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Advanced Cardiovascular Life Support (ACLS) Test guide questions
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Advanced Cardiovascular Life Support(ACLS) Test guide questions
In 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
A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the patient
becomes unresponsive, with the rhythm shown here. Which action is indicated next? - ANS
Give an immediate unsynchronized high-energy shock (defibrillation dose)
How often should you switch chest compressors to avoid fatigue? - ANS About every 2
minutes
You find an unresponsive pt. who is not breathing. After activating the emergency response
system, you determine there is no pulse. What is your next action? - ANS Start chest
compressions of at least 100 per min.
, You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm Hg, the
heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry
reading is 97%. What assessment step is most important now? - ANS Obtaining a 12 lead
ECG.
What is the preferred method of access for epi administration during cardiac arrest in most pts?
- ANS Peripheral IV
An AED does not promptly analyze a rythm. What is your next step? - ANS Begin chest
compressions.
You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm below, and
the patient has no pulse. Another member of your team resumes chest compressions, and an IV
is in place. What management step is your next priority? - ANS Administer 1mg of
epinephrine
During a pause in CPR, you see this lead II ECG rhythm on the monitor. The patient has no
pulse. What is the next action? - ANS Resume compressions
What is a common but sometimes fatal mistake in cardiac arrest management? - ANS
Prolonged interruptions in chest compressions.
Which action is a componant of high-quality chest comressions? - ANS Allowing complete
chest recoil
Which action increases the chance of successful conversion of ventricular fibrillation? - ANS
Providing quality compressions immediately before a defibrillation attempt.
Which situation BEST describes pulseless electrical activity? - ANS Sinus rythm without a
pulse
What is the BEST strategy for performing high-quality CPR on a patient with an advanced
airway in place? - ANS Provide continuous chest compressions without pauses and 10
ventilations per minute.
Three minutes after witnessing a cardiac arrest, one member of your team inserts an
endotracheal tube while another performs continuous chest compressions. During subsequent
ventilation, you notice the presence of a waveform on the capnography screen and a PETCO2
level of 8 mm Hg. What is the significance of this finding? - ANS Chest compressions may
not be effective.
The use of quantitative capnography in intubated patients - ANS allows for monitoring of
CPR quality.
For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who originally
presented in ventricular fibrillation. After the first shock, the ECG screen displayed asystole,
which has persisted despite 2 doses of epinephrine, a fluid bolus, and high-quality CPR. What is
your next treatment? - ANS Consider terminating resuscitive efforts after consulting medical
control.
Which is a safe and effective practice within the defibrillation sequence? - ANS Be sure
oxygen is not blowing over the patient's chest during the shock.
During your assessment, your patient suddenly loses consciousness. After calling for help and
determining that the patient is not breathing, you are unsure whether the patient has a pulse.
What is your next action? - ANS Begin chest compressions.
What is an advantage of using hands-free defibrillation pads instead of defibrillation paddles? -
ANS Hands-free pads allow for a more rapid defibrillation.
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