ACLS Final Test Questions with Correct Answers and
Explanations
Question 1
Which type of atrioventricular block best describes this rhythm?
A) First-degree AV block
B) Second-degree AV block type I
C) Second-degree AV block type II ✓
D) Third-degree AV block
Explanation: Second-degree AV block type II is characterized by intermittent non-
conducted P waves with a constant PR interval. The PR interval remains constant for all
conducted beats, and the QRS complexes are often wide. This rhythm is more
dangerous than type I and can rapidly progress to complete heart block, requiring
immediate attention and possible pacemaker placement.
Question 2
Your patient is in cardiac arrest and has been intubated. To assess CPR quality,
which should you do?
A) Monitor the patient's PETCO2 ✓
B) Check the patient's blood pressure
C) Auscultate breath sounds
D) Monitor the patient's oxygen saturation
,Explanation: PETCO2 monitoring is the most reliable method to assess CPR quality
during cardiac arrest. A PETCO2 value greater than 20 mmHg indicates effective chest
compressions generating adequate cardiac output. Values less than 10 mmHg suggest
poor compression quality or possible patient recovery. Continuous waveform
capnography provides real-time feedback on resuscitation effectiveness.
Question 3
Which facility is the most appropriate EMS destination for a patient with sudden
cardiac arrest who achieved return of spontaneous circulation in the field?
A) Nearest emergency department
B) Community hospital
C) Trauma center
D) Coronary reperfusion-capable medical center ✓
Explanation: Patients who achieve ROSC after sudden cardiac arrest should be
transported to a coronary reperfusion-capable medical center with cardiac
catheterization capabilities. Many cardiac arrests are caused by acute coronary
occlusion, and immediate percutaneous coronary intervention significantly improves
survival and neurological outcomes. These centers provide comprehensive post-cardiac
arrest care.
Question 4
Which of the following signs is a likely indicator of cardiac arrest in an
unresponsive patient?
, A) Snoring respirations
B) Kussmaul respirations
C) Agonal gasps ✓
D) Cheyne-Stokes respirations
Explanation: Agonal gasps are an ominous sign present in many cardiac arrest patients.
These are irregular, gasping breathing attempts that occur due to brainstem ischemia.
Healthcare providers and lay rescuers often mistake them for normal breathing, which
can delay CPR initiation. Recognition of agonal gasps as a cardiac arrest sign is critical
for prompt resuscitation.
Question 5
Which type of atrioventricular block best describes this rhythm?
A) First-degree AV block
B) Second-degree AV block type I ✓
C) Second-degree AV block type II
D) Third-degree AV block
Explanation: Second-degree AV block type I (Wenckebach) is characterized by
progressively prolonging PR intervals until a P wave is not conducted. The PR interval
lengthens beat by beat, followed by a dropped QRS complex. This rhythm is typically
less dangerous than type II and often resolves with atropine, but may progress if the
patient develops symptoms or hemodynamic instability.
Question 6
Explanations
Question 1
Which type of atrioventricular block best describes this rhythm?
A) First-degree AV block
B) Second-degree AV block type I
C) Second-degree AV block type II ✓
D) Third-degree AV block
Explanation: Second-degree AV block type II is characterized by intermittent non-
conducted P waves with a constant PR interval. The PR interval remains constant for all
conducted beats, and the QRS complexes are often wide. This rhythm is more
dangerous than type I and can rapidly progress to complete heart block, requiring
immediate attention and possible pacemaker placement.
Question 2
Your patient is in cardiac arrest and has been intubated. To assess CPR quality,
which should you do?
A) Monitor the patient's PETCO2 ✓
B) Check the patient's blood pressure
C) Auscultate breath sounds
D) Monitor the patient's oxygen saturation
,Explanation: PETCO2 monitoring is the most reliable method to assess CPR quality
during cardiac arrest. A PETCO2 value greater than 20 mmHg indicates effective chest
compressions generating adequate cardiac output. Values less than 10 mmHg suggest
poor compression quality or possible patient recovery. Continuous waveform
capnography provides real-time feedback on resuscitation effectiveness.
Question 3
Which facility is the most appropriate EMS destination for a patient with sudden
cardiac arrest who achieved return of spontaneous circulation in the field?
A) Nearest emergency department
B) Community hospital
C) Trauma center
D) Coronary reperfusion-capable medical center ✓
Explanation: Patients who achieve ROSC after sudden cardiac arrest should be
transported to a coronary reperfusion-capable medical center with cardiac
catheterization capabilities. Many cardiac arrests are caused by acute coronary
occlusion, and immediate percutaneous coronary intervention significantly improves
survival and neurological outcomes. These centers provide comprehensive post-cardiac
arrest care.
Question 4
Which of the following signs is a likely indicator of cardiac arrest in an
unresponsive patient?
, A) Snoring respirations
B) Kussmaul respirations
C) Agonal gasps ✓
D) Cheyne-Stokes respirations
Explanation: Agonal gasps are an ominous sign present in many cardiac arrest patients.
These are irregular, gasping breathing attempts that occur due to brainstem ischemia.
Healthcare providers and lay rescuers often mistake them for normal breathing, which
can delay CPR initiation. Recognition of agonal gasps as a cardiac arrest sign is critical
for prompt resuscitation.
Question 5
Which type of atrioventricular block best describes this rhythm?
A) First-degree AV block
B) Second-degree AV block type I ✓
C) Second-degree AV block type II
D) Third-degree AV block
Explanation: Second-degree AV block type I (Wenckebach) is characterized by
progressively prolonging PR intervals until a P wave is not conducted. The PR interval
lengthens beat by beat, followed by a dropped QRS complex. This rhythm is typically
less dangerous than type II and often resolves with atropine, but may progress if the
patient develops symptoms or hemodynamic instability.
Question 6
