ACLS QUESTIONS AND ANSWERS
A 42-year-old woman presents to the emergency department with complaints of fatigue,
shortness of breath, back pain and nausea. A 12-lead ECG is obtained and shows ST-
segment depression in leads II, III, and aVF and intermittent runs of nonsustained ventricular tachycardia. Cardiac serum markers are elevated. These findings suggest which condition? - Answer- High-risk non-ST-segment elevation ACS (NSTE-ACS)
A patient in cardiac arrest experiences return of spontaneous circulation. As part of post-cardiac arrest care, the patient is receiving mechanical ventilation at an initial rate of 10 breaths/min and a fraction of inspired oxygen (FiO2) of 0.30. Which finding(s) would indicate the need for change in the ventilator settings to optimize the patient's ventilation and oxygenation? - Answer- ETCO2 55 mmHg
PaCO2 48 mmHg
SaO2 90%
A responsive patient is choking. What method should the provider use first to clear the obstructed airway? - Answer- Back blows
A member of the resuscitation team is preparing to administer medications intravenously to a patient in cardiac arrest. The team member should follow each peripherally administered drug dose with a normal saline flush. How much would the team member give? - Answer- 10 to 20 mL
The stroke team is assessing a patient with a suspected stroke. The patient is alert and able to carry on a conversation, although the patient has difficulty getting the words out. Testing confirms that the patient has had an ischemic stroke. Based on the patient's medical history, a history of which arrhythmia would alert the team to the patient's increased risk for stroke? - Answer- Atrial fibrillation
Which statement accurately reflects the management of cardiac arrest in a pregnancy of
26 weeks' gestation? - Answer- Resuscitative cesarean delivery (RCD) should be performed within 5 minutes from the time of arrest.
What is the priority intervention for a patient with a narrow-complex tachycardia (160 bpm) and a blood pressure of 72/48 mmHg? - Answer- Perform immediate synchronized cardioversion
A patient is receiving ventilation support via bag-valve-mask (BVM) resuscitator. Capnography is established and a blood gas is obtained to evaluate the adequacy of the ventilations. Which arterial carbon dioxide (PaCO2) value signifies adequate ventilations? - Answer- 35 to 45 mmHg
A patient comes to the emergency department complaining of palpitations and "some shortness of breath." Cardiac monitoring is initiated and reveals the following ECG rhythm strip. The provider interprets this strip as indicating which arrhythmia? - Answer- Atrial flutter
An ECG strip of a patient in the emergency department reveals the following rhythm. Which feature would the healthcare provider interpret as indicating atrial fibrillation? - Answer- Absence of discrete P waves and presence of irregularly irregular QRS complexes
Cardiac monitoring indicates that a patient has a ventricular tachyarrhythmia. The patient has a pulse and is not showing any signs of hemodynamic compromise. A 12-
lead ECG reveals an irregular rhythm with QRS complexes greater than 0.12 second in duration. Which action would be appropriate at this time? - Answer- Consider an antiarrhythmic medication
A 35-year-old female patient's ECG is consistent with STEMI. The ECG reveals a new ST-segment elevation at the J point in leads V2 and V3 of at least which size? - Answer- 0.15 mV
A patient is experiencing respiratory distress secondary to an exacerbation of chronic obstructive pulmonary disease. The patient begins to exhibit signs and symptoms of worsening respiratory function and experiences respiratory arrest. The team intervenes,
delivering ventilations via BVM resuscitator. The team should provide ventilations at a rate of 1 ventilation: - Answer- Every 6 seconds
The ECG rhythm strip of a patient who arrived in the emergency department complaining of dizziness, syncope and shortness of breath reveals sinus bradycardia. When reviewing the patient's medication history, the healthcare provider identifies which
agent(s) as a potential cause of the patient's current condition? - Answer- Metoprolol
Verapamil
Digoxin
Cardiac monitoring reveals a tachyarrhythmia. The patient is hemodynamically stable and has a regular heart rate ranging from 120 to 135 beats per minute. Which statements by the patient could the team interpret as contributing to the tachyarrhythmia? - Answer- "I've had a terrible cold with a horrible cough for the past week and today I developed a fever."
"I've been so anxious lately because I just lost my job."
"I've been vomiting for the past 2 days from a gastrointestinal bug."
A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a narrow-complex supraventricular tachyarrhythmia. The patient is not showing signs of hemodynamic compromise. Which intervention would be initiated first if it does not delay
other interventions? - Answer- Vagal maneuvers
For a patient with third-degree atrioventricular (AV) block and a blood pressure of 70/48 mmHg, what interventions should be considered? - Answer- Initiate a dopamine infusion
A 42-year-old woman presents to the emergency department with complaints of fatigue,
shortness of breath, back pain and nausea. A 12-lead ECG is obtained and shows ST-
segment depression in leads II, III, and aVF and intermittent runs of nonsustained ventricular tachycardia. Cardiac serum markers are elevated. These findings suggest which condition? - Answer- High-risk non-ST-segment elevation ACS (NSTE-ACS)
A patient in cardiac arrest experiences return of spontaneous circulation. As part of post-cardiac arrest care, the patient is receiving mechanical ventilation at an initial rate of 10 breaths/min and a fraction of inspired oxygen (FiO2) of 0.30. Which finding(s) would indicate the need for change in the ventilator settings to optimize the patient's ventilation and oxygenation? - Answer- ETCO2 55 mmHg
PaCO2 48 mmHg
SaO2 90%
A responsive patient is choking. What method should the provider use first to clear the obstructed airway? - Answer- Back blows
A member of the resuscitation team is preparing to administer medications intravenously to a patient in cardiac arrest. The team member should follow each peripherally administered drug dose with a normal saline flush. How much would the team member give? - Answer- 10 to 20 mL
The stroke team is assessing a patient with a suspected stroke. The patient is alert and able to carry on a conversation, although the patient has difficulty getting the words out. Testing confirms that the patient has had an ischemic stroke. Based on the patient's medical history, a history of which arrhythmia would alert the team to the patient's increased risk for stroke? - Answer- Atrial fibrillation
Which statement accurately reflects the management of cardiac arrest in a pregnancy of
26 weeks' gestation? - Answer- Resuscitative cesarean delivery (RCD) should be performed within 5 minutes from the time of arrest.
What is the priority intervention for a patient with a narrow-complex tachycardia (160 bpm) and a blood pressure of 72/48 mmHg? - Answer- Perform immediate synchronized cardioversion
A patient is receiving ventilation support via bag-valve-mask (BVM) resuscitator. Capnography is established and a blood gas is obtained to evaluate the adequacy of the ventilations. Which arterial carbon dioxide (PaCO2) value signifies adequate ventilations? - Answer- 35 to 45 mmHg
A patient comes to the emergency department complaining of palpitations and "some shortness of breath." Cardiac monitoring is initiated and reveals the following ECG rhythm strip. The provider interprets this strip as indicating which arrhythmia? - Answer- Atrial flutter
An ECG strip of a patient in the emergency department reveals the following rhythm. Which feature would the healthcare provider interpret as indicating atrial fibrillation? - Answer- Absence of discrete P waves and presence of irregularly irregular QRS complexes
Cardiac monitoring indicates that a patient has a ventricular tachyarrhythmia. The patient has a pulse and is not showing any signs of hemodynamic compromise. A 12-
lead ECG reveals an irregular rhythm with QRS complexes greater than 0.12 second in duration. Which action would be appropriate at this time? - Answer- Consider an antiarrhythmic medication
A 35-year-old female patient's ECG is consistent with STEMI. The ECG reveals a new ST-segment elevation at the J point in leads V2 and V3 of at least which size? - Answer- 0.15 mV
A patient is experiencing respiratory distress secondary to an exacerbation of chronic obstructive pulmonary disease. The patient begins to exhibit signs and symptoms of worsening respiratory function and experiences respiratory arrest. The team intervenes,
delivering ventilations via BVM resuscitator. The team should provide ventilations at a rate of 1 ventilation: - Answer- Every 6 seconds
The ECG rhythm strip of a patient who arrived in the emergency department complaining of dizziness, syncope and shortness of breath reveals sinus bradycardia. When reviewing the patient's medication history, the healthcare provider identifies which
agent(s) as a potential cause of the patient's current condition? - Answer- Metoprolol
Verapamil
Digoxin
Cardiac monitoring reveals a tachyarrhythmia. The patient is hemodynamically stable and has a regular heart rate ranging from 120 to 135 beats per minute. Which statements by the patient could the team interpret as contributing to the tachyarrhythmia? - Answer- "I've had a terrible cold with a horrible cough for the past week and today I developed a fever."
"I've been so anxious lately because I just lost my job."
"I've been vomiting for the past 2 days from a gastrointestinal bug."
A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a narrow-complex supraventricular tachyarrhythmia. The patient is not showing signs of hemodynamic compromise. Which intervention would be initiated first if it does not delay
other interventions? - Answer- Vagal maneuvers
For a patient with third-degree atrioventricular (AV) block and a blood pressure of 70/48 mmHg, what interventions should be considered? - Answer- Initiate a dopamine infusion
