ACLS EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS |
PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
* Recognition and management of cardiac arrest
* Basic Life Support and high-quality CPR
* Advanced airway management and ventilation
* Management of acute coronary syndromes
* Acute stroke care and neurological assessment
* Pharmacological interventions in resuscitation
* Bradycardia and tachycardia rhythm recognition
* Effective team communication and dynamics
* Post-cardiac arrest care and stabilization
* Ethical considerations in resuscitation care
Introduction
*This examination is designed to assess the clinical proficiency and
decision-making capabilities of healthcare professionals in complex
cardiac scenarios. The primary purpose is to ensure competency in
evidence-based resuscitation protocols. Candidates will be tested on
foundational theory, pharmacological interventions, and critical
team-based interventions. The assessment utilizes a rigorous
multiple-choice and scenario-based structure to mirror real-world
emergency demands. Emphasis is placed on the ability to synthesize
information rapidly, apply current standards of care, and lead
effective team responses during time-sensitive, life-threatening
cardiovascular events.*
SECTION ONE: QUESTIONS 1–100
1. A patient presents with symptomatic bradycardia and a heart rate of 35 bpm. Which
is the first-line pharmacological intervention? A. Atropine 1 mg IV B. Epinephrine 1
, mg IV C. Dopamine 5 mcg/kg/min D. Adenosine 6 mg IV A. Atropine 1 mg IV
Explanation: Atropine is the first-line medication for symptomatic bradycardia to
increase heart rate by blocking the parasympathetic nervous system.
2. In the setting of ventricular fibrillation, what is the recommended energy dose for a
biphasic defibrillator? A. 50 to 100 Joules B. 120 to 200 Joules C. 300 to 360 Joules D.
200 to 300 Joules B. 120 to 200 Joules Explanation: Biphasic defibrillators are
recommended at 120 to 200 Joules, depending on the manufacturer's specific
recommendations for effective conversion.
3. Which rhythm is most commonly associated with a pulseless electrical activity (PEA)
arrest? A. Ventricular tachycardia B. Atrial fibrillation C. Sinus rhythm D. Ventricular
fibrillation C. Sinus rhythm Explanation: PEA is defined by the presence of
organized electrical activity on the monitor despite the absence of a palpable pulse.
4. A patient is in stable wide-complex tachycardia. Which antiarrhythmic agent is most
appropriate? A. Amiodarone B. Atropine C. Epinephrine D. Magnesium sulfate A.
Amiodarone Explanation: Amiodarone is indicated for stable wide-complex
tachycardia of unknown or known ventricular origin.
5. What is the goal for the initiation of chest compressions within the start of an arrest?
A. Within 5 seconds B. Within 10 seconds C. Within 20 seconds D. Within 30 seconds
B. Within 10 seconds Explanation: Minimizing interruptions in chest
compressions is vital, and compressions should begin within 10 seconds of
recognizing cardiac arrest.
6. Which reversible cause of PEA is associated with an elevated potassium level? A.
Hypovolemia B. Hypoxia C. Hyperkalemia D. Hydrogen ion (acidosis) C.
Hyperkalemia Explanation: Hyperkalemia is a reversible cause that can lead to
conduction disturbances and cardiac arrest, requiring specific treatment like calcium
and insulin/glucose.
7. During CPR, what is the targeted end-tidal CO2 (ETCO2) to suggest high-quality chest
compressions? A. Less than 10 mmHg B. 10 to 20 mmHg C. 35 to 40 mmHg D.
Greater than 45 mmHg C. 35 to 40 mmHg Explanation: While values >10
mmHg are a goal, an ETCO2 of 35-40 mmHg is an indicator of effective cardiac output
and high-quality CPR.
8. When should the first dose of epinephrine be administered in a non-shockable
rhythm? A. After the second rhythm check B. As soon as feasible C. After 5 minutes
of CPR D. Before the first rhythm check B. As soon as feasible Explanation:
For non-shockable rhythms, epinephrine should be administered as soon as feasible
to improve coronary perfusion pressure.
, 9. What is the correct compression-to-ventilation ratio for an adult with an advanced
airway in place? A. 30:2 B. 15:2 C. Continuous compressions with breaths every 6
seconds D. Continuous compressions with breaths every 2 seconds C. Continuous
compressions with breaths every 6 seconds Explanation: Once an advanced
airway is placed, ventilations are delivered every 6 seconds (10 breaths/min) while
chest compressions continue uninterrupted.
10. Which medication is indicated for Torsades de Pointes? A. Amiodarone B. Magnesium
sulfate C. Calcium chloride D. Sodium bicarbonate B. Magnesium sulfate
Explanation: Magnesium sulfate is the drug of choice for Torsades de Pointes to
stabilize the membrane and terminate the polymorphic ventricular tachycardia.
11. What is the recommended compression depth for an adult patient? A. At least 1 inch
B. At least 2 inches (5 cm) C. 3 to 4 inches D. 1.5 inches B. At least 2 inches (5 cm)
Explanation: High-quality CPR requires a compression depth of at least 2 inches
(5 cm) to effectively move blood.
12. A patient with ACS has ongoing chest pain despite nitroglycerin. What is the next
drug of choice? A. Aspirin B. Morphine C. Oxygen D. Fibrinolytics B. Morphine
Explanation: Morphine is used for ischemic chest pain that is unresponsive to
nitroglycerin, though it should be used cautiously.
13. What is the primary purpose of a "Code Team" huddle? A. To assign specific roles B.
To critique the resuscitation afterward C. To decide whether to terminate efforts D.
To gather family consent A. To assign specific roles Explanation: Clear
communication and role assignment are essential in team dynamics to ensure
efficiency during a cardiac arrest.
14. What rhythm requires immediate unsynchronized cardioversion? A. Supraventricular
tachycardia B. Atrial fibrillation C. Pulseless ventricular tachycardia D. Symptomatic
bradycardia C. Pulseless ventricular tachycardia Explanation: Pulseless VT is a
lethal rhythm that requires immediate defibrillation (unsynchronized shock).
15. What is the maximum recommended dose of Adenosine for the first dose? A. 3 mg B.
6 mg C. 12 mg D. 15 mg B. 6 mg Explanation: The initial dose of Adenosine is
6 mg given as a rapid IV push, followed by a flush.
16. Which H in the H's and T's is treated with fluid boluses? A. Hypovolemia B. Hypoxia C.
Hyperkalemia D. Hypothermia A. Hypovolemia Explanation: Hypovolemia is
treated by rapid administration of isotonic crystalloid fluids to restore volume.
17. If a patient becomes pulseless while being monitored, what is the first action? A.
Administer epinephrine B. Start chest compressions C. Check for a rhythm D. Give a
shock B. Start chest compressions Explanation: In a witnessed arrest with a
PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
* Recognition and management of cardiac arrest
* Basic Life Support and high-quality CPR
* Advanced airway management and ventilation
* Management of acute coronary syndromes
* Acute stroke care and neurological assessment
* Pharmacological interventions in resuscitation
* Bradycardia and tachycardia rhythm recognition
* Effective team communication and dynamics
* Post-cardiac arrest care and stabilization
* Ethical considerations in resuscitation care
Introduction
*This examination is designed to assess the clinical proficiency and
decision-making capabilities of healthcare professionals in complex
cardiac scenarios. The primary purpose is to ensure competency in
evidence-based resuscitation protocols. Candidates will be tested on
foundational theory, pharmacological interventions, and critical
team-based interventions. The assessment utilizes a rigorous
multiple-choice and scenario-based structure to mirror real-world
emergency demands. Emphasis is placed on the ability to synthesize
information rapidly, apply current standards of care, and lead
effective team responses during time-sensitive, life-threatening
cardiovascular events.*
SECTION ONE: QUESTIONS 1–100
1. A patient presents with symptomatic bradycardia and a heart rate of 35 bpm. Which
is the first-line pharmacological intervention? A. Atropine 1 mg IV B. Epinephrine 1
, mg IV C. Dopamine 5 mcg/kg/min D. Adenosine 6 mg IV A. Atropine 1 mg IV
Explanation: Atropine is the first-line medication for symptomatic bradycardia to
increase heart rate by blocking the parasympathetic nervous system.
2. In the setting of ventricular fibrillation, what is the recommended energy dose for a
biphasic defibrillator? A. 50 to 100 Joules B. 120 to 200 Joules C. 300 to 360 Joules D.
200 to 300 Joules B. 120 to 200 Joules Explanation: Biphasic defibrillators are
recommended at 120 to 200 Joules, depending on the manufacturer's specific
recommendations for effective conversion.
3. Which rhythm is most commonly associated with a pulseless electrical activity (PEA)
arrest? A. Ventricular tachycardia B. Atrial fibrillation C. Sinus rhythm D. Ventricular
fibrillation C. Sinus rhythm Explanation: PEA is defined by the presence of
organized electrical activity on the monitor despite the absence of a palpable pulse.
4. A patient is in stable wide-complex tachycardia. Which antiarrhythmic agent is most
appropriate? A. Amiodarone B. Atropine C. Epinephrine D. Magnesium sulfate A.
Amiodarone Explanation: Amiodarone is indicated for stable wide-complex
tachycardia of unknown or known ventricular origin.
5. What is the goal for the initiation of chest compressions within the start of an arrest?
A. Within 5 seconds B. Within 10 seconds C. Within 20 seconds D. Within 30 seconds
B. Within 10 seconds Explanation: Minimizing interruptions in chest
compressions is vital, and compressions should begin within 10 seconds of
recognizing cardiac arrest.
6. Which reversible cause of PEA is associated with an elevated potassium level? A.
Hypovolemia B. Hypoxia C. Hyperkalemia D. Hydrogen ion (acidosis) C.
Hyperkalemia Explanation: Hyperkalemia is a reversible cause that can lead to
conduction disturbances and cardiac arrest, requiring specific treatment like calcium
and insulin/glucose.
7. During CPR, what is the targeted end-tidal CO2 (ETCO2) to suggest high-quality chest
compressions? A. Less than 10 mmHg B. 10 to 20 mmHg C. 35 to 40 mmHg D.
Greater than 45 mmHg C. 35 to 40 mmHg Explanation: While values >10
mmHg are a goal, an ETCO2 of 35-40 mmHg is an indicator of effective cardiac output
and high-quality CPR.
8. When should the first dose of epinephrine be administered in a non-shockable
rhythm? A. After the second rhythm check B. As soon as feasible C. After 5 minutes
of CPR D. Before the first rhythm check B. As soon as feasible Explanation:
For non-shockable rhythms, epinephrine should be administered as soon as feasible
to improve coronary perfusion pressure.
, 9. What is the correct compression-to-ventilation ratio for an adult with an advanced
airway in place? A. 30:2 B. 15:2 C. Continuous compressions with breaths every 6
seconds D. Continuous compressions with breaths every 2 seconds C. Continuous
compressions with breaths every 6 seconds Explanation: Once an advanced
airway is placed, ventilations are delivered every 6 seconds (10 breaths/min) while
chest compressions continue uninterrupted.
10. Which medication is indicated for Torsades de Pointes? A. Amiodarone B. Magnesium
sulfate C. Calcium chloride D. Sodium bicarbonate B. Magnesium sulfate
Explanation: Magnesium sulfate is the drug of choice for Torsades de Pointes to
stabilize the membrane and terminate the polymorphic ventricular tachycardia.
11. What is the recommended compression depth for an adult patient? A. At least 1 inch
B. At least 2 inches (5 cm) C. 3 to 4 inches D. 1.5 inches B. At least 2 inches (5 cm)
Explanation: High-quality CPR requires a compression depth of at least 2 inches
(5 cm) to effectively move blood.
12. A patient with ACS has ongoing chest pain despite nitroglycerin. What is the next
drug of choice? A. Aspirin B. Morphine C. Oxygen D. Fibrinolytics B. Morphine
Explanation: Morphine is used for ischemic chest pain that is unresponsive to
nitroglycerin, though it should be used cautiously.
13. What is the primary purpose of a "Code Team" huddle? A. To assign specific roles B.
To critique the resuscitation afterward C. To decide whether to terminate efforts D.
To gather family consent A. To assign specific roles Explanation: Clear
communication and role assignment are essential in team dynamics to ensure
efficiency during a cardiac arrest.
14. What rhythm requires immediate unsynchronized cardioversion? A. Supraventricular
tachycardia B. Atrial fibrillation C. Pulseless ventricular tachycardia D. Symptomatic
bradycardia C. Pulseless ventricular tachycardia Explanation: Pulseless VT is a
lethal rhythm that requires immediate defibrillation (unsynchronized shock).
15. What is the maximum recommended dose of Adenosine for the first dose? A. 3 mg B.
6 mg C. 12 mg D. 15 mg B. 6 mg Explanation: The initial dose of Adenosine is
6 mg given as a rapid IV push, followed by a flush.
16. Which H in the H's and T's is treated with fluid boluses? A. Hypovolemia B. Hypoxia C.
Hyperkalemia D. Hypothermia A. Hypovolemia Explanation: Hypovolemia is
treated by rapid administration of isotonic crystalloid fluids to restore volume.
17. If a patient becomes pulseless while being monitored, what is the first action? A.
Administer epinephrine B. Start chest compressions C. Check for a rhythm D. Give a
shock B. Start chest compressions Explanation: In a witnessed arrest with a
