ACLS PRE-COURSE SELF-
ASSESSMENT EXAM QUESTIONS
WITH COMPLETE ANSWERS
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 mm Hg. Which
therapy is now indicated?
Adenosine 6 mg
Epinephrine 2 to 10 mcg/min
Normal saline 250 mL to 500 mL bolus
Atropine 1 mg - ANSWER-Epinephrine 2 to 10 mcg/min
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial
shock. If no pathway for medication administration is in place, which method is
preferred?
Endotracheal tube
Central line
External jugular vein
IV or IO - ANSWER-IV or IO
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second
shock. Which drug should be administered first?
Epinephrine 1 mg IV/IO
Lidocaine 1 mg/kg IV/IO
Atropine 1 mg IV/IO
Sodium bicarbonate 50 mEq IV/IO - ANSWER-Epinephrine 1 mg IV/IO
A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is
138/min. He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a
history of angina. What action is recommended next?
Performing synchronized cardioversion
Giving lidocaine 1 to 1.5 mg IV bolus
Giving adenosine 6 mg IV bolus
Seeking expert consultation - ANSWER-Seeking expert consultation
In which situation does bradycardia require treatment?
Diastolic blood pressure greater than 90 mm Hg
12-lead ECG showing a normal sinus rhythm
Hypotension
Systolic blood pressure greater than 100 mm Hg - ANSWER-Hypotension
, What is the indication for the use of magnesium in cardiac arrest?
Shock-refractory monomorphic ventricular tachycardia
Ventricular tachycardia associated with a normal QT interval
Shock-refractory ventricular fibrillation
Pulseless ventricular tachycardia-associated torsades de pointes - ANSWER-
Pulseless ventricular tachycardia-associated torsades de pointes
A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a
blood pressure of 80/60 mm Hg. What is the initial dose of atropine?
0.1 mg
1 mg
3 mg
0.5 mg - ANSWER-1 mg
A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and
a heparin infusion of 1000 units per hour are being administered. The patient did not
take aspirin because he has a history of gastritis, which was treated 5 years ago.
What is your next action?
Give enteric-coated aspirin 325 mg rectally
Give aspirin 162 to 325 mg to chew
Give enteric-coated aspirin 75 mg orally
Give clopidogrel 300 mg orally - ANSWER-Give aspirin 162 to 325 mg to chew
A 57-year-old woman has palpitations, chest discomfort, and tachycardia. The
monitor shows 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?
Seek expert consultation
Perform electrical cardioversion
Establish IV access
Obtain a 12-lead ECG - ANSWER-Perform electrical cardioversion
A patient is in refractory ventricular fibrillation and has received multiple appropriate
defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone
300 mg IV. The patient is intubated. Which best describes the recommended second
dose of amiodarone for this patient?
150 mg IV push
1 to 2 mg/min infusion
300 mg IV push
1 mg/kg IV push - ANSWER-150 mg IV push
You arrive on the scene with the code team. High-quality CPR is in progress. An
AED has previously advised "no shock indicated." A rhythm check now finds
asystole. After resuming high-quality compressions, which action do you take next?
Perform endotracheal intubation
ASSESSMENT EXAM QUESTIONS
WITH COMPLETE ANSWERS
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 mm Hg. Which
therapy is now indicated?
Adenosine 6 mg
Epinephrine 2 to 10 mcg/min
Normal saline 250 mL to 500 mL bolus
Atropine 1 mg - ANSWER-Epinephrine 2 to 10 mcg/min
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial
shock. If no pathway for medication administration is in place, which method is
preferred?
Endotracheal tube
Central line
External jugular vein
IV or IO - ANSWER-IV or IO
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second
shock. Which drug should be administered first?
Epinephrine 1 mg IV/IO
Lidocaine 1 mg/kg IV/IO
Atropine 1 mg IV/IO
Sodium bicarbonate 50 mEq IV/IO - ANSWER-Epinephrine 1 mg IV/IO
A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is
138/min. He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a
history of angina. What action is recommended next?
Performing synchronized cardioversion
Giving lidocaine 1 to 1.5 mg IV bolus
Giving adenosine 6 mg IV bolus
Seeking expert consultation - ANSWER-Seeking expert consultation
In which situation does bradycardia require treatment?
Diastolic blood pressure greater than 90 mm Hg
12-lead ECG showing a normal sinus rhythm
Hypotension
Systolic blood pressure greater than 100 mm Hg - ANSWER-Hypotension
, What is the indication for the use of magnesium in cardiac arrest?
Shock-refractory monomorphic ventricular tachycardia
Ventricular tachycardia associated with a normal QT interval
Shock-refractory ventricular fibrillation
Pulseless ventricular tachycardia-associated torsades de pointes - ANSWER-
Pulseless ventricular tachycardia-associated torsades de pointes
A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a
blood pressure of 80/60 mm Hg. What is the initial dose of atropine?
0.1 mg
1 mg
3 mg
0.5 mg - ANSWER-1 mg
A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and
a heparin infusion of 1000 units per hour are being administered. The patient did not
take aspirin because he has a history of gastritis, which was treated 5 years ago.
What is your next action?
Give enteric-coated aspirin 325 mg rectally
Give aspirin 162 to 325 mg to chew
Give enteric-coated aspirin 75 mg orally
Give clopidogrel 300 mg orally - ANSWER-Give aspirin 162 to 325 mg to chew
A 57-year-old woman has palpitations, chest discomfort, and tachycardia. The
monitor shows 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?
Seek expert consultation
Perform electrical cardioversion
Establish IV access
Obtain a 12-lead ECG - ANSWER-Perform electrical cardioversion
A patient is in refractory ventricular fibrillation and has received multiple appropriate
defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone
300 mg IV. The patient is intubated. Which best describes the recommended second
dose of amiodarone for this patient?
150 mg IV push
1 to 2 mg/min infusion
300 mg IV push
1 mg/kg IV push - ANSWER-150 mg IV push
You arrive on the scene with the code team. High-quality CPR is in progress. An
AED has previously advised "no shock indicated." A rhythm check now finds
asystole. After resuming high-quality compressions, which action do you take next?
Perform endotracheal intubation
