Question 1

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

Accepted Answer

Medications that can be administered through the endotracheal tube until IV access is established are atropine,epinephrine,lidocaine,and vasopressin.

Question 2

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

Accepted Answer

Documentation includes the time the code is called,the time CPR is started,any actions that are taken,and the patient's response (e.g.,presence or absence of a pulse,heart rate,blood pressure,cardiac rhythm).Intubation and defibrillation (and the energy used)must be documented,along with the patient's response.The time and sites of IV initiations,types and amounts of fluids administered,and medications given to the patient must be accurately recorded.Rhythm strips are recorded to document events and response to treatment.Signatures of those involved in the code effort,including the recorder,are essential.

Question 3

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

Accepted Answer

If a biphasic defibrillator is available,use the dose at which that defibrillator has been shown to be effective for terminating VF (typically 120 to 200 J).If the dose is not known,use 200 J.If a monophasic defibrillator is available,use an initial shock of 360 J and use 360 J for subsequent shocks.Dobutamine is used for hypotension not related to hypovolemia.Amiodarone can be used for ventricular fibrillation not responsive to CPR,defibrillation,and vasopressors.Atropine is not used in this situation.

Question 4

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.)

Accepted Answer

Administer atropine,0.5 mg IV every 3 to 5 minutes to a total dose of 3 mg for symptomatic bradycardia.Transcutaneous pacing is also indicated for symptomatic bradycardia unresponsive to atropine.Epinephrine infusion can be used if atropine is not effective but it is not a first-line choice.Lidocaine is contraindicated in bradycardia because it can depress conduction,which would be detrimental with a heart rate of 39 beats/min.Magnesium is not indicated for bradycardia.

Question 5

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

Accepted Answer

Hypothermia decreases the metabolic rate by 6% to 7% for every decrease of 1° C in temperature; decreased metabolic rate may protect neurological function.Induced hypothermia to a core body temperature of 32° C to 34° C for 12 to 24 hours may be beneficial in reducing neurological impairment after cardiac arrest.

Question 6

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

Accepted Answer

Defibrillation is indicated as soon as possible because early defibrillation and CPR increase the chance of survival.Regardless of the method of defibrillation,all personnel must avoid contact with the patient or bed during the shock delivery.Shocks are delivered without synchronization.Anterior paddle placement is used most often; however,the alternative method is anteroposterior placement.Defibrillators come in many models,and nurses must ensure they are familiar with the model in use on their unit.

Question 7

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)

Accepted Answer

The patient may need fluid resuscitation; dopamine is indicated for hypotension once hypovolemia has been corrected.Adenosine,magnesium,and sodium bicarbonate are not indicated in this situation.

Question 8

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

Accepted Answer

Rapid response teams (RRTs)or medical emergency teams focus on addressing changes in a patient's clinical condition before a cardiopulmonary arrest occurs.The patient without a pulse and the patient with apnea needs the code team activated.

Question 9

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?

Accepted Answer

The electrical and mechanical effectiveness of pacing is assessed.The electrical activity is noted by a pacemaker "spike" that indicates that the pacemaker is initiating electrical activity.The spike is followed by a broad QRS complex.Mechanical activity is noted by palpating a pulse during electrical activity.

Question 10

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

Accepted Answer

Postresuscitation goals include optimizing tissue perfusion by airway,blood pressure maintenance,oxygenation,and control of dysrhythmias.Weaning off oxygen and early ambulation are good actions when possible but are not goals of postresuscitation care.

Question 11

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

Accepted Answer

Families who have been present during a code describe the benefits as knowing that everything possible was being done for their loved one,feeling supportive and helpful to the patient and staff,sustaining patient-family relationships,providing a sense of closure on a life shared together,and facilitating the grief process.

Quiz 10: Rapid Response Teams and Code Management