ACLS Certification Exam (99) Questions And Answers Correctly Answered GRADED A+

ACLS CERTIFICATION EXAM (99) QUESTIONS AND ANSWERS CORRECTLY ANSWERED GRADED A+ Any organized rhythm without a pulse is defined as pulseless electrical activity (PEA). Correct ans - True Synchronized cardioversion is appropriate for treating an unknown wide complex tachycardia. Correct ans - True The aorta is the wall that separates the ventricles of the heart. Correct ans - False The most effective treatment for ventricular fibrillation is defibrillation. Correct ans - True An individual should be cleared-Ñ prior to a shock only when convenient. Correct ans - False PEA and asystole are considered non-shockable rhythms and follow the same ACLS algorithm. Correct ans - True Transcutaneous pacing should be used on an individual with bradycardia and inadequate perfusion if atropine is ineffective and the individual is exhibiti ng severe symptoms. Correct ans - True Low blood pressure may be an indication of hemodynamic instability. Correct ans - True Urgent defibrillation is essential for survival in the management of acute strokes. Correct ans - False Fibrinolytic therapy within three hours (in some cases 4.5 hours) of first onset of symptoms is the standard when treating ischemic stroke. Correct ans - True 100% oxygen is acceptable for early intervention but not for extended periods of time. Correct ans - True In a suspected acute stroke individual, you must always immediately obtain IV access. Correct ans - False There is never a pulse associated with VF; therefore, you should follow the PEA algorithm with individuals in VF. Correct ans - False If the AED advises no shock, you should still defibrillate because defibrillation often restarts the heart with no pulse. Correct ans - False If transcutaneous pacing fails, there are no other options to consider. Correct ans - False Medication is the only treatment for an unstable tachycardic individual. Correct ans - False For an individiual in respiratory arrest with a pulse, how often should they be ventilated? A) Give two breaths every 8 to 9 seconds, or 13 to 15 breaths per minute. B) Give one breath every 5 to 6 seconds, or 10 to 12 breaths per minute. C) Give one breath every 3 to 4 seconds, or 15 to 20 breaths per minute. D) Give one breath every 8 to 9 seconds, or 6 to 8 breaths per minute. Correct ans - B) Give one breath every 5 to 6 seconds, or 10 to 12 breaths per minute. Which item is NOT a basic airway skill? A) Placement of endotracheal tube (ET tube) B) Bag-mask ventilation C) Jaw-thrust maneuver without head extension D) Head-tilt-chin-lift maneuver Correct ans - A) Placement of endotracheal tube (ET tube) Which of the following basic airway adjuncts can be used in a conscious or semiconscious indivudual (with an intact cough and gag reflex)? A)Oropharyngeal airway (OPA) B) Endotracheal tube (ET tube) C) Nasopharyngeal airway (NPA) D) Esophageal-tracheal tube (combitube) Correct ans - C) Nasopharyngeal airway (NPA) Blood or secretions in the mouth or upper respiratory tract may threaten the airway. How can they be removed? A) Bag-mask ventllation B) Laryngeal tube C) None of the above D) Suctioning Correct ans - D) Suctioning What item is NOT an example of Advanced Airways? A) Esophageal-tracheal tube (combitube) B) Oropharyngeal airway (OPA) C) Endotracheal tube (ET tube) D) Laryngeal mask airway (LMA) Correct ans - B) Oropharyngeal airway (OPA) The compression-to-ventilation ratio during CPR prior to placement of an advanced airway is: A) 15:02 B) 20:01 C) 30:01:00 D) 30:02:00 Correct ans - D) 30:02:00 True statements about AED use in special situations include all of the following EXCEPT: A) Do not use an AED in water. B) Leave medication patches in place and place the AED electrode pads directly over the patch. C) Do not place the AED electrode pads directly over an implanted defibrillator or pacemaker. D) Extra care in placing electrode pads may be needed in individuals with a hairy chest. Correct ans - B) Leave medication patches in place and place the AED electrode pads directly over the patch. Antiarrhythmic drugs to consider for persistent VF/pulseless VT include all of the following EXCEPT: A) Lidocaine B) Amiodarone C) Atropine D) Magnesium Correct ans - INCORRECT: Lidocaine, Magnesium Bradycardia is defined as any rhythm disorder with a heart rate less than: A) 50 beats per minute B) 60 beats per minute C) 70 beats per minute D) 40 beats per minute Correct ans - B) 60 beats per minute Symptoms of bradycardia may include: A) Chest pain B) Shortness of breath C) Dizziness D) All of the above Correct ans - D) All of the above In the absence of immediately reversible causes, what is the first-line drug given for symptomatic bradycardia? A) Atropine B) Metoprolol C) Nitroglycerine D) Albuterol Correct ans - A) Atropine What is the first step in the treatment of persistent tachycardia (heart rate > 150 bpm) causing hypotension, altered mental status, and signs of shock? A) Defibrillation B) Obtain a 12-lead ECG C) Synchronized cardioversion D) Administer a calcium channel blocker Correct ans - INCORRECT: B) Obtain a 12-lead ECG D) Administer a calcium channel blocker CORRECT: If uncertain whether or not an individual is an appropriate candidate for synchronized cardioversion, the ACLS trained provider should: A) Seek expert consultation. B) Provide increased oxygenation. C) Obtain a coronary CT scan. D) Defer cardioversion until symptoms become irreversible. Correct ans - Seek expert consultation Which of the following is true concerning ischemic strokes? A) They account for 50% of all strokes and are caused by an occlusion of a vein to a region of the brain. B) They account for 87% of all strokes and are usually caused by an occlusion of an artery to a region of the brain. C) They account for 80% of all strokes and are caused by an occlusion of a vein to a region of the brain. D) They account for 13% of all strokes and are caused by an occlusion of an artery to a region of the brain. Correct ans - B) They account for 87% of all strokes and are usually caused by an occlusion of an artery to a region of the brain. All of the following are found within the 8 D's of Stroke Care EXCEPT: A) Delivery B) Detection C) Decision D) Debilitation Correct ans - D) Debilitation Where is the start of the mechanical movement of the heart generally thought to begin? A) Left atrium B) Right atrium C) Left ventricle D) Right ventricle Correct ans - B) Right atrium You are alone when you encounter an individual in what appears to be cardiac or respiratory arrest. What are the first three steps you should take to stabilize them? Check for danger, check for response, and . A) Insert an advanced airway. B) Administer an initial shock. C) Send for help. D) Start CPR. Correct ans - INCORRECT: D) Start CPR. CORRECT: You are alone when you encounter an individual in cardiac arrest. They are not breathing, have no pulse, and have no suspected cervical spine trauma. Which maneuver should you use to open the airway? A) Jaw-thrust maneuver B) Blind finger-sweeps C) Head-tilt only D) Head-tilt-chin-lift maneuver Correct ans - D) Head-tilt-chin-lift maneuver According to the 2015 ILCOR update, high-quality CPR is defined as: A) 100 chest compressions per minute at a depth of at least one inch B) 100-120 chest compressions per minute at a depth of at least two inches, but not greater than 2.4 inches C) 80 chest compressions per minute at a depth of at least two inches D) 80 chest compressions per minute at a depth of at least one inch Correct ans - 100-120 chest compressions per minute at a depth of at least two inches, but not greater than 2.4 inches This is an example of which type of heart rhythm? A) Atrial fibrillation B) Pulseless electrical activity C) Ventricular fibrillation D) Atrial flutter Correct ans - C) Ventricular fibrillation During the post-cardiac arrest phase, which of the following medications can be used to treat hypotension? A) Dopamine B) Epinephrine C) Norepinephrine D) All of the above Correct ans - D) All of the above Treatment of PEA should include the following EXCEPT: A) Identify and reverse etiologies of the arrest B) Epinephrine C) Effective CPR D) Defibrillation Correct ans - INCORRECT: B) Epinephrine CORRECT: Thirty and two equal one cycle of CPR. A) Chest compressions, ventilations B) Ventilations, compressions C) Chest compressions, pulse checks D) Chest compressions, jaw lifts Correct ans - A) Chest compressions, ventilations According to the 2015 ILCOR Guidelines, stopping chest compressions for any reason, such as pulse checks, should be limited to less than: A) 30 seconds B) 60 seconds C) 10 seconds D) 3 seconds Correct ans - C) 10 seconds The following drugs and/or interventions may be used in the ACS individual for cardiac reperfusion: A. Fibrinolytic therapy B. Atropine C. Percutaneous coronary intervention (PCI) D. Both A and C Correct ans - D. Both A and C If an individual suffering from tachycardia loses their pulse, the following should be done: A) Administer atropine B) Immediate defibrillation C) CPR until pulse is detectable D) Immediately resume CPR and switch to ACLS cardiac arrest algorithm Correct ans - D) Immediately resume CPR and switch to ACLS cardiac arrest algorithm Cardioversion should not be delayed if: A. The individual suddenly deteriorates B. Tachycardia is causing the instability C. The individual becomes pulseless D. Both A and B Correct ans - D. Both A and B Where does sinus tachycardia originate? A) Atrioventricular node B) Sinoatrial node C) Purkinje system D) Septum wall Correct ans - B) Sinoatrial node During a tachycardic episode, if the individual at any point, you must switch algorithms. A) Salivates B) C) Urinates Vomits D) Loses a pulse Correct ans - D) Loses a pulse All of the following are appropriate actions by first responders EXCEPT: A) Transport to a nearby stroke center. B) Administer oxygen. C) Check glucose level. D) Find IV access immediately. Correct ans - D) Find IV access immediately. Why should therapeutic hypothermia be considered in an adult comatose person during the post-cardiac arrest period? A) To protect the brain/organs B) To re-establish circulation C) To prevent sepsis D) To prevent tachycardia Correct ans - A) To protect the brain/organs All of the following are goals of resuscitation EXCEPT: A) Maintain blood pressure. B) Obtain normal sinus rhythm. C) Adequate perfusion. D) Decrease glucose level. Correct ans - D) Decrease glucose level. All of the following statements regarding asystole are correct EXCEPT: A) Vital organs can be permanently damaged. B) Asystolic rhythms can result in severe myocardial ischemia. C) A pulse will not be present in an asystolic individual. D) All heart tissue immediately dies when an individual enters asystole. Correct ans - D) All heart tissue immediately dies when an individual enters asystole. Fast coronary reperfusion times are associated with: A) Atrioventricular block B) Increased risk of preeclampsia C) Sinus bradycardia D) Improved outcomes Correct ans - D) Improved outcomes The right side of the heart is responsible for pulmonary circulation. Correct ans - True Any bradycardia less than 60 beats per minute is a pathologic event. Correct ans - False Therapeutic hypothermia should be considered in the comatose adult after cardiac arrest. Correct ans - True Ventricular fibrillation can be a life-threatening complication of ACS. Correct ans - True Supplemental oxygen should never be given to an individual with acute stroke . Correct ans - False Transcutaneous pacing is recommended for asystolic individuals who fail to respond to pharmacological interventions. Correct ans - False In an individual with ventricular fibrillation (VF), what should occur immediately following a shock? A) Resume CPR. B) Give epinephrine. C) Analyze rhythm. D) Check pulse. Correct ans - Resume CPR Early access to medical care, from EMS through reperfusion, improves overall outcomes by: A) Increased access to social support services B) Delaying onset of hypothermia C) Saving more heart tissue from cell death D) Faster access to medications that increase blood clotting Correct ans - C) Saving more heart tissue from cell death Serious signs and symptoms of unstable tachycardia are usually NOT seen with ventricular rates less than: A) 150 beats per minute B) 200 beats per minute C) 120 beats per minute D) 250 beats per minute Correct ans - INCORRECT: C) 120 beats per minute CORRECT: Signs and symptoms of a stroke may include: A) Sudden weakness or numbness of the face, arm, or leg B) Sudden trouble seeing in one or both eyes C) Dizziness or loss of balance or coordination D) All of the above Correct ans - D) All of the above The chambers of the heart responsible for circulating deoxygenated blood from the systemic circulation to the pulmonary circulation are the following: A) Left ventricle and right atrium B) Right atrium and right ventricle C) Left atrium and right ventricle D) Left atrium and left ventricle Correct ans - B) Right atrium and right ventricle What does the QRS represent? A) Repolarization of the ventricular B) SA node C) Conduction through the AV node D) Depolarization of the ventricular Correct ans - D) Depolarization of the ventricular Which of the following may be essential to maintain an individual's airway open? A) Rescue breaths B) Chest thrusts C) Suctioning D) O2 administration Correct ans - C) Suctioning The BLS Survey changed in the 2010 ILCOR update. Which of the following describes this change? A) Start with chest compressions instead of two rescue breaths. B) Survey is no longer represented by the mnemonic ABCD; instead, it is represented by the numbers 1, 2, 3, 4. C) Chest compressions should be continued while preparing the AED to minimize breaks. D) All of the above Correct ans - All of the above Treatment of PEA should include the following EXCEPT: A) Defibrillation B) Epinephrine C) Effective CPR D) Identify and reverse etiologies of the arrest Correct ans - INCORRECT: D) Identify and reverse etiologies of the arrest CORRECT: After performing CPR for two minutes on an individual in asystole, what is the ACLS trained provider's next intervention? A) IV or IO access for atropine administration B) Advanced airway insertion C) IV or IO access for epinephrine administration D) AED shock administration Correct ans - INCORRECT: D) AED shock administration CORRECT: Which of the following can represent a correct treatment choice for an individual in asystole? A. Synchronized shock with an AED B. Epinephrine C. Vasopressin D. Both B and C Correct ans - D. Both B and C Individuals experiencing a suspected ACS should be transported to: A) An appropriate center for triage B) A center that has a dedicated stroke team C) A facility that performs PCI D) A facility with trauma care Correct ans - INCORRECT: A) An appropriate center for triage Which of the following is an alternative to atropine in treating bradycardia? A) Dopamine B) Epinephrine C) Transcutaneous pacing D) All of the above are alternatives. Correct ans - D) All of the above are alternatives. Which of the following is a correct statement regarding sinus tachycardia? A) Sinus tachycardia only results from strenuous exercise or high stress situations. B) Sinus tachycardia is a normal rhythm and never considered dangerous. C) The goal of treatment is to identify and correct the underlying cause. D) Sinus tachycardia should always be treated with shock therapy. Correct ans - C) The goal of treatment is to identify and correct the underlying cause. For appropriate treatment, it is vital to discern if the QRS wave is in a tachycardic individual. A) Present or absent B) Right or left C) Positive or negative D) Wide or narrow Correct ans - D) Wide or narrow After arrival of an acute stroke individual in the ED, in what time frame should an assessment and an order for a CT scan be completed? A) 60 minutes B) 30 minutes C) 10 minutes D) 90 minutes Correct ans - INCORRECT: B) 30 minutes Upon assessment, the individiual is confused and complains of a headache and the left side of his body being numb. What do you suspect is the most likely diagnosis? A) Sepsis B) Unstable tachycardia C) Acute coronary syndrome D) Acute stroke Correct ans - Acute stroke Within what time period of arrival to the ED is percutaneous coronary intervention (PCI) recommended for STEMI individuals? A) 10 minutes B) 150 minutes C) 90 minutes D) 20 minutes Correct ans - C) 90 minutes If bradycardia is symptomatic, what is the most likely heart rate exhibited? A) Above 50 bpm B) Above 60 bpm C) Below 100 bpm D) Below 50 bpm Correct ans - D) Below 50 bpm Fibrinolytic therapy is the treatment of choice for hemorrhagic stroke. Correct ans - False Nausea in conjunction with chest pain may be indicative of myocardial ischemia. Correct ans - True Symptomatic bradycardia and poor perfusion may degrade into cardiac arrest. Correct ans - True Interruptions in CPR for repeated consecutive defibrillator shocks always provide better resuscitation. Correct ans - False What is the maximum time allowed for interruptions in CPR such as checking for breathing and pulse in order to maximize time spent on compressions? Correct ans - 10 seconds The ACLS Survey includes assessing which of the following? Correct ans - Airway, Breathing, Circulation, Differential Diagnosis Hyperventillation (over ventillation) can be harmful because it: Correct ans - All of the above What reason is NOT valid during the critical early defibrillation for individuals experiencing sudden cardiac arrest? Correct ans - INCORRECT: The probability of successful defibrillation decreases quickly over time. The proper steps for operating an AED are: Correct ans - Power on the AED, attach electrode pads, analyze the rhythm, and shock the individual. The two most common and easily reversible causes of PEA are: Correct ans - INCORRECT: Acidosis, hypokalemia Symptoms suggestive of ACS may include all of the following EXCEPT: Correct ans - Chest discomfort with lightheadedness, sweating, or nausea Medications administered in the early treatment of suspected ACS include: Correct ans - Oxygen, aspirin, nitroglycerin, and morphine What is the only means of identifying ST-elevation MI (STEMI)? Correct ans - 12-lead ECG Tachycardia is defined as a heart rate greater than: Correct ans - INCORRECT: 120 Signs of unstable tachycardia may include all of the following EXCEPT: Correct ans - Abdominal tenderness Critical in-hospital goals of stroke care include a neurological assessment by the stroke team and a CT scan performed within of hospital arrival. Correct ans - 25 minutes Which wave represents repolarization of the ventricles? Correct ans - T wave Defibrillators have two different designs for delivering energy. What are they? Correct ans - Monophasic & Biphasic Which of the following would be your next action if the rhythm is unshockable, and there is no pulse? Correct ans - Immediately resume CPR. An important link in the STEMI Chain of Survival is improving myocardial perfusion by: Correct ans - INCORRECT: Defibrillation Acute strokes are a result of: Correct ans - Either B or C: Blockage of an artery in the brain Rupture of an artery in the brain All of the following are considered classic symptoms of an acute stroke EXCEPT: Correct ans - INCORRECT: all of the above In confirming and monitoring placement of the ET tube, the 2015 ACLS guidelines suggest what? Correct ans - INCORRECT: pulse oximetry Which of the following is the primary treatment in management of ventricular fibrillation? Correct ans - INCORRECT: all of the above