2024 ACLS Complete Bundle ( ALL TOPIC ) ( Final Exam 1 – 3, Study Guide 1-3, Exam V1-V2, Comprehensive Review, Post Test, Pretest, Practice Questions, etc.. ) Questions and Answers Included | Passed | A Rated Guide | New Full Exam Actual
ACLS Pharmacology ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- You are caring for a 66-year-old man with a history of a large intracerebralhemorrhage 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 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?
A. aspirin
B. glucose (D50)
C. nicardipine
D. rtPA
Answer: A. aspirin - A patient with sinus bradycardia and a heart rate of 42/min has diaphoresisand a blood
pressure of 80/60 mm Hg.What is the initial dose of atropine?
A. 0.1 mg
B. 0.5 mg
C. 1 mg
D. 3 mg
Answer: B. 0.5 mg - A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IVbolus and a
heparin infusion of 1000 unit per hour are being administered.Thepatient did not take aspirin
because he has a history of gastritis, which was treated 5 years ago.What is your next action?
A. give aspirin 160 to 325 mg to chew
B. give clopidogrel 300 mg orally
C. give enteric-coated aspirin 75 mg orally
D. give enteric-coated aspirin 325 mg rectally
Answer: A. give aspirin 160 to 325 mg tochew - A patient is in pulseless ventricular tachycardia.Two shocks and 1 dose ofepinephrine 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 - What is the indication for the us of magnesium in cardiac arrest?
A. ventricular tachycardia associated with a normal QTinterval
B. shock-refractory monomorphic ventricular tachycardia
C. pulseless ventricular tachycardia-associated torsadesde pointes
D. shock-refractory ventricular fibrillation
Answer: C. pulseless ventricular tachycardia-associated torsades de pointes - In which situation does bradycardia require treatment?
A. 12-lead ECG showing a normal sinus rhythm
B. hypotension
C. diastolic blood pressure greater than 90 mm Hg
D. systolic blood pressure greater than 100 mm Hg
Answer: B. hypotension - You arrive on the scene with the code team.High-quality CPR isin 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 - 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?
A. giving adenosine 6 mg IV bolus
B. giving lidocaine 1 to 1.5 mg IV bolus
C. performing synchronized cardioversion
D. seeking expert consultation
Answer: D.seeking expert consultation - 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 theteam leader.Which medication do you order
next?
A. epinephrine 1 mg
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ACLS Practical Application ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- 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?
A. atropine 0.5 mg IV
B. epinephrine 1 mg IV
C. endotracheal intubation
D. transcutaneous pacing
Answer: B. epinephrine 1 mg IV - A 45-year-old woman with a history of palpitations develops light-headed-ness and
palpitations. She has received adenosine 6 mg IV for the rhythm shown here (SVT), without
conversion of the rhythm. She is n9ow extremelyapprehensive. Her blood pressure is 128/70
mm Hg. What is the next appropriate intervention?
A. administer adenosine 12 mg IV
B. perform unsynchronized cardioversion
C. perform vagal maneuvers
D. perform synchronized cardioversion
Answer: A. administer adenosine 12 mg IV - What is the recommended depth of chest compression for an adult victim?
A. at least 1.5 inches
B. at least 2 inches
C. at least 2.5 inches
D. at least 3 inches
Answer: B. at least 2 inches - A patient’s 12-lead ECG istransmitted by the paramedics and shows a STE-MI.When the
patient arrives in the emergency department, the rhythm shownhere (ST elevation) is seen on
the cardiac monitor.The patient has resolutionof moderate (5/10) chest pain after 3 doses of
sublingual nitroglycerin. Bloodpressure is 104/70 mm Hg. Which intervention is most
important in reducingthis patient’s in-hospital and 30-day mortality rate?
A. application of transcutaneous pacemaker
B. atropine administration
C. nitroglycerin administration
D. reperfusion therapy
Answer: D. reperfusion therapy
- A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the
patient becomes unresponsive, with the rhythm shown here(polymorphic ventricular
tachycardia). which action is indicated next?
A. give an immediate unsynchronized high-energy shock(defibrillation dose)
B. give lidocaine 1 to 1.5 mg/kg IV
C. perform synchronized cardioversion
D. repeat amiodarone 300 mg IV
Answer: A. give an immediate unsynchronized high-energy shock (defibrillation dose) - A patient becomes unresponsive. You are uncertain if a faint pulse is pre- sent.The rhythm
shown here is seen on the cardiac monitor. An IV is in place.Which action do you take next?
A. begin transcutaneous pacing
B. start high-quality CPR
C. administer atropine 1 mg
D. administer epinephrine 1 mg IV
Answer: B.start high-quality CPR - Your patient is notresponsive and is not breathing. You can palpate a carotidpulse.Which
action do you take next?
A. apply an AED
B. obtain a 12-lead ECG
C. start an IV
D. start rescue breathing
Answer: D.start rescue breathing - After initiation of CPR and 1 shock for ventricular fibrillation, this rhythm (ventricular
fibrillation) is present on the next rhythm check. A second shockis given, and chest
compressions are resumed immediately. An IV is in place,and no drugs have been given. Bagmask ventilations are producing visible chest rise.What is your next intervention?
A. administer 3 sequential (stacked) shocks at 360 J(monophasic defibrillator)
B. give amiodarone 300 mg IV / IO
C. give epinephrine 1 mg IV / IO
D. intubate and administer 100% oxygen
Answer: C. give epinephrine 1 mg IV / IO
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ACLS AHA Exam ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- A patient has a rapid irregular wide-complex tachycardia;The ventricular rate is
138/min.;
It is asymptomatic, with a BP of 110/70 mmHG;He has a h/o angina;
What action is recommended next?
Answer:
a) Giving Adenosine: 6 mg IV bolus;
b) Giving Lidocaine: 1.5 mg IV bolus;
c) Performing synchronized cardioversion;
d) *Seeking expert consultation *; - What testsshould be performed for a patient with a suspected stroke within2 hours of
arrival?
Answer: non contrast CT scan of the head - SVT types
Answer:
1) Atrial fibrillation (A-fib);
2) Paroxysmal Supraventricular Tachycardia (PSVT):
3) Atrial Flutter (A-flutter);
4) Wolff-Parkinson-White syndrome; - The patient is in cardiac arrest.
High-quality chest compressions are being given. The patient is intubated, and an IV is being
started.The rhythm is asystole.
What is the first drug/dose to administer?
Answer: Epinephrine 1 mg IV/IO - Transcutaneous Pacing
Answer: Aka external pacing: is a temporary means of pacinga patient’s heart during a medical
emergency.
It is accomplished by gradually delivering pulses of electric current (50-100 mA)through
the patient’s chest until capture is reached (usually at a selected rate of 70),which stimulates the
heart to contract at a regular pace. - Which intervention is most appropriate for the treatment of a patient in
asystole?
Answer: Epinephrine - A patient with sinus bradycardia and a heart rate of 42/min is diaphoretic and with a
blood pressure of 80/60 mm Hg.
What is the initial dose of atropine?
Answer: 0.5 mg of Atropine
- A patient has sinus bradycardia with a heart rate of 36/min. Atropine hasbeen
administered to a total dose of 3 mg. A transcutaneous pacing has failed to capture.The
patient is confused, and her BP is 88/56 mmHg.Whichtherapy is now indicated?
Answer: Epinephrine infusion: 2-10 mcg/min. - A monitored patient in the ICU developed a sudden onset of regular narrow-complex tachycardia at a rate of 220/min.
The patient’s BP is 128/88 mm Hg, the PETCO2 is 38 mm Hg, and the pulseoximetry reading
is 98%.
There is a vascular (IV) access in the left arm, and the patient has not beengiven any basic
active drugs.
A 12-lead ECG confirms SVT with no evidence of ischemia or infraction.The HR has not
responded to vagal maneuvers.
What is your next action?
Answer: Administer adenosine 6 mg IV push - A patient with possible STEMI has ongoing chest discomfort.What is a
contraindication to nitrate administration?
Answer: Use of a phosphodiesteraseinhibitors (eg.Viagra) within the previous 24 hours - A patient isin pulselessV-tach (PEA).2 shocks and 1 dose of epinephrinehave been
given.
Which drug should be given next?
Answer: Amiodarone 300 mg (first dose) - What isthe indication forthe use of magnesium in cardiac arrest?
Answer: Pulse-less V-tach associated with Torsades des pointes - Which is one way to minimize interruptions in chest compressions duringCPR?
Answer: Continue CPR while the defibrillator charges - A 35-years-old woman has palpitations, light-headedness, and a stable
tachycardia.
The monitor shows a regular-narrow-monomorphic-complex QRS at a rateof 180/minutes.
Vagal maneuvers have not been effective in terminating the rhythm.An IV has been
established.
Which drug should be administered?
Answer: Adenosine 6 mg (first dose)
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ACLS basics and STEMI ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- Physiologic ADULT pt criteria for determination of when to act:
Answer:
-AirwayCompromise
-RR <6/min -RR >30/min
-HR <40/min -HR >140/min
-SBP <90
–Symptomatic HTN
-Unexpected dec. in LOC
–Unexplained Agitation
–Seizure
-Significant dec. in Urine Output - The purpose of the Rapid Response Team (RRT) or Medical Emergency Team (MET) is
to..
Answer: Improve pt outcomes by identifying and treating early clinicaldeterioration - What are signs of clinical deterioration that would prompt the activation ofa rapid response
system?
Answer: Symptomatic HTN, Seizure, Unexplained Agitation - 4 elements of an integrated system of care:
Answer: Structure, Processes, System,and patient outcomes - Element “Structure” includes what 3 things?
Answer: people, education, equipment - Element “Process” includes what 3 things?
Answer: protocols, policies, procedures - Element “System” includes what 3 things?
Answer: programs, organization, culture - Element “Patient Outcome” includes what 3 things?
Answer: Satisfaction, safety,quality - What isthe primary purpose oftheRRT or MET?
Answer: To improve patient outcomesby identifying and treating early clinical deterioration - In-patient cardiac arrest is often preceded by?
Answer: Changes in the pt’s vitalsigns. - What happens when teams rapidly assess and intervene when patients have abnormal
vital signs?
Answer: The number of in-hospital cardiac arrests decreases. - The chain of Survival is a metaphor used to organize and describe:
Answer: the integrated set of time-sensitive coordinated actions necessary to maximize
survival - Among others, which of the following factors has been associated withimproved survival
in pts with cardiac arrest?
Answer: immediate high-quality CPR - TeamLeaderRole (focuses on comprehensive pt care)
Answer:
-organizesthe group
-Monitors individual performance of the team
-backs up team members
-trains and coaches
-facilitates understanding
-focuses on comprehensive pt care
-Places advanced airway - CPR Coach (supports performance of high-quality BLS skills)
Answer:
-coordinatesinitiation of CPR
-Coaches to improve quality chest compressions
-coaches to improve high quality ventilations
-states guideline targets
-minimizes length of pauses in compressions - which is the best example of a role of a team member?
Answer: Prepared to fulfilltheir role responsibilities - To function effectively, a high performance team needs to focus on (4things):
Answer: Timing, Quality, Coordination, and Administration - Timing explanation (5):
Answer:
-Time to first compression
-time of first shock
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ACLS Drugs Dosages & Uses ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- For poor perfusion with BradycardiaTreat with which first line treatment?-
Answer: Atropine 1mg IV
(repeat to a total of 3mg IV) - For poor perfusion with Bradycardia Treat, if the first line of treatment is ineffective, what
should be provided and what med should be given?
Answer:
Transcutaneous pacing
Dopamine 5-20mcg/kg/minute infusionOR
Epinephrine 2-10mcg/min infusion - What is the first line drug for acute stable bradycardia and how do youadminister it?
Answer: Atropine given as 1mg IV q 3-5minutes (up to 3mg IV) - Hoe does Atropine work?
Answer: Reverses the cholinergic-mediated decreases in theheart rate and AV node
conduction - Which two AV block types will not respond to Atropine?
Answer: Mobitz type IIsecond-degree AV block and third-degree AV block - What is the preferred treatment for Mobitz type II second-degree AV blockand third-degree
AV block?
Answer: TCP or B-adrenergic (dopamine, epinephrine) sup-port until transcutaneous pacing
can be achieved - If only 0.5mg of IV Atropine is given what consequence could it have?
Answer: It canfurther lower the HR - What can be used if bradycardia is unresponsive to Atropine?
Answer: B-adrenergicinfusions (dopamine or epinephrine) - What must you consider before giving B-adrenergic infusions in bradycardia?
Answer: The pt’s BP/intravascular volume status for hypovolemia - What can be given for bradycardia when vasoconstriction is not desired?-
Answer: Dobutamine (b-adrenergic agonist) - Epinephrine should be given at what dose/rate for Bradycardia?
Answer: -2-10mcg/min - Dopamine should be given at what dose/rate for Bradycardia?
Answer: -5-20mcg/kg/min - How does Transcutaneous Pacing (TCP) work and when should it be used?
Answer: It delivers pacing impulses to the heart through skin via cutaneous electrodes.
for unstable bradycardia (hypotension, AMS, shock, ischemic chest pain) - For light sedation within the RN scope of practice give which 3 things should be given
before TCP if the pt’s condition allows for it?
Answer:
-Parenteralnarcotic
-Parenteral benzodiazepine
-Chronotropic infusion - How much of a safety margin (energy above the dose at which consistent capture is
observed) should you allow when using the transcutaneous pace-maker?
Answer: 2 mA - The HR that takes on clinical significance and is more likely to contributeto arrhythmia in
tachycardia is what rate?
Answer: 150/min or greater - What are the 7 rhythms associated with unstable tachycardia?
Answer: - SinusTachycardia
- Atrial fibrillation
- Atrial Flutter
- Superventricular Tachycardia (SVT)
- Monomorphic Ventricular Tachycardia (giant shark teeth-looking)
- Polymorphic Ventricular Tachycardia (Mutiple random shark teeth-looking)
- Wide-complex tachycardia of uncertain type
- What is the first line treatment for unstable tachycardia?
Answer: Immediate Synchronized Cardioversion - ifthe QRS complex is————- seconds or greater, consider expert consultation.-
Answer: 0.12 seconds - If the width of the ORs complex is 0.12 or less treat with what two things?-
Answer: Vagal maneuvers and Adenosine
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ACLS Exam ( Updated 2024 )
Complete Questions & Answers (Solved) 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 to arrive 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 ofTCP 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 and thesecond dose of epinephrine - When treating an acute stroke patient, you must immediately create immediate IV access.
Answer: True - Which of the following should be considered in the IV access of an asystolic patient?
Answer: never interrupt CPR - Which of the following choices representsthe 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?
Answer: Sinus tachycardia may result from hypovolemia - Chest pain that is indicative of myocardial ischemia may be accompaniedby nausea.
Answer: True - Patients with symptomatic bradycardia and may
quicklydegrade into cardiac arrest:
Answer: poor perfusion - Hypotension may indicate that the patient is unstable.
Answer: True - After defibrillation, CPR may be necessary.
Answer: True - A sinus rhythm originates in the:
Answer: sinoatrial node - The QRS complex on an ECG represents the:
Answer: contraction of the ventricles - Myocardial ischemia is caused by:
Answer: insufficient oxygen/blood supply - Use of the child AED pads is necessary if the patient is:
Answer: 8 years of age oryounger - Which of the following choices is NOT considered to be an underlyingcause of PEA?
Answer: Hyperglycemia - In the treatment of an acute stroke patient, the speed of response maydetermine patient
outcome and survival.
Answer: True - Lidocaine can be used for post-resuscitation therapy.
Answer: True
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ACLS Final Exam 2 ( Updated 2024 )
Complete Questions & Answers (Solved) 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?
Hypertension
Esophageal injury
Pneumothorax
Rib fracture
Answer: Pneumothorax
Complications can occur with the use of a BVM resuscitator due to improper technique.
Delivering excessive volume or ventilating too fast creates excessive pressure that can damage
the airways, lungs and other organs. Excessive volumecan lead to tension pneumothorax. - A person suddenly collapses while sitting in the sunroom of a healthcare facility. A
healthcare provider observes the event and hurries over to assessthe situation.The healthcare
provider performs which assessment first?
Rapid assessment
Basic life support assessment
Secondary assessment
Primary assessment
Answer: Rapid assessment
A systematic approach to assessment is necessary.The healthcare provider shouldfirst perform
a rapid assessment. A rapid assessment is a visual survey to ensure safety, form an initial
impression about the patient’s condition (including looking forlife-threatening bleeding), and
determine the need for additional resources. This would be followed by a primary assessment
and then a secondary assessment. - A patient is receiving ventilation support via bag-valve-mask (BVM) resus-citator.
Capnography is established and a blood gas is obtained to evaluate the adequacy of the
ventilations.Which arterial carbon dioxide (PaCO2) valuesignifies adequate ventilations?
10 to 15 mmHg
20 to 25 mmHg
25 to 30 mmHg
35 to 45 mmHg
Answer: 35 to 45 mmHg
Arterial carbon dioxide (PaCO2) values in the range of 35 to 45 mmHg confirmadequacy of
ventilation.
- A resuscitation team is debriefing following a recent event. A patient expe-rienced cardiac
arrest, and advanced life support was initiated. The patient required the placement of an
advanced airway to maintain airway patency. Which statement indicates that the team
performed high-quality CPR?
“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 provided chest compressions at a rate of 100 to 120 compressions per minute while
giving 1 ventilation every 6 seconds without pausing compressions.”
“We provided chest compressions at a rate of 80 to 120 per minute to a depthof at least 2
inches and gave 1 ventilation every 6 seconds without pausing compressions.”
“We kept the rate of chest compressions to around 100 per minute but adjust- ed their depth to
1.5 inches while giving 1 ventilation every 3 seconds withoutpausing compressions.”
Answer: “We provided chest compressions at a rate of 100 to 120compressions per minute while
giving 1 ventilation every 6 seconds without pausingcompressions.”
When an advanced airway has been placed in a patient who is in cardiac arrest, compressions
should be delivered continuously (100 to 120 per minute) with nopauses for ventilations. - 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?
Respiratory failure
Respiratory arrest
Cardiac arrest
Respiratory distress
Answer: Respiratory failure
An SaO2 level of less than 90% (PaO2 of less than 50 mmHg) accompanied byETCO2 values
greater than 50 mmHg is indicative of respiratory failure. - A responsive patient is choking.What method should the provider use firstto clear the
obstructed airway?
Back blows
Abdominal thrusts
Magill forceps extraction
Chest compressions
Answer: Back blows
To clear an obstructed airway in a responsive adult, first provide up to 5 back blowsto clear the
obstruction.
- A patient arrives at the emergency department complaining of shortnessof breath. The
patient has a long history of chronic obstructive pulmonary disease. Assessment reveals
respiratory failure.Which action would be theinitial priority to address the respiratory failure?
Establishment of vascular access
Delivery of supplemental oxygen via nasal cannula
Assisted ventilation with BVM resuscitator
Initiation of capnography
Answer: Assisted ventilation with BVM resuscitator
Patients who cannot ventilate adequately despite an open airway or who have insufficient
respiratory effort require assisted ventilation initially provided via a BVMresuscitator. - A 20-year-old man with respiratory depression is brought to the emergencydepartment by
his parents. Opioid overdose is suspected, and an initial doseof naloxone is administered at 10
p.m. The patient does not respond to this initial dose. The team would expect to administer a
second dose after how many minutes?
2 minutes
4 minutes
6 minutes
8 minutes
Answer: 2 minutes
The dose of naloxone may be repeated after 2 to 3 minutes. - Assessment of a patient in the emergency department reveals that the patient is
experiencing respiratory compromise. From the assessment, the team identifies that the patient
is in the earliest stage of this condition.Whichstage would this be?
Respiratory distress
Respiratory failure
Respiratory arrest
Respiratory acidosis
Answer: Respiratory distress
Respiratory compromise occurs along a continuum, beginning with respiratorydistress,
progressing to respiratory failure and then to respiratory arrest.
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ACLS Final Exam 3 ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- A patient admitted to the ED with signs & symptoms of stroke. The stroke team should
complete a comprehensive neurologic assessment and obtainbrain imaging results within what
time frame?
Answer: With in 20 mins - A person suddenly collapses while sitting in the sunroom of a healthcare facility.A healthcare
provider observesthe event and hurries over to assess thesituation. The healthcare provider
performs which assessment first?
Answer: Rapid assessment - A patient is receiving ventilation support via BVM resuscitator. Capnography is
established & a blood gas is obtained to evaluate the adequacy of the ventilations.Which PaO2
value signifies adequate ventilations?
Answer: 35 – 45 mmHg - A patient experiences cardiac arrest & the resuscitation team initiates ventilations using a
BVM resuscitator. The development of which condition during the provision care would lead
the team to suspect that improper BVMtechnique is being used?
Answer: Pneumothorax - A resuscitation team is debriefing following a recent event. A patient experienced cardiac
arrest & ALS wasinitiated.The patient required the placementof an advanced airway to
maintain airway latency. Which statement indicatesthat the team performed high quality CPR?
Answer: We provided chest compressions ata rate of 100-120 compressions/minute while
giving 1 ventilation Q 6secs. without pausing compressions. - Assessment of a patient reveals an ETCO2 level of 55mmHg & an SaO2 level of 88%.The
provider would interpret these findings asindicative of whichcondition?
Answer: Respiratory failure - A responsive patient is choking.What method should the provider use firstto clear the
obstructed airway?
Answer: Back blows - A patient arrives at the ED complaining of SOB. The patient has a long history of COPD.
Assessment reveals respiratory failure.Which action wouldbe the initial priority to addressthe
respiratory failure?
Answer: Assisted ventilation withBVM resuscitator - A 20YO man with respiratory depression is brought to the ED by his parents. Opioid OD is
suspected & an initial dose of naloxone is administered at 10pm.The patient doesn’t not respond
to this initial dose. The team would expect to administer a second dose after how many
minutes?
Answer: 2 minutes
- Assessment of a patient in the ED reveals that the patient is experiencingrespiratory
compromise. From the assessment, the team identifies that the patient is in the earliest stage of
this condition.Which stage would this be?
Answer: Respiratory distress - The following capnogram is from a patient experiencing respiratory dis-tress. At which
point in the waveform would the patient’s ETCO2 level be measured?
Answer: D - A patient is experiencing respiratory distress secondary to extinction of COPD.The
patient beginsto exhibitsigns &symptoms of worsening respiratory function and experiences
respiratory arrest.The team intervenes,deliveringventilations via BVM resuscitator. The team
should provide ventilations at a rate of 1 ventilation:
Answer: Every 6 seconds - A patient enters the ED in respiratory compromise.The team is monitoringthe patient using
capnography and ID’s the ETCO2 levels are initially 33mmHg and later 40mmHg. From these
readings, the team identifies that the patient is progressing in what stage of respiratory
compromise?
Answer: Respiratory distress - A patient is in cardiac arrest.The underlying cause is thought to be opioidtoxicity. Which
statement accurately describes the use of naloxone for this patient?
Answer: Naloxone should be administered ASAP but is not a priority over high quality CPR
& AED use. - A patient in the telemetry unit is receiving continuous cardiac monitoring.
The patient has a history of MI.The patient’s ECG rhythm strip is shown
in the following figure.The provider interprets this strip as indicating whicharrhythmia?
Answer: Third degree AV block - A patient with dyspnea, inadequate BP & a change in mentalstatus arrivesat the ED. The
healthcare team completes the necessary assessment & be- gins to care for the patient,
including initiating cardiac monitoring and pulseoximetry; providing supplemental oxygen
and ensuring adequate ventilation;and obtaining vascular access. The team reviews the
patients EKG strip as shown. Which agent would the team most likely administer?
Answer: Atropine 1 mg Q3-5 minutes - A patient comes to the ED complaining of palpations and SOB. Cardiac monitoring is
initiated and reveals the following EKG.The provider interpretsthis as which arrhythmia?
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ACLS Final Exam ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- A patient with suspected acute coronary syndromes (ACS) is placed on a cardiac monitor.
The patient is complaining of dyspnea and is given supple- mental oxygen.The provider
determines that the oxygen is effective based onwhich SaO2 level?
Answer: When a patient presents with potential ACS, the patientshouldhave 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 of which 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, lungsand 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 providerdetermines that ventilations are adequate based on
which end-tidal carbon dioxide (ETCO2) value?
Answer: End-tidal carbon dioxide values in the range of 35 to 45mmHg confirm adequacy of
ventilation. - A patient comes to the emergency department complaining of palpitationsand “some
shortness of breath.” Cardiac monitoring is initiated and reveals the following ECG rhythm
strip.The provider interprets this strip as indicatingwhich arrhythmia?
Answer: In atrial flutter, atrial contraction occurs atsuch a rapid rate thatdiscrete 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 andIII, the flutter waves may be quite
prominent, creating a “sawtooth” pattern.Becauseof the volume of atrial impulses, the AV
node allows only some of the impulses to passthrough to the ventricles.In atrial flutter, a 2:1
ratio isthe most common (i.e., forevery two flutter waves, only one impulse passes through the
AV node to generatea QRS complex). Ratios of 3:1 and 4:1 are also frequently seen. - A person suddenly collapses while sitting in the sunroom of a healthcare
facility. A healthcare provider observes the event and hurries over to assessthe situation. The
healthcare provider performs which assessment first?
Answer: A systematic approach to assessment is necessary. The healthcare provider should
first 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, and to check for
responsiveness, breathing and a pulse if the patient appears to be unresponsive.This would be
followed by a primary assessment and then a secondary assessment.
- A 35-year-old female patient’s ECG is consistent with STEMI. The ECG reveals a new STsegment elevation at the J point in leads V2 and V3 of at least which size?
Answer: New ST-segment elevation at the J point in leads V2 and V3 ofat least 0.15 mV (1.5
mm) in women 40 years or younger is considered diagnosticof STEMI. - An ECG strip of a patient in the emergency department revealsthe followingrhythm. Which
feature would the healthcare provider interpret as indicating atrial fibrillation?
Answer: The two key features of atrial fibrillation on ECG are the absenceof discrete P waves
and the presence of irregularly irregular QRS complexes. - A patient presents to the emergency department with mild to moderate re-current chest
pain,without any nausea or vomiting.A 12-lead ECG is obtainedand shows ST-segment
depression with transient T-wave elevation indicativeof NSTE-ACS.Cardiac enzyme levels are
obtained and are not elevated.Thesefindings suggest which condition?
Answer: A patient who presents with ECG findings consistent with NSTE-ACS and does not
have elevated cardiac serum markersistobe considered as having unstable angina. - A healthcare provider is establishing cardiac monitoring using a five-electrode system.The
healthcare provider demonstrates proper use of the systemby placing the green electrode in
which location?
Answer: In a five-electrode cardiac monitoring system, the green electrode should be placed
on the lower right abdomen. - 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 air- way patency.Which statement indicates that the team
performed high-qualityCPR?
Answer: When an advanced airway has been placed in a patient who is in cardiac arrest,
compressions and ventilations are delivered continuously with no interruptions.One provider
delivers 1 ventilation every 6 seconds, while the second providerperforms compressions at a
rate of 100 to 120 compressions per minute. - A patient’s capnogram reveals the following waveform. Which segment would the
healthcare provider interpret as reflecting the beginning of exhalation?
Answer: The A-B segment is the respiratory baseline that represents the beginningof
exhalation. - A patient arrives at the emergency department complaining of shortnessof breath. The
patient has a long history of chronic obstructive pulmonary disease. Assessment reveals
respiratory failure.Which action would be the
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ACLS Final Test ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- 1. Which type of atrioventricular block best describes this rhythm?
Answer: C)Second-degree type II - 2. Your patient is in cardiac arrest and has been intubated.To assess CPRquality, which
should you do?
Answer: A) Monitor the patient’s PETCO2 - 3. Which facility is the most appropriate EMS destination for a patient with sudden cardiac
who achieved return of spontaneous circulation in thefield?
Answer: D) Coronary reperfusion-capable medical center - 4. Which of the following signs is a likely indicator of cardiac arrest in anunresponsive
patient?
Answer: C) Agonal gasps - 5. Which type of atrioventricular block best describes this rhythm?
Answer: B)Second-degree atrioventricular block type I - 6. To properly ventilate a patient with a perfusing rhythm, how often do yousqueeze the
bag?
Answer: B) Once every 5 to 6 seconds. - 7. In addition to clinical assessment, which is the most reliable method to confirm and
monitor correct placement of an endotracheal tube?
Answer: C) Continuous waveform capnography - 8. 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.Whichtreatment is the best for this patient?
Answer: B) Start fibrinolytic therapy as soon as possible. - 9. Which best describes this rhythm?
Answer: D) Third-degree atrioventricular block.- What is the recommended range from which a temperature should be selected and
maintained constantly to achieve targeted temperature management after cardiac arrest?
Answer: C) 32 to 36 Degrees Celsius
- Which is the recommended first intravenous dose of amiodarone for a patient with
refractory ventricular fibrillation?
Answer: D) 300 mg
- What is the primary of a medical emergency team or rapid responseteam?
Answer: B) Improving patient outcomes by identifying and treating early clinical
deterioration.
- What is the recommended next step after a defibrillation attempt?
Answer: D)Resume CPR, starting with chest compressions
- EMS providers are treating a patient with suspected stroke. Accordingto the Adult
Suspected Stroke Algorithm, which critical action performed by the EMS team will expedite
this patient’s care on arrival and reduce the time to treatment?
Answer: A) Alert the hospital.
- A responder is caring for a patient with a history of congestive heartfailure.The
patient is experiencing shortness of breath, a blood pressure of 68/50 mmHg, and a heart rate
of 190/min.The patient’s lead II ECG is displayed here.Which best characterizes this patient’s
rhythm?
Answer: D) Unstablesupraventricular tachycardia
- Your rescue team arrives to find a 59-year-old man lying on the kitchenfloor. You
determine that he is unresponsive. Which is the next step in your assessment and management
of this patient?
Answer: B) Check the patient’s breathingand pulse.
- Which best describes the length of time it should take to perform apulse check during
the BLS assessment?
Answer: B) 5 to 10 seconds
- You instruct a team member to give 1 mg Atropine IV.Which is the bestexample of
closed-loop communication?
Answer: C) I’ll draw up 1 mg of Atropine.
- What is an effect of excessive ventilation?
Answer: A) Decreased cardiac output.
- If a team member is about to make a mistake during a resuscitation attempt, which
best describes the action that the team leader or other teammembers should take?
Answer: C) Address the team members immediately.
- What is the recommended range from which a temperature should be selected and
- 21.Which best describesthisrhythm?
Answer: A) Monomorphic ventriculartachycardia.- For STEMI patient, which best describes the recommended maximum goal time for
emergency department door-to-balloon inflation time for percutaneous coronary intervention?
Answer: D) 90 minutes.
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- For STEMI patient, which best describes the recommended maximum goal time for
ACLS Final Test ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- Cardiac monitoring of a patient in cardiac arrest reveals ventricular fibrillation. In addition
to high-quality CPR,what intervention should be a priority forthe team?
Select the correct answer to this question.
Defibrillation.
Insert an advanced airway.
Initiate capnography.
Perform a pulse check.
Answer: Defibrillation. - A patient with suspected stroke arrives at the emergency department. Thepatient is
diagnosed with acute ischemic stroke and is a candidate for fibrinolytic therapy.To achieve the
best outcomes, this therapy should be initiatedwithin what time frame?
Within 30 minutes of the patient’s arrival
Within 1 hour of the patient’s arrival
Within 2 hours of the patient’s arrival
Within 3 hours of the patient’s arrival
Answer: Within 1 hour of the patient’s arrival
For patients with ischemic stroke who meet the eligibility criteria, fibrinolytic therapyis the
first-line treatment. Administration of IV recombinant tissue plasminogen activator (rtPA)
within 1 hour of the patient’s arrival and within 3 hours of the onsetof signs and symptoms is
optimal. - A 35-year-old female patient’s ECG is consistent with STEMI. The ECG reveals a new STsegment elevation at the J point in leadsV2 andV3 of at leastwhich size?
0.10 mV
0.15 mV
0.2 mV
0.25 mV
Answer: 0.15 mV - A 28-year-old pregnant patient who residesin transitional housing presentsto the emergency
department with complaints of feeling feverish and very faint.The patient tells the emergency
nurse that she does not know when shebecame pregnant.Upon palpation,the fundusis not at or
above the umbilicus.The patient’s condition quickly deteriorates and she goes into cardiac
arrest.If available and able to be used without impeding or delaying the resuscitationeffort,what
diagnostic tool could be used to guide decision-making in the care of this patient?
Abdominal radiograph
Fetal monitoring
Point-of-care ultrasound
Fetal echocardiogram
Answer: Point-of-care ultrasound
Gestational age is an important consideration when determining the approach to a pregnant
patient in cardiac arrest. If the gestational age is not known and point-of-care ultrasound is
available and able to be performed without impeding ordelaying the resuscitation effort, it can
be used to quickly estimate gestational ageand guide decision-making.
- An ECG strip of a patient in the emergency department revealsthe followingrhythm. Which
feature would the healthcare provider interpret as indicating atrial fibrillation?
Presence of flutter waves and sawtooth patterns
Narrow QRS complex with PP interval constant or slightly irregular
Absence of discrete P waves and presence of irregularly irregular QRS complexes
Presence of wide QRS complexes that are bizarrely and consistently shapedAnswer: Absence of discrete P waves and presence of irregularly irregular QRS complexes - 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?
Pneumothorax
Hypertension
Esophageal injury
Rib fracture
Answer: Pneumothorax - Which statements accurately reflect the recommendations for post-cardiacarrest patient
care?
Select all correct options that apply.
Perfusion should be assessed and maintained to ensure the best outcome for the post-cardiac
arrest patient.
Arterial blood gases may be used to guide ventilation and oxygenation in the
post-cardiac arrest patient.
Targeted temperature management (TTM)should not be initiated in a post-cardiac arrest patient
who is receiving mechanical circulatory support.
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ACLS Healthcare Provider ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- Within the first 10 minutes, on the basis of the patient showing symptomssuggestive of
myocardial ischemia, what will your first actions include (if notcompleted by EMS before
arrival)?
o Obtain a 12-lead electrocardiogram (ECG)
o Administer a blood thinner
o Administer aspirin and establish IV access
o Activate the ST-segment elevation myocardial infarction (STEMI) team
o If SPO2 is less than 90%, start oxygen
o Assess airway, breathing, and circulation (ABCs)
o Administer epinephrine 1 mg IV
o Consider nitroglycerin, morphine and a P2Y inhibitor
Answer:
o Obtain a 12-leadelectrocardiogram (ECG)
o Administer aspirin and establish IV access
o Activate the ST-segment elevation myocardial infarction (STEMI) team
o If SPO2 is less than 90%, start oxygen
o Assess airway, breathing, and circulation (ABCs)
o Consider nitroglycerin, morphine and a P2Y inhibitor - His initial vital signs are HR 120/min, BP 135/88 mm Hg, RR 23/min, SpO287%, and
temperature 37.3C. When considering oxygen saturation, what is your course of action?
o Intubate the patient immediately
o Administer albuterol nebulizer
o Do not start oxygen
o Start oxygen at 4L/min via nasal cannula
Answer: o Start oxygen at 4L/min via nasalcannula - What additional question help you determine next steps?
o Do you take any medication?
o Do you have any allergies?
o When was the last time you went to the doctor?
o When did the symptoms start?
o Have you had any recent falls?
Answer:
o Do you take any medication?
o Do you have any allergies?
o When did the symptoms start? - Your patient continues to say that he has chest discomfort.What treatmentcan you repeat as
long as it is not contradicted by vital signs?
o Morphine sublingual every 1 to 3 minutes
o Morphine IV every 1 to 3 minutes
o Nitroglycerine sublingual or translingual every 3 to 5 minutes
o Nitroglycerine every 1 to 3 minutes
Answer: o Nitroglycerine sublingual or translingualevery 3 to 5 minutes - What is your interpretation of the patient’s ECG tracing?
o Anterior ST-segment elevation of myocardial infarction (STEMI)
o Ventricular tachycardia
o Posterior ST-segment elevation myocardial infarction (STEMI)
o Normal sinus rhythm with premature ventricular contractions
Answer: o AnteriorST-segment elevation of myocardial infarction (STEMI) - With the diagnosis of STEMI, what is the most probable treatment?
o Release to home
o Admission to an intensive car unit
o Admission for observation
o Admission for PCI or fibrinolysis
Answer: o Admission for PCI or fibrinolysis - What is your goal for PCI when treating this patient?
o Door-to-balloon inflation time of 30 minutes
o First medical contact-to-balloon inflation time of 90 minutes
o Door-to-needle time of 90 minutes
o First medical contact-to-needle time of 30 minutes
Answer: o First medical con-tact-to-balloon inflation time of 90 minutes - The patient’s vital signs show HR 92/min, RR 14/min, BP 130/86 mm Hg, SpO2 97%, and
atrial fibrillation on the monitor. What additional assessmentand stabilization activities should
be completed with the first 10 minutes afterthe patient’s arrival?
o Establish IV access
o Order an emergent CT scan or MRI of the brain and review patient history
o Monitor for worsening symptoms
o Activate the stroke team
o Complete neurologic screening
o Check glucose
o Administer O2
Answer:
o Establish IV access
o Order an emergent CT scan or MRI of the brain and review patient history
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ACLS Heartcode ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- in cardiac arrest when do you first introduce medical intervention? whichdrug?
Answer:
after 2 rounds of CPR/shock
after 2nd shock give 1 mg epinephrine every 3-5 minutes - when do you introduce amiodarone during cardiac arrest?
Answer:
after the 3rdshock give 300 mg bolus of amiodarone
if second dose is needed give 150mg as second dose - what rhythms are shockable in cardiac arrest
Answer: VFVT - what rhythms are not shockable in cardiac arrest
Answer: asystolePEA - if you are in an unshockable rhythm arrest when do you give epi
Answer: 1mg epievery 3-5 minutes after 1st round of CPR - what do you do after return of spontaneous circulation
Answer: maintain O2 sat at94%
treat hypotension (fluids vasopressor)12 lead EKG
if in coma consider hypothermia
if not in coma and ekg shows STEMI or AMI consider re-perfusion - what are the 5 h’s and 5 t’s
Answer: hypovolemiahypoxia
hydrogen ion (acidosis)hypo/hyperkalemia hypothermia
tension pneumothoraxtamponade, cardiac toxins
thrombosis, pulmonarythrombosis, coronary - how do you treat non-symptomatic bradycardia
Answer: monitor and observe - what constitutes symptomatic bradycardia
Answer: hypotensionaltered mental status
signs of shockchest pain
acute heart failure - how do you treat symptomatic bradycardia
Answer: - give 0.5mg atropine every 3-5mins to max of 3mg
if that doesn’t work try one of the following:
transcutaneous pacing
2-10mcg/kg / minute dopamine infusion
2-10mcg/minute epinephrine infusion - what is considered a tachycardia requiring treatment
Answer: over 150 per minute - when do you consider cardioversion
Answer: if persistent tachycardia is causing:hypotension
altered mental statussigns of shock
chest pain
acute heart failure - if persistent tachycardia does not present with symptoms what do youneed to consider
Answer: wide QRS?
greater than 0.12 seconds - If persistent tachycardia without symptoms DOES have a wide QRS whatto do you do?
Answer: IV access and 12 lead if available
6mg adenosine followed by NS flush only IF regular and monomorphicconsider antiarrhythmic infusion:
- 20-50mg/min procainamide (max 17mg/kg)
- 150mg amiodarone over 10 minutes
- 100mg sotalol over 5 minutes
- which anti-arrhythmic drugs can be used if prolonged QT
Answer: only amiodarone
150mg over 10 minutes, repeat if VT occurs
follow by maintenance infusion 1mg/min for first 6 hours - if persistent tachycardia withoutsymptoms and without wide QRS what doyou do
Answer: IV access and 12 lead EKG if available
vagal maneuvers
6mg adenosine followed by NS flush only IF regularBeta blocker or calcium channel blocker
- patient comes in with symptoms of ACS what do you do first
Answer:
chew 325mgaspirin
O2
nitro morphine
get 12 lead EKGIV access - IF ACS patient has EKG showing ST elevation and symptoms are lessthan12 hours then
what
Answer: re-perfusion
door to balloon 90 minutesdoor to needle 30 minutes - If ACS patient has EKG showing non ST elevation MI or high risk unstableangina then
what
Answer: early invasive strategy?
adjunctive treatment?
-nitroglycerin
-heparin
-beta blockers
-clopidogrel
-glycoprotein IIb / IIIa inhibitor - what are the contraindications to fibrinolytics in ACS treatment
Answer:
systolic >180
diastolic > 100
right arm left arm systolic difference > 15
history of structural central nervous system diseaserecent head/facial trauma
stroke more than 3 hours or less then 3 months agorecent trauma, surgery or bleed
any history of intracranial hemorrhage bleeding, clotting problem or on blood thinnersserious
systemic disease - adenosine
Answer: used in tachy
6mg bolus followed by 20mL normal saline
12mg can be used after 1-2 minutes
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ACLS Post Test ( Updated 2024 )
Complete Questions & Answers (Solved) 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-balloon-inflation time forPCI?
a. 150 mins
b. 180 mins
c. 120 mins
d. 90 mins
Answer: 90 mins - Which is the recommended oral dose of ASA for a pt w/ suspected ACS?
a. 81 mg
b. 325-650 mg
c. 160-325 mg
d. 40 mg
Answer: 160-325 mg - chest compressions during for adult rate
Answer: 100-120/min - effect of excessive ventilation
a. decresed cardiac output
b. decreased intrathoracic pressure
c. increased perfusion pressure
d. increased venous return
Answer: decreased cardiac output - temperature to achieve targeted temperature management after cardiacarrest
Answer: 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 is the 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
d. the patient meets the criteria for termination of efforts
Answer: a. chest compressionmay not be effective
- Your patient is in cardiac arrest and has been intubated. to assess CPRquality, you should
Answer: monitor the patient’s PETCO2 - In addition to clinical assessment, which is the most reliable method to confirm & monitor
correct placement of an endotracheal tube?
Answer: continouswaveform capnography - A 45M had coronary artery stents placed 2 days ago.Today he is in severedistress and
reporting “crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial
pulse is very weak, blood pressure is 64/40,respiratory is 28 bpm/min and O2 set is 89% on
room air.
Answer: answer hasto do withacute coronary syndrome - A 45M had coronary artery stents placed 2 days ago.Today he is in severedistress and
reporting “crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial
pulse is very weak, blood pressure is 64/40,respiratory is 28 bpm/min and O2 set is 89% on
room air. When applied, the cardiac monitor initially showed ventricular tachycardia, which
then quickly changed to ventricular fibrillation.What do we do?
a. chest compression
b. vasoactive meds
c. vascular access
d. advanced airway
Answer: a. chest compression - A 45M had coronary artery stents placed 2 days ago.Today he is in severedistress and
reporting “crushing” chest discomfort. He is pale, diphoretic, and cool to the touch. His radial
pulse is very weak, blood pressure is 64/40,respiratory is 28 bpm/min and O2 set is 89% on
room air. Despite 2 defib attempt, the patient remains in V-fib.Which drug & dose should be
given?
a. lidocaine 1 mg/kg
b. amiodarone 300mg
c. epi 1mg
d. atropine 1 mg
Answer: epi 1 mg
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ACLS Practice Exam ( Updated 2024 )
Complete Questions & Answers (Solved) 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 14breaths/min, and the pulse
oximetry reading is 97%.What assessment step ismost important now?
Answer: Obtaining a 12 lead ECG. - What isthe preferred method of accessfor epi administration during cardiacarrest 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 leadII rhythm
below, and the patient has no pulse. Another member of your teamresumes 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 compressions?
Answer: Allowingcomplete chest recoil - Which action increases the chance of successful conversion of ventricularfibrillation?
Answer: Providing quality compressions immediately before a defibrillation attempt. - Which situation BEST describes pulseless electrical activity?
Answer: Sinus rythmwithout 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 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 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.Afterthe firstshock,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 medical control. - 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 chest com-pressions during
CPR?
Answer: Continue CPR while charging the defibrillator. - Which action is included in the BLS survey?
Answer: Early defibrillation - Which drug and dose are recommended for the management of a patientin refractory
ventricular fibrillation?
Answer: Amioderone 300mg - What is the appropriate interval for an interruption in chest compressions?
Answer: 10 seconds or less - Which of the following is a sign of effective CPR?
Answer: PETCO2 e10 mm Hg
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ACLS Practice Questions 2 ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- Rate of chest compressions for adults
Answer: 100-120 compressions per minute - Ratio of compressions to breaths in adults
Answer: 30:2 - Rate of bag valve mask ventilation for adults in respiratory arrest
Answer: Onceevery 5-6 seconds or 10-12 times per minute - Treatmentsfor hypotension following cardiac arrest
Answer:
IV dopamine infusion, IVepinephrine infusion
IV Ringer’s lactate, IV normal saline - Recommended ED door-to-balloon inflation time for a STEMI patient
Answer: Nolonger than 90 minutes - Waysto estimate effectiveness of CPR
Answer: Arterial diastolic blood pressure, quantitative waveform capnography, central venous
oxygen saturation - Best drug used for narrow complex supraventriculartachycardia
Answer: Adenosine - Drug used for pulseless electrical activity
Answer: Epinephrine - Sequence of basic life support
Answer: Compressions, airway, breathing (CAB) - Initial dose of adenosine for treatment of supraventricular tachycardia
Answer: 6mg IV - Heart rate at which tachycardia usually becomes symptomatic
Answer: 150 bpm - Longest duration for pulse check
Answer: 10 seconds - Recommended initial dosage of atropine forsymptomatic bradycardia
Answer: 0.5mg IV - Recommended dose of oxygen during CPR
Answer: 100% - Goal for initiation of fibrinolytic therapy in stroke patients
Answer: Within 1 hour ofED arrival - Common reversible causes of cardiac arrest (“H’s andT’s”)
Answer: Hypotension,hypoxia, hypothermia, hydrogen ions (acidosis), hypo-/hyperkalemia
Tension pneumothorax, tamponade, thrombosis (coronary), thrombosis (pulmonary), toxins - Best option for treatment of STEMI diagnosed in ambulance via 12-leadECG
Answer: Transport to PCI-capable hospital - Components of Cincinnati Prehospital Stroke Scale (CPSS)
Answer: Facial droop,arm drift, speech abnormality - Asystole should be treated with all of the following EXCEPT
Answer:
CPR
Ventilations
Defibrillation
Epinephrine: Asystole should be treated with all of the following
EXCEPT:
CPR
Ventilations
DefibrillationEpinephrine - Appropriate response to an AED that is having problems analyzing rhythmAnswer: Continue chest compressions
- Which of the following is treated with synchronized shocks?
Unstable atrial fibrillation
Sinus tachycardia
VT without a pulse
VF: Which of the following is treated with synchronized shocks?
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ACLS Practice Questions ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- What element of a system of care is represented by properly functioningresuscitation
equipment?
System
Structure
Process
Patient outcome
Answer: Structure - What is the first link in the out-of-hospital cardiac arrest (OHCA) chain ofsurvival?
Activation of emergency response
Defibrillation
Advanced resuscitation
High-quality CPR
Answer: Activation of emergency response - What are signs of clinical deterioration that would prompt the activation ofrapid response
system?
Symptomatic hypertension
Seizure
Unexplained agitation
Diastolic blood pressure greater than 60 mm Hg or less than 100 mm Hg
Answer: –
Symptomatic hypertension
Seizure
Unexplained agitation - What is the primary purpose of a rapid response team (RRT) or medicalemergency team
(MET)?
To provide diagnostic consultation to emergency department patients
To improve care for patients admitted to critical care units
To improve patient outcomes by identifying and treating early clinical deterioration
To provide online consultation to emergency medical services personnel inthe field
Answer: To improve patient outcomes by identifying and treating early clinical deterioration - What happens when teamsrapidly assess and intervene when patients haveabnormal vital
signs?
Morbidity and mortality rates are maintained
The number of out of hospital cardiac arrest increases
The number of in hospital cardiac arrest decreases
Morbidity and mortality rates increase
Answer: The number of in hospital cardiac arrestdecreases - In addition to decreased IHCA, what are some other benefits of implementing a rapid
response system? Select all that apply
Decreased ICU length of stay
Decreased emergency department admissions
Increased ICU admissions
Increased Hospital Length of Stay Decreased in total hospital length of stay: - Which is the main advantage of effective teamwork?
Early defibrillation
Division of tasks
Mastery or resuscitation skills
Immediate CPR
Answer: Division of tasks - Which is the best example of a role of the team leader?
Proficient at endotracheal intubation
Does not over ventilate the patient
Performs within scope of practice
Models excellent team behavior
Answer: Models excellent team behavior - Which is the best example of a role of a team member?
Monitors individual team members
Helps train future team leaders
Focuses on comprehensive patient care
Prepared to fulfill their role responsibilities
Answer: Prepared to fulfill their role responsibilities - What is the primary purpose of the CPR coach on a resuscitation team?
Recording CPR data
Resolving team conflicts
Increasing CPR quality
Giving encouragement
Answer: Increasing CPR quality - What are the 6 positions for high performance teams in resuscitation?
Answer: – Team leader Airway Timer/recorder
Compressor (rotate every 2 minutes)Monitor/defibrillator/cpr coach IV/IO/Medications - Which member of the high performance team has the responsibility forassigning roles
(positions)?
Compressor
Time/recorder
Airway
Team leader
Answer: Team leader - Which high performance team member is part of the resuscitation triangle?
Timer/recorder
Monitor/defibrillator/Cpr coach
IV/IO/medications
Team leader
Answer: Monitor/defibrillator/cpr coach - Which is an example of knowledge sharing by a team leader?
Changing a treatment strategy when supported by new information
Maintaining an ongoing record of treatments
Asking for suggestions about interventions
Asking the compressor to decrease or increase rate
Answer: Asking for suggestionsabout interventions - Which is an example of summarizing and reevaluating?
“1mg of epinephrine given”
Questioning a colleague who is about to make a mistake”Compressions are at a good rate”
Increasing monitoring if the patients condition deteriorates
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ACLS Practice Exam ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- Some clues for PEA caused by acidosis (hydrogen ion) would be allof the below except:
clues for PEA caused by acidosis (hydrogen ion) wouldbe all of the below except: - recent trauma
- history of diabetes
- renal failure
- smaller-amplitude QRS complexes
Answer: 1 (Recent trauma, think about H’s and T’s) - Recommended treatment to reverse PEA caused by acidosis is:
- adequate ventilation
- sodium bicarbonate
- normal saline bolus
- both 1 and 2
Answer: 2 (Providing adequate ventilation and administration of socium bicarbonate both can
help reverse PEA related to acidosis) - PEA caused by HYPERkalemia may present with which of the followingrhythm changes?
- narrow QRS complex,smaller P-waves, andT- waves taller and peaked
- wide QRS complex, taller P-waves, andT-waves taller and peaked
- wide QRS complex, smaller P-waves, andT-waves taller and peaked
- narrow QRS complex,smaller P-waves, andT-waves smaller and rounded
Answer: 3(All of the following ECG changes can be seen in the patient with PEA caused by
hyperkalemia: T waves that are taller and peaked, P waves that become smaller, Widened
QRS, Sine-wave PEA (PEA rhythm has a sign-wave appearance) - Patients that you might more commonly see with PEA caused by HYPER-kalemia are all
the following except which one? - renal failure
- diabetes
- elderly
- dialysisrecipient
Answer: 3 (Elderly, Any condition that involvesrenal function can placea patient at a higher
risk for hyperkalemia. Renal failure, diabetes, recent dialysis, dialysis fistulas, and certain
medications can put patients at risk for hyperkalemia) - Reversing HYPERkalemia is done using which of the following medications?
- sodium bicarbonate
- glucose and insulin
- albuterol
- any of the above
Answer: 4 (CPR & ECC Guidelines: Part 10 Special Circumstances, Hyperkalemia (11.2.1)
These three medications shift potassium intracellularly andenhance potassium elimination) - PEA caused by HYPOkalemia may present with which if the following symptoms?
- flattenedT-waves, prominent U waves, wide QRS, prolonged QT
- peakedT-waves, prominent U waves, narrow QRS, prolonged QT
- flattenedT-waves, prominent U waves, narrow QRS,shortened QT
- peaked T-waves, non-visible U waves, wide QRS, prolonged QT
Answer: 1 ( All of the following ECG changes can be seen with hypokalemia induced PEA:
FlattenedT-waves, prominent U waves, Wide QRS, prolonged QT, or wide complex
tachycardia) - Patients that you might more commonly see with PEA caused by HY-POkalemia are:
- diabetic patients
- patients using diuretics
- patients with chest pain
- all ofthe above
Answer: 2 (patients using diuretics.Many diureticsincrease the excretionof potassium which
can increase the risk of hypokalemia.) - A clue that PEA could be caused by drug overdose “Toxins” is:
- narrow QRS complex
- prolonged QT interval
- tachycardia
- tracheal deviation
Answer: 2 (prolonged QT. Various effects can be seen on an ECG with drug overdose, but the
most common ECG change is the prolongation of theQT interval.) - (True or False)
In patients with PEA/cardiac arrest and without known pulmonary embolism(PE), routine
fibrinolytic treatment given during CPR shows no benefit and is not recommended.
Answer: True (Special Circumstances of Resuscitation Pulmonary
Embolism: “routine fibrinolytic treatment given during CPR shows no benefit and is not
recommended.” also “In patients with cardiac arrest due to presumed or known pulmonary
embolism, it is reasonable to administer fibrinolytics.”)
- Reversing PEA caused byTamponade is performed by:
- chest tube placement
- emergency surgery
- pericardiocentesis
- needle decompression
Answer: 3 (pericardiocentesis. Cardiac tamponade is a condition in which an accumulation of
fluid within the pericardium creates excessive pressure, which then prevents the heart from
filling normally with blood. This can critically decrease the amount of blood that is pumped
from the heart, which can belethal.The removal of the excess fluid reverses this dangerous
process.) - Tension pneumothroax which can be a cause of PEA may be recognizedby all of the
following symptoms except: - unequal breath sounds
- neck vein distension
- wide QRS complex on ECG
- tracheal deviation
Answer: 3 (Major symptoms of PEA associated with tension pneumothorax include unequal
breath sounds, difficulty with ventilation and neck vein distention.Most common seen during
CPR will be difficulty with ventilation.This willalso more commonly be associated with chest
trauma.) - The “T” in PEA representing Acute MI or massive pulmonary embolismstands for .
- tamponade
- thrombosis
- thoracic
- tension pneumothorax
Answer: 2 (thrombosis. ) - PulmonaryThrombosis (massive pulmonary embolism) induced PEA maymanifest itself
with which symptoms? - no pulse with CPR
- distended neck veins
- narrow QRS complex on ECG
- all of the above
Answer: 4 (All of the above)
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ACLS Pre-Course Self-Assessment ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- A monitored patient in the ICU developed a sudden onset of narrow-com-plex 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 supraventricular
tachycardiawith no evidence of ischemia or infarction. The heart rate has not respondedto
vagal maneuvers.What is your next action?
Administer amiodarone 300 mg IV push
Administer adenosine 6 mg IV push
Perform synchronized cardioversion at 200 J
Perform synchronized cardioversion at 50 J
Answer: Administer adenosine 6 mg IV push - You are caring for a 66-year-old man with a history of a large intracerebralhemorrhage 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 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?
Aspirinrt
PA
Glucose (D50)
Nicardipine
Answer: Aspirin - A patient isin pulseless ventricular tachycardia.Two shocks and 1 dose ofepinephrine have
been given.Which drug should be given next?
Epinephrine 3 mg
Lidocaine 0.5 mg/kg
Amiodarone 300 mg
Adenosine 6 mg
Answer: Amiodarone 300 mg - A patient with possible STEMI has ongoing chest discomfort.What is acontraindication
to nitrate administration?
Heart rate less than 90/min
Use of a phosphodiesterase inhibitor within the previous 24 hours
Anterior wall myocardial infarction
Systolic blood pressure greater than 180 mm Hg
Answer: Use of a phosphodiesteraseinhibitor within the previous 24 hours
- A patient is in cardiac arrest. High-quality chest compressions are beinggiven. The patient
is intubated, and an IV has been started. The rhythm is asystole.What is the first drug/dose to
administer?
Dopamine 2 to 20 mcg/kg per minute IV/IO
Atropine 1 mg IV/IO
Epinephrine 1 mg IV/IO
Atropine 0.5 mg IV/IO
Answer: Epinephrine 1 mg IV/IO - 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 theteam leader.Which medication do you order
next?
Epinephrine 1 mg
A second dose of the antiarrhythmic drug
Epinephrine 3 mg
Sodium bicarbonate 50 mEq
Answer: Epinephrine 1 mg - Which intervention is most appropriate for the treatment of a patient inasystole?
Atropine
Transcutaneous pacing
Defibrillation
Epinephrine
Answer: Epinephrine - A patient with sinus bradycardia and a heart rate of 42/min has diaphoresisand a blood
pressure of 80/60 mm Hg.What is the initial dose of atropine?
0.1 mg
1 mg
3 mg
0.5 mg
Answer: 1 mg - A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IVbolus 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, which was treated 5 years ago.What is your next
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ACLS Precourse Work ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- Lesson1: system of care. Which quality improvement component of systems of care best
describes the capture and review of data related to resuscitation education, processes, and
outcomes?
Answer: Measurement - Lesson1: system of care. Which one of the following is an interdependentcomponent of
systems of care?
Answer: Structure - Lesson2: Science of Resuscitation. What is an effect of excessive ventilation?
Answer: decreased CO - Lesson2: Science of Resuscitation.Which is the maximum interval youshould allow for an
interruption in chest compressions?
Answer: 10 s - Lesson2: Science of Resuscitation. Which is the recommended next stepafter a
defibrillation attempt?
Answer: Resume CPR, starting with chest compressions - Lesson2: Science of Resuscitation. How does complete chest recoil con-tribute to effective
CPR?
Answer: Allows maximum blood return to the heart - Lesson3: Systematic Approach. What is an advantage of a systematic approach to patient
assessment?
Answer: Reduces the chances of missing important signsand symptoms - Lesson3: Systematic Approach. What is the first step in the systematicapproach to patient
assessment?
Answer: Initial impression - Lesson3: Systematic Approach. Which action is part of the Secondary Assessment of a
conscious patient? Which action is part of the Secondary Assessment of a conscious patient?
Answer: Formulate a differential diagnosis - Lesson3: Systematic Approach. Which is one of the H’s and T’s that rep- resent a
potentially reversible cause of cardiac arrest and other emergency cardiopulmonary
conditions?
Answer: Hypothermia - Lesson4:CPR Coach. What should be the primary focus of the CPR Coachon a
resuscitation team?
Answer: To ensure high-quality CPR - Lesson4:CPR Coach. The CPR Coach role can be blended into which ofthefollowing
roles?
Answer: The monitor/defibrillator - Lesson4: CPR Coach. Which of the following is a responsibility of the CPRCoach?
Answer: Coordinating compressor switches - Lesson 5:High Quality BLS Part 1.What isthe recommended compressionrate for highquality CPR?
Answer: 100 to 120 - Lesson 5: High Quality BLS Part 1.Which best describes the length of timeit should take to
perform a pulse check during the BLS Assessment?
Answer: 5-10 seconds - Lesson 5: High Quality BLS Part 1.Which is a component of high-qualityCPR?
Answer: Compression depth of at least 2 inches - Lesson 5: High Quality BLS Part 1.Which component of high-quality CPRdirectly affects
chest compression fraction?
Answer: Interruptions - Lesson6: Airway Management. pg 103.To properly ventilate a patient witha perfusing
rhythm, how often do you squeeze the bag?
Answer: Once every 6 seconds - Lesson6: Airway Management. pg 103.Which is an acceptable method of selecting an
appropriately sized oropharyngeal airway?
Answer: Measure from thecorner of the mouth to the angle of the mandible - Lesson6: Airway Management. pg 103. Which action is likely to cause air to enter the
victim’s stomach (gastric inflation) during bag-mask ventilation?-
Answer: Ventilating too quickly - Lesson6: Airway Management. pg 103. In addition to clinical assessment, which is the
most reliable method to confirm and monitor correct placementof an endotracheal tube?
Answer: Continuous waveform capnography - Lesson 7: Recognition: Signs of Clinical Deterioration. pgs27-28.What arethe 3 signs of
clinical deterioration that would cause activation of a rapid response system?
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ACLS Pretest ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- Please identify the rhythm by selecting the bestsingle answer.
Answer: SinusBrady-cardia - Please identify the rhythm by selecting the best single answer.
Answer: Reentrysupraventricular tachycardia - Please identify the rhythm by selecting the best single answer.
Answer: Second-degree AV block (Mobitz II block) - Please identify the rhythm by selecting the best single answer.
Answer: Agonalrhythm/asystole - Please identify the rhythm by selecting the bestsingle answer.
Answer: Third-DegreeAV block - Please identify the rhythm by selecting the best single answer.
Answer: Monomorphic Ventricular Tachycardia - Please identify the rhythm by selecting the bestsingle answer.
Answer: SinusTachy-cardia - Please identify the rhythm by selecting the bestsingle answer.
Answer: SinusBrady-cardia - Please identify the rhythm by selecting the best single answer.
Answer: Atrial Fibrillation - Please identify the rhythm by selecting the best single answer.
Answer: CourseVentricular Fibrillation - Please identify the rhythm by selecting the best single answer.
Answer: Polymorphic Ventricular Tachycardia - Please identify the rhythm by selecting the bestsingle answer.
Answer: Second-degree AV block (Mobitz I Wenchebach) - Please identify the rhythm by selecting the best single answer.
Answer: NormalSinus Rhythm - Please identify the rhythm by selecting the best single answer.
Answer: Pulselesselectrical activity - Please identify the rhythm by selecting the best single answer.
Answer: CourseVentricular Fibrillation - Please identify the rhythm by selecting the best single answer.
Answer: Reentrysupraventricular tachycardia - Please identify the rhythm by selecting the best single answer.
Answer: Fine Ventricular Fibrillation - Please identify the rhythmby selecting the bestsingle answer.
Answer: Atrial Flutter - Please identify the rhythm by selecting the bestsingle answer.
Answer: Second-degree AV block (Mobitz II block) - Please identify the rhythm by selecting the best single answer.
Answer: Reentrysupraventricular tachycardia - A 57-year-old woman has palpitations, chest discomfort, and tachycardia.The monitor
shows a regular wide-complex QRS at a rate of 180/min. She becomes diaphoretic, and her
blood pressure is 80/60 mm Hg.The next actionis to:
Answer: Perform immediate electrical cardioversion - A patient with a possible acute coronary syndrome has ongoing chest discomfort
unresponsive to 3 sublingual nitroglycerin tablets. There are no contraindications, and 4 mg of
morphine sulfate was administered. Shortly afterward, blood pressure falls to 88/60 mm Hg,
and the patient has increasedchest discomfort.You should:
Answer: Give normal Saline 250 mL to 500 ml fluid bolus - A patient is in pulseless ventricular tachycardia.Two shocks and 1 doseof epinephrine
have been given. Which is the next drug/dose to anticipate administering?
Answer: Amiodarone 300 mg - A patient is in refractory ventricular fibrillation and has received multiple appropriate
defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amidarone IV.
The patient is intubated. A second does of amiodarone is now called for.The recommended
second dose of amiodaroneis
Answer: 150 mg IV push - A 35-year-old woman has palpitations, light-headiness, and a stable tachy- cardia. The
monitor shows a regular narrow-complex QRS at a rate of 180/min.Vagal maneuvers have not
been effective in terminated the rhythm. An IV has been established. What drug should be
administered IV?
Answer: Adenosine 6 mg
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ACLS Quiz ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- Which are the elements of a system of care?
Answer: Structure, processes, system,patient outcome - What element of a system of care is represented by properly functioningresuscitation
equipment?
Answer: Structure - Among others, which factor has been associated with improved survival inpatients with
cardiac arrest?
Answer: Immediate high- quality CPR - What is the first link in the out-of-hospital cardiac arrest (OHCA) chain ofsurvival?
Answer: Activation of emergency response - What are signs of clinical deterioration that would prompt the activation ofa rapid response
system?
Answer: Systemic hypertension, unexplained agitation,seizure - What is the primary purpose of a rapid response team (RRT) or medical emergency team
(MET)?
Answer: To improve patient outcomes by identifying and treatingearly clinical deterioration - What happens when teamsrapidly assess and intervene when patients haveabnormal vital
signs?
Answer: The number of in-hospital cardiac- arrest decreases - In addition to decreased IHCA, what are some other benefits of implementing a rapid
response system?
Answer: Decrease ICU length of stay, decreased in total hospital length of stay - Which component of effective high-performance teams is represented bythe use of realtime feedback devices?
Answer: Quality - What is the main advantage of effective teamwork?
Answer: Division of tasks - Which is the best example of a role of the team leader?
Answer: Models excellentteam behavior - Which is the best example of a role of a team member?
Answer: Prepared to fulfilltheir role responsibilities - What is primary purpose of the CPR coach on a resuscitation team?
Answer: In-creasing CPR quality - Which member of the high-performance team has the responsibility forassigning roles
(positions)?
Answer: Team leader - Which high-performance team member is part of the resuscitation triangle?
Answer: Monitor/ defibrillator/ CPR coach - Which is an example of knowledge sharing by a team leader?
Answer: Asking forsuggestions about interventions - Which is an example ofsummarizing and reevaluating?
Answer: Increasing monitoring of the patient’s condition deteriorates - Which is a step of closed-loop communication?
Answer: Confirming task completionbefore assigning another task - Which are examples of mutualrespect?
Answer:
· Acknowledging correctly completedtasks in a positive way
· Ensuring that only 1 person talks at a time - What are the components of high-quality CPR?
Answer:
· Compression depth of atleast 2 inches (5cm)
· Complete chest recoil after each compression
· Interruptions limited £ 10 seconds
· Switching compressions every 2 minutes
· Avoiding excessive ventilation - Which of the following defines chest compression fraction (CCF)?
Answer: CCF=actual chest compression time/
Total code time - During CPR, chest compression fraction (CCF) should be at least — andideally greater
than 80%.
Answer: 60% - How do interruptions in chest compressions negatively impact survivalafter cardiac
arrest?
Answer: Decrease coronary perfusion pressure - Coronary perfusion pressure (CPP) equals aortic —- pressure minus rightatrial diastolic
pressure.
Answer: diastolic - What is the only intervention that can restore on organize rhythm inpatients with
ventricular fibrillation (VF)?
Answer: Early and effective defibrillation - How quickly does the chance of survival describe for every minute ofdefibrillation delay
in patients with ventricular fibrillation (VF) who do notreceive bystander CPR?
Answer: 7-10% - What is the advantage of a systematic approach to patient assessment?
Answer: -Reduces the chances of missing important signs and symptoms - What is the first step in the systematic approach to patient assessment?-
Answer: Initial impression - What is the maximum amount of time you should simultaneously perform the pulse and
breathing checks?
Answer: 10 seconds - The BLS Assessment is a systematic approach to BLS for trained health- care providers.
This approach stresses:
Answer: Early CPR and defibrillation - While you performing the BLS Assessment, you initiate high-quality CPR and assist
ventilation with a bag-mask device.The AED does not recommenda shock.Which action in the
Primary Assessment should you perform first?-
Answer: Determine if the patient’s airway is patent - The initial assessment reveals a conscious patent. The patient’s airway is patent, and an
advanced airway is not indicated. Which action is the Primary Assessment should perform
next?
Answer: Administer oxygen as needed - Which action is part of the Secondary Assessment of conscious patient?-
Answer: Formulate a differential diagnosis
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ACLS Respiratory Emergencies ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- What does capnography measure?
Answer: Carbon dioxide in expired air - What is the normal range for the ETCO2 value?
Answer: 35-45 mmHg - Which signs of possible respiratory compromise would be noted during therapid
assessment?
Answer:
Difficulty speaking in complete sentences
Tripod positioning
Agitation - Which actions should be performed as part of the primary assessment of apatient with
apparent respiratory compromise?
Answer:
Establish pulse oximetry
Establish capnography
Establish vascular access - When caring for a patient with respiratory compromise, what are the goalsof the secondary
assessment?
Answer:
To possibly discern underlying causes of the respiratory compromise
To further evaluate the severity of the patient’s condition - Which diagnostic tests may be ordered when evaluating a patient withrespiratory
compromise?
Answer: Chest radiograph - What interventions would be appropriate at this time?
Answer:
Administer supple-mental oxygen.
Prepare to suction - What primary assessment data should the team gather at this time?:
Answer
Lungsounds
Capnography
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ACLS Review 2 ( Updated 2024 )
Complete Questions & Answers (Solved) 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 14breaths/min, and the pulse
oximetry reading is 97%.What assessment step ismost important now?
Answer: Obtaining a 12 lead ECG. - What isthe preferred method of accessfor epi administration during cardiacarrest 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 leadII rhythm
below, and the patient has no pulse. Another member of your teamresumes 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 increases the chance of successful conversion of ventricularfibrillation?
Answer: Providing quality compressions immediately before a defibrillation attempt. - Which situation BEST describes pulseless electrical activity?
Answer: Sinus rythmwithout 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 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 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.Afterthe firstshock,the ECG screen displayed
asystole, which has persisted despite 2 doses of
epinephrine, a fluid bolus, and high-qualityCPR.What is your next treatment?-
Answer: Consider terminating resuscitive efforts after consulting medical control. - 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 chest com-pressions during
CPR?
Answer: Continue CPR while charging the defibrillator. - Which action is included in the BLS survey?
Answer: Early defibrillation - Which drug and dose are recommended for the management of a patientin refractory
ventricular fibrillation?
Answer: Amiodarone 300mg - What is the appropriate interval for an interruption in chest compressions?
Answer: 10 seconds or less - Which of the following is a sign of effective CPR?
Answer: PETCO2 e10 mm Hg
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ACLS Review Questions ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- What is the primary purpose of the CPR coach on a resuscitation team?
Answer: -increasing CPR quality - What is the most common type of stroke?
Answer: ischemic stroke - What is a contraindication to the administration of aspirin for the management of a pt with
acute coronary syndromes?
Answer: recent gastrointestinal bleeding - What blood component is acted upon by aspirin administration during themanagement of a
pt with ACS?
Answer: platelets - What is the most appropriate destination for pts with suspected acuteischemic stroke?
Answer: certified stroke center - A 49-year-old man arrives at the emergency department with chest discom- fort. He states
that he was working in the garden this morning when his cheststarted hurting. The last episode
lasted about 25 minutes, and he was sweaty.The chest discomfort is not relieved with rest.
Within the first 10 minutes, on the basis of the pt showing symptoms suggestive of MI, what
will your first actions include (if not completed by EMS beforearrival)?
Answer:
If SpO2 is less than 90%, start oxygen
Obtain a 12-lead EKG
Administer aspirin and establish IV access
Assess ABCs
Consider nitroglycerin, morphine, and a P2Y inhibitor
Activate the STEMI team - His initial VS are HR 120/min, BP 135/88 mmHg, RR 23/min, SpO2 87%, andtemperature
37.3 degrees C.
When considering oxygen saturation, what is your course of action?
Start oxygen at 4L/min via nasal cannula
Do not start oxygen
Intubate pt immediately
Administer albuterol nebulizer
Answer: Start oxygen at 4L/min via nasal cannula
- What additional questions help you determine next steps?
Answer:
When did thesymptoms start?
Do you have any allergies?
Do you take any medication? - Your pt continues to say that he has chest discomfort.
What treatment can you repeat as long as it is not contraindicated by vitalsigns?
Nitroglycerin IV every 1 to 3 mins Morphine sublingual every 1 to 3 mins
Nitroglycerin sublingual or translingual every 3 to 5 mins
Morphine IV every 1 to 3 mins
Answer: Nitroglycerin sublingual or translingual every 3 to5 mins - What is your interpretation of the pt’s EKG tracing?
Answer: Anterior STEMI - With the diagnosis of STEMI, what is the most probable treatment?
Admission for observation Admission for PCI or fibrinolysisAdmission to ICU
Release to home
Answer: Admission for PCI or fibrinolysis - What is your goal for PCI when treating this patient?
First medical contact-to-balloon inflation time of 90 mins
First medical contact-to-needle time of 30 mins
Door-to-needle time of 90 mins
Door-to-balloon inflation time of 30 mins
Answer: First medical contact-to-balloon inflation time of 90 mins - Among others, which of the following factors has been associated withimproved survival
in pts with cardiac arrest?
Immediate high-quality CPR
Presence of 2 or more rescuers
Compression-only CPR
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ACLS Exam Review ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- What are the 6 principles behind AHA’s definition of “High-Quality CPR”. (ie.What needs
to be done to achieve “high-quality” CPR?): High-quality CPRmeans
Answer:
- Rate of at least 100 chest compressions/minute.
- Compression depth of at least 2″ in the adult victim.
- Complete chest recoil after each chest compression.
- Minimizing interruption in compressions.
- Switching providers every 2 minutes (5 cycles of CPR).
- Avoiding excessive ventilations.
- What does the AHA suggest as a target for CPP (coronary perfusion pressure) to increase
the chances of SROC (spont. return of circulation)?
Answer: It is recommended that the CPP be 10mm/Hg to give the best chances for achieving
SROC.
This requires “high-quality CPR”. - An end-tidal CO2 reading of will not achieve ROSC according to
the AHA.
Answer: A PETCO2 reading of 10mm Hg or less indicates poor or inadequate CPP (coronary
perfusion pressure) because chest compressions are not providingadequate circulation to the
lungs to eliminate CO2. - An intra-arterialrelaxation pressure of < indicatesineffective
compressions.
Answer: Intra-arterial relaxation pressures of < 20mmHg correlate with poor CPP (coronary
perfusion pressure) and ineffective compressions. - The recommended sternal compression depth for an adult during resuscitation is inches.
Answer: The recommended sternal compression depth for an adultduring resuscitation is 2
inches.
Keep in mind, there needs to be complete chest recoil or CPP will remain sub-optimal. - AHA recommends that, during resuscitation, the tidal volumes for adults be between and
mmHg.
Answer: Adult Vt’s should be between 500 – 600mmHg which correlates to about 1/2 the
squeeze of an adult ambubag. - What 4 negative consequences of excessive ventilation does the AHAemphasize?
Answer: Excessive ventilation can cause:
- gastric inflation
- increased intrathoracic pressures
- decreased venous return
- overall lower survival
- What are the 5 “critical concepts” for BLS according to the AHA?
Answer: The criticalconcepts are:
- Push hard and fast (100+/min)
- Allow complete chest recoil
- Minimize interruptions in compressions
- Switch providers Q 2 minutes
- Avoid excessive ventilations
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ACLS Study Cards ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- Primary Survey
Answer: ABCD
A-airway
B-breathing
C-circulation
D-defibrilation - Secondary Survey
Answer: IAID
I-intabate (if resp. arrest or can’t get good venitlaiton)
A-access airway
I-IV/IO access for Drugs
D-differential diagnosis (H’s & T’s) - What do you do with a non responsive patient?
Answer: 1st survey, then secondsurvey - Med Administration
Answer:
-IV access: large bore 18 g
-Site: AC
-always flush after med admin - What do you do if AED determines non-shockable rhythm?
Answer: continue chestcompressions - What is PEA?
Answer: Pulseless electrical activity
(ECG shows activity but there is no pulse felt in patient) - ACLS Survey
Answer: ABCD
A-airway
B-breathing
C-circulation
D-defibrilation - ACLS Airway Survey
Answer:
SUPPLEMENTAL OXYGEN when indicated:
-100% for cardiac arrest
-titrate others to achieve >94% O2 sats
MONITOR VENTILATION EFFECTIVENESS by:
-chest rise/fall
-cyanosis
-O2 sats
-waveform capnography
AVOID EXCESSIVE VENTILATION
- How many ventilations do you provide when patient is in cardiac arrest? With an advanced
airway? In respiratory arrest only?
Answer: 2 ventilations every 30compressions
if advanced airway: 1 every 6-8 secondsif respiratory arrest: 1 every 5-6 seconds - What do you do with a non-responsive patient?
Answer: - Shout for help/Activatethe Emergency Response System (get AED)
- Check for Pulse
- Start CPR
- What do you do for a patient who is stable and has chest pain?
Answer:
Moni-tor-support ABC
Be prepared to give CPR & Defib
Admin Aspirin (O2-sats<94%, Nitro, Morphine if needed)
Get 12 lead ECG - Cases NOT to give Nitro
Answer:
hypotension (SBP < 90)
bradycardia (< 50/min)
tachycardia - Nitro Administration
Answer: 1 tablet (or spray dose) every 3-5 minup to total of 3 doses - H’s
Answer:
Hypovolemia
Hypoxia
Hypothermia
Hyper/Hypokalemia
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ACLS Study Guide ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- A 68-year-old woman presents with light-headedness, nausea, and chest discomfort. 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, andher neck veins are flat.Herlung sounds are equal,with moderate rales
presentbilaterally.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 describes this 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 describes this 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 con-firm and monitor
correct placement of an endotracheal (ET) tube?
Answer: Continuouswaveform 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.Whichtreatment approach is best for this patient?
Answer: Start fibrinolytic therapy as soon aspossible - 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 for apatient 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 early clinicaldeterioration - Which is the recommended next step after a defibrillation attempt?
Answer: Resume CPR, starting with chest compressions - EMS providers are treating a patient with suspected stroke. According tothe Adult
Suspected Stroke Algorithm, which critical action performed by theEMS team will expedite
this patient’s care on arrival and reduce the time to treatment?
Answer: Alert the hospital - A responder is caring for a patient with a history of congestive heart failure(CHF).The
patient is experiencing shortness of breath, a blood pressure (BP) of 68/50 mmHg, and a heart
rate of 190/min.The patient’s lead II ECG is displayed here.Which best characterizes this
patient’s rhythm?
Answer: Unstablesupraventricular tachycardia (SVT) - Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You
determine that he is unresponsive. Which is the next step in your assessment and management
of this patient?
Answer: Check the patient’s breathing andpulse - Which best describes the length of time it should take to perform a pulsecheck during the
BLS Assessment?
Answer: 5 to 10 seconds - You instruct a team member to give 0.5 mg atropine IV.Which response isan example of
closed-loop communication?
Answer: “I’ll draw up 0.5 mg of atropine.” - What is an effect of excessive ventilation?
Answer: Decreased cardiac output - If a team member is about to make a mistake during a resuscitation attempt, which best
describes the action that the team leader or other teammembers should take?
Answer: Address the team member immediately
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ACLS Test 2 ( Updated 2024 )
Complete Questions & Answers (Solved) 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 and a 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 isthe preferred method of accessfor epi administration during cardiacarrest 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 below(PEA) and the
pt. has no pulse. You partner resumes chest compressions and an IV is in place. What
management step is your next priority?
Answer: Administer 1mgof epinepherine - During a pause in CPR, you see a narrow complex rythm on the monitor.Thept. 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 compressions?
Answer: Allowingcomplete chest recoil - Which action increases the 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 compressions withoutpauses 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 compressions. During subsequent bentilation, you
notice the presence of a wavefom on thecapnogrophy screen and a PETCO2 of 8 mm Hg.
What is the significance of this finding?
Answer: Chest compressions may not be effective. - The use of quantitative capnography in intubated pt’s does what?
Answer: Allows-for monitoring CPR quality - For the past 25 min, EMS crews have attemptedresuscitation of a pt who originally
presented withV-FIB. After the 1st shock, the ECG screen displayedasystole which has
persisted despite 2 doses of epi, a fluid bolus, and high quality CPR.What is your next
treatment?
Answer: Consider terminating resuscitiveefforts after consulting medical control. - Which is a safe and effective practice within the defibrillation sequence?-
Answer: Be sure O2 is NOT blowing over the pt’s chest during shock. - During your assessment, your pt suddenly loses consciousness. After calling for help and
determining that the pt. is not breathing, you are unsurewhether the pt. has a pulse. What is
your next action?
Answer: Begin chest compressions. - What is an advantage of using hands-free d-fib pads instead of d-fibpaddles?
Answer: Hands-free allows for more rapid d-fib. - What action is recommended to help minimize interruptions in chest com-pressions during
CPR?
Answer: Continue CPR while charging the defibrillator. - Which action is included in the BLS survey?
Answer: Early defibrillation - Which drug and dose are recommended for the management of a pt. inrefractory V-FIB?
Answer: Amioderone 300mg - What isthe appropriate intervalfor an interruption in chest compressions?-
Answer: 10 seconds or less - Which of the following is a sign of effective CPR?
Answer: PETCO2 = or > 10mmHg - What is the primary purpose of a medical emergency team or rapid response team?
Answer: Identifying and treating early clinical deterioration.
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ACLS Test ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- Which quality improvement component of systems of care best describesthe capture and
review of data related to resuscitation education, processes,and outcomes?
Answer: Measurement - Which one of the following is an interdependent component of systems ofcare?
Answer: Structure - Which is the max interval you should allow for an interruption in chestcompressions
Answer: 10 seconds - What is an effect of excessive ventilation?
Answer: Decreased cardiac output - What is the recommended next step after a defibrillation attempt?
Answer: ResumeCPR, starting with chest compressions - How does complete chest recoil contribute to effective CPR?
Answer: Allows maxi-mum blood return to the heart - What is an advantage of a systematic approach to patient assessment?
Answer: -Reduces the changes of missing important signs and symptoms - What is the first step in the systematic approach to patient assesssment?-
Answer: Initial impression - Which action is part of the secondary assessment of a conscious patient?-
Answer: Formulate a differential diagnosis - Which is one of the H’s and T’s that represent a potentially reversible cause of cardiac
arrest and other emergency cardiopulmonary conditions?
Answer: -Hypothermia - What should be the primary focus of the CPR Coach on a resuscitationteam?
Answer: To ensure high quality CPR - TheCPRCoachRole can be blended into which ofthe following roles?
Answer: Themonitor/defibrillator - Which of the following is a responsibility of the CPR coach?
Answer: Coordinatingcompressor switches
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AHA ACLS Written Test ( Updated 2024 )
Complete Questions & Answers (Solved) 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 and a 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 isthe preferred method of accessfor epi administration during cardiacarrest 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 below(PEA) and the
pt. has no pulse. You partner resumes chest compressions and an IV is in place. What
management step is your next priority?
Answer: Administer 1mgof epinepherine - During a pause in CPR, you see a narrow complex rythm on the monitor.Thept. 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 increases the 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 compressions without pauses and 10 ventilations per
minute. - 3 min after witnessing a cardiac arrest, one memeber of your team inserts an ET tube
while another performs continuous chest comressions. During subsequent bentilation, you
notice the presence of a wavefom on thecapnogrophy screen and a PETCO2 of 8 mm Hg.
What is the significance of this finding?
Answer: Chest compressions may not be effective. - The use of quantitative capnography in intubated pt’s does what?
Answer: Allows-for monitoring CPR quality - For the past 25 min, EMS crews have attemptedresuscitation of a pt who originally
presented withV-FIB. After the 1st shock, the ECG screen displayedasystole which has
persisted despite 2 doses of epi, a fluid bolus, and high quality CPR.What is your next
treatment?
Answer: Consider terminating resuscitiveefforts after consulting medical control. - Which is a safe and effective practice within the defibrillation sequence?-
Answer: Be sure O2 is NOT blowing over the pt’s chest during shock. - During your assessment, your pt suddenly loses consciousness. After calling for help and
determining that the pt. is not breathing, you are unsurewhether the pt. has a pulse. What is
your next action?
Answer: Begin chest compressions. - What is an advantage of using hands-free d-fib pads instead of d-fibpaddles?
Answer: Hands-free allows for more rapid d-fib. - What action is recommended to help minimize interruptions in chest com-pressions during
CPR?
Answer: Continue CPR while charging the defibrillator. - Which action is included in the BLS survey?
Answer: Early defibrillation - Which drug and dose are recommended for the management of a pt. inrefractory V-FIB?
Answer: Amioderone 300mg - What isthe appropriate intervalfor an interruption in chest compressions?-
Answer: 10 seconds or less - Which of the following is a sign of effective CPR?
Answer: PETCO2 = or > 10mmHg - What is the primary purpose of a medical emergency team or rapid response team?
Answer: Identifying and treating early clinical deterioration.
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American Red Cross ACLS Final ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- A patient is in cardiac arrest.The cardiac monitor shows asystole. In addition to providing
continuous high-quality CPR, what is the other priorityintervention for this patient?
Answer: Administering epinephrine as early as possible - A patient has experienced return of spontaneous circulation (ROSC) after cardiac arrest.
The healthcare team is conducting a secondary assessment to determine the possible cause of
the patient’s cardiac arrest. Before the arrest, the patient exhibited jugular venous distension,
cyanosis, apnea and hyperresonance on percussion. The patient was also difficult to ventilate
during the response.The team would most likely suspect which condition asthe cause?
Answer: Tension Pneumothorax - A patient with suspected stroke arrives at the emergency department. Thepatient is
diagnosed with acute ischemic stroke and is a candidate for fibrinolytic therapy.To achieve the
best outcomes, this therapy should be initiatedwithin what time frame?
Answer: Within 1 hour of patient’s arrival. - A patient in the telemetry unit is receiving continuous cardiac monitoring.The patient has a
history of myocardial infarction. The patient’s ECG rhythmstrip is shown in the following
figure. The provider interprets this strip as indicating which arrhythmia?
Answer: Third-degree AV block - A 28-year-old pregnant patient who residesin transitional housing presentsto the emergency
department with complaints of feeling feverish and very faint.The patient tells the emergency
nurse that she does not know when shebecame pregnant.Upon palpation,the fundusis not at or
above the umbilicus.The patient’s condition quickly deteriorates and she goes into cardiac
arrest.If available and able to be used without impeding or delaying the resuscitationeffort,what
diagnostic tool could be used to guide decision-making in the careof this patient?
Answer: Point-of-care ultrasound - Cardiac monitoring indicates that a patient has a ventricular tachyarrhythmia. The patient
has a pulse and is not showing any signs of hemodynamic compromise. A 12-lead ECG
reveals an irregular rhythm with QRS complexesgreater than 0.12 second in duration. Which
action would be appropriate at this time?
Answer: Consider an antiarrhythmic medication - A responsive patient is choking.What method should the provider use firstto clear the
obstructed airway?
Answer: Back blows - What is the priority intervention for a patient with a narrow-complex tachy-cardia (160
bpm) and a blood pressure of 72/48 mmHg?
Answer: Perform immediate synchronized cardioversion - A patient is admitted to the emergency department with signs and symptoms of stroke. The
stroke team should complete a comprehensive neurologic assessment and obtain brain imaging
results within what time frame?
Answer: Within20 minutes - Cardiac monitoring of a patient in cardiac arrest reveals ventricular fibrillation. In
addition to high-quality CPR, what intervention should be a priorityfor the team?
Answer: Defibrillation. - A patient with suspected acute coronary syndromes (ACS) has a pulseoximetry reading of
86% and is given supplemental oxygen. The provider determines that the supplemental
oxygen dose is correct based on whichSaO2 level?
Answer: 93% - After cardiac arrest and successful resuscitation, the patient has a returnof spontaneous
circulation.The patient is unable to follow verbal commands.Targeted temperature
management is initiated. Which method(s) would be appropriate for the resuscitation team to
use?
Answer:
-Applying cooling blankets to thepatient’s body
-Using an endovascular catheter
-Giving an ice-cold IV fluid bolus - A patient comesto the emergency department complaining of palpitationsand “some
shortness of breath.” Cardiac monitoring is initiated and reveals the following ECG rhythm
strip.The provider interprets this strip as indicatingwhich arrhythmia?
Answer: Atrial flutter - A 35-year-old female patient’s ECG is consistent with STEMI. The ECG reveals a new
ST-segment elevation at the J point in leadsV2 andV3 of at leastwhich size?
Answer: 0.15 mV - The following capnogram is from a patient experiencing respiratory dis-tress. At which
point in the waveform would the patient’s ETCO2 level be measured?
Answer: D - For a patient with third-degree atrioventricular (AV) block and a blood pressure of 70/48
mmHg, what interventions should be considered?
Answer:
-Initiatea dopamine infusion
-Administer atropine
-Initiate transcutaneous pacing
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ACLS Final Exam ( Updated 2024 )
Complete Questions & Answers (Solved) 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 injury
Pneumothorax
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 a 12-lead ECG would confirm this
suspicion?
Wide-complex ventricular rhythm and tall, peakedT 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 at 2 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 airway patency. 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 adjust-ed 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 a rateof 100 to 120
compressions per minute.”
Answer: 4
“We delivered 1 ventilation every 6 seconds and chest compressions at a rate of 100to 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 assessment using the National Institutes
of Health Stroke Scale (NIHSS) is completedand 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 assessmentshould be
completed and brain imaging should be performed.That would be 7:30
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HESI Case Study ACLS ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- The nurse is aware that the older adult client is at an increased risk for surgical
complications due to normal physiological functions and comorbidities.Which risk factors
place the older adult client at increased risk for surgical complications?
Answer: Decreased respiratory muscle strength - Upon completing the client’s assessment, the nurse determines that theclient has which
surgical risk factors? (Select all that apply.)
Answer:
Metoprolol
Poor appetite
Diabetes mellitus
Albumin 3.0 g/dL - What is the priority preoperative nursing action to prevent postoperativeatelectasis?
Answer: Instruct on incentive spirometer use - Which is the likely reason for the elevated serum creatinine in the absenceof kidney
disease?
Answer: dehydration - The nurse is caring for the client who has just been extubated.What shouldthe nurse do first,
afterthe client is extubated?
Answer: Administersupplemental oxygen - One hour has passed since the client was extubated.Which nursing actionstake priority at
this time? (select all that apply)
Answer: Monitor respiratory rate Assess cardiac rhythm - Based on the nurse’s assessment,which isthe priority nursing action?
Answer: Ad-minister morphine - Upon reviewing the remaining postoperative prescriptions and comparingwith preoperative
prescriptions, the nurse realizes that the metformin doses are different. What is the nurse’s
priority action?
Answer: Contact the HCP for clarification - The client’s spouse inquires about the client’s blood sugar because she has never seen it that
high. and she reports that the client isn’t even eating.Whatis the nurse’s best response?
Answer: “Stress can increase blood sugar”
HESI Case Study ACLS ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- The nurse is aware that the older adult client is at an increased risk for surgical
complications due to normal physiological functions and comorbidities.Which risk factors
place the older adult client at increased risk for surgical complications?
Answer: Decreased respiratory muscle strength - Upon completing the client’s assessment, the nurse determines that theclient has which
surgical risk factors? (Select all that apply.)
Answer:
Metoprolol
Poor appetite
Diabetes mellitus
Albumin 3.0 g/dL - What is the priority preoperative nursing action to prevent postoperativeatelectasis?
Answer: Instruct on incentive spirometer use - Which is the likely reason for the elevated serum creatinine in the absenceof kidney
disease?
Answer: dehydration - The nurse is caring for the client who has just been extubated.What shouldthe nurse do first,
afterthe client is extubated?
Answer: Administersupplemental oxygen - One hour has passed since the client was extubated.Which nursing actionstake priority at
this time? (select all that apply)
Answer: Monitor respiratory rate Assess cardiac rhythm - Based on the nurse’s assessment,which isthe priority nursing action?
Answer: Ad-minister morphine - Upon reviewing the remaining postoperative prescriptions and comparingwith preoperative
prescriptions, the nurse realizes that the metformin doses are different. What is the nurse’s
priority action?
Answer: Contact the HCP for clarification - The client’s spouse inquires about the client’s blood sugar because she has never seen it that
high. and she reports that the client isn’t even eating.Whatis the nurse’s best response?
Answer: “Stress can increase blood sugar”
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ACLS Peds ( Updated 2024 )
Complete Questions & Answers (Solved) 100% Correct
- A pediatric nurse is preparing to deliver chest compressions to a child in cardiac arrest. In
which location should the nurse’s hands be placed?
Answer: Centerof the chest on the lower half of the sternum - While conducting a rapid assessment, the healthcare provider notes the patient appears
unresponsive.What isthe provider’s next initial action?
Answer: checkfor responsiveness - The pediatric clinical team is caring for a pediatric patient in cardiac arrest.During the
resuscitation, the team leader notes changes in the patient’s ECGrhythm and physical
appearance. After quickly evaluating these new findings,the leader determines a new course of
action. Which technique is the leader demonstrating?
Answer: critical thinking - A provider is using a BVM to administer ventilations during CPR. The provider should
make sure that each ventilation has which characteristics?
Answer: -Lasts about 1 second and delivers an appropriate volume to make the chest beginto
rise - After participating in a resuscitation event in which the pediatric patient did not survive,
you are feeling very stressed and having difficulty with dailyactivities.What is the best action
to help you cope with the stress?
Answer: Considera referral to a qualified mental health professional. - While performing CPR on a 7-month-old infant, the team leader reminds the compressor to
maintain appropriate chest compression depth. The team member understands compressions
should be delivered at about which depth?
Answer: -1.5 - Two providers are performing CPR on a pediatric patient in cardiac arrest. Which chest
compression rate is correct?
Answer: 100-120 - Two healthcare providers are performing CPR on a child.The providerscorrectly deliver
compressions and ventilations at which rate?
Answer: 15:2 - Both the Pediatric In-Hospital Cardiac Chain of Survival and the PediatricOut-of-Hospital
Cardiac Chain of Survival include a link emphasizing the importance of continued followedup during the recovery process. True or False?
Answer: T - The provider would use pediatric AED pads for which children?
Answer: 8 andunder and 55lbs and under - Pediatric In-Hospital Cardiac Chain of Survival
Answer: 6 links - While performing a rapid assessment on a child, the nurse notes skin mottling and lifethreatening bleeding.Which action should the nurse takefirst?
Answer: attempt to stop the bleeding - During CPR in a cardiac arrest situation, the pediatric patient was success-fully intubated
with an endotracheal tube.At which rate should the respiratorytherapist deliver ventilations?
Answer: 1 breath every 2-3 seconds - During a resuscitation event,the teamleaderinstructsthe medication teammember to
prepare IV epinephrine. The medication member prepares medication and approaches the
patient for administration. Following closed-loopcommunication, which is the best action by
the team leader to perform prior to the administration of medication?
Answer: Ask for feedback to ensure the medicationmember received the message. - The healthcare provider uses which acronym when completing the PALSprimary
assessment on a pediatric patient?
Answer: ABCDE - Which characteristics contribute to an effective, high-performance PALSteam?
Answer:
The team practices mock codes together regularly.
The team holds debriefing sessions after each resuscitation event. - A 5-year-old patient is brought to the emergency department with a temperature of
102.4° F and a cough. Upon assessment, the healthcare providerobserves decreased breath
sounds and localized crackles and tachycardia. The provider suspects these findings most
likely indicate which disorder?
Answer: -PNA - The healthcare provider suspects impending respiratory failure in a recently admitted
school-aged child. Which new assessment finding would thehealthcare provider most likely
observe?
Answer: Respiratory rate change from 25 to 11breaths per minute - A 7-year-old patient is brought to the emergency department with difficultybreathing and
angioedema.The parent states, “My child is allergic to peanuts,but ate some during lunch
today!” Which medication should the healthcare provider prepare first?
Answer: epi
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