ACLS COMPLETE QUESTIONS AND ANSWERS
1.In which situation does bradycardia require treatment?
ANS Hypotension
2.Which intervention is most appropriate for the treatment of a patient
in asystole?
ANS Epinephrine
3.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?
ANS Establish IV or IO access
4.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 38mm Hg, and the pulse oximetry reading is
98%. There is vascular access in the left arm, and the patient has not been
given any
vasoactive drugs. A 12-lead ECG confirm a supraventricular tachycardia with
no evidence of ischemia or infarction. The heart rate has not responded to
vagal maneuvers. what is your next action?
ANS Administer adenosine 6mg IV push
5.A patient has sinus bradycardia with a heart rate of 36/min. Atropine has
been administered to a toal does 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?
ANS Epinephrine 2 to 10 mcg/min
,6.A patient is in cardiac arrest. Ventricular fibrillation has been refractory
to a second shock. Which drug should be administered first?
ANS Epinephrine 1 mg IV/IO
7.A 62-year-old man suddenly experienced difficulty speaking and left-
sided weakness. He meets initial criteria for fibrinolytic therapy, and a CT
scan of the brain si ordered. Which best describes the guidelines for
antiplatelet and fibrinolytic therapy?
ANS Hold aspirin for at least 24 hours if rtPA is administered
8.A patient is in refractory ventricular fibrillation and has received multiple
appropriate defribillation shocks, epinephrine 1 mg IV twice, and an initial
dose of amiodarone 300mg IV. The patient is intubated. Which best
describe the recommended second does of amiodarone for this patient?
ANS 150 mg IV push
9. A patient with sinus bradycardia and a heart rate of 42/min has
diaphoresis and a blood pressure of 80/60mm Hg. What is the initial does of
atropine?
ANS - 0.5mg
10.A 35-year-old woman has palpitations, light-headedness, and a stable
tachycardia. The monitor shows a regular narrow-complex QRS at a rate of
180/min. Vagal maneuvers have not been effective in terminating the
rhythm. An IV has been established. Which drug should be administered?
ANS Adenosine 6mg
11.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?
ANS IV or IO
12.What is the indication for the use of magnesium in cardiac arrest?
,ANS Pulse- less ventricular tachycardia-associated torsades de pointes
13.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?
ANS Seeking expert consultation
14.A patient is in cardiac arrest. High-quality chest compressions are
being given. The patient is intubated, and an IV has been started. The
rhythm is asystole. What is the first drug/dose to administer?
ANS Epinephrine 1mg IV/IO
15.A patient is in refractory ventricular fibrillation. High-quality CPR is in
progress. One does of epinephrine was given after the second shock. An
antiarrhythmic drug was given immediately after the third shock. You are
the team leader. Which medication do you order next.
ANS Epinephrine 1 mg
16.A patient with possible STEMI has ongoing chest discomfort. What is a
contraindication to nitrate administration?
ANS Use of a phosphodiestrase inhibitor within the previous 24 hours
17.A 57-year-old woman has palpitation, chest discomfort, and tachycardia.
The monitor shows a regular wide-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?
ANS Perform electrical cardioversion
18.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, with was treated 5 years ago. What is your next action?
ANS Give aspirin 160-325 mg to chew
, 19.You are caring for a 66-year-old man with a history of a large
intracerebral hemorrhage 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 2L/min, and an IV has been established. His blood pressure
is 180/100mm Hg. Which drug do you anticipate giving to this patient?
ANS Aspirin
20.A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose
of epinephrine have been given. Which drug should be given next?
ANS Amiodarone 300mg
21.What is the maximum interval for pausing chest compressions?
ANS 10 sec- onds
22.Your patient is a 56-year-old woman with a history of type 2 diabetes
who reports feeling dizzy. She is pale and diaphoretic. Her blood pressure
is 80/66mm Hg. The cardiac monitor documents the rhythm shown here.
She is
receiving oxygen at 4L/min by nasal cannula, and an Iv has been established
What do you administer next?
ANS Atropine 0.5mg IV
23.A 35-year-old woman presents with a chief complaint of palpitations. She
has no chest discomfort, shortness of breath, or light-headedness. Her
blood pressure is 120/78mm Hg. Which intervention is indicated first?
ANS Vagal maneu- vers
24.Which action should you take immediately after providing an AED shock?
ANS Resume chest compressions
25.What action minimizes the risk of air entering the victim's stomach dur-
ing-bag mask ventilation?
1.In which situation does bradycardia require treatment?
ANS Hypotension
2.Which intervention is most appropriate for the treatment of a patient
in asystole?
ANS Epinephrine
3.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?
ANS Establish IV or IO access
4.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 38mm Hg, and the pulse oximetry reading is
98%. There is vascular access in the left arm, and the patient has not been
given any
vasoactive drugs. A 12-lead ECG confirm a supraventricular tachycardia with
no evidence of ischemia or infarction. The heart rate has not responded to
vagal maneuvers. what is your next action?
ANS Administer adenosine 6mg IV push
5.A patient has sinus bradycardia with a heart rate of 36/min. Atropine has
been administered to a toal does 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?
ANS Epinephrine 2 to 10 mcg/min
,6.A patient is in cardiac arrest. Ventricular fibrillation has been refractory
to a second shock. Which drug should be administered first?
ANS Epinephrine 1 mg IV/IO
7.A 62-year-old man suddenly experienced difficulty speaking and left-
sided weakness. He meets initial criteria for fibrinolytic therapy, and a CT
scan of the brain si ordered. Which best describes the guidelines for
antiplatelet and fibrinolytic therapy?
ANS Hold aspirin for at least 24 hours if rtPA is administered
8.A patient is in refractory ventricular fibrillation and has received multiple
appropriate defribillation shocks, epinephrine 1 mg IV twice, and an initial
dose of amiodarone 300mg IV. The patient is intubated. Which best
describe the recommended second does of amiodarone for this patient?
ANS 150 mg IV push
9. A patient with sinus bradycardia and a heart rate of 42/min has
diaphoresis and a blood pressure of 80/60mm Hg. What is the initial does of
atropine?
ANS - 0.5mg
10.A 35-year-old woman has palpitations, light-headedness, and a stable
tachycardia. The monitor shows a regular narrow-complex QRS at a rate of
180/min. Vagal maneuvers have not been effective in terminating the
rhythm. An IV has been established. Which drug should be administered?
ANS Adenosine 6mg
11.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?
ANS IV or IO
12.What is the indication for the use of magnesium in cardiac arrest?
,ANS Pulse- less ventricular tachycardia-associated torsades de pointes
13.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?
ANS Seeking expert consultation
14.A patient is in cardiac arrest. High-quality chest compressions are
being given. The patient is intubated, and an IV has been started. The
rhythm is asystole. What is the first drug/dose to administer?
ANS Epinephrine 1mg IV/IO
15.A patient is in refractory ventricular fibrillation. High-quality CPR is in
progress. One does of epinephrine was given after the second shock. An
antiarrhythmic drug was given immediately after the third shock. You are
the team leader. Which medication do you order next.
ANS Epinephrine 1 mg
16.A patient with possible STEMI has ongoing chest discomfort. What is a
contraindication to nitrate administration?
ANS Use of a phosphodiestrase inhibitor within the previous 24 hours
17.A 57-year-old woman has palpitation, chest discomfort, and tachycardia.
The monitor shows a regular wide-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?
ANS Perform electrical cardioversion
18.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, with was treated 5 years ago. What is your next action?
ANS Give aspirin 160-325 mg to chew
, 19.You are caring for a 66-year-old man with a history of a large
intracerebral hemorrhage 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 2L/min, and an IV has been established. His blood pressure
is 180/100mm Hg. Which drug do you anticipate giving to this patient?
ANS Aspirin
20.A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose
of epinephrine have been given. Which drug should be given next?
ANS Amiodarone 300mg
21.What is the maximum interval for pausing chest compressions?
ANS 10 sec- onds
22.Your patient is a 56-year-old woman with a history of type 2 diabetes
who reports feeling dizzy. She is pale and diaphoretic. Her blood pressure
is 80/66mm Hg. The cardiac monitor documents the rhythm shown here.
She is
receiving oxygen at 4L/min by nasal cannula, and an Iv has been established
What do you administer next?
ANS Atropine 0.5mg IV
23.A 35-year-old woman presents with a chief complaint of palpitations. She
has no chest discomfort, shortness of breath, or light-headedness. Her
blood pressure is 120/78mm Hg. Which intervention is indicated first?
ANS Vagal maneu- vers
24.Which action should you take immediately after providing an AED shock?
ANS Resume chest compressions
25.What action minimizes the risk of air entering the victim's stomach dur-
ing-bag mask ventilation?
