ACLS PRETEST PHARMACOLOGY AND
PRACTICAL APPLICATION ACTUAL PAPER 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Which intervention is most appropriate for the treatment of a
patient in asystole? Answer: Epinephrine
◉ You arrive on the scene with the code team. High-quality CPR is in
progress. An AED has previousy advised "no shock indicated." A
rhythm check now finds asystole. After resuming high-quality
compressions, which action do you take next? Answer: Establish IV
or IO access
◉ A patient is in cardiac arrest. Ventricular fibrillation has been
refractory to a second shock. Which drug should be administered
first? Answer: Epinephrine 1 mg IV/IO
◉ 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? Answer: Hold
aspirin for at least 24 hours if rtPA is administered
,◉ 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? Answer: 150 mg IV push
◉ 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? Answer: Adenosine 6mg
◉ 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? Answer: IV or
IO
◉ What is the indication for the use of magnesium in cardiac arrest?
Answer: Pulseless ventricular tachycardia-associated torsades de
pointes
◉ 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? Answer: Seeking expert consultation
, ◉ 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?
Answer: Epinephrine 1mg IV/IO
◉ 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.
Answer: Epinephrine 1 mg
◉ A patient with possible STEMI has ongoing chest discomfort.
What is a contraindication to nitrate administration? Answer: Use of
a phosphodiestrase inhibitor within the previous 24 hours
◉ 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? Answer: Perform electrical
cordioversion
◉ 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? Answer: Give aspirin 160-325 mg to chew
PRACTICAL APPLICATION ACTUAL PAPER 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Which intervention is most appropriate for the treatment of a
patient in asystole? Answer: Epinephrine
◉ You arrive on the scene with the code team. High-quality CPR is in
progress. An AED has previousy advised "no shock indicated." A
rhythm check now finds asystole. After resuming high-quality
compressions, which action do you take next? Answer: Establish IV
or IO access
◉ A patient is in cardiac arrest. Ventricular fibrillation has been
refractory to a second shock. Which drug should be administered
first? Answer: Epinephrine 1 mg IV/IO
◉ 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? Answer: Hold
aspirin for at least 24 hours if rtPA is administered
,◉ 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? Answer: 150 mg IV push
◉ 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? Answer: Adenosine 6mg
◉ 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? Answer: IV or
IO
◉ What is the indication for the use of magnesium in cardiac arrest?
Answer: Pulseless ventricular tachycardia-associated torsades de
pointes
◉ 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? Answer: Seeking expert consultation
, ◉ 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?
Answer: Epinephrine 1mg IV/IO
◉ 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.
Answer: Epinephrine 1 mg
◉ A patient with possible STEMI has ongoing chest discomfort.
What is a contraindication to nitrate administration? Answer: Use of
a phosphodiestrase inhibitor within the previous 24 hours
◉ 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? Answer: Perform electrical
cordioversion
◉ 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? Answer: Give aspirin 160-325 mg to chew
