AHA ACLS Final Exam Questions and
Answers with Explanations (Latest): Most
Comprehensive to Pass the Exam, 100%
Verified
Question 1
A patient with suspected stroke arrives at the emergency department. The patient is
diagnosed with acute ischemic stroke and is a candidate for fibrinolytic therapy. To
achieve the best outcomes, this therapy should be initiated within what time frame?
Correct Answer
Within 1 hour of the patient's arrival
Question 2
During your assessment, your pt suddenly loses consciousness. After calling for help
and determining that the pt. is not breathing, you are unsure whether the pt. has a
pulse. What is your next action?
Correct Answer
Begin chest compressions.
Question 3
Family members found a 45-year-old woman unresponsive in bed. The patient is
unconscious and in respiratory arrest. What is the recommended initial airway
management technique?
Correct Answer
Performing a head tilt-chin lift maneuver
Page 1 of 147
,Question 4
Which is the maximum interval you should allow for an interruption in chest
compressions?
Correct Answer
A) 10 seconds.
Question 1: A 58-year-old man collapses in the hospital corridor. He is
unresponsive, pulseless, and not breathing. The defibrillator is not
immediately available. According to AHA ACLS guidelines, what is the nurse’s
immediate priority action?
A. Establish IV access and administer epinephrine
B. Begin high-quality chest compressions at a rate of 100–120 per minute
C. Insert an advanced airway
D. Obtain a 12-lead ECG
CORRECT ANSWER: B. Begin high-quality chest compressions at a rate of 100–
120 per minute
Rationale: Immediate high-quality CPR is the first priority in cardiac arrest to
maintain circulation until a defibrillator is available. Chest compressions should be
started without delay while the defibrillator is retrieved.
Question 2: A patient in ventricular fibrillation has received one shock. High-
quality CPR is in progress. Which medication should be administered next
according to the ACLS Adult Cardiac Arrest Algorithm?
A. Amiodarone 300 mg IV
B. Atropine 1 mg IV
C. Epinephrine 1 mg IV
D. Lidocaine 1–1.5 mg/kg IV
CORRECT ANSWER: C. Epinephrine 1 mg IV
Rationale: After the first shock and 2 minutes of CPR, epinephrine 1 mg IV/IO is
given every 3–5 minutes. Antiarrhythmics such as amiodarone are considered after
the third shock.
Page 2 of 147
,Question 3: A patient in asystole is receiving high-quality CPR. The team leader
asks for the next medication. Which drug is indicated?
A. Atropine 1 mg IV
B. Epinephrine 1 mg IV every 3–5 minutes
C. Amiodarone 300 mg IV
D. Adenosine 6 mg rapid IV push
CORRECT ANSWER: B. Epinephrine 1 mg IV every 3–5 minutes
Rationale: Epinephrine is the only medication routinely recommended in asystole.
Atropine is no longer recommended for routine use in asystole or PEA.
Question 4: During CPR, the quantitative waveform capnography shows an
ETCO₂ of 8 mm Hg. What does this finding most likely indicate?
A. Adequate CPR quality and good prognosis
B. Poor CPR quality or prolonged arrest with low chance of ROSC
C. Hyperventilation
D. Successful return of spontaneous circulation
CORRECT ANSWER: B. Poor CPR quality or prolonged arrest with low chance
of ROSC
Rationale: An ETCO₂ less than 10 mm Hg after 20 minutes of high-quality CPR is
associated with a very low likelihood of ROSC and may indicate inadequate
compressions or prolonged downtime.
Question 5: A patient develops symptomatic bradycardia with a heart rate of
38 bpm, blood pressure 78/42 mm Hg, and altered mental status. Atropine 1
mg IV has been given without improvement. What is the next recommended
intervention?
A. Administer epinephrine 2–10 mcg/min infusion
B. Immediate synchronized cardioversion
C. Administer adenosine 6 mg rapid IV push
D. Give amiodarone 150 mg IV over 10 minutes
Page 3 of 147
, CORRECT ANSWER: A. Administer epinephrine 2–10 mcg/min infusion
Rationale: For symptomatic bradycardia unresponsive to atropine, the next steps
include transcutaneous pacing or continuous infusions of epinephrine or dopamine
while preparing for possible transvenous pacing.
Question 6: A patient in stable narrow-complex tachycardia at a rate of 180
bpm is being treated. Vagal maneuvers have failed. What is the first-line
medication?
A. Amiodarone 150 mg IV
B. Adenosine 6 mg rapid IV push
C. Metoprolol 5 mg IV
D. Digoxin 0.5 mg IV
CORRECT ANSWER: B. Adenosine 6 mg rapid IV push
Rationale: Adenosine is the first-line drug for stable regular narrow-complex SVT
after vagal maneuvers fail. It is given as a rapid IV push followed by a saline flush.
Question 7: A patient with pulseless ventricular tachycardia has received three
shocks and epinephrine. High-quality CPR continues. Which antiarrhythmic is
recommended next?
A. Lidocaine 1–1.5 mg/kg IV
B. Amiodarone 300 mg IV bolus
C. Procainamide 20–50 mg/min
D. Sotalol 1.5 mg/kg IV
CORRECT ANSWER: B. Amiodarone 300 mg IV bolus
Rationale: After the third shock, amiodarone 300 mg IV/IO is the preferred
antiarrhythmic. A second dose of 150 mg may be given if VF/pVT persists.
Question 8: During resuscitation of a patient in PEA, the ETCO₂ suddenly rises
from 12 mm Hg to 38 mm Hg. What does this change most likely indicate?
A. Worsening prognosis
B. Return of spontaneous circulation (ROSC)
Page 4 of 147
Answers with Explanations (Latest): Most
Comprehensive to Pass the Exam, 100%
Verified
Question 1
A patient with suspected stroke arrives at the emergency department. The patient is
diagnosed with acute ischemic stroke and is a candidate for fibrinolytic therapy. To
achieve the best outcomes, this therapy should be initiated within what time frame?
Correct Answer
Within 1 hour of the patient's arrival
Question 2
During your assessment, your pt suddenly loses consciousness. After calling for help
and determining that the pt. is not breathing, you are unsure whether the pt. has a
pulse. What is your next action?
Correct Answer
Begin chest compressions.
Question 3
Family members found a 45-year-old woman unresponsive in bed. The patient is
unconscious and in respiratory arrest. What is the recommended initial airway
management technique?
Correct Answer
Performing a head tilt-chin lift maneuver
Page 1 of 147
,Question 4
Which is the maximum interval you should allow for an interruption in chest
compressions?
Correct Answer
A) 10 seconds.
Question 1: A 58-year-old man collapses in the hospital corridor. He is
unresponsive, pulseless, and not breathing. The defibrillator is not
immediately available. According to AHA ACLS guidelines, what is the nurse’s
immediate priority action?
A. Establish IV access and administer epinephrine
B. Begin high-quality chest compressions at a rate of 100–120 per minute
C. Insert an advanced airway
D. Obtain a 12-lead ECG
CORRECT ANSWER: B. Begin high-quality chest compressions at a rate of 100–
120 per minute
Rationale: Immediate high-quality CPR is the first priority in cardiac arrest to
maintain circulation until a defibrillator is available. Chest compressions should be
started without delay while the defibrillator is retrieved.
Question 2: A patient in ventricular fibrillation has received one shock. High-
quality CPR is in progress. Which medication should be administered next
according to the ACLS Adult Cardiac Arrest Algorithm?
A. Amiodarone 300 mg IV
B. Atropine 1 mg IV
C. Epinephrine 1 mg IV
D. Lidocaine 1–1.5 mg/kg IV
CORRECT ANSWER: C. Epinephrine 1 mg IV
Rationale: After the first shock and 2 minutes of CPR, epinephrine 1 mg IV/IO is
given every 3–5 minutes. Antiarrhythmics such as amiodarone are considered after
the third shock.
Page 2 of 147
,Question 3: A patient in asystole is receiving high-quality CPR. The team leader
asks for the next medication. Which drug is indicated?
A. Atropine 1 mg IV
B. Epinephrine 1 mg IV every 3–5 minutes
C. Amiodarone 300 mg IV
D. Adenosine 6 mg rapid IV push
CORRECT ANSWER: B. Epinephrine 1 mg IV every 3–5 minutes
Rationale: Epinephrine is the only medication routinely recommended in asystole.
Atropine is no longer recommended for routine use in asystole or PEA.
Question 4: During CPR, the quantitative waveform capnography shows an
ETCO₂ of 8 mm Hg. What does this finding most likely indicate?
A. Adequate CPR quality and good prognosis
B. Poor CPR quality or prolonged arrest with low chance of ROSC
C. Hyperventilation
D. Successful return of spontaneous circulation
CORRECT ANSWER: B. Poor CPR quality or prolonged arrest with low chance
of ROSC
Rationale: An ETCO₂ less than 10 mm Hg after 20 minutes of high-quality CPR is
associated with a very low likelihood of ROSC and may indicate inadequate
compressions or prolonged downtime.
Question 5: A patient develops symptomatic bradycardia with a heart rate of
38 bpm, blood pressure 78/42 mm Hg, and altered mental status. Atropine 1
mg IV has been given without improvement. What is the next recommended
intervention?
A. Administer epinephrine 2–10 mcg/min infusion
B. Immediate synchronized cardioversion
C. Administer adenosine 6 mg rapid IV push
D. Give amiodarone 150 mg IV over 10 minutes
Page 3 of 147
, CORRECT ANSWER: A. Administer epinephrine 2–10 mcg/min infusion
Rationale: For symptomatic bradycardia unresponsive to atropine, the next steps
include transcutaneous pacing or continuous infusions of epinephrine or dopamine
while preparing for possible transvenous pacing.
Question 6: A patient in stable narrow-complex tachycardia at a rate of 180
bpm is being treated. Vagal maneuvers have failed. What is the first-line
medication?
A. Amiodarone 150 mg IV
B. Adenosine 6 mg rapid IV push
C. Metoprolol 5 mg IV
D. Digoxin 0.5 mg IV
CORRECT ANSWER: B. Adenosine 6 mg rapid IV push
Rationale: Adenosine is the first-line drug for stable regular narrow-complex SVT
after vagal maneuvers fail. It is given as a rapid IV push followed by a saline flush.
Question 7: A patient with pulseless ventricular tachycardia has received three
shocks and epinephrine. High-quality CPR continues. Which antiarrhythmic is
recommended next?
A. Lidocaine 1–1.5 mg/kg IV
B. Amiodarone 300 mg IV bolus
C. Procainamide 20–50 mg/min
D. Sotalol 1.5 mg/kg IV
CORRECT ANSWER: B. Amiodarone 300 mg IV bolus
Rationale: After the third shock, amiodarone 300 mg IV/IO is the preferred
antiarrhythmic. A second dose of 150 mg may be given if VF/pVT persists.
Question 8: During resuscitation of a patient in PEA, the ETCO₂ suddenly rises
from 12 mm Hg to 38 mm Hg. What does this change most likely indicate?
A. Worsening prognosis
B. Return of spontaneous circulation (ROSC)
Page 4 of 147
