All of the below are signs of cardiopulmonary arrest, EXCEPT?

Appeared in: AIIMS Bhopal NO - 2018 (Shift-1st)

Explanation

Pupillary constriction (miosis) is not a sign of cardiopulmonary arrest.
During cardiac arrest, a severe lack of oxygen to the brain (cerebral anoxia) causes the iris sphincter muscle to relax.
This relaxation leads to pupillary dilatation (mydriasis), and the pupils become fixed and unresponsive to light, typically within a minute of the arrest.

Option B: This is a cardinal sign of cardiopulmonary arrest. The absence of a central pulse (e.g., carotid) confirms that the heart is not circulating blood.
Option C: This is a critical neurological sign of cardiopulmonary arrest, indicating severe brain hypoxia from the cessation of blood flow.
Option D: This is one of the first and most obvious signs of cardiac arrest. Consciousness is lost almost instantly when perfusion to the brain stops.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Recognition of signs of cardiopulmonary arrest as background academic context rather than a clinical decision trigger.
Rapid and accurate recognition of cardiopulmonary arrest is critical for initiating Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) protocols promptly, which significantly improves survival chances.
A nurse's first action upon finding an unresponsive patient is to check for responsiveness, breathing, and a central pulse simultaneously for no more than 10 seconds before starting chest compressions.
What if? If the patient was unresponsive and apneic but had constricted or 'pinpoint' pupils, the nurse should have a high index of suspicion for an opioid overdose. The priority action would be to administer naloxone while providing rescue breaths, assuming a pulse is still present.

How to Approach the Question

First, identify the negative framing of the question by noting the keyword 'EXCEPT'. This means you are looking for the option that is NOT a sign of cardiopulmonary arrest.
Recall the cardinal signs of cardiac arrest: unresponsiveness (loss of consciousness), absence of breathing (or only agonal gasps), and absence of a pulse.
Evaluate each option against this knowledge.
'Absence of pulse' and 'Immediate loss of consciousness' are core components of the definition of cardiac arrest.
Consider the pupillary response. Remember that severe lack of oxygen to the brain causes pupillary DILATION, not constriction.
Therefore, 'Constriction of pupil' is the outlier and the correct answer to this 'EXCEPT' question.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 p. 45-47

E6 Medicine Harrison 22e Part 1 p. 231-233

Practise the full AIIMS Bhopal NO - 2018 (Shift-1st)

Attempt every question from this paper in a timed mock, then review the full solution for each one.