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ACLS Recertification questions and answers 2022

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ACLS Recertification A pt with STEMI has ongoing chest dicomfort. Heparin 4000 units IV bolus and heparin infusion of 1000 units/hr are being administered. The pt did not take ASA because he has a hx of gastritis, which was tx 5 years ago. What is the next action? A. Give ASA 160 to 325 mg to chew B. Give clopidogrel 300 mg PO C. Give enteric-coated ASA 75 mg PO D. Give enteric-coated ASA 325 mg rectally ans: A. Give ASA 160 to 325 mg to chew A pt is in pulseless ventricular tachycardia. 2 shocks and 1 dose of epinephrine 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 ans: B. Amiodarone 300 mg A pt is in cardiac arrest. V fib has been refractory to an initial shock. If no pathway for medication administration is in place, which method is preferred A. Central line B. Endotracheal tube C. External Jugular vein D. IV or IO ans: D. IV or IO What is the indicatio for the use of Mg in cardiac arrest? A. V tach associated with a normal QT interval B. shock-refractory monomorphic v tach C. Pulseless v tach-associated torsades de pointes D. shock-refractory v fib ans: C. Pulseless v tach-associated torsades de pointes You arrive on the scene with the code team. CRP is in progess. An AED previously advised "no shock indicated." A rhythm chec now finds asystole. After resuming compressions, which action do you take next? A. Call for a pulse check B. establish IV or IO access C. Insert a laryneal airway D. Perform endotracheal intubation ans: B. establish IV or IO access A pt is in cardiac arrest. V fib has been refractory to a second shock. Which drug should be administered first? A. Atropine 1 mg IV/IO B. epinephrine 1 mg IV/IO C. Lidocaine 1 mg/kg IV/IO D. Sodium bicarbonate 50 mEq IV/IO ans: B. epinephrine 1 mg IV/IO A pt with sinus bradycardia and a HR of 42/min has diaphoresis and a BP of 80/60 mg. What is the initial dose of atropine? A. 0.1 mg B. 0.5 mg C. 1 mg D. 3 mg ans: B. 0.5 mg A pt is in refractory V fib. CRP is in progess. One dose of epinephrine was given after the second shock. An antiarrhythimic drug was given immediate after the thirst shock. You are the team leader. Which med do you order next? A. Epinephrine 1 mg B. epinephrine 3 mg C. Sodium bicarbonate 50 mEq D. a second dose of the antiarrhythmic drug ans: A. Epinephrine 1 mg A monitored pt in the ICU developed a sudden onset of narrow-complex tachycardia at 220/min. The pt BP is 128/58. The PETCO2 is 38 mm Hg, and the puse Ox is 98%. There is a vascular access in the L arm, and the pt has not been given any vasoactive drugs. An ECG confirms supraventricular tachycardia with no evidence of ischemia or infarction. The HR has not responsed to vagal maneuvers. What is the next action? A. Administer adenosine 6 mg IV push B. Administer amiodarone 300 mg IV push C. perform synchronized cardioversion at 50 J D. perform synchronized cardioversion at 200 J ans: A. Administer adenosine 6 mg IV push A pt has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asx with a BP of 110/70. PMHx of angina. What action is recommended next? A. Give adenosine 6 mg IV bolus B. Give lidocaine 1 to 1.5 mg IV bolus C. performing synchronized cardioversion D. Seeking expert consultation ans: D. Seeking expert consultation at 61yoM suddenly experienced difficulty speaking and L sided weakness. HE meet initial criteria for fibrinolytic therapy, and a CT scan of the brain is ordered. Which best describes the guidelines for anti-platelet and fibrinolytic therapy? A. give ASA 160-325 to be chewed immediately B. give ASA 160 mg and clopidogrel 75 mg orally C. Give heparin if the CT scan is negative for hemorrhage D. Hold ASA for at least 24 hours if rtPA is administered ans: D. Hold ASA for at least 24 hours if rtPA is administered Which intervention is most appropriate for the tx of a pt in asystole? A. atropine B. defibrillation C. epinephrine D. transcutaneous pacing ans: C. epinephrine you are caring for a 66 yo M with hx of a large ICH 2 months ago. He is being evaluated for another acute stroke. The CT scan is neg. for hemorrhage. The pt is getting O2 via nasal cannula at 2 L/min and has an IV. His BP is 180/100. Which drug do you anticipate giving the pt? A. ASA B. glucose C. nicardipine D. rtPA ans: A. ASA Pt in refractory v fib and has gotten multiple debribillations, epinephrine 1 mg IV x 2 and amiodarone 300 mg IV x 1. Pt is intubated. Which best describes the recommended 2nd dose of amiodarone? A. 1 mg/kg IV push B. 1 to 2 mg/min infusion C. 150 mg IV push D. 300 mg IV push ans: C. 150 mg IV push 57yoW with palpitations, chest discomfort and tachycardia. Monitor shows regular wide-complex QRS of 180/min. She becomes diaphrotic and her BP is 80/60. What is next action? A. establish IV/IO B. obtain a 12 lead EKG C. perform electrical cardioversion D. seek expert consultation ans: C. perform electrical cardioversion A pt is in cardiac arrest. CRP are performed. Pt is intubated and has IV access. Rhythm is asystole. What is the first drug? A. Atropine 0.5 mg IV/IO B. Atropine 1 mg IV/IO C. Dopamine 2 to 20 mcg/kg per minute IV/IO D. epinephrine 1 mg IV/IO ans: D. epinephrine 1 mg IV/IO 35yoW w/ palpitations, light-headedness and a stable tachy. Monitor shows regular narrow-complex QRS at 180/min/ Vagal maneuvers have not been effective. Has IV access. What drug? A. Adenosine 6 mg B. Atropine 0.5 mg

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ACLS Recertification
A pt with STEMI has ongoing chest dicomfort. Heparin 4000 units IV bolus and heparin infusion of 1000
units/hr are being administered. The pt did not take ASA because he has a hx of gastritis, which was tx 5
years ago. What is the next action?

A. Give ASA 160 to 325 mg to chew
B. Give clopidogrel 300 mg PO
C. Give enteric-coated ASA 75 mg PO
D. Give enteric-coated ASA 325 mg rectally ans: A. Give ASA 160 to 325 mg to chew

A pt is in pulseless ventricular tachycardia. 2 shocks and 1 dose of epinephrine 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 ans: B. Amiodarone 300 mg

A pt is in cardiac arrest. V fib has been refractory to an initial shock. If no pathway for medication
administration is in place, which method is preferred

A. Central line
B. Endotracheal tube
C. External Jugular vein
D. IV or IO ans: D. IV or IO

What is the indicatio for the use of Mg in cardiac arrest?

A. V tach associated with a normal QT interval
B. shock-refractory monomorphic v tach
C. Pulseless v tach-associated torsades de pointes
D. shock-refractory v fib ans: C. Pulseless v tach-associated torsades de pointes

You arrive on the scene with the code team. CRP is in progess. An AED previously advised "no shock
indicated." A rhythm chec now finds asystole. After resuming compressions, which action do you take
next?

A. Call for a pulse check
B. establish IV or IO access
C. Insert a laryneal airway
D. Perform endotracheal intubation ans: B. establish IV or IO access

A pt is in cardiac arrest. V fib has been refractory to a second shock. Which drug should be administered
first?

, A. Atropine 1 mg IV/IO
B. epinephrine 1 mg IV/IO
C. Lidocaine 1 mg/kg IV/IO
D. Sodium bicarbonate 50 mEq IV/IO ans: B. epinephrine 1 mg IV/IO

A pt with sinus bradycardia and a HR of 42/min has diaphoresis and a BP of 80/60 mg. What is the initial
dose of atropine?

A. 0.1 mg
B. 0.5 mg
C. 1 mg
D. 3 mg ans: B. 0.5 mg

A pt is in refractory V fib. CRP is in progess. One dose of epinephrine was given after the second shock.
An antiarrhythimic drug was given immediate after the thirst shock. You are the team leader. Which
med do you order next?

A. Epinephrine 1 mg
B. epinephrine 3 mg
C. Sodium bicarbonate 50 mEq
D. a second dose of the antiarrhythmic drug ans: A. Epinephrine 1 mg

A monitored pt in the ICU developed a sudden onset of narrow-complex tachycardia at 220/min. The pt
BP is 128/58. The PETCO2 is 38 mm Hg, and the puse Ox is 98%. There is a vascular access in the L arm,
and the pt has not been given any vasoactive drugs. An ECG confirms supraventricular tachycardia with
no evidence of ischemia or infarction. The HR has not responsed to vagal maneuvers. What is the next
action?

A. Administer adenosine 6 mg IV push
B. Administer amiodarone 300 mg IV push
C. perform synchronized cardioversion at 50 J
D. perform synchronized cardioversion at 200 J ans: A. Administer adenosine 6 mg IV push

A pt has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asx with a BP
of 110/70. PMHx of angina. What action is recommended next?

A. Give adenosine 6 mg IV bolus
B. Give lidocaine 1 to 1.5 mg IV bolus
C. performing synchronized cardioversion
D. Seeking expert consultation ans: D. Seeking expert consultation

at 61yoM suddenly experienced difficulty speaking and L sided weakness. HE meet initial criteria for
fibrinolytic therapy, and a CT scan of the brain is ordered. Which best describes the guidelines for anti-
platelet and fibrinolytic therapy?

A. give ASA 160-325 to be chewed immediately
B. give ASA 160 mg and clopidogrel 75 mg orally
C. Give heparin if the CT scan is negative for hemorrhage

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