AHA ACLS STUDY GUIDE UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
⫸22. A patient with pulseless ventricular tachycardia is defibrillated. What is the next action?
A. Check for a pulse.
B. Administer an IV antiarrhythmic.
C. Start chest compressions at a rate of at least 100/min.
D. Repeat the unsynchronized shock, increasing to 200 J. Answer - Start chest compressions at a
rate of at least 100/min.
⫸23. You have completed your first 2-minute period of CPR. You see an organized,
nonshockable rhythm on the ECG monitor. What is the next action?
A. Administer normal saline at 20 mL/kg.
B. Administer epinephrine at 1 mg/kg IV.
C. Obtain a blood pressure and oxygen saturation.
D. Have a team member attempt to palpate a carotid pulse. Answer - Have a team member
attempt to palpate a carotid pulse.
⫸24. Emergency medical responders are unable to obtain a peripheral IV for a patient in
cardiac arrest. What is the next most preferred route for drug administration?
A. Intraosseous (IO)
B. Endotracheal (ET)
C. Intramuscular (IM)
D. Central venous access Answer - Intraosseous (IO)
⫸25. What is the appropriate rate of chest compressions for an adult in cardiac arrest?
A. At least 150/min
B. At least 100/min
C. Approximately 100/min
D. Approximately 120/min Answer - At least 100/min
,⫸26. You are receiving a radio report from an EMS team en route with a patient who may be
having an acute stroke. The hospital CT scanner is not working at this time. What should you do
in this situation?
A. Contact the patient's family to see what they would prefer.
B. Have the EMS crew choose an appropriate patient disposition.
C. Accept the report and provide care within your present capability.
D. Divert the patient to a hospital 15 minutes away with CT capabilities. Answer - Divert the
patient to a hospital 15 minutes away with CT capabilities.
⫸27. A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient's
blood pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16
breaths/min, and the pulse oximetry reading is 96%. The lead II ECG is displayed below. A
patent peripheral IV is in place. What is the next action?
A. Acquisition of a 12-lead ECG
B. Vagal maneuvers
C. Procedural sedation
D. Immediate defibrillation Answer - Vagal maneuvers
⫸28. A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is
diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the
heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is
95%. The patient's 12-lead ECG shows ST-segment elevation in the anterior leads. First
responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is
described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What is
the next action?
A. Administer an additional dose of aspirin.
B. Administer an additional nitroglycerin tablet.
C. Administer high-flow oxygen via an oxygen mask.
D. Administer 2 to 4 mg of morphine by slow IV bolus. Answer - Administer 2 to 4 mg of
morphine by slow IV bolus.
⫸29. A 56-year-old man reports that he has palpitations but not chest pain or difficulty
breathing. The blood pressure is 132/68 mm Hg, the pulse is 130/ min and regular, the
respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95%. The lead II ECG
displays a wide-complex tachycardia. What is the next action after establishing an IV and
obtaining a 12-lead ECG?
A. Administration of IV epinephrine
B. Seeking expert consultation
, C. Procedural sedation
D. Synchronized cardioversion Answer - Seeking expert consultation
⫸30. A postoperative patient in the ICU reports new chest pain. What actions have the highest
priority?
A. Administer an IV fluid bolus and obtain arterial blood gas.
B. Start dopamine at 2 mcg/ kg per minute and obtain a chest x-ray.
C. Send blood to the laboratory for chemistry and cardiac enzymes.
D. Obtain a 12-lead ECG and administer aspirin if not contraindicated. Answer - Obtain a 12-lead
ECG and administer aspirin if not contraindicated.
⫸31. An 80-year-old woman presents to the emergency department with dizziness. She now
states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She is
alert and oriented. Her lead II ECG is below. After you start an IV, what is the next action?
A. Give an IV fluid bolus.
B. Give atropine and monitor for changes in mental status.
C. Start an epinephrine infusion and titrate to patient response.
D. Conduct a problem-focused history and physical examination. Answer - Conduct a problem-
focused history and physical examination.
⫸32. What is the recommended oral dose of aspirin for patients suspected of having one of the
acute coronary syndromes?
A. 2 to 4 mg
B. 80 to 120 mg
C. 160 to 325 mg
D. 400 to 600 mg Answer - 160 to 325 mg
⫸33. A responder is caring for a patient with a history of congestive heart failure. The patient is
experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of
190/min. The patient's lead II ECG is displayed below. Which of the following terms best
describes this patient?
A. Sinus tachycardia
B. Perfusing ventricular tachycardia
C. Stable supraventricular tachycardia
D. Unstable supraventricular tachycardia Answer - Unstable supraventricular tachycardia
CORRECT ANSWERS
⫸22. A patient with pulseless ventricular tachycardia is defibrillated. What is the next action?
A. Check for a pulse.
B. Administer an IV antiarrhythmic.
C. Start chest compressions at a rate of at least 100/min.
D. Repeat the unsynchronized shock, increasing to 200 J. Answer - Start chest compressions at a
rate of at least 100/min.
⫸23. You have completed your first 2-minute period of CPR. You see an organized,
nonshockable rhythm on the ECG monitor. What is the next action?
A. Administer normal saline at 20 mL/kg.
B. Administer epinephrine at 1 mg/kg IV.
C. Obtain a blood pressure and oxygen saturation.
D. Have a team member attempt to palpate a carotid pulse. Answer - Have a team member
attempt to palpate a carotid pulse.
⫸24. Emergency medical responders are unable to obtain a peripheral IV for a patient in
cardiac arrest. What is the next most preferred route for drug administration?
A. Intraosseous (IO)
B. Endotracheal (ET)
C. Intramuscular (IM)
D. Central venous access Answer - Intraosseous (IO)
⫸25. What is the appropriate rate of chest compressions for an adult in cardiac arrest?
A. At least 150/min
B. At least 100/min
C. Approximately 100/min
D. Approximately 120/min Answer - At least 100/min
,⫸26. You are receiving a radio report from an EMS team en route with a patient who may be
having an acute stroke. The hospital CT scanner is not working at this time. What should you do
in this situation?
A. Contact the patient's family to see what they would prefer.
B. Have the EMS crew choose an appropriate patient disposition.
C. Accept the report and provide care within your present capability.
D. Divert the patient to a hospital 15 minutes away with CT capabilities. Answer - Divert the
patient to a hospital 15 minutes away with CT capabilities.
⫸27. A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient's
blood pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16
breaths/min, and the pulse oximetry reading is 96%. The lead II ECG is displayed below. A
patent peripheral IV is in place. What is the next action?
A. Acquisition of a 12-lead ECG
B. Vagal maneuvers
C. Procedural sedation
D. Immediate defibrillation Answer - Vagal maneuvers
⫸28. A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is
diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the
heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is
95%. The patient's 12-lead ECG shows ST-segment elevation in the anterior leads. First
responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is
described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What is
the next action?
A. Administer an additional dose of aspirin.
B. Administer an additional nitroglycerin tablet.
C. Administer high-flow oxygen via an oxygen mask.
D. Administer 2 to 4 mg of morphine by slow IV bolus. Answer - Administer 2 to 4 mg of
morphine by slow IV bolus.
⫸29. A 56-year-old man reports that he has palpitations but not chest pain or difficulty
breathing. The blood pressure is 132/68 mm Hg, the pulse is 130/ min and regular, the
respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95%. The lead II ECG
displays a wide-complex tachycardia. What is the next action after establishing an IV and
obtaining a 12-lead ECG?
A. Administration of IV epinephrine
B. Seeking expert consultation
, C. Procedural sedation
D. Synchronized cardioversion Answer - Seeking expert consultation
⫸30. A postoperative patient in the ICU reports new chest pain. What actions have the highest
priority?
A. Administer an IV fluid bolus and obtain arterial blood gas.
B. Start dopamine at 2 mcg/ kg per minute and obtain a chest x-ray.
C. Send blood to the laboratory for chemistry and cardiac enzymes.
D. Obtain a 12-lead ECG and administer aspirin if not contraindicated. Answer - Obtain a 12-lead
ECG and administer aspirin if not contraindicated.
⫸31. An 80-year-old woman presents to the emergency department with dizziness. She now
states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She is
alert and oriented. Her lead II ECG is below. After you start an IV, what is the next action?
A. Give an IV fluid bolus.
B. Give atropine and monitor for changes in mental status.
C. Start an epinephrine infusion and titrate to patient response.
D. Conduct a problem-focused history and physical examination. Answer - Conduct a problem-
focused history and physical examination.
⫸32. What is the recommended oral dose of aspirin for patients suspected of having one of the
acute coronary syndromes?
A. 2 to 4 mg
B. 80 to 120 mg
C. 160 to 325 mg
D. 400 to 600 mg Answer - 160 to 325 mg
⫸33. A responder is caring for a patient with a history of congestive heart failure. The patient is
experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of
190/min. The patient's lead II ECG is displayed below. Which of the following terms best
describes this patient?
A. Sinus tachycardia
B. Perfusing ventricular tachycardia
C. Stable supraventricular tachycardia
D. Unstable supraventricular tachycardia Answer - Unstable supraventricular tachycardia
