ACLS Final Exam Questions and Answers
1.Dosing of epinephrine in the setting of VF/pVT and asystole/PEA
ANS 1 mg every 3-5 minutes
2.Dosing of amiodarone (first and second dose) in the setting of
cardiac arrest
ANS 300mg first dose
150mg second dose after 3-5 min
3.Dosing of lidocaine (first and second dose) in the setting of cardiac arrest-
ANS 1-1.5mg/kg first dose
0.5-0.75 mg/kg second dose, repeat in 5-10 min
4.What is the maximum dose of lidocaine?
ANS 3 doses or 3mg/kg
5.ROSC is typically signified by a PETCO2 of what?
ANS 40 mm Hg or more
6.The "Hs" of reversible causes of cardiac arrest
ANS 1. Hypovolemia
2. Hypoxia
3.Hydrogen ions (acidosis)
4. Hypo/hyperkalemia
5. Hypothermia
7.The "Ts" of reversible causes of cardiac arrest
ANS 1. Tension pneumothorax
2. Tamponade, cardiac
3. Toxins
,4.Thrombosis, pulmonary
5.Thrombosis, coronary
8.In the setting of cardiac arrest, once an advanced airway is in place, 1
breath should be given every seconds. Should chest compressions be
inter- rupted once an advanced airway is in place?
ANS 6-8 seconds (8-10 breaths/min) with continuous chest
compressions
9.If PETCO2 falls below , attempts should be made to improve
chest compressions
ANS 10
10.If intra-arterial pressure monitoring is being utilized during a
resuscitation attempt, if the diastolic pressure falls below mm Hg, attempts
should be made to improve chest compressions
ANS 20
11.depth of adequate chest compressions
ANS 2 inches
12.rate of adequate chest compressions
ANS 100-120/min
13.If no advanced airway is in place, what is the ratio of chest
compressions to ventilations?
ANS 30:2
14.Shock energy that should be used on a biphasic machine for defibrillation
ANS 120-200 J, if recommended setting not known, use maximum
available
,15.Shock energy that should be used on a monophasic machine for
defibril- lation
ANS 360J
16.In the setting of cardiac arrest, when should vasopressors be adminis-
tered?
ANS after the patient has failed CPR and defibrillation (shock-refractory
arrhyth- mias)
17.The only vasopressor recommended in the cardiac arrest algorithm
ANS epi- nephrine
18.Why is vasopressin no longer recommended in the cardiac arrest al-
gorithm as a vasopressor?
ANS no additional benefit and may increase delays in medication
administration
19.Are higher doses of epinephrine recommended in certain situations of
cardiac arrest? If so, what situations are higher doses of epinephrine
recom- mended?
ANS no; no benefit to support use, possible harm
20.When is endotracheal medication administration recommended?
ANS not rec- ommended unless unable to give meds IV or IO
21.Which medications can be administered via endotracheal tube?
ANS lidocaine, epinephrine, atropine, naloxone
22.What is different about the dosing of medications if endotracheal
medica- tion administration is performed?
ANS Typically ETT dose 2-2.5 higher than IV due to lower absorption
, and dilution in 5-10mL of fluid is recommended
23.When can antiarrhythmics be considered in the setting of cardiac arrest?
ANS use may be considered in patients with VF/VT who have failed high-
quality CPR, shocks, and vasopressors
24.Why must antiarrhythmics never interfere with CPR and shocks?
ANS never been shown to increase survival to discharge
25.Antiarrhythmics that could be considered in the setting of VF/VT
ANS amio- darone and lidocaine
26.The traditional formulation of amiodarone contains what component
that may cause bradycardia and hypotension
ANS polysorbate 80
27.Premixed bags of amiodarone contain what component instead of
polysor- bate 80?
ANS captisol
28.Are premixed bags (360mg/200mL) of amiodarone typically found in
the code cart?
ANS no; used in the ICU
29.Sodium bicarbonate is not typically used in the setting of cardiac
arrest, except under what circumstances?
ANS -known preexisting hyperkalemia
-known preexisiting bicarbonate-responsive acidosis such as DKA
-OD of TCAs, aspirin, cocaine, or diphenhydramine
-prolonged resuscitation with effective ventilation; on return of
spontaneous circula- tion after long arrest interval
30.Calcium is not typically used in the setting of cardiac arrest, except
under what circumstances?
ANS -beta blocker or calcium channel blocker overdose
1.Dosing of epinephrine in the setting of VF/pVT and asystole/PEA
ANS 1 mg every 3-5 minutes
2.Dosing of amiodarone (first and second dose) in the setting of
cardiac arrest
ANS 300mg first dose
150mg second dose after 3-5 min
3.Dosing of lidocaine (first and second dose) in the setting of cardiac arrest-
ANS 1-1.5mg/kg first dose
0.5-0.75 mg/kg second dose, repeat in 5-10 min
4.What is the maximum dose of lidocaine?
ANS 3 doses or 3mg/kg
5.ROSC is typically signified by a PETCO2 of what?
ANS 40 mm Hg or more
6.The "Hs" of reversible causes of cardiac arrest
ANS 1. Hypovolemia
2. Hypoxia
3.Hydrogen ions (acidosis)
4. Hypo/hyperkalemia
5. Hypothermia
7.The "Ts" of reversible causes of cardiac arrest
ANS 1. Tension pneumothorax
2. Tamponade, cardiac
3. Toxins
,4.Thrombosis, pulmonary
5.Thrombosis, coronary
8.In the setting of cardiac arrest, once an advanced airway is in place, 1
breath should be given every seconds. Should chest compressions be
inter- rupted once an advanced airway is in place?
ANS 6-8 seconds (8-10 breaths/min) with continuous chest
compressions
9.If PETCO2 falls below , attempts should be made to improve
chest compressions
ANS 10
10.If intra-arterial pressure monitoring is being utilized during a
resuscitation attempt, if the diastolic pressure falls below mm Hg, attempts
should be made to improve chest compressions
ANS 20
11.depth of adequate chest compressions
ANS 2 inches
12.rate of adequate chest compressions
ANS 100-120/min
13.If no advanced airway is in place, what is the ratio of chest
compressions to ventilations?
ANS 30:2
14.Shock energy that should be used on a biphasic machine for defibrillation
ANS 120-200 J, if recommended setting not known, use maximum
available
,15.Shock energy that should be used on a monophasic machine for
defibril- lation
ANS 360J
16.In the setting of cardiac arrest, when should vasopressors be adminis-
tered?
ANS after the patient has failed CPR and defibrillation (shock-refractory
arrhyth- mias)
17.The only vasopressor recommended in the cardiac arrest algorithm
ANS epi- nephrine
18.Why is vasopressin no longer recommended in the cardiac arrest al-
gorithm as a vasopressor?
ANS no additional benefit and may increase delays in medication
administration
19.Are higher doses of epinephrine recommended in certain situations of
cardiac arrest? If so, what situations are higher doses of epinephrine
recom- mended?
ANS no; no benefit to support use, possible harm
20.When is endotracheal medication administration recommended?
ANS not rec- ommended unless unable to give meds IV or IO
21.Which medications can be administered via endotracheal tube?
ANS lidocaine, epinephrine, atropine, naloxone
22.What is different about the dosing of medications if endotracheal
medica- tion administration is performed?
ANS Typically ETT dose 2-2.5 higher than IV due to lower absorption
, and dilution in 5-10mL of fluid is recommended
23.When can antiarrhythmics be considered in the setting of cardiac arrest?
ANS use may be considered in patients with VF/VT who have failed high-
quality CPR, shocks, and vasopressors
24.Why must antiarrhythmics never interfere with CPR and shocks?
ANS never been shown to increase survival to discharge
25.Antiarrhythmics that could be considered in the setting of VF/VT
ANS amio- darone and lidocaine
26.The traditional formulation of amiodarone contains what component
that may cause bradycardia and hypotension
ANS polysorbate 80
27.Premixed bags of amiodarone contain what component instead of
polysor- bate 80?
ANS captisol
28.Are premixed bags (360mg/200mL) of amiodarone typically found in
the code cart?
ANS no; used in the ICU
29.Sodium bicarbonate is not typically used in the setting of cardiac
arrest, except under what circumstances?
ANS -known preexisting hyperkalemia
-known preexisiting bicarbonate-responsive acidosis such as DKA
-OD of TCAs, aspirin, cocaine, or diphenhydramine
-prolonged resuscitation with effective ventilation; on return of
spontaneous circula- tion after long arrest interval
30.Calcium is not typically used in the setting of cardiac arrest, except
under what circumstances?
ANS -beta blocker or calcium channel blocker overdose
