ACLS Written Exam Questions and Verified Answers Graded A+ 2026/27
Atropine 0.5 mg IV. - You arrive on the scene to find a 56-year-old diabetic woman with
dizziness. She is pale and diaphoretic. Her blood pressure is 80/60 mm Hg. The cardiac monitor
documents the rhythm below. She is receiving oxygen at 4 L/min by nasal cannula and an IV has
been established. Your next order is:
Begin chest compression. - An AED does not promptly analyze a rhythm. What is your
next step?
Atrial Flutter -
Indication: life threatening arrhythmia such as VF, pulse-less VT, unresponsive to shock delivery,
CPR, and vasopressin Precaution: Rapid infusion can lead to hypotension Route: IV. Dosage:
300 mg, second dose of 150 mg - Amiodarone
Sinus Tachycardia - A pt. with *regular* narrow-complex QRS at a rate >150bpm in
which vagal maneuvers are ineffective should be given 6mg adenosine IV
Synchronized cardioversion is indicated if the pt. is hypotensive, AMS, shock, ischemic CP, or
acute HF. dx rhythm?
Responding to verbal commands - Which condition is a contraindication to therapeutic
hypothermia during the post-cardiac arrest period for pt's who achieve return of spontaneous
circulation (ROSC)?
,Indication: Alternative use for amiodarone in cardiac arrest: VF/VT. Precaution: discontinue if
toxicity develop. Route: IV. Dosage: 1-1.5 mg max 3mg. - Lidocaine
note: Lidocaine not a correct question choice on test
Sinus Bradycardia
Sinus bradycardia can be treated with atropine at an initial dose of 0.5mg
*Not ALL cases of sinus brady needed to be treated with atropine! If pt. is symptomatic (chest
pain, SOB) it requires treatment. - dx rhythm?
Do not give aspirin for at least 24 hours if tPA is administered. - A 62-year-old man
suddenly experienced difficulty speaking and left-side weakness. He was brought to the
emergency department. He meets initial criteria for fibrinolytic therapy, and a CT scan of the
brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy (ASA)?
Second Degree Heart Block (Mobitz II) -
120 - 200 J biphasic OR 200 J monophasic - energy shock for narrow irregular QRS?
(afib)
Divert the pt. to a hospital 15 min away with CT capabilities. - You receiving a radio
report from an EMS team enroute with a pt. who may be having a stroke. The hospital CT
scanner is broken. What should you do?
, Fine Ventricular Fibrillation...
VFib should be treated with defibrillation followed by 1mg epi if necessary...and of course CPR -
dx?
Obtain a 12 lead ECG. - A 62 y/o male pt. in the ER says his heart is beating fast. No
chest pain or SOB. BP is 142/98, pulse rate is 200/min, reps rate is 14/min, O2 sats are 95 at
room air. What should be the next evaluation?
Epinephrine 1 mg - A patient is in cardiac arrest. Ventricular fibrillation has been
refractory to a second shock. Of the following, which drug and dose should be administered first
by the IV/IO route?
Agonal Rhythm/Asystole
Asystole is treated with high quality CPR and epi 1mg or vasopressin 40mg IV/IO - dx?
Amiodarone 300 mg - A patient is in pulseless ventricular tachycardia. Two shocks and 1
dose of epinephrine have been given. Which is the next drug/dose to anticipate to administer?
Prepare to give epinephrine 1 mg IV. - Following initiation of CPR and 1 shock for VF,
this rhythm is present on the next rhythm check. A second shock is given and chest compressions
Atropine 0.5 mg IV. - You arrive on the scene to find a 56-year-old diabetic woman with
dizziness. She is pale and diaphoretic. Her blood pressure is 80/60 mm Hg. The cardiac monitor
documents the rhythm below. She is receiving oxygen at 4 L/min by nasal cannula and an IV has
been established. Your next order is:
Begin chest compression. - An AED does not promptly analyze a rhythm. What is your
next step?
Atrial Flutter -
Indication: life threatening arrhythmia such as VF, pulse-less VT, unresponsive to shock delivery,
CPR, and vasopressin Precaution: Rapid infusion can lead to hypotension Route: IV. Dosage:
300 mg, second dose of 150 mg - Amiodarone
Sinus Tachycardia - A pt. with *regular* narrow-complex QRS at a rate >150bpm in
which vagal maneuvers are ineffective should be given 6mg adenosine IV
Synchronized cardioversion is indicated if the pt. is hypotensive, AMS, shock, ischemic CP, or
acute HF. dx rhythm?
Responding to verbal commands - Which condition is a contraindication to therapeutic
hypothermia during the post-cardiac arrest period for pt's who achieve return of spontaneous
circulation (ROSC)?
,Indication: Alternative use for amiodarone in cardiac arrest: VF/VT. Precaution: discontinue if
toxicity develop. Route: IV. Dosage: 1-1.5 mg max 3mg. - Lidocaine
note: Lidocaine not a correct question choice on test
Sinus Bradycardia
Sinus bradycardia can be treated with atropine at an initial dose of 0.5mg
*Not ALL cases of sinus brady needed to be treated with atropine! If pt. is symptomatic (chest
pain, SOB) it requires treatment. - dx rhythm?
Do not give aspirin for at least 24 hours if tPA is administered. - A 62-year-old man
suddenly experienced difficulty speaking and left-side weakness. He was brought to the
emergency department. He meets initial criteria for fibrinolytic therapy, and a CT scan of the
brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy (ASA)?
Second Degree Heart Block (Mobitz II) -
120 - 200 J biphasic OR 200 J monophasic - energy shock for narrow irregular QRS?
(afib)
Divert the pt. to a hospital 15 min away with CT capabilities. - You receiving a radio
report from an EMS team enroute with a pt. who may be having a stroke. The hospital CT
scanner is broken. What should you do?
, Fine Ventricular Fibrillation...
VFib should be treated with defibrillation followed by 1mg epi if necessary...and of course CPR -
dx?
Obtain a 12 lead ECG. - A 62 y/o male pt. in the ER says his heart is beating fast. No
chest pain or SOB. BP is 142/98, pulse rate is 200/min, reps rate is 14/min, O2 sats are 95 at
room air. What should be the next evaluation?
Epinephrine 1 mg - A patient is in cardiac arrest. Ventricular fibrillation has been
refractory to a second shock. Of the following, which drug and dose should be administered first
by the IV/IO route?
Agonal Rhythm/Asystole
Asystole is treated with high quality CPR and epi 1mg or vasopressin 40mg IV/IO - dx?
Amiodarone 300 mg - A patient is in pulseless ventricular tachycardia. Two shocks and 1
dose of epinephrine have been given. Which is the next drug/dose to anticipate to administer?
Prepare to give epinephrine 1 mg IV. - Following initiation of CPR and 1 shock for VF,
this rhythm is present on the next rhythm check. A second shock is given and chest compressions
