ALS Extra Mock Exam Paper 1 out of 12
Question Sheet:
1. Question
You are receiving a radio report from an EMS team en route with a patient who may be
having an acute stroke. The hospital CT scanner is not working at this time. What should you
do in this situation?
1. Contact the patient’s family to see what they would prefer.
2. Have the EMS crew choose an appropriate patient disposition.
3. Accept the report and provide care within your present capability.
4. Divert the patient to a hospital with CT capabilities.
2. Question
A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient’s
blood pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16
breaths/min, and the pulse oximetry reading is 96%. The lead II ECG is displayed below. A
patent peripheral IV is in place. What is the next action?
1. Acquisition of a 12-lead ECG
2. Vagal maneuvers
3. Procedural sedation
4. Immediate defibrillation
3. Question
A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is
diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the
heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is
95%. The patient’s 12-lead ECG shows STsegment elevation in the anterior leads. First
responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is
described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What
is the next action?
1. Administer an additional dose of aspirin.
2. Administer an additional nitroglycerin tablet.
3. Administer high-flow oxygen via an oxygen mask.
4. Administer 2 to 4 mg of morphine by slow IV bolus.
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,4. Question
A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing.
The blood pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate
is 12 breaths/min, and the pulse oximetry reading is 95%. The lead II ECG displays a
wide-complex tachycardia. What is the next action after establishing an IV and obtaining a
12-lead ECG?
1. Administration of IV epinephrine
2. Seeking expert consultation
3. Procedural sedation
4. Synchronized cardioversion
5. Question
A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at
a rate of 220/min. The patient’s blood pressure is 128/58 mm Hg, the PETCO2 is 38 mm Hg,
and the pulse oximetry reading is 98%. There is vascular access at the left internal jugular
vein, and the patient has not been given any vasoactive drugs. A 12-lead ECG confirms a
supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate has
not responded to vagal maneuvers. What is the next recommended intervention?
1. Adenosine 6 mg IV push
2. Amiodarone 300 mg IV push
3. Synchronized cardioversion at 50 J
4. Synchronized cardioversion at 200 J
6. Question
An 80-year-old woman presents to the emergency department with dizziness. She now
states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She
is alert and oriented. Her lead II ECG is below. After you start an IV, what is the next action?
1. Give an IV fluid bolus.
2. Give atropine and monitor for changes in mental status.
3. Start an epinephrine infusion and titrate to patient response.
4. Conduct a problem-focused history and physical examination.
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, 7. Question
What is the recommended oral dose of aspirin for patients suspected of having one of the
acute coronary syndromes?
1. 2 to 4 mg
2. 80 to 120 mg
3. 160 to 325 mg
4. 400 to 600 mg
8. Question
A responder is caring for a patient with a history of congestive heart failure. The patient is
experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of
190/min. The patient’s lead II ECG is displayed below.
1. Sinus tachycardia
2. Perfusing ventricular tachycardia
3. Stable supraventricular tachycardia
4. Unstable supraventricular tachycardia
9. Question
What is the most appropriate intervention for a rapidly deteriorating patient who has this lead
II ECG?
1. Valsalva maneuver
2. Synchronized cardioversion
3. Intravenous administration of adenosine
4. Immediate unsynchronized countershock
ALS Revision Resources at ALSQuestionBank.com
Question Sheet:
1. Question
You are receiving a radio report from an EMS team en route with a patient who may be
having an acute stroke. The hospital CT scanner is not working at this time. What should you
do in this situation?
1. Contact the patient’s family to see what they would prefer.
2. Have the EMS crew choose an appropriate patient disposition.
3. Accept the report and provide care within your present capability.
4. Divert the patient to a hospital with CT capabilities.
2. Question
A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient’s
blood pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16
breaths/min, and the pulse oximetry reading is 96%. The lead II ECG is displayed below. A
patent peripheral IV is in place. What is the next action?
1. Acquisition of a 12-lead ECG
2. Vagal maneuvers
3. Procedural sedation
4. Immediate defibrillation
3. Question
A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is
diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the
heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is
95%. The patient’s 12-lead ECG shows STsegment elevation in the anterior leads. First
responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is
described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What
is the next action?
1. Administer an additional dose of aspirin.
2. Administer an additional nitroglycerin tablet.
3. Administer high-flow oxygen via an oxygen mask.
4. Administer 2 to 4 mg of morphine by slow IV bolus.
ALS Revision Resources at ALSQuestionBank.com
,4. Question
A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing.
The blood pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate
is 12 breaths/min, and the pulse oximetry reading is 95%. The lead II ECG displays a
wide-complex tachycardia. What is the next action after establishing an IV and obtaining a
12-lead ECG?
1. Administration of IV epinephrine
2. Seeking expert consultation
3. Procedural sedation
4. Synchronized cardioversion
5. Question
A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at
a rate of 220/min. The patient’s blood pressure is 128/58 mm Hg, the PETCO2 is 38 mm Hg,
and the pulse oximetry reading is 98%. There is vascular access at the left internal jugular
vein, and the patient has not been given any vasoactive drugs. A 12-lead ECG confirms a
supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate has
not responded to vagal maneuvers. What is the next recommended intervention?
1. Adenosine 6 mg IV push
2. Amiodarone 300 mg IV push
3. Synchronized cardioversion at 50 J
4. Synchronized cardioversion at 200 J
6. Question
An 80-year-old woman presents to the emergency department with dizziness. She now
states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She
is alert and oriented. Her lead II ECG is below. After you start an IV, what is the next action?
1. Give an IV fluid bolus.
2. Give atropine and monitor for changes in mental status.
3. Start an epinephrine infusion and titrate to patient response.
4. Conduct a problem-focused history and physical examination.
ALS Revision Resources at ALSQuestionBank.com
, 7. Question
What is the recommended oral dose of aspirin for patients suspected of having one of the
acute coronary syndromes?
1. 2 to 4 mg
2. 80 to 120 mg
3. 160 to 325 mg
4. 400 to 600 mg
8. Question
A responder is caring for a patient with a history of congestive heart failure. The patient is
experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of
190/min. The patient’s lead II ECG is displayed below.
1. Sinus tachycardia
2. Perfusing ventricular tachycardia
3. Stable supraventricular tachycardia
4. Unstable supraventricular tachycardia
9. Question
What is the most appropriate intervention for a rapidly deteriorating patient who has this lead
II ECG?
1. Valsalva maneuver
2. Synchronized cardioversion
3. Intravenous administration of adenosine
4. Immediate unsynchronized countershock
ALS Revision Resources at ALSQuestionBank.com
