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AHA ACLS ACUTE CORONARY SYNDROMES (ACS)
ACTUAL EXAM 2026/2027 | COMPLETE COURSE
REVIEW | 50 VERIFIED Q&A | COMPLETE RATIONALES
| PASS GUARANTEED - A+ GRADED
QUESTION 1
A 62-year-old male presents with substernal chest pain radiating to his left arm, diaphoresis, and nausea.
What is the most appropriate initial intervention?
A. Administer morphine sulfate 4 mg IV push
B. Administer aspirin 324 mg chewed and obtain a 12-lead ECG within 10 minutes
C. Administer sublingual nitroglycerin 0.4 mg SL
D. Administer oxygen 2 L/min via nasal cannula
Rationale: The most appropriate initial intervention for suspected ACS is to administer aspirin 324 mg
chewed and obtain a 12-lead ECG within 10 minutes of arrival. Aspirin reduces mortality in patients with
ACS. The ECG is essential for diagnosing STEMI.
QUESTION 2
A 58-year-old female presents with chest pain, shortness of breath, and ECG showing ST-segment elevation in
leads II, III, and aVF. What is the most appropriate immediate intervention?
A. Administer sublingual nitroglycerin 0.4 mg SL
B. Activate the STEMI protocol and prepare for emergent PCI
C. Administer morphine sulfate 4 mg IV push
D. Administer heparin 60 units/kg IV bolus
Rationale: This patient is presenting with an acute inferior STEMI. The most appropriate immediate
intervention is to activate the STEMI protocol and prepare for emergent PCI. Door-to-balloon time should be
less than 90 minutes.
QUESTION 3
A 65-year-old male presents with chest pain, shortness of breath, and ECG showing ST-segment depression in
leads V1-V4. Troponin is elevated. What is the most appropriate diagnosis?
A. STEMI
B. NSTEMI
,2
C. Unstable angina
D. Aortic dissection
Rationale: ST-segment depression with elevated troponin indicates NSTEMI (non-ST-elevation myocardial
infarction). NSTEMI is managed with antiplatelet therapy, anticoagulation, and consideration of PCI.
Troponin elevation confirms myocardial injury.
QUESTION 4
A 55-year-old male presents with chest pain, shortness of breath, and ECG showing ST-segment elevation in
leads V1-V4. He is hypotensive with a blood pressure of 80/50 mmHg. What is the most appropriate
immediate intervention?
A. Administer sublingual nitroglycerin 0.4 mg SL
B. Activate the STEMI protocol and prepare for emergent PCI
C. Administer morphine sulfate 4 mg IV push
D. Administer dopamine 5 mcg/kg/min IV infusion
Rationale: This patient is presenting with an acute anterior STEMI with cardiogenic shock. The most
appropriate immediate intervention is to activate the STEMI protocol and prepare for emergent PCI.
Inotropes may be needed to support blood pressure.
QUESTION 5
What is the dose of aspirin for suspected acute coronary syndrome (ACS)?
A. 81 mg chewed
B. 162-325 mg chewed
C. 500 mg chewed
D. 1000 mg chewed
Rationale: The dose of aspirin for suspected ACS is 162-325 mg chewed. Aspirin reduces mortality in patients
with ACS. It should be given as soon as possible if no contraindications exist.
QUESTION 6
A 60-year-old male presents with chest pain, shortness of breath, and ECG showing ST-segment elevation in
leads II, III, and aVF. What is the most appropriate immediate intervention?
A. Administer sublingual nitroglycerin 0.4 mg SL
B. Activate the STEMI protocol and prepare for emergent PCI
, 3
C. Administer morphine sulfate 4 mg IV push
D. Administer heparin 60 units/kg IV bolus
Rationale: This patient is presenting with an acute inferior STEMI. The most appropriate immediate
intervention is to activate the STEMI protocol and prepare for emergent PCI.
QUESTION 7
What is the dose of nitroglycerin for acute coronary syndrome (ACS)?
A. 0.2 mg SL every 5 minutes
B. 0.4 mg SL every 5 minutes (up to 3 doses)
C. 1 mg SL every 5 minutes
D. 2 mg SL every 5 minutes
Rationale: The dose of nitroglycerin for ACS is 0.4 mg SL every 5 minutes, up to a maximum of 3 doses.
Nitroglycerin is a vasodilator that reduces chest pain and improves myocardial perfusion.
QUESTION 8
A 62-year-old male presents with chest pain, shortness of breath, and ECG showing ST-segment elevation in
leads V1-V4. What is the most appropriate immediate intervention?
A. Administer sublingual nitroglycerin 0.4 mg SL
B. Activate the STEMI protocol and prepare for emergent PCI
C. Administer morphine sulfate 4 mg IV push
D. Administer heparin 60 units/kg IV bolus
Rationale: This patient is presenting with an acute anterior STEMI. The most appropriate immediate
intervention is to activate the STEMI protocol and prepare for emergent PCI.
QUESTION 9
What is the dose of heparin for acute coronary syndrome (ACS)?
A. 1000 units IV bolus
B. 60 units/kg IV bolus (maximum 4000 units)
C. 100 units/kg IV bolus
D. 5000 units IV bolus
Rationale: The dose of heparin for ACS is 60 units/kg IV bolus (maximum 4000 units), followed by an
infusion of 12 units/kg/hour. Heparin is an anticoagulant that prevents clot formation and progression.
AHA ACLS ACUTE CORONARY SYNDROMES (ACS)
ACTUAL EXAM 2026/2027 | COMPLETE COURSE
REVIEW | 50 VERIFIED Q&A | COMPLETE RATIONALES
| PASS GUARANTEED - A+ GRADED
QUESTION 1
A 62-year-old male presents with substernal chest pain radiating to his left arm, diaphoresis, and nausea.
What is the most appropriate initial intervention?
A. Administer morphine sulfate 4 mg IV push
B. Administer aspirin 324 mg chewed and obtain a 12-lead ECG within 10 minutes
C. Administer sublingual nitroglycerin 0.4 mg SL
D. Administer oxygen 2 L/min via nasal cannula
Rationale: The most appropriate initial intervention for suspected ACS is to administer aspirin 324 mg
chewed and obtain a 12-lead ECG within 10 minutes of arrival. Aspirin reduces mortality in patients with
ACS. The ECG is essential for diagnosing STEMI.
QUESTION 2
A 58-year-old female presents with chest pain, shortness of breath, and ECG showing ST-segment elevation in
leads II, III, and aVF. What is the most appropriate immediate intervention?
A. Administer sublingual nitroglycerin 0.4 mg SL
B. Activate the STEMI protocol and prepare for emergent PCI
C. Administer morphine sulfate 4 mg IV push
D. Administer heparin 60 units/kg IV bolus
Rationale: This patient is presenting with an acute inferior STEMI. The most appropriate immediate
intervention is to activate the STEMI protocol and prepare for emergent PCI. Door-to-balloon time should be
less than 90 minutes.
QUESTION 3
A 65-year-old male presents with chest pain, shortness of breath, and ECG showing ST-segment depression in
leads V1-V4. Troponin is elevated. What is the most appropriate diagnosis?
A. STEMI
B. NSTEMI
,2
C. Unstable angina
D. Aortic dissection
Rationale: ST-segment depression with elevated troponin indicates NSTEMI (non-ST-elevation myocardial
infarction). NSTEMI is managed with antiplatelet therapy, anticoagulation, and consideration of PCI.
Troponin elevation confirms myocardial injury.
QUESTION 4
A 55-year-old male presents with chest pain, shortness of breath, and ECG showing ST-segment elevation in
leads V1-V4. He is hypotensive with a blood pressure of 80/50 mmHg. What is the most appropriate
immediate intervention?
A. Administer sublingual nitroglycerin 0.4 mg SL
B. Activate the STEMI protocol and prepare for emergent PCI
C. Administer morphine sulfate 4 mg IV push
D. Administer dopamine 5 mcg/kg/min IV infusion
Rationale: This patient is presenting with an acute anterior STEMI with cardiogenic shock. The most
appropriate immediate intervention is to activate the STEMI protocol and prepare for emergent PCI.
Inotropes may be needed to support blood pressure.
QUESTION 5
What is the dose of aspirin for suspected acute coronary syndrome (ACS)?
A. 81 mg chewed
B. 162-325 mg chewed
C. 500 mg chewed
D. 1000 mg chewed
Rationale: The dose of aspirin for suspected ACS is 162-325 mg chewed. Aspirin reduces mortality in patients
with ACS. It should be given as soon as possible if no contraindications exist.
QUESTION 6
A 60-year-old male presents with chest pain, shortness of breath, and ECG showing ST-segment elevation in
leads II, III, and aVF. What is the most appropriate immediate intervention?
A. Administer sublingual nitroglycerin 0.4 mg SL
B. Activate the STEMI protocol and prepare for emergent PCI
, 3
C. Administer morphine sulfate 4 mg IV push
D. Administer heparin 60 units/kg IV bolus
Rationale: This patient is presenting with an acute inferior STEMI. The most appropriate immediate
intervention is to activate the STEMI protocol and prepare for emergent PCI.
QUESTION 7
What is the dose of nitroglycerin for acute coronary syndrome (ACS)?
A. 0.2 mg SL every 5 minutes
B. 0.4 mg SL every 5 minutes (up to 3 doses)
C. 1 mg SL every 5 minutes
D. 2 mg SL every 5 minutes
Rationale: The dose of nitroglycerin for ACS is 0.4 mg SL every 5 minutes, up to a maximum of 3 doses.
Nitroglycerin is a vasodilator that reduces chest pain and improves myocardial perfusion.
QUESTION 8
A 62-year-old male presents with chest pain, shortness of breath, and ECG showing ST-segment elevation in
leads V1-V4. What is the most appropriate immediate intervention?
A. Administer sublingual nitroglycerin 0.4 mg SL
B. Activate the STEMI protocol and prepare for emergent PCI
C. Administer morphine sulfate 4 mg IV push
D. Administer heparin 60 units/kg IV bolus
Rationale: This patient is presenting with an acute anterior STEMI. The most appropriate immediate
intervention is to activate the STEMI protocol and prepare for emergent PCI.
QUESTION 9
What is the dose of heparin for acute coronary syndrome (ACS)?
A. 1000 units IV bolus
B. 60 units/kg IV bolus (maximum 4000 units)
C. 100 units/kg IV bolus
D. 5000 units IV bolus
Rationale: The dose of heparin for ACS is 60 units/kg IV bolus (maximum 4000 units), followed by an
infusion of 12 units/kg/hour. Heparin is an anticoagulant that prevents clot formation and progression.
