adenosine
B) Atropine
C) Epinephrine
D) Vasopressin
E) Amiodarone

Question 22

Which of the following are documented as part of the cardiopulmonary arrest record? (Select all that apply)

A) Medication administration times
B) Defibrillation times, joules, outcomes
C) Rhythm strips of cardiac rhythm(s) noted
D) Signatures of recorder and other personnel
E) Model of defibrillator used.

Question 23

Ventricular fibrillation should initially be treated by which of the following? (Select all that apply)

A) Administration of amiodarone, followed by defibrillation at 360 J
B) Atropine 1 mg, followed by defibrillation at 200 J
C) Defibrillation at 200 J with biphasic defibrillation
D) Defibrillation at 360 J with monophasic defibrillation
E) Dopamine continuous infusion.

Question 24

A patient is admitted to the critical care unit with bradycardia at a heart rate of 39 beats/min and frequent premature ventricular contractions.The nurse notes that the patient is lethargic and reports dizziness for the past 12 hours.Which of the following are acceptable initial treatments for this patient? (Select all that apply.)

A) Atropine
B) Epinephrine
C) Lidocaine
D) Transcutaneous pacemaker
E) Magnesium sulfate infusion

Question 25

What is the major reason for using a treatment to lower body temperature after cardiac arrest to promote better neurological recovery?

A) Hypothermia decreases the metabolic rate by 7% for each decrease of 1° C.
B) Lower body temperatures are beneficial in patients with low blood pressure.
C) Temperatures of 40° C may reduce neurological impairment.
D) The lower body temperature leads to decreased oxygen delivery.

Question 26

Which of the following statements about defibrillation are correct? (Select all that apply)

A) Early defibrillation ( if warranted ) is recommended before other actions.
B) It is not necessary to ensure that personnel are clear of the patient if hands-off defibrillation is used.
C) It is not necessary to synchronize the defibrillation shocks.
D) Paddles/patches can be placed anteriorly and posteriorly on the chest.
E) All models of defibrillators are the same for standardization.

Question 27

A patient has been successfully converted from ventricular tachycardia with a pulse to a sinus rhythm.Upon further assessment,it is noted that the patient is hypotensive.The appropriate treatment for her hypotension may include (Select all that apply)

A) adenosine.
B) dopamine infusion.
C) magnesium.
D) normal saline infusion.
E) sodium bicarbonate.

Question 28

The nurse should call the rapid response team for which patients? (Select all that apply)

A) 53-year-old with pneumonia and severe respiratory distress
B) 17-year-old with apnea following a severe head injury
C) 24-year-old experiencing a severe asthmatic attack with stridor
D) 73-year-old patient with bradycardia of 40 beats per minute
E) 52-year-old patient with no palpable pulse

Question 29

The patient has a transcutaneous pacemaker in place.Pacemaker spikes followed by QRS complexes are noted on the cardiac rhythm strip.To determine if the pacemaker is working,the nurse must do which of the following?

A) Obtain a 12-lead electrocardiogram (ECG).
B) Call for a pacemaker interrogation.
C) Palpate the pulse.
D) Run a 2-minute monitor strip for analysis.

Question 30

Postresuscitation goals include which of the following? (Select all that apply)

A) Control dysrhythmias
B) Maintain airway
C) Maintain blood pressure
D) Wean off oxygen
E) Early ambulation

Question 31

Benefits of having the family present during resuscitation include which of the following? (Select all that apply)

A) Facilitates the grief process
B) Lets the family see that everything is being done
C) Sustains patient-family relationships
D) Allows the staff easy access to ask for organ transplant
E) Provides a sense of closure