ATLS PRACTICE TEST LATEST 2024 ACTUAL EXAM 200 REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS ALREADY GRADED A+)

ATLS PRACTICE TEST LATEST 2024 ACTUAL EXAM 200 REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS ALREADY GRADED A+)

Which information about a client who is in cardiac arrest and has been transported by ambulance to the emergency department is most important to communicate to the health care provider?

a. the client is male and age is 86 years
b. nitroglycerin was taken before cardiac arrest
c. the client has a history of coronary artery disease and previous cardiac surgery
d. cardiopulmonary resuscitation (CPR) was started 9 minutes after the cardiac arrest - Answer-d. cardiopulmonary resuscitation (CPR) was started 9 minutes after the cardiac arrest

Successful resuscitation from cardiac arrest usually occurs when CPR is started immediately. When clients have had prolonged periods of cardiac arrest before initiation of CPR, it is unlikely that resuscitation will be successful. In addition, irreversible hypoxic brain injury occurs when there is no brain perfusion for 4 minutes. The client gender and age will not affect the decision making by the resuscitation team. The use of nitroglycerin indicates that the client likely had angina before the cardiac arrest, but it will not affect the immediate resuscitation efforts. A history of coronary artery disease and cardiac surgery will be reported to the health care provider, but it will not affect resuscitation decision-making.

When assigned the care of a client arriving in the emergency department with possible acute coronary syndrome, which prescribed action would the nurse take first?

a. obtain a 12 lead electrocardiogram (ECG)
b. draw blood for troponin and creatine kinase MB
c. ask the client about level of intensity of the chest pain
d. notify the cardiac catheterization laboratory about the client - Answer-a. obtain a 12 lead electrocardiogram (ECG)

Because ECG changes occur within minutes with acute coronary syndrome, an ECG should be obtained and interpreted within 10 minutes of admission for any client with possible acute coronary syndrome. Confirmation of changes indicating myocardial infarction will lead to rapid transfer to the cardiac catheterization laboratory and percutaneous coronary interventions. It is appropriate to obtain troponin and cardiac enzyme levels, but these do not immediately elevate in myocardial infarction and results will not affect immediate care of the client. Intensity of pain is asked of all clients, but is not a good reflection of the size of the ischemic area. Notification of the cardiac catheterization laboratory will be done, but the ECG will need to be done before making decisions about whether to transfer the client for interventions.

Which physiological change in the cardiovascular system is related to the aging process? Select all that apply

a. less sensitivity to beta-adrenergic drugs
b. tachycardia when changing position
c. development of systolic murmurs
d. shortening of the PR, QRS, and QT intervals
e. increase in systolic blood pressure - Answer-a, c, e

With age, people might become less sensitive to beta-adrenergic drugs due to a decrease in the number and function of beta-adrenergic receptors in the heart. Valvular fibrosis and calcification occur with aging (especially with the mitral and aortic valves) and can lead to murmurs caused by mitral regurgitation or aortic stenosis. An increase in systolic blood pressure can occur with aging due to arterial stiffening. The normal elevation in heart rate seen when changing position is muted with age, secondary to the sympathetic nervous pathway being affected by fibrous tissue and fatty deposits. With age, there is sometimes a slight lengthening of the PR, QRS, and QT intervals.

The nurse caring for a client with the following arterial blood gas (ABG) values: PO2 89mmHg, PCO2 35mmHg, and pH of 7.37. These findings indicate that the client is experiencing which condition?

a. respiratory alakalosis
b. poor oxygen perfusion
c. normal acid-base balance
d. compensated metabolic acidosis - Answer-c. normal acid-base balance

All data are within expected limits; PO2 is 80-100mmHg, PCO2 is 35-45mmHg, and the pH is 7.35-7.45. None of the data are indicators of fluid balance., but of acid-base balance. Oxygen (PO2) is within the expected limits of 80-100mmHg. With respiratory alkalosis, the blood pH is greater than 7.45 and the PCO2 is greatly decreased. With metabolic acidosis, the pH is less than 7.35.

Which adverse hemodynamic effect typically occurs when a client develops tachycardia?

a. decreased ventricular filling time
b. increased coronary artery filling
c. lower cardiac output
d. enhanced atrial kick
e. weaker pulse quality - Answer-a, c, e

Tachycardia may cause a decrease in cardiac output because of the decreased filling time for the ventricles and lower stroke volume. Pulse quality is weaker because of the lower stroke volume secondary to decreased ventricular filling time. There is a decreased time for coronary artery filling during diastole. During atrial systole, a bolus of atrial blood is ejected into the ventricles; this step is called the atrial kick, and it contributes more blood to the cardiac output of the ventricles. With fast heart rates, there is less time for the atria to fill, and less blood (atrial kick) to pump.

Which finding would the nurse expect when assessing a client with acute respiratory distress syndrome (ARDS)?

a. hypertension
b. tenacious sputum
c. altered mental status
d. slowed rate of breathing - Answer-c. altered mental status