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ACLS Exam 2021
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ACLS Exam 2021 ACLS Exam 2021 ACLS Exam 2021
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ACLS Exam 2021In which situation does bradycardia require treatment? - ANS Hypotension
Which intervention is most appropriate for the treatment of a patient in asystole? - ANS
Epinephrine
You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previousy
advised "no shock indicated." A rhythm check now finds asystole. After resuming high-quality
compressions, which action do you take next? - ANS Establish IV or IO access
A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of
220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38mm Hg, and the pulse
oximetry reading is 98%. There is vascular access in the left arm, and the patient has not been given
any vasoactive drugs. A 12-lead ECG confirm a supraventricular tachycardia with no evidence of
ischemia or infarction. The heart rate has not responded to vagal maneuvers. what is your next
action? - ANS Administer adenosine 6mg IV push
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a
toal does of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and
her blood pressure is 88/56 mm Hg. Which therapy is now indicated? - ANS Epinephrine 2 to 10
mcg/min
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which
drug should be administered first? - ANS Epinephrine 1 mg IV/IO
A 62-year-old man suddenly experienced difficulty speaking and left-sided weakness. He meets initial
criteria for fibrinolytic therapy, and a CT scan of the brain si ordered. Which best describes the
guidelines for antiplatelet and fibrinolytic therapy? - ANS Hold aspirin for at least 24 hours if rtPA is
administered
A patient is in refractory ventricular fibrillation and has received multiple appropriate defribillation
shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300mg IV. The patient is
intubated. Which best describe the recommended second does of amiodarone for this patient? -
ANS 150 mg IV push
A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure of
80/60mm Hg. What is the initial does of atropine? - ANS 0.5mg
,A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor
shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective
in terminating the rhythm. An IV has been established. Which drug should be administered? - ANS
Adenosine 6mg
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. If no
pathway for medication administration is in place, which method is preferred? - ANS IV or IO
What is the indication for the use of magnesium in cardiac arrest? - ANS Pulseless ventricular
tachycardia-associated torsades de pointes
A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is
asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. What action is
recommended next? - ANS Seeking expert consultation
A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is
intubated, and an IV has been started. The rhythm is asystole. What is the first drug/dose to
administer? - ANS Epinephrine 1mg IV/IO
A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One does of
epinephrine was given after the second shock. An antiarrhythmic drug was given immediately after
the third shock. You are the team leader. Which medication do you order next. - ANS Epinephrine 1
mg
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate
administration? - ANS Use of a phosphodiestrase inhibitor within the previous 24 hours
A 57-year-old woman has palpitation, chest discomfort, and tachycardia. The monitor shows a
regular wide-QRS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60
mm HG/ Which action do you take next? - ANS Perform electrical cordioversion
A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin
infusion of 1000 units per hour are being administered. The patient did not take aspirin because he
has a history of gastritis, with was treated 5 years ago. What is your next action? - ANS Give aspirin
160-325 mg to chew
,You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage 2 months
ago. He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The
patient is receiving oxygen via nasal cannula at 2L/min, and an IV has been established. His blood
pressure is 180/100mm Hg. Which drug do you anticipate giving to this patient? - ANS Aspirin
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been
given. Which drug should be given next? - ANS Amiodarone 300mg
What is the maximum interval for pausing chest compressions? - ANS 10 seconds
Your patient is a 56-year-old woman with a history of type 2 diabetes who reports feeling dizzy. She
is pale and diaphoretic. Her blood pressure is 80/66mm Hg. The cardiac monitor documents the
rhythm shown here. She is receiving oxygen at 4L/min by nasal cannula, and an Iv has been
established. What do you administer next? - ANS Atropine 0.5mg IV
A 35-year-old woman presents with a chief complaint of palpitations. She has no chest discomfort,
shortness of breath, or light-headedness. Her blood pressure is 120/78mm Hg. Which intervention is
indicated first? - ANS Vagal maneuvers
Which action should you take immediately after providing an AED shock? - ANS Resume chest
compressions
What action minimizes the risk of air entering the victim's stomach during-bag mask ventilation? -
ANS Ventilating until you see the chest rise
You are providing bag-mask ventilations to a patient in respiratory arrest. How often should you
provide ventilation? - ANS About every 5-6 seconds
After initiation of CPR and 1 shock for ventricular fibrillation, this rhythm is present on the next
rhythm check. A second shock is given, and chest compressions are resumed immediately. An IV is in
place, and no drugs have been given. Bag-mask ventilations are producing visible chest rise. What is
your next intervention? - ANS Give epinephrine 1mg IV/IO
A patient's 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the patient
arrives in the emergency department, the rhythm shown here is seen on the cardiac monitor. The
patient has resolution of moderate (5/10) chest pain after 3 doses of sublingual nitroglycerin. Blood
pressure is 104/70mm Hg. Which intervention is most important in reducing this patient's in-hospital
and 30-day mortality rate? - ANS Repersfusion therapy
, A patient was in refractory ventricular fibrillation. A thrid shock has just been administered. Your
team looks to you for instructions. What is your next action? - ANS Resume high quality chest
compressions
Which action is likely to cause air to enter the victim's stomach (gastric inflation) during bag-mask
ventilation? - ANS Ventilating too quickly
A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She
has received adensoine 6mg IV for the rhythm shown here (SVT), without conversion of the rhythm.
She is now extremely apprehensive. Her blood pressure si 128/70mm Hg. What is the next
appropriate intervention? - ANS Administer adenosine 12 mg IV
Your patient is not responsive and is not breathing, You can palpate a carotid pulse. Which action do
you take next? - ANS Start rescue breathing
You arrive on the scene to find CPR in progress. Nursing staff report the patient was recovering from
a pulmonary embolism and suddenly collapsed. Two shocks have been delivered, and an IV has been
initiated. What do you administer now? - ANS Epinephrine 1 mg IV
You are the code team leader and arrive to find a patient with CPR in progress. On the next rhythm
check, you see the rhythm shown here. Team members tell you that the patient was well but
reported chest discomfort and then collapsed. She has no pulse or respirations. Bag-mask
ventilations are producing visible chest rise, and IV access has been established, Which intervention
would be your next action? - ANS Epinephrine 1mg
What is recommended depth of chest compressions for an adult victim? - ANS At least 2 inches
How does complete chest recoil contribute to effective CPR? - ANS Allows maximum blood return to
the heart
What is the recommended compression rate for high-quality CPR? - ANS 100-120 compressions per
minute
A patient becomes unresponsive. You are uncertain if a faint pulse is present. They rhythm shown
here is seen on the cardiac monitor. An IV is in pace. Which action do you take next? - ANS Start
high-quality CPR
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