ACLS PHARMACOLOGY
1. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been
administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The
patient is confused, and her blood pressure is 88/56 mmHg. Which therapy is now indicated?
A. atropine 1 mg
B. epinephrine 2 to 10 mcg/min
C. adenosine 6 mg
D. normal saline 250 ml to 500 ml bolus
Answer: B. epinephrine 2 to 10 mcg/min
2. a 57 year-old-woman has palpitations, chest discomfort, and tachycardia.The monitor
show a regular wide-complex QRS at a rate of 180/min. she becomes diaphoretic, and her
blood pressure is 80/60 mm Hg. Which action do you take next?
A. establish IV access
B. obtain a 12-lead ECG
C. perform electrical cardioversion
D. seek expert consultation
Answer: C. perform electrical cardioversion
3. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock.
If no pathway for medication administration is in place, whichmethod is preferred?
A. central line
B. endotracheal tube
C. external jugular vein
D. IV or IO
Answer: D. IV or IO
4. A patient with possible STEMI has ongoing chest discomfort. What is acontraindication
to nitrate administration?
A. anterior wall myocardial infarction
B. heart rate less than 90/min
C. systolic blood pressure greater that 180 mm Hg
D. use of a phosphodiesterase inhibitor within the previous24 hours
Answer: D. use of a phosphodiesterase inhibitor within the last 24 hours
5. A patient is in refractory ventricular fibrillation and has received multipleappropriate
defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300 mg
IV.The patient is intubated. Which best describethe recommended second dose of amiodarone
, for this patient?
A. 1 mg/kg IV push
B. 1 to 2 mg/min infusion
C. 150 mg IV push
D. 300 mg IV push
Answer: C. 15o mg IV push
6. You are caring for a 66-year-old man with a history of a large intracerebralhemorrhage 2
months ago. He is being evaluated for another acute stroke. The CT scan is negative for
hemorrhage. The patient is receiving oxygen via nasal cannula at 2 L/min, and an IV has been
established. His blood pressureis 180/100 mm Hg. Which drug do you anticipate giving to this
patient?
A. aspirin
B. glucose (D50)
C. nicardipine
D. rtPA
Answer: A. aspirin
7. A patient with sinus bradycardia and a heart rate of 42/min has diaphoresisand a blood
pressure of 80/60 mm Hg. What is the initial dose of atropine?
A. 0.1 mg
B. 0.5 mg
C. 1 mg
D. 3 mg
Answer: B. 0.5 mg
8. A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IVbolus and a
heparin infusion of 1000 unit per hour are being administered.Thepatient did not take aspirin
because he has a history of gastritis, which was treated 5 years ago. What is your next action?
A. give aspirin 160 to 325 mg to chew
B. give clopidogrel 300 mg orally
C. give enteric-coated aspirin 75 mg orally
D. give enteric-coated aspirin 325 mg rectally
Answer: A. give aspirin 160 to 325 mg tochew
9. A patient is in pulseless ventricular tachycardia.Two shocks and 1 dose ofepinephrine have
been given. Which drug should be given next?
A. adenosine 6 mg
B. amiodarone 300 mg
1. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been
administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The
patient is confused, and her blood pressure is 88/56 mmHg. Which therapy is now indicated?
A. atropine 1 mg
B. epinephrine 2 to 10 mcg/min
C. adenosine 6 mg
D. normal saline 250 ml to 500 ml bolus
Answer: B. epinephrine 2 to 10 mcg/min
2. a 57 year-old-woman has palpitations, chest discomfort, and tachycardia.The monitor
show a regular wide-complex QRS at a rate of 180/min. she becomes diaphoretic, and her
blood pressure is 80/60 mm Hg. Which action do you take next?
A. establish IV access
B. obtain a 12-lead ECG
C. perform electrical cardioversion
D. seek expert consultation
Answer: C. perform electrical cardioversion
3. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock.
If no pathway for medication administration is in place, whichmethod is preferred?
A. central line
B. endotracheal tube
C. external jugular vein
D. IV or IO
Answer: D. IV or IO
4. A patient with possible STEMI has ongoing chest discomfort. What is acontraindication
to nitrate administration?
A. anterior wall myocardial infarction
B. heart rate less than 90/min
C. systolic blood pressure greater that 180 mm Hg
D. use of a phosphodiesterase inhibitor within the previous24 hours
Answer: D. use of a phosphodiesterase inhibitor within the last 24 hours
5. A patient is in refractory ventricular fibrillation and has received multipleappropriate
defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300 mg
IV.The patient is intubated. Which best describethe recommended second dose of amiodarone
, for this patient?
A. 1 mg/kg IV push
B. 1 to 2 mg/min infusion
C. 150 mg IV push
D. 300 mg IV push
Answer: C. 15o mg IV push
6. You are caring for a 66-year-old man with a history of a large intracerebralhemorrhage 2
months ago. He is being evaluated for another acute stroke. The CT scan is negative for
hemorrhage. The patient is receiving oxygen via nasal cannula at 2 L/min, and an IV has been
established. His blood pressureis 180/100 mm Hg. Which drug do you anticipate giving to this
patient?
A. aspirin
B. glucose (D50)
C. nicardipine
D. rtPA
Answer: A. aspirin
7. A patient with sinus bradycardia and a heart rate of 42/min has diaphoresisand a blood
pressure of 80/60 mm Hg. What is the initial dose of atropine?
A. 0.1 mg
B. 0.5 mg
C. 1 mg
D. 3 mg
Answer: B. 0.5 mg
8. A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IVbolus and a
heparin infusion of 1000 unit per hour are being administered.Thepatient did not take aspirin
because he has a history of gastritis, which was treated 5 years ago. What is your next action?
A. give aspirin 160 to 325 mg to chew
B. give clopidogrel 300 mg orally
C. give enteric-coated aspirin 75 mg orally
D. give enteric-coated aspirin 325 mg rectally
Answer: A. give aspirin 160 to 325 mg tochew
9. A patient is in pulseless ventricular tachycardia.Two shocks and 1 dose ofepinephrine have
been given. Which drug should be given next?
A. adenosine 6 mg
B. amiodarone 300 mg
