Critical Care - Basic Life Support/Cardiopulmonary Resuscitation

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nursedaisy98
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256705
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Critical Care - Basic Life Support/Cardiopulmonary Resuscitation
Updated:
2014-04-20 10:35:13
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NCLEX RN
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Critical Care
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Basic Life Support/Cardiopulmonary Resuscitation
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  1. The nurse on the day shift walks into a client's room and finds the client unresponsive. The client is not breathing and does not have a pulse, and the nurse immediately calls out for help. Which is the next nursing action?
    1. Open the airway.
    2. Give the client oxygen.
    3. Start chest compressions.
    4. Ventilate with a mouth-to-mask device.
    3. Start chest compressions.
  2. The nurse witnesses a neighbor's husband sustain a fall from the roof of his house. The nurse rushes to the victim and determines the need to open the airway. The nurse opens the airway in this victim by using which method?
    1. Flexed position
    2. Head tilt–chin lift
    3. Jaw thrust maneuver
    4. Modified head tilt–chin lift
    3. Jaw thrust maneuver
  3. The nurse understands that which is a correct guideline for adult cardiopulmonary resuscitation (CPR) for a health care provider (HCP)?
    1. One breath should be given for every five compressions.
    2. Two breaths should be given for every 15 compressions.
    3. Initially, two quick breaths should be given as rapidly as possible.
    4. Each rescue breath should be given over 1 second and should produce a visible chest rise.
    4. Each rescue breath should be given over 1 second and should produce a visible chest rise.
  4. The nurse attempts to relieve an airway obstruction in a 3-year-old conscious child. The nurse performs the abdominal thrust maneuver correctly by standing behind the child, placing her arms under the child's axillae and around the child, and positioning her hands to deliver the thrusts between which areas?
    1. Groin and the abdomen
    2. Umbilicus and the groin
    3. Lower abdomen and the chest
    4. Umbilicus and the xiphoid process
    4. Umbilicus and the xiphoid process
  5. The nurse is performing rescue breathing on a 7-year-old child. The nurse delivers one breath per how many seconds to the child?
    1. 6-8
    2. 8-10
    3. 10-12
    4. 12-14
    1. 6-8
  6. The nurse is performing cardiopulmonary resuscitation (CPR) on an infant. When performing chest compressions, the nurse compresses at least how many times?
    1. 60 times per minute
    2. 80 times per minute
    3. 100 times per minute
    4. 160 times per minute
    3. 100 times per minute
  7. The nurse is teaching cardiopulmonary resuscitation (CPR) to a group of nursing students. The nurse asks a student to describe the reason why blind finger sweeps are avoided in infants. The nurse determines that the student understands this reason if the student makes which statement?
    1. "The object may have been swallowed."
    2. "The infant may bite down on the finger."
    3. "The mouth is too small to see the object."
    4. "The object may be forced back farther into the throat."
    4. "The object may be forced back farther into the throat."
  8. The nurse witnesses the collapse of a victim in her neighborhood and suspects cardiac arrest. Which action should the nurse take first?
    1. Initiate rescue breathing.
    2. Begin giving chest compressions.
    3. Activate the emergency response system.
    4. Obtain an automated external defibrillator.
    3. Activate the emergency response system.
  9. The nursing instructor asks a nursing student to describe the procedure for performing abdominal thrusts on an unconscious pregnant woman at 32 weeks' gestation. The student describes a component of the procedure correctly if the student states that he will take which action?
    1. Place his hands on the pelvis to perform the thrusts.
    2. Perform abdominal thrusts until the object is dislodged.
    3. Perform left lateral abdominal thrusts until the object is dislodged.
    4. Place a rolled blanket under the right abdominal flank and hip area.
    4. Place a rolled blanket under the right abdominal flank and hip area.
  10. The nurse is performing cardiopulmonary resuscitation (CPR) on an adult client. When performing chest compressions, the nurse should depress the sternum by how many inch(es)?
    1. ¾ inch
    2. 1 inch
    3. 2 inches
    4. 3 inches
    3. 2 inches
  11. The nurse is assisting to defibrillate a client in ventricular fibrillation. After placing the paddles on the client's chest and before discharging them, which intervention should be done?
    1. Ensure that the client has been intubated.
    2. Set the defibrillator to the "synchronize" mode.
    3. Administer an amiodarone bolus intravenously.
    4. Confirm that the rhythm is actually ventricular fibrillation.
    4. Confirm that the rhythm is actually ventricular fibrillation.
  12. A client in ventricular fibrillation is about to be defibrillated. A nurse knows that to convert this rhythm effectively, the monophasic defibrillator machine should be set at which energy level (in joules, J) for the first delivery?
    1. 50 J
    2. 120 J
    3. 200 J
    4. 360 J
    4. 360 J
  13. The nurse would evaluate that defibrillation of a client was most successful if which observation was made?
    1. Arousable, sinus rhythm, BP 116/72 mm Hg
    2. Nonarousable, sinus rhythm, BP 88/60 mm Hg
    3. Arousable, marked bradycardia, BP 86/54 mm Hg
    4. Nonarousable, supraventricular tachycardia, BP 122/60 mm Hg
    1. Arousable, sinus rhythm, BP 116/72 mm Hg
  14. To perform cardiopulmonary resuscitation (CPR), the nurse should use this method to open the airway in which situation?

    1. If neck trauma is suspected
    2. In all situations requiring CPR
    3. If the client has a history of seizures
    4. If the client has a history of headaches
    1. If neck trauma is suspected
  15. The nurse is documenting information in a client's chart when the electrocardiogram telemetry alarm sounds, and the nurse notes that the client is in ventricular tachycardia (VT). The nurse rushes to the client's bedside and should perform which assessment first?
    1. Cardiac rate
    2. Blood pressure
    3. Respiratory rate
    4. Responsiveness of the client
    4. Responsiveness of the client
  16. A client is brought into the emergency department in ventricular fibrillation (VF). The advanced cardiac life support (ACLS) nurse prepares to defibrillate by placing conductive gel pads on which part of the chest?
    1. The upper and lower halves of the sternum
    2. Parallel between the umbilicus and the right nipple
    3. The right shoulder and the back of the left shoulder
    4. The right of the sternum just below the clavicle and to the left of the precordium
    4. The right of the sternum just below the clavicle and to the left of the precordium
  17. An adult client has been defibrillated three times unsuccessfully for ventricular fibrillation, and cardiopulmonary resuscitation (CPR) is resumed. The nurse confirms that CPR is being administered effectively by noting which action?
    1. The ratio of compressions to ventilations is 30:2.
    2. The carotid pulse is palpable with each compression.
    3. Respirations are given at a rate of 10 breaths per minute.
    4. The chest compressions are given at a depth of 1.5 to 2 inches.
    2. The carotid pulse is palpable with each compression.
  18. The nurse is assigned the care of a client who experienced a myocardial infarction and is being monitored by cardiac telemetry. The nurse notes the sudden onset of this cardiac rhythm on the monitor. The nurse should immediately take which action? 


    1. Take the client's blood pressure.
    2. Initiate cardiopulmonary resuscitation (CPR).
    3. Place a nitroglycerin tablet under the client's tongue.
    4. Continue to monitor the client for 1 minute and then contact the health care provider (HCP).
    2. Initiate cardiopulmonary resuscitation (CPR).
  19. A client in ventricular fibrillation is brought into the emergency department. The advanced cardiac life support (ACLS) nurse prepares to defibrillate by placing conductive gel pads on which part of the client's chest?
    1. The upper and lower halves of the sternum
    2. Parallel between the umbilicus and the right nipple
    3. The right shoulder and the back of the left shoulder
    4. To the right of the sternum below the clavicle and to the left of the precordium
    4. To the right of the sternum below the clavicle and to the left of the precordium
  20. The nurse is caring for a client who is pulseless and experiencing this dysrhythmia. Which interventions should the nurse anticipate implementing in collaboration with the health care provider (HCP)? Select all that apply.
    1. Prepare for cardioversion.
    2. Prepare to administer epinephrine.
    3. Prepare to administer digoxin (Lanoxin).
    4. Provide cardiopulmonary resuscitation (CPR).
    5. Prepare to administer amiodarone (Cordarone).
    • 2. Prepare to administer epinephrine.
    • 4. Provide cardiopulmonary resuscitation (CPR).
    • 5. Prepare to administer amiodarone (Cordarone).
  21. A nurse is performing cardiopulmonary resuscitation on a client who has had a cardiac arrest. An automatic external defibrillator is available to treat the client. Which activity will allow the nurse to assess the client's cardiac rhythm?
    1. Hold the defibrillator paddles firmly against the chest.
    2. Apply adhesive patch electrodes to the chest and move away from the client.
    3. Connect standard electrocardiographic electrodes to a transtelephonic monitoring device.
    4. Apply standard electrocardiographic monitoring leads to the client, and observe the rhythm.
    2. Apply adhesive patch electrodes to the chest and move away from the client.
  22. The nurse is conducting a basic life support (BLS) recertification class and is discussing automated external defibrillation (AED). A member of the class asks the nurse to identify the correct location of pads to treat ventricular fibrillation. Which is the nurse's best response?
    1. Centered on the upper and lower halves of the sternum
    2. Bilaterally, under the right-sided and left-sided clavicles
    3. Parallel, between the umbilicus and the left-sided nipple
    4. Under the right-sided clavicle and to the left of the nipple in the midaxillary line
    4. Under the right-sided clavicle and to the left of the nipple in the midaxillary line
  23. A nurse is initiating one-rescuer cardiopulmonary resuscitation (CPR) on an adult client. The nurse should place the hands in which position to begin chest compressions?
    1. On the lower half of the sternum
    2. On the lower third of the sternum
    3. On the upper third of the sternum
    4. On the upper half of the sternum
    1. On the lower half of the sternum
  24. The nurse walking in a downtown business area witnesses a worker fall from a ladder. The nurse rushes to the victim, who is unresponsive. How should the nurse open the victim's airway?
    1. Chin lift position
    2. Head tilt–chin lift
    3. Jaw thrust maneuver
    4. Head tilt–jaw thrust
    3. Jaw thrust maneuver
  25. The nurse notes that a 5-year-old child is choking but is awake and alert at this time. The nurse rushes to perform the abdominal thrust maneuver. At which landmark should the nurse place the hands between?
    1. The umbilicus and the groin
    2. The lower abdomen and chest
    3. The umbilicus and xiphoid process
    4. The groin and the xiphoid process
    3. The umbilicus and xiphoid process
  26. A nurse assigned to the pediatric unit finds an infant unresponsive and without respirations or a pulse. The nurse should begin chest compressions at which rate? 
    1. 60 times/min
    2. 80 times/min
    3. 100 times/min
    4. 140 times/min
    3. 100 times/min
  27. The nurse is undergoing annual recertification in basic life support (BLS). The BLS instructor asks the nurse to identify the pulse point to use when determining pulselessness on an infant. Which statement by the nurse undergoing recertification identifies the most appropriate pulse point?
    1. Radial
    2. Carotid
    3. Brachial
    4. Popliteal
    3. Brachial
  28. An automatic external defibrillator (AED) interprets that the rhythm of a pulseless client is ventricular fibrillation. Which action should the nurse take next?
    1. Administers rescue breathing during the defibrillation
    2. Performs cardiopulmonary resuscitation (CPR) for 1 minute before defibrillating
    3. Charges the machine and immediately pushes the discharge buttons on the console
    4. Orders personnel away from the client, charges the machine, and depresses the discharge buttons
    4. Orders personnel away from the client, charges the machine, and depresses the discharge buttons
  29. The client has been defibrillated unsuccessfully three times using an automatic external defibrillator (AED). Which action should the nurse take next?
    1. Defibrillate one more time, and then terminate the resuscitation effort.
    2. Administer sodium bicarbonate intravenously, and resume defibrillation attempts.
    3. Perform cardiopulmonary resuscitation (CPR) for 5 minutes, and then defibrillate three more times.
    4. Perform cardiopulmonary resuscitation (CPR) for 1 minute, assess, and then defibrillate up to three more times.
    4. Perform cardiopulmonary resuscitation (CPR) for 1 minute, assess, and then defibrillate up to three more times.
  30. A nurse has completed four cycles of compressions after beginning cardiopulmonary resuscitation (CPR) on a hospitalized adult client. What should the nurse do next?
    1. Stop CPR.
    2. Continue CPR.
    3. Administer bicarbonate.
    4. Prepare for defibrillation.
    2. Continue CPR.
  31. A nurse is teaching cardiopulmonary resuscitation (CPR) to a group of lay clients. Which behavior by one of the participants indicates a need for further teaching?
    1. Keeping the shoulders directly over the hands
    2. Straightening the arms and locking the elbows
    3. Letting the right and left fingers rest on the chest
    4. Placing the heel of one hand on the lower half of the sternum
    3. Letting the right and left fingers rest on the chest
  32. A nursing student is asked to describe the correct steps for performing abdominal thrusts on an unconscious adult. In order of priority, how should the nurse perform this technique? Arrange the actions in the order that they should be performed. All options must be used.
    1. Attempt ventilation
    2. Open the airway
    3. Assess unconsciousness
    4. Look in the mouth and remove the object blocking the airway if seen
    5. Perform abdominal thrusts
    • 3. Assess unconsciousness
    • 2. Open the airway
    • 4. Look in the mouth and remove the object blocking the airway if seen
    • 1. Attempt ventilation
    • 5. Perform abdominal thrusts

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