American Red Cross ACLS
Pharmacology Examination Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A |
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1. Which medication is the primary vasopressor recommended during
adult cardiac arrest to improve coronary and cerebral perfusion?
A. Amiodarone
B. Atropine
C. Epinephrine
D. Adenosine
Answer: C. Epinephrine
Rationale: Epinephrine is administered during adult cardiac arrest to
produce peripheral vasoconstriction through alpha-adrenergic effects.
This increases aortic diastolic pressure and can improve coronary and
cerebral perfusion pressure during CPR. It is used in both shockable
and nonshockable cardiac arrest rhythms, although its timing differs
depending on the rhythm.
2. A patient remains in ventricular fibrillation after defibrillation and
high-quality CPR. Which antiarrhythmic medication may be
administered for refractory ventricular fibrillation or pulseless
ventricular tachycardia?
A. Amiodarone
B. Adenosine
,C. Atropine
D. Diltiazem
Answer: A. Amiodarone
Rationale: Amiodarone is an antiarrhythmic that can be used for
refractory ventricular fibrillation or pulseless ventricular tachycardia
after defibrillation attempts and CPR. It acts on several ion channels
and can help stabilize ventricular electrical activity. Lidocaine is
another acceptable antiarrhythmic option in appropriate
circumstances.
3. Which medication is commonly used for symptomatic bradycardia
when the patient has a pulse?
A. Epinephrine infusion only
B. Amiodarone
C. Adenosine
D. Atropine
Answer: D. Atropine
Rationale: Atropine is an anticholinergic medication that decreases
parasympathetic influence on the heart. It can increase sinus-node
activity and improve atrioventricular conduction, making it an initial
pharmacologic treatment for symptomatic bradycardia in appropriate
adult patients. If atropine is ineffective, transcutaneous pacing and/or
vasoactive infusions may be considered.
4. Which medication is particularly useful for terminating certain
regular narrow-complex supraventricular tachycardias?
A. Lidocaine
B. Adenosine
,C. Amiodarone
D. Magnesium sulfate
Answer: B. Adenosine
Rationale: Adenosine transiently blocks conduction through the
atrioventricular node. It is particularly effective for regular narrow-
complex supraventricular tachycardia involving the AV node. Because
its half-life is extremely short, it is administered rapidly followed by a
saline flush. It should not be used indiscriminately for irregular or
polymorphic rhythms.
5. Which medication is an appropriate consideration for torsades de
pointes associated with a prolonged QT interval?
A. Atropine
B. Adenosine
C. Magnesium sulfate
D. Diltiazem
Answer: C. Magnesium sulfate
Rationale: Magnesium sulfate is commonly used when torsades de
pointes is present, particularly when associated with a prolonged QT
interval. Magnesium can help stabilize myocardial electrical activity.
Defibrillation is required when torsades produces cardiac arrest, while
correction of contributing electrolyte abnormalities and medications
that prolong QT are also important.
6. What is the principal pharmacologic effect of epinephrine during
cardiac arrest?
A. Peripheral vasoconstriction that increases vascular resistance
B. Selective slowing of AV-node conduction
, C. Prolongation of the PR interval
D. Direct reduction of myocardial contractility
Answer: A. Peripheral vasoconstriction that increases vascular
resistance
Rationale: Epinephrine stimulates alpha-adrenergic receptors,
producing vasoconstriction. During cardiac arrest, this can increase
systemic vascular resistance and aortic diastolic pressure, helping
maintain blood flow to the heart and brain during chest compressions.
Epinephrine also has beta-adrenergic effects that influence heart rate
and contractility.
7. A patient with a pulse has symptomatic bradycardia and remains
hypotensive despite appropriate initial treatment with atropine.
Which medication can be administered as an infusion while
additional interventions are prepared?
A. Adenosine
B. Epinephrine
C. Amiodarone
D. Lidocaine
Answer: B. Epinephrine
Rationale: An epinephrine infusion can provide chronotropic and
vasopressor support in symptomatic bradycardia when atropine is
ineffective. Transcutaneous pacing should also be considered,
especially when severe bradycardia is associated with hemodynamic
instability. Medication therapy should not delay pacing when pacing is
urgently indicated.
8. Which antiarrhythmic medication is classified as a sodium-channel
blocker and may be used as an alternative to amiodarone for
Pharmacology Examination Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A |
Instant Download Pdf
1. Which medication is the primary vasopressor recommended during
adult cardiac arrest to improve coronary and cerebral perfusion?
A. Amiodarone
B. Atropine
C. Epinephrine
D. Adenosine
Answer: C. Epinephrine
Rationale: Epinephrine is administered during adult cardiac arrest to
produce peripheral vasoconstriction through alpha-adrenergic effects.
This increases aortic diastolic pressure and can improve coronary and
cerebral perfusion pressure during CPR. It is used in both shockable
and nonshockable cardiac arrest rhythms, although its timing differs
depending on the rhythm.
2. A patient remains in ventricular fibrillation after defibrillation and
high-quality CPR. Which antiarrhythmic medication may be
administered for refractory ventricular fibrillation or pulseless
ventricular tachycardia?
A. Amiodarone
B. Adenosine
,C. Atropine
D. Diltiazem
Answer: A. Amiodarone
Rationale: Amiodarone is an antiarrhythmic that can be used for
refractory ventricular fibrillation or pulseless ventricular tachycardia
after defibrillation attempts and CPR. It acts on several ion channels
and can help stabilize ventricular electrical activity. Lidocaine is
another acceptable antiarrhythmic option in appropriate
circumstances.
3. Which medication is commonly used for symptomatic bradycardia
when the patient has a pulse?
A. Epinephrine infusion only
B. Amiodarone
C. Adenosine
D. Atropine
Answer: D. Atropine
Rationale: Atropine is an anticholinergic medication that decreases
parasympathetic influence on the heart. It can increase sinus-node
activity and improve atrioventricular conduction, making it an initial
pharmacologic treatment for symptomatic bradycardia in appropriate
adult patients. If atropine is ineffective, transcutaneous pacing and/or
vasoactive infusions may be considered.
4. Which medication is particularly useful for terminating certain
regular narrow-complex supraventricular tachycardias?
A. Lidocaine
B. Adenosine
,C. Amiodarone
D. Magnesium sulfate
Answer: B. Adenosine
Rationale: Adenosine transiently blocks conduction through the
atrioventricular node. It is particularly effective for regular narrow-
complex supraventricular tachycardia involving the AV node. Because
its half-life is extremely short, it is administered rapidly followed by a
saline flush. It should not be used indiscriminately for irregular or
polymorphic rhythms.
5. Which medication is an appropriate consideration for torsades de
pointes associated with a prolonged QT interval?
A. Atropine
B. Adenosine
C. Magnesium sulfate
D. Diltiazem
Answer: C. Magnesium sulfate
Rationale: Magnesium sulfate is commonly used when torsades de
pointes is present, particularly when associated with a prolonged QT
interval. Magnesium can help stabilize myocardial electrical activity.
Defibrillation is required when torsades produces cardiac arrest, while
correction of contributing electrolyte abnormalities and medications
that prolong QT are also important.
6. What is the principal pharmacologic effect of epinephrine during
cardiac arrest?
A. Peripheral vasoconstriction that increases vascular resistance
B. Selective slowing of AV-node conduction
, C. Prolongation of the PR interval
D. Direct reduction of myocardial contractility
Answer: A. Peripheral vasoconstriction that increases vascular
resistance
Rationale: Epinephrine stimulates alpha-adrenergic receptors,
producing vasoconstriction. During cardiac arrest, this can increase
systemic vascular resistance and aortic diastolic pressure, helping
maintain blood flow to the heart and brain during chest compressions.
Epinephrine also has beta-adrenergic effects that influence heart rate
and contractility.
7. A patient with a pulse has symptomatic bradycardia and remains
hypotensive despite appropriate initial treatment with atropine.
Which medication can be administered as an infusion while
additional interventions are prepared?
A. Adenosine
B. Epinephrine
C. Amiodarone
D. Lidocaine
Answer: B. Epinephrine
Rationale: An epinephrine infusion can provide chronotropic and
vasopressor support in symptomatic bradycardia when atropine is
ineffective. Transcutaneous pacing should also be considered,
especially when severe bradycardia is associated with hemodynamic
instability. Medication therapy should not delay pacing when pacing is
urgently indicated.
8. Which antiarrhythmic medication is classified as a sodium-channel
blocker and may be used as an alternative to amiodarone for
