Advanced Cardiovascular Life Support (ACLS) Practice Exam

A patient in respiratory failure becomes apneic but has a strong pulse. What should be your highest priority intervention?

1. Start intravenous medications

2. Perform CPR immediately

3. Simple airway maneuvers and assisted ventilations

4. Apply supplemental oxygen

The correct answer is: Simple airway maneuvers and assisted ventilations

In a scenario where a patient is in respiratory failure but has a strong pulse, the highest priority intervention is to perform simple airway maneuvers and provide assisted ventilations. When a patient becomes apneic, it means they are not breathing effectively on their own, which can quickly lead to hypoxia if not addressed. Ensuring adequate ventilation is crucial because even with a strong pulse, the lack of adequate oxygenation and carbon dioxide removal can lead to serious complications, including respiratory and cardiac arrest. By performing airway maneuvers—such as positioning the patient properly to ensure patency of the airway—and using assisted ventilations, you can deliver oxygen directly to the lungs, improve gas exchange, and prevent further deterioration of the patient’s condition. While other options, like starting intravenous medications or applying supplemental oxygen, may also be relevant in the management of respiratory failure, they do not address the immediate need for ventilation in an apneic patient. Performing CPR would not be appropriate in this case, as the presence of a strong pulse indicates that the heart is still pumping, and the immediate concern is ensuring effective breathing rather than chest compressions. Therefore, focusing on airway management and assisted ventilation aligns with the critical need to restore adequate oxygenation promptly.