ACLS Complete 2022 Test Bank – Questions and Answers
In which situation does bradycardia require treatment? - ANS: Hypotension
Which intervention is most appropriate for the treatment of a patient in asystole? - ANS: 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? - ANS: Establish IV or IO access
A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of
220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38mm Hg, and the pulse
oximetry reading is 98%. There is vascular access in the left arm, and the patient has not been given any
vasoactive drugs. A 12-lead ECG confirm a supraventricular tachycardia with no evidence of ischemia or
infarction. The heart rate has not responded to vagal maneuvers. what is your next action?
- ANS: Administer adenosine 6mg IV push
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a toal
does of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood
pressure is 88/56 mm Hg. Which therapy is now indicated? - ANS: Epinephrine 2 to 10 mcg/min
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug
should be administered first? - ANS: 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? - ANS: 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? - ANS: 150 mg IV
push
,A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure of
80/60mm Hg. What is the initial does of atropine? - ANS: 0.5mg
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? - ANS:
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? - ANS: IV or IO
What is the indication for the use of magnesium in cardiac arrest? - ANS: 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? - ANS: 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? - ANS:
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. - ANS: Epinephrine 1 mg
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate
administration? - ANS: 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? - ANS: 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? - ANS: Give aspirin 160-325 mg to
chew
You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage 2 months ago.
He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The patient is
receiving oxygen via nasal cannula at 2L/min, and an IV has been established. His blood pressure is
180/100mm Hg. Which drug do you anticipate giving to this patient? - ANS: Aspirin
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given.
Which drug should be given next? - ANS: Amiodarone 300mg
What is the maximum interval for pausing chest compressions? - ANS: 10 seconds
Your patient is a 56-year-old woman with a history of type 2 diabetes who reports feeling dizzy. She is
pale and diaphoretic. Her blood pressure is 80/66mm Hg. The cardiac monitor documents the rhythm
shown here. She is receiving oxygen at 4L/min by nasal cannula, and an Iv has been established. What
do you administer next? - ANS: Atropine 0.5mg IV
A 35-year-old woman presents with a chief complaint of palpitations. She has no chest discomfort,
shortness of breath, or light-headedness. Her blood pressure is 120/78mm Hg. Which intervention is
indicated first? - ANS: Vagal maneuvers
Which action should you take immediately after providing an AED shock? - ANS: Resume chest
compressions
What action minimizes the risk of air entering the victim's stomach during-bag mask ventilation? - ANS:
Ventilating until you see the chest rise
You are providing bag-mask ventilations to a patient in respiratory arrest. How often should you provide
ventilation? - ANS: About every 5-6 seconds
, After initiation of CPR and 1 shock for ventricular fibrillation, this rhythm is present on the next rhythm
check. A second shock is given, and chest compressions are resumed immediately. An IV is in place, and
no drugs have been given. Bag-mask ventilations are producing visible chest rise. What is your next
intervention? - ANS: Give epinephrine 1mg IV/IO
A patient's 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the patient arrives
in the emergency department, the rhythm shown here is seen on the cardiac monitor. The patient has
resolution of moderate (5/10) chest pain after 3 doses of sublingual nitroglycerin. Blood pressure is
104/70mm Hg. Which intervention is most important in reducing this patient's in-hospital and 30-day
mortality rate? - ANS: Repersfusion therapy
A patient was in refractory ventricular fibrillation. A thrid shock has just been administered. Your team
looks to you for instructions. What is your next action? - ANS: Resume high quality chest compressions
Which action is likely to cause air to enter the victim's stomach (gastric inflation) during bag-mask
ventilation? - ANS: Ventilating too quickly
A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She has
received adensoine 6mg IV for the rhythm shown here (SVT), without conversion of the rhythm. She is
now extremely apprehensive. Her blood pressure si 128/70mm Hg. What is the next appropriate
intervention? - ANS: Administer adenosine 12 mg IV
Your patient is not responsive and is not breathing, You can palpate a carotid pulse. Which action do you
take next? - ANS: Start rescue breathing
You arrive on the scene to find CPR in progress. Nursing staff report the patient was recovering from a
pulmonary embolism and suddenly collapsed. Two shocks have been delivered, and an IV has been
initiated. What do you administer now? - ANS: Epinephrine 1 mg IV
You are the code team leader and arrive to find a patient with CPR in progress. On the next rhythm
check, you see the rhythm shown here. Team members tell you that the patient was well but reported
chest discomfort and then collapsed. She has no pulse or respirations. Bag-mask ventilations are
producing visible chest rise, and IV access has been established, Which intervention would be your next
action? - ANS: Epinephrine 1mg
In which situation does bradycardia require treatment? - ANS: Hypotension
Which intervention is most appropriate for the treatment of a patient in asystole? - ANS: 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? - ANS: Establish IV or IO access
A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of
220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38mm Hg, and the pulse
oximetry reading is 98%. There is vascular access in the left arm, and the patient has not been given any
vasoactive drugs. A 12-lead ECG confirm a supraventricular tachycardia with no evidence of ischemia or
infarction. The heart rate has not responded to vagal maneuvers. what is your next action?
- ANS: Administer adenosine 6mg IV push
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a toal
does of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood
pressure is 88/56 mm Hg. Which therapy is now indicated? - ANS: Epinephrine 2 to 10 mcg/min
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug
should be administered first? - ANS: 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? - ANS: 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? - ANS: 150 mg IV
push
,A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure of
80/60mm Hg. What is the initial does of atropine? - ANS: 0.5mg
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? - ANS:
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? - ANS: IV or IO
What is the indication for the use of magnesium in cardiac arrest? - ANS: 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? - ANS: 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? - ANS:
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. - ANS: Epinephrine 1 mg
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate
administration? - ANS: 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? - ANS: 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? - ANS: Give aspirin 160-325 mg to
chew
You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage 2 months ago.
He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The patient is
receiving oxygen via nasal cannula at 2L/min, and an IV has been established. His blood pressure is
180/100mm Hg. Which drug do you anticipate giving to this patient? - ANS: Aspirin
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given.
Which drug should be given next? - ANS: Amiodarone 300mg
What is the maximum interval for pausing chest compressions? - ANS: 10 seconds
Your patient is a 56-year-old woman with a history of type 2 diabetes who reports feeling dizzy. She is
pale and diaphoretic. Her blood pressure is 80/66mm Hg. The cardiac monitor documents the rhythm
shown here. She is receiving oxygen at 4L/min by nasal cannula, and an Iv has been established. What
do you administer next? - ANS: Atropine 0.5mg IV
A 35-year-old woman presents with a chief complaint of palpitations. She has no chest discomfort,
shortness of breath, or light-headedness. Her blood pressure is 120/78mm Hg. Which intervention is
indicated first? - ANS: Vagal maneuvers
Which action should you take immediately after providing an AED shock? - ANS: Resume chest
compressions
What action minimizes the risk of air entering the victim's stomach during-bag mask ventilation? - ANS:
Ventilating until you see the chest rise
You are providing bag-mask ventilations to a patient in respiratory arrest. How often should you provide
ventilation? - ANS: About every 5-6 seconds
, After initiation of CPR and 1 shock for ventricular fibrillation, this rhythm is present on the next rhythm
check. A second shock is given, and chest compressions are resumed immediately. An IV is in place, and
no drugs have been given. Bag-mask ventilations are producing visible chest rise. What is your next
intervention? - ANS: Give epinephrine 1mg IV/IO
A patient's 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the patient arrives
in the emergency department, the rhythm shown here is seen on the cardiac monitor. The patient has
resolution of moderate (5/10) chest pain after 3 doses of sublingual nitroglycerin. Blood pressure is
104/70mm Hg. Which intervention is most important in reducing this patient's in-hospital and 30-day
mortality rate? - ANS: Repersfusion therapy
A patient was in refractory ventricular fibrillation. A thrid shock has just been administered. Your team
looks to you for instructions. What is your next action? - ANS: Resume high quality chest compressions
Which action is likely to cause air to enter the victim's stomach (gastric inflation) during bag-mask
ventilation? - ANS: Ventilating too quickly
A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She has
received adensoine 6mg IV for the rhythm shown here (SVT), without conversion of the rhythm. She is
now extremely apprehensive. Her blood pressure si 128/70mm Hg. What is the next appropriate
intervention? - ANS: Administer adenosine 12 mg IV
Your patient is not responsive and is not breathing, You can palpate a carotid pulse. Which action do you
take next? - ANS: Start rescue breathing
You arrive on the scene to find CPR in progress. Nursing staff report the patient was recovering from a
pulmonary embolism and suddenly collapsed. Two shocks have been delivered, and an IV has been
initiated. What do you administer now? - ANS: Epinephrine 1 mg IV
You are the code team leader and arrive to find a patient with CPR in progress. On the next rhythm
check, you see the rhythm shown here. Team members tell you that the patient was well but reported
chest discomfort and then collapsed. She has no pulse or respirations. Bag-mask ventilations are
producing visible chest rise, and IV access has been established, Which intervention would be your next
action? - ANS: Epinephrine 1mg
