ACLS Written Exam (Latest 2023 / 2024)
Complete Questions & Answers 100% Correct
- You find an unresponsive pt. who is not breathing. After activating the
emergency response system, you determine there is no pulse.What is yournext
action?- Answer 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?- Answer Obtaining a 12 lead ECG. - What is the preferred method of access for epi administration during
cardiac arrest in most pts?- Answer Peripheral IV - An AED does not promptly analyze a rythm.What is your next step?-
Answer Beginchest 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?- Answer 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?- Answer Resume compressions - What is a common but sometimes fatal mistake in cardiac arrest management?- Answer Prolonged interruptions in chest compressions.
- Which action is a componant of high-quality chest comressions?- Answer Allowingcomplete chest recoil
- Which action increasesthe chance ofsuccessful conversion of ventricular
fibrillation?- Answer Providing quality compressions immediately before a
defibrillation attempt. - Which situation BEST describes pulseless electrical activity?- Answer
Sinus ry-thm without a pulse - What is the BEST strategy for performing high-quality CPR on a patient
with an advanced airway in place?- Answer 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.Whatis
the significance of this finding?- Answer Chest compressions may not be
effective. - The use of quantitative capnography in intubated patients- Answer
allows formonitoring 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?- Answer Consider terminating resuscitive efforts after
consulting medicalcontrol. - Which is a safe and effective practice within the defibrillation sequence?-
- Answer 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?- Answer
Beginchest compressions. - What is an advantage of using hands-free defibrillation pads instead of
defibrillation paddles?- Answer Hands-free pads allow for a more rapid
defibrillation. - What action is recommended to help minimize interruptions in chest
compressions during CPR?- Answer Continue CPR while charging the
defibrillator. - Which action is included in the BLS survey?- Answer Early defibrillation20. Which drug and dose are recommended for the management of a patientin
refractory ventricular fibrillation?- Answer Amioderone 300mg
ACLS exam 1 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
Which of the following choices represents appropriate treatment
of anasystolic patient?
Answer: Administration of atropine
Each cycle of CPR consists of 30 and two .
Answer: -compressions and ventilations
Bradycardia in a normal adult patient is defined as:
Answer: a resting heart rate lessthan 60 beats per minute
Sinus tachycardia originates in the:
Answer: Sinoatrial node
Which of the following represents a true statement regarding the
NPA andOPA?
Answer: An NPA can be used on a semi-conscious or conscious
patient, while an OPA can only be used on an unconscious
patient.
In the management of an acute stroke patient, the goal is for the
patient toarrive in the Emergency Department (ED) within of
the onset of signsand symptoms.
Answer: ten minutes
Stable tachycardia is defined as:
Answer: a heart rate faster than 100 beats per minute(bpm)
Begin use of TCP on a bradycardic patient with inadequate
perfusion:
Answer: ifatropine is ineffective or patient is exhibiting severe or
degrading symptoms
Vasopressin can be substituted for:
Answer: both the first dose of epinephrine andthe second dose of
epinephrine
When treating an acute stroke patient, you must immediately
createimmediate IV access.
Answer: True
Which of the following should be considered in the IV access of
anasystolic patient?
Answer: never interrupt CPR
Which of the following choicesrepresentsthe two types of
defibrillation?-
Answer: Biphasic and monophasic
Which of the following does NOT represent unstable
tachycardia?
Answer: Ventricular escape rhythm
clear the patient before delivering a shock:
Answer: Always
Which of the following represents a true statement about sinus
tachycardia?
ACLS Exam 2 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- Your patient is in cardiac arrest and has been intubated.To assess
CPRquality, which should you do?
A. Monitor the patients PETCO2
B. Obtain a 12-lead ECG
C. Check the patients pulse
D. Obtain a chest X-Ray
Answer: A. Monitor the patients PETCO2 - Which facility is the most appropriate EMS destination for a
patient with sudden cardiac arrest who achieved return of
spontaneous circulation in thefield?
A. Comprehensive stroke care unit
B. Acute rehabilitation care unit
C. Acute long-term care unit
D. Coronary reperfusion- capable medical center
Answer: D. Coronary reperfusion-capable medical center - Which of the following signs is a likely indicator of cardiac
arrest in anunresponsive patient?
A. Slow, weak pulse rate
B. Cyanosis
C. Agonal gasps
D. Irregular, weak pulse rate
Answer: C. Agonal gasps - To properly ventilate a patient with a perfusing rhythm, how
often do yousqueeze the bag?
A. Once every 3 to 4 seconds
B. Once every 5 to 6 seconds
C. Once every 10 seconds
D. Once every 12 seconds
Answer: B. Once every 5 to 6 seconds - In addition to clinical assessment, which is the most reliable
method toconfirm and monitor correct placement of the
endotracheal tube?
A. Arterial Blood Gases
B. Chest radiography
C. Continuous waveform capnography
D. Hemoglobin levels
Answer: C. Continuous waveform capnography - You are caring for a patient with a suspected stroke whose
symptoms started 2 hours ago.The CT scan was normal, with no
signs of hemorrhage.The patient does not have any
contraindications to fibrinolytic therapy. Which treatment approach
is the best for this patient?
A. Hold fibrinolytic therapy for 24 hours
B. Start fibrinolytic therapy as soon as possible
C. Order an echocardiogram before fibrinolytic administration
D.Wait for the results of the MRI
Answer: B. Start fibrinolytic therapy as soon as possible - What is the recommended range from which a temperature
should be selected and maintained constantly to achieve targeted
ACLS Exam Form A (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- You find an unresponsive patient who is not breathing. after
activating theemergency response system, you determine that there
is no pulse. what is your next action?
Answer: start chest compressions at a rate of at least 100/min. - you are evaluating a 58-year-old man with chest pain. the blood
pressureis 92/50 mm hg, the heart rate is 92/min, the nonlabored
respiratory rate is 14breaths/min, and the pulse oximetry reading is
97%. what assessment stepis most important now?
Answer: obtaining 12-lead ecg. - what is the preferred method of access for epinephrine
administrationduring cardiac arrest in most patients?
Answer: peripheral intravenous - An activated AED does not promptly analyze the rhythm.What is
your nextaction?
Answer: begin chest compressions. - You have completed 2 min of CPR. The ECG monitor displays
the lead be- low and the pt. has no pulse. another member resumes
chest compressions and an IV is in place. What management step is
your next priority?
Answer: administerone mg of epinephrine - During a pause in CPR, you see this lead II ECG rhythm on the
monitor.Thepatient has no pulse.What is the next action?
Answer: resume chest compressions - what is a common but sometimes fatal mistake in cardiac arrest
management?
Answer: prolonged interruptions of chest compressions - what action is a component of high-quality chest compressions?
Answer: uninterrupted compressions at a depth of 1 1/2 inches - Which action increasesthe chance ofsuccessful conversion of
ventricularfibrillation?
Answer: ventricular tachycardia with a pulse - which situation BEST describes pulseless electrical activity?
Answer: sinusrhythm without a pulse - What is the best strategy for perfoming high-quality CPR on a
pt.with an advanced airway in place?
Answer: provide continuous chest compressions withoutpauses 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 chestcompressions. During subsequent ventilation, you
notice the presence of a waveform on the capnography screen and a
PETCO2 level of 8 mm Hg.Whatis the significance of this finding?
Answer: chest compressions may not be effective
ACLS Exam Form B (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- What should be done to minimize interruptions in chest
compressionsduring CPR?
Answer: continue CPR while the defibrillator is charging - what condition is an indication to stop of withhold resuscitative
efforts?-
Answer: safety to threat providers? - After verifying the absence of a pulse, you initiate CPR with
adequate bag-mask ventilation.The patient’s lead II ECG appears
below.What is yournext action?
Answer: IV or IO access - After verifying unresponsiveness and abnormal breathing, you
activatethe emergency response team.What is your next action?
Answer: check for a pulse - what is the recommendation on the use of cricoid pressure to
preventaspiration during cardiac arrest?
Answer: not recommended for routine use? - What survival advantages does CPR provide to a patient in
ventricularfibrillation?
Answer: produces a small amount of blood flow to the heart - what is the recommended compression rate for performing CPR?
Answer: at least100 per minute - EMS personnel arrive to find a patient in cardiac arrest.
Bystanders are performing CPR. After attaching a cardiac monitor,
the responder observesthe following rhythm strip.What is the most
important early intervention?
Answer: -defibrillation - a patient remains in ventricular fibrillation despite 1 shock and 2
minutesof continuous CPR. the next intervention is to:
Answer: administer a second shock - what is the recommended next step after a defibrillation
attempt?
Answer: beginCPR, starting with chest compressions - which of the following is the recommended first choice for
establishing intravenous access during the attempted resuscitation of
a patient in cardiacarrest?
Answer: antecubital vein - what is the recommended first intravenous dose of amiodarone
for apatient with refractory ventricular fibrillation?
Answer: 300 mg - IV/IO drug administration during CPR should be
Answer: given rapidly during com-pressions
ACLS Final Exam 1 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- A patient experiences cardiac arrest, and the resuscitation team
initiates ventilations using a bag-valve-mask (BVM) resuscitator.
The development ofwhich condition during the provision of care
would lead the team to suspectthat improper BVM technique is
being used?
Select the correct answer to this question.
Rib fracture Esophageal injuryPneumothorax
Hypertension
Answer: Pneumothorax - 1 A member of the resuscitation team is preparing to administer
medications intravenously to a patient in cardiac arrest.The team
member followseach medication administration with a bolus of
fluid. How much would the team member give?
Select the correct answer to this question.
5 to 10 mL
10 to 20 mL
20 to 30 mL
30 to 40 mL
Answer: When administering medications during a cardiac arrest,
all medications administrated through the IV or intraosseous
infusion route should be followed by a 10- to 20-mL fluid bolus. - The resuscitation team suspects that hyperkalemia is the cause of
cardiac arrest in a patient brought to the emergency department.
Which finding on a12-lead ECG would confirm this suspicion?
Wide-complex ventricular rhythm and tall, peaked T waves
ST-segment changes,T-wave inversion
Flat T waves, prominent U waves and possibly prolonged QT
intervals Narrow-complex ventricular tachycardia
Answer: Wide-complex ventricular rhythm andtall, peaked T waves
In hyperkalemia the patient’s 12-lead ECG rhythm strip will show
wide-complexventricular rhythm and tall, peaked T waves.
- A patient with an ischemic stroke arrives at the emergency
department at2 a.m.The patient’s symptoms started about 12:30
a.m. After completing thenecessary assessments, the healthcare
team diagnoses an ischemic stroke,and the patient is determined to
be a candidate for fibrinolytic therapy. To achieve the best
outcomes, the team should initiate therapy for this patient no later
than by which time?
Select the correct answer to this question.
3:00 a.m.
5:30 a.m.
6:00 a.m.
8:30 a.m.
Answer: 1
3:00 a.m. - A resuscitation team is debriefing following a recent event. A
patient experienced cardiac arrest, and advanced cardiac life
support was initiated.The patient required the placement of an
advanced airway to maintain airwaypatency. Which statement
indicates that the team performed high-quality CPR?
Select the correct answer to this question.
“We kept the rate of chest compressions to around 100 per minute
but adjusted their depth to 1.5 inches while giving 1 ventilation every
3 seconds.”
“We delivered chest compressions at a rate of 80 to 100 per minute to
a depthof at least 2 inches and gave 1 ventilation every 6 seconds.”
“We initiated chest compressions at a rate of 100 to 110 per minute to
a depthof 2.4 inches and then gave 1 ventilation every 10 seconds.”
“We delivered 1 ventilation every 6 seconds and chest
compressions at arate of 100 to 120 compressions per minute.”
Answer: 4
“We delivered 1 ventilation every 6 seconds and chest
compressions at a rate of100 to 120 compressions per minute.”
- A patient with a suspected stroke arrives at the emergency
department at 7:10 p.m.The stroke team ensures that a
comprehensive neurologic as-sessment using the National
Institutes of Health Stroke Scale (NIHSS) is completed and that
brain imaging is performed by which time?
7:20 p.m.
7:30 p.m.
7:40 p.m.
7:50 p.m.
Answer: 2
Within 20 minutes of the patient’s arrival, a comprehensive
neurologic assessment should be completed and brain imaging
should be performed.That would be 7:30
p.m. for this patient.
ACLS Final Exam 2 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- A patient with suspected acute coronary syndromes (ACS) is
placed on acardiac monitor.The patient is complaining of dyspnea
and is given supple-mental oxygen. The provider determines that the
oxygen is effective based on which SaO2 level?
Answer: When a patient presents with potential ACS, the patient
should have oxygen administered to maintain an SaO2 of at least
94%. - A patient experiences cardiac arrest, and the resuscitation team
initiates ventilations using a bag-valve-mask (BVM) resuscitator.
The development ofwhich condition during the provision of care
would lead the team to suspectthat improper BVM technique is being
used?
Answer: Complications can occur with theuse of a BVM resuscitator
due to improper technique. Delivering excessive volumeor
ventilating too fast creates excessive pressure that can damage the
airways, lungs and other organs. Excessive volume can lead to
tension pneumothorax. - Assessment of a patient reveals an ETCO2 level of 55 mmHg and
an arterialoxygen saturation (SaO2) level of 88%. The provider
would interpret these findings as indicative of which condition?
Answer: An SaO2 level of less than 90% (PaO2 of less than 50
mmHg) accompanied by ETCO2 values greater than 50 mmHg is
indicative of respiratory failure. - A healthcare provider initiates ventilations to ensure adequate
breathing and oxygenation. While ventilations are being performed,
capnography is established to evaluate the adequacy of the
ventilations. The healthcare provider determines that ventilations are
adequate based on which end-tidalcarbon dioxide (ETCO2) value?
Answer: End-tidal carbon dioxide values in the range of35 to 45
mmHg confirm adequacy of ventilation. - A patient comesto the emergency department complaining of
palpitationsand “some shortness of breath.” Cardiac monitoring is
initiated and revealsthe following ECG rhythm strip. The provider
interprets this strip as indicating which arrhythmia?
Answer: In atrial flutter, atrial contraction occurs at such a rapid
rate that discrete P waves separated by a flat baseline cannot be seen
on the strip.Instead, the baseline continually rises and falls,
producing the “flutter” waves. In leads II and III, the flutter waves
may be quite prominent, creating a “sawtooth” pattern. Because of
the volume of atrial impulses, the AV node allows only someof the
impulses to pass through to the ventricles. In atrial flutter, a 2:1
ratio is the most common (i.e., for every two flutter waves, only one
impulse passes through the AV node to generate a QRS complex).
Ratios of 3:1 and 4:1 are also frequentlyseen. - A person suddenly collapses while sitting in the sunroom of a
healthcarefacility. A healthcare provider observes the event and
hurries over to assess the situation. The healthcare provider performs
which assessment first?
Answer: A systematic approach to assessment is necessary.The
healthcare provider shouldfirst perform a rapid assessment. A rapid
assessment is a quick visual survey to ensure safety, to form an
initial impression about the patient’s condition, andto check for
responsiveness, breathing and a pulse if the patient appears to
ACLS Final Exam 3 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- Dosing of epinephrine in the setting of VF/pVT and asystole/PEA
Answer: 1 mgevery 3-5 minutes - Dosing of amiodarone (first and second dose) in the setting of
cardiacarrest
Answer:
300mg first dose
150mg second dose after 3-5 min - Dosing of lidocaine (first and second dose) in the setting of cardiac
arrestAnswer:
1-1.5mg/kg first dose
0.5-0.75 mg/kg second dose, repeat in 5-10 min - What is the maximum dose of lidocaine?
Answer: 3 doses or 3mg/kg - ROSC is typically signified by a PETCO2 of what?
Answer: 40 mm Hg or more - The “Hs” of reversible causes of cardiac arrest
Answer: - Hypovolemia
- Hypoxia
- Hydrogen ions (acidosis)
- Hypo/hyperkalemia
- Hypothermia
- The “Ts” of reversible causes of cardiac arrest
Answer:
1.Tension pneumothorax - Tamponade, cardiac
- Toxins
- Thrombosis, pulmonary
- Thrombosis, coronary
- In the setting of cardiac arrest, once an advanced airway is in
place, 1 breath should be given every seconds. Should chest
compressionsbe interrupted once an advanced airway is in place?
Answer: 6-8 seconds (8-10 breaths/min) with continuous chest
compressions - If PETCO2 falls below , attempts should be made to
improve chestcompressions
Answer: 10 - If intra-arterial pressure monitoring is being utilized during a
resuscitation attempt, if the diastolic pressure falls below mm Hg,
attempts shouldbe made to improve chest compressions
Answer: 20 - depth of adequate chest compressions
Answer: 2 inches - rate of adequate chest compressions
Answer: 100-120/min - If no advanced airway is in place, what is the ratio of chest
compressionsto ventilations?
Answer: 30:2 - Shock energy that should be used on a biphasic machine for
defibrillation
Answer: 120-200 J, if recommended setting not known, use
maximum available - Shock energy that should be used on a monophasic machine for
defibrillation
Answer: 360J - In the setting of cardiac arrest, when should vasopressors be
administered?
Answer: after the patient hasfailed CPR and defibrillation (shockrefractory arrhythmias) - The only vasopressor recommended in the cardiac arrest
algorithm
Answer: epinephrine - Why is vasopressin no longer recommended in the cardiac arrest
algorithm as a vasopressor?
Answer: no additional benefit and may increase delays in
medication administration - Are higher doses of epinephrine recommended in certain
situations of cardiac arrest? If so, what situations are higher doses of
epinephrine recommended?
Answer: no; no benefit to support use, possible harm - When is endotracheal medication administration recommended?
Answer: not recommended unless unable to give meds IV or IO - Which medications can be administered via endotracheal tube?
Answer: lidocaine, epinephrine, atropine, naloxone - What is different about the dosing of medications if
endotracheal medication administration is performed?
Answer: Typically ETT dose 2-2.5 higher than IVdue to lower
absorption and dilution in 5-10mL of fluid is recommended - When can antiarrhythmics be considered in the setting of cardiac
arrest?-
Answer: use may be considered in patients with VF/VT who have
failed high-quality CPR,shocks, and vasopressors - Why must antiarrhythmics never interfere with CPR and shocks?
Answer: neverbeen shown to increase survival to discharge - Antiarrhythmics that could be considered in the setting of
VF/VT
Answer: amiodarone and lidocaine
ACLS Pharmacology Form A (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- ADENOSINE
indications for use
Answer: *First drug for most forms of stable narrow complex SVT.
*Effective in terminating those due to reentry involving AV node
or sinus node. - AMIODARONE
indications for use
Answer: *VF/pulseless VT unresponsive to shock delivery, CPR,
anda vasopressor.
*Recurrent, hemodynamically unstable VT - ATROPINE SULFATE
indications for use
Answer: *First drug for symptomatic bradycardia
*May be beneficial in pressence of AV nodal block
*Organophosphate poisoning - DOPAMINE
indications for use
Answer: *Second line drug for symptomatic bradycardia
*For hypotension with signs and symptoms of shock - EPINEPHRINE
indications for use
Answer: *Cardiac arrest: VF, pulseless VT, asystole, PEA
*Symptomatic bradycardia
*Severe hypotension
*Anaphylaxis, severe allergic reactions - LIDOCAINE
indications for use
Answer: *Alternative to amiodarone in cardiac arrest from VF/VT
*Stable monophasic VT with preserved ventricular function
*Stable polymorphic VT with normal baseline QT interval &
preserves LV function
*Stable polymorphic VT with baseline QT-interval prolongation if
torsadessuspect-ed
- MAGNESIUM SULFATE
indications for use
Answer: *For use in cardiac arrest only if torsades-de-pointes or
suspected hypomagnesemia present
*Life threatening ventricular arrhyhmias due to digitalis toxicity - VASOPRESSIN
indicationsfor use
Answer: *Alternative to epinephrine in treatment of adult shock
refractory VF
*Alternative to epinphrine in asystole, PEA
*Useful for hemodynamic support in vasodilatory shock - ADENOSINE
adult dosage
Answer: *Initial bolus of 6 mg given RAPIDLY OVER 1 TO 3
SECONDS
followed by 20 ml bolus of NS, then elevate extremity
*Second dose of 12 mg can be given after 1 to 2 minutes if needed - AMIODARONE
adult dosage
Answer: VF/VT Cardiac Arrest First dose 300 mg IV/IO push,
Second doseif needed 150 mg IV/IO push
Life Tnhreatening Arrhythmias 2.2 g IV over 24 hours. Rapid
infusion: 150 mg IVover 10 minutes, may repeat every 10 minutes.
Slow infusion: 360 mg IV over 6 hours. Maintenamce infusion:
540 mg IV over 18 hours.
ACLS Pharmacology Exam (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- Goals of ACLS
Answer: restoration of spontaneous ventilation and circulation
cerebral perfusion and resuscitation - Keys to ACLS: Early
Answer: access, CPR, defibrillation, ACLS - Classes: I
Answer: benefit far greater than risk- Do Tx
IIa: benefit greater than risk- Do Tx
IIb: benefit equal to or greater than risk- consider TxIII: risk greater
than or equal to benefit-do NOT do - ACLS meds
Answer: AdenosineAmiodarone
Atropine Beta blockersdigoxin diltiazem dopamine epinephrine
lidocaine
magnesium sulfate sodium bicarbonateverapamil - Routes for ACLS administration
Answer: IV: peripheral or centralIO: all ages, takes 30-60 seconds,
any med that is IV
ET tube: Epi, vasopressin, atropine, lidocaine, naloxone - Why should you smile?
Answer: There is only one month left of the semester, lessnow! - Why do you need ACLS?
Answer:
pulseless arrest
-VFib/VTach
-Asystole
-PEA
Bradycardia Tachycardia (w/ pulses)
-stable
-unstableACS
Acute stroke - possible primary causes of asystole or PEA to consider H’s andT’s
Answer:
Hypo-volemia Toxins
Hypoxia Tamponade
Hydrogen ion(acidosis) Tension Pneumo.hyper/hypokalemia
Throbosis hypoglycemia (coronary or pulm) hypothermia Trauma - Adenosine indications
Answer: stable narrow-complex SVTNOT AFib/AFlutter/VTach - Adenosine MOA
Answer: Slows conduction through AV node and causes coronary
vasodilation - Adenosine Cautions
Answer: flushing, chest pain/tightness,brief asystole/bradycardia
ACLS Pharmacology Test (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- what are the goals of ACLS?
Answer: -restoration of spontaneous ventilation andcirculation - what is the key of ACLS?
Answer:
-early access
-early CPR
-early defibrillation
-early ACLS - what is the emphasis now of ACLS?
Answer: compressions - what is class I of ACLS meds recommendations?
Answer:
-procedure/tx or diagnostic test/assessment should be
performed/administeed
-benefit> risk - what is class IIa of ACLS meds recommendations?
Answer:
-reasonable to performprocedure/administer tx or perform
diagnostic test or assessment
-benefit > risk - what is class IIb of ACLS meds recommendations?
Answer:
-procedure/tx or diagnostic test/assessment may be considered
-benefit e risk - what is class III of ACLS meds recommendations?
Answer:
-procedure/tx or diagnostic test/assessment should not be
performed/administered
-not helpful and may be harmful
-risk e benefit - what are the possible routes of administration of ACLS
pharmacology?
Answer: –
-IV (peripheral or central)
-intraosseous (IO)
-endotracheal tube - what is intraosseous?
Answer: needle in bone, usually tibial tuberosity - what medications can be given via an endotracheal tube?
Answer:
-epi
-vasopressin
-atropine
-lidocaine
-naloxone - what is the typical dose administered via endotracheal tube?
Answer: 2-2.5x IVdose
ACLS Post Test 1 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- Which type of atrioventricular (AV) block best describesthis
rhythm?
Answer: Second degree type II - Your patient is in cardiac arrest and has been intubated.To assess
CPRquality, which should you do?
Answer: Monitor the patient’s PetCO2 - Which facility is the most appropriate EMS destination for a
patient with sudden cardiac arrest who achieved return a
spontaneous circulation in thefield?
Answer: Coronary reperfusion-capable medical center - Which of the following signs is a likely indicator of cardiac
arrest in anunresponsive patient?
Answer: Gasps - Which type of atrioventricular (AV) block best describesthis
rhythm?
Answer: Second degree atrioventricular (AV) block type I - To properly ventilate a patient with a perfusing rhythm, how
often do yousqueeze the bag?
Answer: Once every 5 to 6 seconds - In addition to clinical assessment, which is the most reliable
method to confirm and monitor correct placement of an
endotracheal (ET) tube?
Answer: Continuous waveform capnography - You are caring for a patient with a suspected stroke whose
symptoms started 2 hours ago.The CT scan was normal, with no
signs of hemorrhage.The patient does not have any
contraindications to fibrinolytic therapy. Which treatment approach
is best for this patient?
Answer: Start fibrinolytic therapy as soon as possible - Which best describes this rhythm?
Answer: Third-degree atrioventricular block - What is the recommended range from which a temperature
should be selected and maintained constantly to achieve targeted
management aftercardiac arrest?
Answer: 32 degrees celsius to 36 degrees Celsius - Which is the recommended first intravenous (IV) dose of
amiodarone fora patient with refractory ventricular fibrillation?
Answer: 300mg - Which is the primary purpose of a medical emergency team or
rapid response team?
Answer: Improving patient outcomes by identifying and treating
earlyclinical deterioration
ACLS Post Test 2 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- You are caring for a patient with a suspected stroke whose
symptoms started 2 hours ago.The CT was normal with no sign of
hemorrhage.Thepatient does not have any contraindications to
fibrinolytic therapy.Whichtreatment is best?
a. start fibrinolytic therapy ASAP
b. hold fibrinolytic therapy for 24 hours
c. order an echo before fibrinolytic administration
d. wait for MRI result
Answer: a. start fibrinolytic therapy ASAP - For STEMI pt, maximum goal time for ED door-to-ballooninflation time forPCI?
a. 150 mins
b. 180 mins
c. 120 mins
d. 90 mins
Answer: d. 90 mins - Which is the recommended oral dose of aspirin for a patient with
suspect-ed acute coronary syndrome?
a. 81 mg
b. 325-650 mg
c. 160-325 mg
d. 40 mg
Answer: c. 160-325 mg - chest compressions during for adult rate
a. 40-60/min
b. 60-80/min
c. 80-100/min
d. 100-120/min
Answer: d. 100-120/min - What is the effect of excessive ventilation?
a. decresed cardiac output
b. decreased intrathoracic pressure
c. increased perfusion pressure
d. increased venous return
Answer: a. decreased cardiac output - temperature to achieve targeted temperature management after
cardiacarrest
a. 30-34C
b. 32-36C
c. 36-40C
d. 38-42C
Answer: b. 32-36C - 3 mins into cardiac arrest resuscitation attempt, one member of
your teaminserts an endotracheal tube while another performs chest
compressions. Capnography shows a persistent waveform & a
PETCO2 of 8mmHg.What isthe significance of the finding?
a. chest compression may not be effective
b.The endotrachael tube is in the esophagus
c. the team is ventilating the patient too often
ACLS Post Test 3 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- A 48-year-old man became unresponsive shortly after presenting
to you with nausea and generalized chest discomfort.You observe
gasping breathing and are unsure if you feel a pulse.You should
know:
A. Call for help and begin chest compressions.
B.Wait until breathing stops and then check again for a pulse.
C. Begin chest compressions only if you are certain a pulse is
absent.
D.Observe the patient for 2 minutes, then reassess his breathing and
pulse.-
Answer: A. Call for help and begin chest compressions. - Which of the following is the most likely complication of
inferior wallmyocardial infarction (MI)?
A. Cardiogenic shock
B. Ventricular rupture
C. Bradydysrhythmias
D.Tachydysrhythmias
Answer: C. Bradydysrhythmias - A 52-year-old man is complaining of palpitations that came on
suddenly after walking up a short flight of stairs. His symptoms
have been present for about 20 minutes. He denies chest pain and
is not short of breath. His skin is warm and dry; breath sounds are
clear. His blood pressure (BP) is 144/88 millimeters of mercury
(mm Hg), his heart rate is 186 beats per minute(beats/min), and his
ventilatory rate is 18 breaths/min. The cardiac monitor reveals the
rhythm here.Vascular access has been established.Which of the
following medications is most appropriate in this situation?
A. Dopamine or sotalol
B. Furosemide or atropine
C. Nitroglycerin (NTG) or morphine
D. Procainamide or amiodarone
Answer: D. Procainamide or amiodarone
- Your general impression of a 78-year-old woman reveals that her
eyes are closed, she is not moving, you can see no rise and fall of
her chest or abdomen, and her skincolor is pale. When you arrive at
the patient’s side, you confirm that she is unresponsive.Your best
action in this situation willbe to:
A. Open her airway and give two breaths.
B. Apply an automated external defibrillator (AED).
C. Assess breathing and determine whether she has a pulse.
D. Prepare the necessary equipment to insert an advanced airway.
Answer: C. Assessbreathing and determine whether she has a
pulse. - A 60-year-old woman has suffered a cardiac arrest. A health care
professional trained in endotracheal intubation has intubated the
patient.Which of the following findings would indicate inadvertent
esophageal intubation?
A. Jugular vein distention
B. Subcutaneous emphysema
C. Gurgling sounds heard over the epigastrium
D. Breath sounds heard on only one side of the chest
Answer: C. Gurgling soundsheard over the epigastrium - Hypotension (ie, a systolic BP of less than 90 mm Hg) after the
return ofspontaneous circulation (ROSC) may necessitate the use
of:
A. Fluid boluses and isoproterenol.
B. Procainamide, epinephrine, or dopamine.
C. Epinephrine, dopamine, or norepinephrine.
D.Fluid boluses, procainamide, and isoproterenol.
Answer: C.Epinephrine, dopamine,or norepinephrine.
- Which of the following is incorrect with regard to a postevent
debriefing?
A.The facilitatorshould use open-ended questionsto encourage
discussion.
B.Team members are encouraged to identify lessons learned in a
nonpuni-tive environment.
C.The gather phase of the debriefing includes a comparison of the
team’sactions with current resuscitation algorithms.
D.Team members are given an opportunity to reflect on their
performanceand how their performance can be improved.
Answer: C. The gather phase of the debriefing includes a
comparison of the team’s actions with current resuscitation
algorithms. - Assuming there are no contraindications, which of the following
can be performed as an initial intervention for a stable but
symptomatic patient withthe rhythm shown?
A. Defibrillation
B. Vagal maneuvers
C. Administration of intravenous (IV) diltiazem
D. Administration of IV epinephrine
Answer: B. Vagal maneuvers - A 62-year-old man received IV tissue plasminogen activator
(tPA) 2 hoursago after a diagnosis of acute ischemic stroke.While
assessing the patient’svital signs, you observe swelling of the
patient’s lips and tongue. Your bestcourse of action will be to:
ACLS PreTest- Pharmacology and Practical Application
(Latest 2023 – 2024) Actual Questions and Answers 100% Correct
- 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 describethe
recommended second does of amiodarone for this patient?
Answer: 150 mg IV amiodarone - 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: Adenosine6 mg - 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: Seekingexpert consultation - A patient with possible STEMI has ongoing chest discomfort. What is a
contraindication to nitrate administration?
Answer: Use of a phosphodiestrase inhibitorwithin the previous 24 hours - How does complete chest recoil contribute to effective CPR?
Answer: Allows maximum blood return to the heart - 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 isin
pace.Which action do you take next?
Answer: 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?
Answer: Give an immediate unsynchronized high-energy shock (defibrillation
dose) - 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 vianasal
cannula at 2 L/min, and an IV has been established. His blood pressureis
180/100 mm Hg.Which drug do you anticipate giving to this patient?
Aspirin
Glucose (D50)
Nicardipiner
tPA
Answer: A - In which situation does bradycardia require treatment?
12-lead ECG showing a normal sinus rhythm
Hypotension
Diastolic blood pressure greater than 90 mm Hg
Systolic blood pressure greater than 100 mm Hg
Answer: B
ACLS Practice Exam (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- You find an unresponsive pt. who is not breathing. After
activating the emergency response system, you determine there is
no pulse.What is yournext action?
Answer: 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 stepis most important now?
Answer: Obtaining a 12 lead ECG. - What is the preferred method of access for epi administration
duringcardiac arrest in most pts?
Answer: Peripheral IV - An AED does not promptly analyze a rythm.What is your next
step?
Answer: Beginchest 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 stepis your next priority?
Answer: Administer 1mg of epinephrine - During a pause in CPR, you see this lead II ECG rhythm on the
monitor.Thepatient has no pulse.What is the next action?
Answer: Resume compressions - What is a common but sometimes fatal mistake in cardiac arrest
management?
Answer: Prolonged interruptions in chest compressions. - Which action is a componant of high-quality chest comressions?
Answer: Allowingcomplete chest recoil - Which action increasesthe chance ofsuccessful conversion of
ventricularfibrillation?
Answer: Providing quality compressions immediately before a
defibrillation attempt. - Which situation BEST describes pulseless electrical activity?
Answer: Sinus rythm without a pulse - What is the BEST strategy for performing high-quality CPR on
a patientwith an advanced airway in place?
Answer: 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 chestcompressions. During subsequent ventilation, you
notice the presence of awaveform on the capnography screen and a
PETCO2 level of 8 mm Hg.Whatis the significance of this finding?
Answer: Chest compressions may not be effective.
- The use of quantitative capnography in intubated patients
Answer: allows formonitoring 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 firstshock, the ECG screen displayed asystole,
which has persisted despite 2doses of epinephrine, a fluid bolus,
and high-quality CPR.What is your next treatment?
Answer: Consider terminating resuscitive efforts after consulting
medicalcontrol. - Which is a safe and effective practice within the defibrillation
sequence?-
Answer: 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?
Answer: Beginchest compressions. - What is an advantage of using hands-free defibrillation pads
instead ofdefibrillation paddles?
Answer: Hands-free pads allow for a more rapid defibrillation. - What action is recommended to help minimize interruptions in
chestcompressions during CPR?
Answer: Continue CPR while charging the defibrillator.
ACLS Practice Exam 2 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- 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 38 mm 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 confirms a super ventricular
tachycardia with no evidence of ischemia or infarction.The heart rate hasnot
responded to vagal maneuvers.What is your next action?
a) Administer adenosine 6 mg IV push
b) Administer adenosine 300 mg IV push
c) Perform synchronized cardioversion at 50 J
d) Perform synchronized cardioversion at 200 J
Answer: a) Administer adenosine 6 mgIV push - A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of
epinephrine have been given.Which drug should be given next?
a) Adenosine 6 mg
b) Amiodarone 300 mg
c) Epinephrine 3 mg
d) Lidocaine 0.5 mg/kg
Answer: b) Amiodarone 300 mg - Which intervention is more appropriate for the treatment of a patient in
asystole?
a) Atropine
b) Defibrillation
c) Epinephrine
d) Transcutaneous pacing
Answer: c) Epinephrine
- 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?
a) Adenosine 6 mg
b) Atropine 0.5 mg
c) Epinephrine 2 to 10 mcg/kg per minute
d) Lidocaine 1 mg/kg
Answer: a) Adenosine 6 mg - 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?
a) Call for a pulse check
b) Establish IV or IO access
c) Insert a laryngeal airway
d) Perform endotracheal intubation
Answer: b) Establish IV or IO access - What is the indication for the use of magnesium in cardiac arrest?
a) Ventricular tachycardia associated with a normal QT interval
b) Shock-refractory monomorphic ventricular tachycardia
c) Pulseless ventricular tachycardia-associated torsades de pointes
d) Shock-refractory ventricular fibrillation
Answer: c) Pulseless ventricular tachycardia-associated torsades de pointes
- A 62-year-old man suddenly experienced difficulty speaking and left-sided
weakness. He meets initial criteria for fibrinolytic therapy, and a CT scan ofthe
brain is ordered.Which best describes the guidelines for antiplatelet and
fibrinolytic therapy?
a) Give asprin 160 to 325 mg to be chewed immediately
b) Give asprin 160 mg and clopidogrel 75 mg orally
c) Give heprin if the CT scan is negative for hemorrhage
d) Hold asprin for at least 24 hours if rtPA is administered:
Answer d) Hold asprin forat least 24 hours if rtPA is administered - In which situation does bradycardia require treatment?
a) 12-lead ECG showing a normal sinus rhythm
b) Hypertension
c) Diastolic blood pressure greater than 90 mm Hg
d) Systolic blood pressure greater than 100 mm Hg
Answer: b) Hypertension - A 57-year-old woman has palpitations, chest discomfort, and tachycardia.The monitor shows a regular wide-complex QRS at a rate of 100/min. She becomes diaphoretic, and her blood pressure is 80/60 mm Hg.Which actiondo you take
next?
a) Establish IV access
b) Obtain a 12-lead ECG
c) Perform electrical cardioversion
d) Seek expert consultation
Answer: c) Perform electrical cardioversion - A patient with STEMI has ongoing chest discomfort. Heparin 4000 unitsIV
bolus and a heparin infusion of 1000 units per hour are being administered.The
patient did not take asprin because he has a history of gastritis, which was
treated 5 years ago.What is your next action?
a) Give asprin 160 to 325 mg to chew
b) Give clopidogrel 300 mg orally
c) Give enteric-coated asprin 75 mg orally
d) Give enteric-coated asprin 325 mg rectally
Answer: a) Give asprin 160 to 325 mg tochew - A patient is in refractory ventricular fibrillation. High-quality CPR is in
progress. One dose 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?
a) Epinephrine 1 mg
b) Epinephrine 3 mg
c) Sodium bicarbinate 50 mEq
d) A second dose of the antiarrhythmic drug
Answer: a) Epinephrine 1 mg - A patient has sinus bradycardia with a heart rate of 36/min. Atropine has
been administered to a total dose 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?
a) Atropine 1 mg
b) Epinephrine 2 to 10 mcg/min
c) Adenosine 6 mg
d) Normal saline 250 mL to 500 mL bolus
Answer: b) Epinephrine 2 to 10 mcg/min
ACLS Precourse Self Assessment (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- how often should you switch compressors to avoid fatigue
Answer: every 2 mins - pt was in refractory v fib. third shock has been administrated. what is the
next action
Answer: resume high quality compressions - you arrive and CPR isin progress. pt wasrecovering from PE and suddenly
collapsed. two shocks have been delivered and IV has been initiated. what
do you administer now
Answer: 1 mg epi IV - 12 lead shows STEMI. pt has resolution of moderate chest pain after 3
doses of sublingual nitroglycerin. BP is 104/70. what intervention is most
important in reducing pt’s in hospital and 30 day mortality rate
Answer: reperfusiontherapy - pt is pale and diaphoretic. BP is 80/60, and in sinus bradycardia. On O2 at4
L/min by NC and IV is established. what do you administer
Answer: 0.5 mg AtropineIV - what action should you take immediately after providing an AED shock
Answer: -resume chest compressions - pt is not responsive and not breathing. you can palpate a carotid pulse.
which action do you take next
Answer: start rescue breathing - what is the recommended depth of chest compressions for an adult victim
Answer: at least 2 inches - how does complete chest recoil contribute to effective CPR
Answer: allows maxi-mum blood to return to heart - pt has history of palpitations and develops light headedness and
palpitations. received adenosine 6 mg IV for V-tach. BP is 128/70. what is
next appropriate intervention?
Answer: adenosine 12 mg IV - pt in ICU has narrow-complex tachy at 220/min.BP 128/58mmHg. PETCO2
38mmHg, 98% O2 sat. 12 ECG confirms SVT w/o ischemia or infarction.
Hasnot been given vasoactive drugs and vagal manuevers are ineffective.
Whatis the next action?
Answer: adenosine 6 mg IV push - what action minimizesthe risk of air entering the victim’s stomach duringbag
mask ventilation
Answer: ventilating until you see chest rise - you are providing bag mask ventilations to a patient in respiratory arrest.how
often should you provide ventilation
Answer: every 5 – 6 breaths
ACLS Precourse Self Assessment Pharmacology
(Latest 2023 – 2024) Actual Questions and Answers 100%
Correct
- A 57-year-old woman has palpitations, chest discomfort, and
tachycardia. The monitor shows a regular wide-complex QRS at a
rate of 180 bpm. She becomes diaphoretic, and her bp is 80/60
mmHG. Which action next?
Answer: Per- form electrical cardioversion (pg.79) - You arrive on scene with the code team. High quality CPR is in
progress. An AED has previously advised “no shock indicated.” A
rhythm now finds asystole. After resuming high-quality
compressions, which action next?
Answer: Establish IV or IO access (pg. 117) - A pt isin pulseless V-Tach.Two shocks and 1 dose of epi have
been given. Which drug next?
Answer: Amiodarone 300omg bolus - Stroke pt (question 4/20)
Answer: admin Aspirin - A pt is in cardiac arrest. High quality compressions are given.
The pt is intubated, and a IV has been started.The rhythm is
asystole.What drug/dose do you give?
Answer: Epinephrine 1 mg
ACLS Precourse Self Assessment Practical Application
(Latest 2023 – 2024) Actual Questions and Answers 100%
Correct
- How does complete recoil contribute to effective CPR?
Answer: Allows maximumblood return to the heart - Your pt is not responsive and is not breathing.You can palpate
a carotidpulse.Which action next?
Answer: Start rescue breathing - You arrive on scene to find CPR in progress. Nursing staff
report pt wasrecovering from PE and suddenly collapsed.Two
shocks have been given,and IV in place.What do you admin
now?
Answer: Epi 1 mg IV - CPR in progress. On next rhythm check, you see the rhythm
shown (sinusbrady). Team says pt was well but reported chest
discomfort the collapsed.No pulse or respirations. Bag is
producing chest rise, IV in place. Which intervention next?
Answer: Epi 1 mg - Fine v-fib is present on monitor after initation of CPR and 1
shock. A second shock is given and chest compression resume.
IV in place but nodrugs have been given. Next intervention?
Answer: Epi 1 mg
ACLS Study Guide (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- A 68-year-old woman presents with light-headedness, nausea,
and chestdiscomfort.Your assessment finds her awake and
responsive but ill-appearing, pale, and goodly disphorttie. Her radial
is weak, thready, and fast. You areunable to obtain a blood pressure.
She has no obvious dependent edema, and her neck veins are flat.
Her lung sounds are equal, with moderate ralespresent bilaterally.
The cardiac monitor shows the rhythm seen here.
After your initial assessment of this patient, which intervention
should beperformed next?
Answer: Synchronized cardioversion - Which type of atrioventricular (AV) block best describesthis
rhythm?
Answer: Second degree type II - Your patient is in cardiac arrest and has been intubated.To assess
CPRquality, which should you do?
Answer: Monitor the patient’s PetCO2 - Which facility is the most appropriate EMS destination for a
patient with sudden cardiac arrest who achieved return a
spontaneous circulation in thefield?
Answer: Coronary reperfusion-capable medical center - Which of the following signs is a likely indicator of cardiac
arrest in anunresponsive patient?
Answer: Agonal gasps - Which type of atrioventricular (AV) block best describesthis
rhythm?
Answer: Second degree atrioventricular (AV) block type I - To properly ventilate a patient with a perfusing rhythm, how
often do yousqueeze the bag?
Answer: Once every 5 to 6 seconds - In addition to clinical assessment, which is the most reliable
method to confirm and monitor correct placement of an
endotracheal (ET) tube?
Answer: Continuous waveform capnography - You are caring for a patient with a suspected stroke whose
symptoms started 2 hours ago.The CT scan was normal, with no
signs of hemorrhage.The patient does not have any
contraindications to fibrinolytic therapy. Which treatment approach
is best for this patient?
Answer: Start fibrinolytic therapy as soon as possible - Which best describes this rhythm?
Answer: Third-degree atrioventricular block - What is the recommended range from which a temperature
should be selected and maintained constantly to achieve targeted
ACLS Study Guide 2 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- Which type of atrioventricular (AV) block best describesthis
rhythm?
Answer: Second degree type II - Your patient is in cardiac arrest and has been intubated.To assess
CPRquality, which should you do?
Answer: Monitor the patient’s PetCO2 - Which facility is the most appropriate EMS destination for a
patient with sudden cardiac arrest who achieved return a
spontaneous circulation in thefield?
Answer: Coronary reperfusion-capable medical center - Which of the following signs is a likely indicator of cardiac
arrest in anunresponsive patient?
Answer: Cyanosis - Which type of atrioventricular (AV) block best describesthis
rhythm?
Answer: Second degree atrioventricular (AV) block type I - To properly ventilate a patient with a perfusing rhythm, how
often do yousqueeze the bag?
Answer: Once every 5 to 6 seconds - In addition to clinical assessment, which is the most reliable
method to confirm and monitor correct placement of an
endotracheal (ET) tube?
Answer: Continuous waveform capnography - You are caring for a patient with a suspected stroke whose
symptoms started 2 hours ago.The CT scan was normal, with no
signs of hemorrhage.The patient does not have any
contraindications to fibrinolytic therapy. Which treatment approach
is best for this patient?
Answer: Start fibrinolytic therapy as soon as possible - Which best describes this rhythm?
Answer: Third-degree atrioventricular block - What is the recommended range from which a temperature
should be selected and maintained constantly to achieve targeted
management aftercardiac arrest?
Answer: 32 degrees celsius to 36 degrees Celsius - Which is the recommended first intravenous (IV) dose of
amiodarone fora patient with refractory ventricular fibrillation?
Answer: 300mg - Which is the primary purpose of a medical emergency team or
rapid response team?
Answer: Improving patient outcomes by identifying and treating
earlyclinical deterioration
ACLS Study Guide 3 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- Your patient is in cardiac arrest and has been intubated.To assess
CPRquality, which should you do?
Answer: Monitor the patient’s PetCO2 - Which facility is the most appropriate EMS destination for a
patient with sudden cardiac arrest who achieved return a
spontaneous circulation in thefield?
Answer: Coronary reperfusion-capable medical center - Which of the following signs is a likely indicator of cardiac
arrest in anunresponsive patient?
Answer: Cyanosis - Which type of atrioventricular (AV) block best describesthis
rhythm?
Answer: Second degree atrioventricular (AV) block type I - To properly ventilate a patient with a perfusing rhythm, how
often do yousqueeze the bag?
Answer: Once every 5 to 6 seconds - In addition to clinical assessment, which is the most reliable
method to confirm and monitor correct placement of an
endotracheal (ET) tube?
Answer: Continous waveform capnography - You are caring for a patient with a suspected stroke whose
symptoms started 2 hours ago.The CT scan was normal, with no
signs of hemorrhage.The patient does not have any
contraindications to fibrinolytic therapy. Which treatment approach
is best for this patient?
Answer: Start fibrinolytic therapy as soon as possible - Which best describes this rhythm?
Answer: Third-degree atrioventricular block - What is the recommended range from which a temperature
should be selected and maintained constantly to achieve targeted
management aftercardiac arrest?
Answer: 32 degrees celsius to 36 degrees Celsius - Which is the recommended first intravenous (IV) dose of
amiodarone fora patient with refractory ventricular fibrillation?
Answer: 300mg - Which is the primary purpose of a medical emergency team or
rapid response team?
Answer: Improving patient outcomes by identifying and treating
earlyclinical deterioration - Which is the recommended next step after a defibrillation
attempt?
Answer: Resume CPR, starting with chest compressions
ACLS Written Exam 1 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- You find an unresponsive pt. who is not breathing. After
activating the emergency response system, you determine there is
no pulse.What is yournext action?
Answer: 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 stepis most important now?
Answer: Obtaining a 12 lead ECG. - What is the preferred method of access for epi administration
duringcardiac arrest in most pts?
Answer: Peripheral IV - An AED does not promptly analyze a rythm.What is your next
step?
Answer: Beginchest 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 stepis your next priority?
Answer: Administer 1mg of epinephrine - During a pause in CPR, you see this lead II ECG rhythm on the
monitor.Thepatient has no pulse.What is the next action?
Answer: Resume compressions - What is a common but sometimes fatal mistake in cardiac arrest
management?
Answer: Prolonged interruptions in chest compressions. - Which action is a componant of high-quality chest comressions?
Answer: Allowing complete chest recoil - Which action increasesthe chance ofsuccessful conversion of
ventricular fibrillation?
Answer: Providing quality compressions immediately before a
defibrillation attempt. - Which situation BEST describes pulseless electrical activity?
Answer: Sinus rythm without a pulse - What is the BEST strategy for performing high-quality CPR on
a patientwith an advanced airway in place?
Answer: 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 chestcompressions. During subsequent ventilation, you
notice the presence of awaveform on the capnography screen and a
PETCO2 level of 8 mm Hg.Whatis the significance of this finding?
Answer: Chest compressions may not be effective.
- The use of quantitative capnography in intubated patients
Answer: allows formonitoring 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 firstshock, the ECG screen displayed asystole,
which has persisted despite 2doses of epinephrine, a fluid bolus,
and high-quality CPR.What is your next treatment?
Answer: Consider terminating resuscitive efforts after consulting
medicalcontrol. - Which is a safe and effective practice within the defibrillation
sequence?-
Answer: 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?
Answer: Beginchest compressions. - What is an advantage of using hands-free defibrillation pads
instead ofdefibrillation paddles?
Answer: Hands-free pads allow for a more rapid defibrillation. - What action is recommended to help minimize interruptions in
chestcompressions during CPR?
Answer: Continue CPR while charging the defibrillator.
ACLS Written exam 2 (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
Pulseless V tach or V Fib algorithm
Answer: CPR 2 min, Shock at 120 Jewels, CPR2 min, Shock at
120 Jewels, give 40 units of vasopressin, CPR 2 min, 300 mg
Amiodarone, CPR 2 min, 1 mg epinephrine, CPR 2 min, 150 mg
Amiodarone
When you see a suspected asystole or PEA what are the first
actions thatyou need to take in order to ensure that is the rthythm
you see
Answer: increase gainon monitor, check leads to make sure none
have fallen off
Asystole/PEA
Answer: CPR 2 minutes, 1 mg every 3-5 minutes, CPR 2
minutes, treatpossible causes
What are the 5 H’s and 5T’s
Answer: Hypovolemia, Hypoxia, Hydrogen ion, HYpo/Hyperkalemia, Hypothermia
5 T’s: Toxins, Tamponade, Tension pneumothorax, thrombosis
(coronary or pul-monary)
What is the treatment if a patient is dead and in acidosis
Answer: 1 meq/kg Bicarb
What is the treatment for Hyperkalemia
Answer: amp of calcium, bicarb, insulin (10units) and glucose
What are some causes of a patient going in to Metabolic Acidosis
Answer: aspirin,antifreeze
What is the treatment for Hypokalemia
Answer: give potassium
What is the treatment for Hypothermia
Answer: warm saline rapid infuser, bear hug-ger, increase temp
on vent
What is the reversal drug for opiates and the dosage
Answer: Narcan 0.4-2 mg
What is the reversal drug for benzodiazepiens
Answer: Romazincon 0.2 mg, 0.3,then 0.5 till a max dose of 3
mg
What are signs of a patient being in cardiac tamponade
Answer: JVD< purple fromnipple line up
What is a good diagnostic tool to determine if a patient is in
cardiactamponade
Answer: Echo machine to see if there’s fluid
What is the treatment for Cardiac Tamponade
Answer: Pericardial centesis ( 5thintercostal space midclavicular
ACLS Certification Exam (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
- Any organized rhythm without a pulse is defined as pulseless
electricalactivity (PEA).
Answer: True - Synchronized cardioversion is appropriate for treating an
unknown widecomplex tachycardia.
Answer: True - The aorta is the wall that separates the ventricles of the heart.
Answer: False - The most effective treatment for ventricular fibrillation is
defibrillation.
Answer: -True - An individual should be cleared-Ñ prior to a shock only when
convenient.-
Answer: False - PEA and asystole are considered non-shockable rhythms and
follow thesame ACLS algorithm.
Answer: True - Transcutaneous pacing should be used on an individual with
bradycardiaand inadequate perfusion if atropine is ineffective and
the individual is exhibiting severe symptoms.
Answer: True
- Low blood pressure may be an indication of hemodynamic
instability.
Answer: True - Urgent defibrillation is essential for survival in the management
of acutestrokes.
Answer: False - Fibrinolytic therapy within three hours (in some cases 4.5
hours) of firstonset of symptoms is the standard when treating
ischemic stroke.
Answer: True - 100% oxygen is acceptable for early intervention but not for
extendedperiods of time.
Answer: True - In a suspected acute stroke individual, you must always
immediatelyobtain IV access.
Answer: False - There is never a pulse associated with VF; therefore, you should
followthe PEA algorithm with individuals in VF.
Answer: False - If the AED advises no shock, you should still defibrillate
because defibrillation often restarts the heart with no pulse.
Answer: False
- If transcutaneous pacing fails, there are no other options to
consider.
Answer: -False - Medication is the only treatment for an unstable tachycardic
individual.-
Answer: False - For an individiual in respiratory arrest with a pulse, how often
should theybe ventilated?
A) Give two breaths every 8 to 9 seconds, or 13 to 15 breaths per
minute.
B) Give one breath every 5 to 6 seconds, or 10 to 12 breaths per
minute.
C) Give one breath every 3 to 4 seconds, or 15 to 20 breaths per
minute.
D) Give one breath every 8 to 9 seconds, or 6 to 8 breaths per minute.
Answer: B) Giveone breath every 5 to 6 seconds, or 10 to 12
breaths per minute. - Which item is NOT a basic airway skill?
A) Placement of endotracheal tube (ET tube)
B) Bag-mask ventilation
C) Jaw-thrust maneuver without head extension
D) Head-tilt-chin-lift maneuver
Answer: A) Placement of endotracheal tube (ET tube) - Which of the following basic airway adjuncts can be used in a
consciousor semiconscious indivudual (with an intact cough and
gag reflex)?
A)Oropharyngeal airway (OPA)
B) Endotracheal tube (ET tube)
C) Nasopharyngeal airway (NPA)
AHA ACLS Post Test (Latest 2023 – 2024)
Actual Questions and Answers 100% Correct
You find an unresponsive pt. who is not breathing. After
activating the emergency response system, you determine there is
no pulse.What is yournext action?
Answer: Start chest compressions of at least 100 per min.
You are evaluating a 58 year old man with chest pain.The BP is
92/50 anda heart rate of 92/min, non-labored respiratory rate is 14
breaths/min and thepulse O2 is 97%.What assessment step is
most important now?
Answer: Obtaining a12 lead ECG.
What is the preferred method of access for epi administration
duringcardiac arrest in most pts?
Answer: Peripheral IV
An AED does not promptly analyze a rythm.What is your next
step?
Answer: Beginchest compressions.
You have completed 2 min of CPR.The ECG monitor displays
the lead be-low (PEA) and the pt. has no pulse.You partner
resumes chest compressionsand an IV isin place.What
management step is your next priority?
Answer: Administer1mg of epinepherine
During a pause in CPR, you see a narrow complex rythm on the
monitor.The pt. has no pulse.What is the next action?
Answer: Resume compressions
What is acommon but sometimes fatal mistake in cardiac arrest
management?
Answer: Prolonged interruptions in chest compressions.
Which action is a componant of high-quality chest comressions?
Answer: Allowingcomplete chest recoil
Which action increasesthe chance of successful conversion of
ventricularfibrillation?
Answer: Providing quality compressions immediately before a
defibrillation attempt.
Which situation BEST describes PEA?
Answer: Sinus rythm without a pulse
What is the best strategy for perfoming high-quality CPR on a
pt.with an advanced airway in place?
Answer: Provide continuous chest compressionswithoutpauses
and 10 ventilations per minute.
3 min after witnessing a cardiac arrest, one member of your team
inserts an ET tube while another performs continuous chest
comressions. During subsequent ventilation, you notice the
presence of a wavefom on thecapnogrophy screen and a PET CO2
of 8 mm Hg.What is the significance ofthis finding?
Answer: Chest compressions may not be effective.
The use of quantitative capnography in intubated pt’s does what?
Answer: Allowsfor monitoring CPR quality