ACLS Final Exam
Complete (2023
solved 100%)
1|Page
,BEST PLAYLIST I'VE FOUND FOR ALL HEART.ORG ACLS CODES! - ANSWER
https://www.youtube.com/watch?v=qQTpqjvvduI&list=PLy60DSDPg9urf_l5ss1FLakrRQ
DKOkTZj
This is a good starting point for Jose (big Mega code at end):
https://www.youtube.com/watch?v=8OB7OreUjy0. Use the feedback after failing to get
closer and closer to passing!
In which situation does bradycardia require treatment? - ANSWER Hypotension
Which intervention is most appropriate for the treatment of a patient in asystole? -
ANSWER Epinephrine
You arrive on the scene with the code team. High-quality CPR is in progress. An AED
has previously advised "no shock indicated." A rhythm check now finds asystole. After
resuming high-quality compressions, which action do you take next? - ANSWER
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? - ANSWER
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? - ANSWER 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? - ANSWER 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? - ANSWER
Hold aspirin for at least 24 hours if rtPA is administered
2|Page
,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? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER IV or IO
What is the indication for the use of magnesium in cardiac arrest? - ANSWER 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? - ANSWER 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? - ANSWER 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. - ANSWER Epinephrine 1 mg
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication
to nitrate administration? - ANSWER 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? - ANSWER 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
3|Page
, aspirin because he has a history of gastritis, with was treated 5 years ago. What is your
next action? - ANSWER 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? - ANSWER Aspirin
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine
have been given. Which drug should be given next? - ANSWER Amiodarone 300mg
What is the maximum interval for pausing chest compressions? - ANSWER 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? -
ANSWER 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? - ANSWER Vagal maneuvers
Which action should you take immediately after providing an AED shock? - ANSWER
Resume chest compressions
What action minimizes the risk of air entering the victim's stomach during-bag mask
ventilation? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER
Repersfusion therapy
4|Page
Complete (2023
solved 100%)
1|Page
,BEST PLAYLIST I'VE FOUND FOR ALL HEART.ORG ACLS CODES! - ANSWER
https://www.youtube.com/watch?v=qQTpqjvvduI&list=PLy60DSDPg9urf_l5ss1FLakrRQ
DKOkTZj
This is a good starting point for Jose (big Mega code at end):
https://www.youtube.com/watch?v=8OB7OreUjy0. Use the feedback after failing to get
closer and closer to passing!
In which situation does bradycardia require treatment? - ANSWER Hypotension
Which intervention is most appropriate for the treatment of a patient in asystole? -
ANSWER Epinephrine
You arrive on the scene with the code team. High-quality CPR is in progress. An AED
has previously advised "no shock indicated." A rhythm check now finds asystole. After
resuming high-quality compressions, which action do you take next? - ANSWER
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? - ANSWER
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? - ANSWER 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? - ANSWER 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? - ANSWER
Hold aspirin for at least 24 hours if rtPA is administered
2|Page
,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? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER IV or IO
What is the indication for the use of magnesium in cardiac arrest? - ANSWER 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? - ANSWER 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? - ANSWER 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. - ANSWER Epinephrine 1 mg
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication
to nitrate administration? - ANSWER 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? - ANSWER 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
3|Page
, aspirin because he has a history of gastritis, with was treated 5 years ago. What is your
next action? - ANSWER 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? - ANSWER Aspirin
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine
have been given. Which drug should be given next? - ANSWER Amiodarone 300mg
What is the maximum interval for pausing chest compressions? - ANSWER 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? -
ANSWER 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? - ANSWER Vagal maneuvers
Which action should you take immediately after providing an AED shock? - ANSWER
Resume chest compressions
What action minimizes the risk of air entering the victim's stomach during-bag mask
ventilation? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER
Repersfusion therapy
4|Page
