ACLS QUESTIONS
1. You are providing bag-mask ventilations to a patient in respiratory arrest.How often
should you provide ventilation?
Answer: About every 5-6 seconds
2. 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 havebeen given. Bag-mask ventilations are
producing visible chest rise. What is your next intervention?
Answer: Give epinephrine 1mg IV/IO
3. 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
reducingthis patient's in-hospital and 30-day mortality rate?
Answer: Repersfusion therapy
4. A patient was in refractory ventricular fibrillation. A thrid shock has just been
administered. Your team looks to you for instructions. What is your nextaction?
Answer: Resume high quality chest compressions
5. Which action is likely to cause air to enter the victim's stomach (gastricinflation) during
bag-mask ventilation?
Answer: Ventilating too quickly
6. 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 ap-prehensive. Her blood pressure si 128/70mm
Hg. What is the next appropriateintervention?
Answer: Administer adenosine 12 mg IV
7. Your patient is not responsive and is not breathing, You can palpate acarotid pulse. Which
action do you take next?
Answer: Start rescue breathing
8. 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?
Answer: Epinephrine 1 mg IV
,9. 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 ventilationsare producing visible chest rise, and IV access has been established,
Whichintervention would be your next action?
Answer: Epinephrine 1mg
10. What is recommended depth of chest compressions for an adult victim?-
Answer: At least 2 inches
11. How does complete chest recoil contribute to effective CPR?
Answer: Allows maximum blood return to the heart
12. What is the recommended compression rate for high-quality CPR?
Answer: -100-120 compressions per minute
13. A patient becomes unresponsive. You are uncertain if a faint pulse is present. They
rhythm shown here is seen on the cardiac monitor. An IV is inpace. Which action do you take
next?
Answer: Start high-quality CPR
14. A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the
patient becomes unresponsive, with the rhythm shown here. Which action is indicated next?
Answer: Give an immediate unsynchronized high-energyshock (defibrillation dose)
15. How often should you switch chest compressors to avoid fatigue?
Answer: Aboutevery 2 minutes
16. You find an unresponsive pt. who is not breathing. After activating the emergency
response system, you determine there is no pulse. What is yournext action?
Answer: Start chest compressions of at least 100 per min.
17. You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm
Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse
oximetry reading is 97%. What assessment step ismost important now?
Answer: Obtaining a 12 lead ECG.
18. What is the preferred method of access for epi administration duringcardiac arrest in most
pts?
Answer: Peripheral IV
19. In which situation does bradycardia require treatment?
Answer: Hypotension
,20. Which intervention is most appropriate for the treatment of a patient inasystole?
Answer: Epinephrine
21. 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?
Answer: Establish IV or IO access
22. A monitored patient in the ICU developed a sudden onset of narrow-complextachycardia 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 withno evidence of ischemia or infarction. The heart rate has not responded to
vagal maneuvers. what is your next action?
Answer: Administer adenosine 6mg IV push
23. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been
administered to a total does of 3 mg. A transcutaneous pacemaker has failed to capture. The
patient is confused, and her blood pressure is 88/56 mmHg. Which therapy is now indicated?
Answer: Epinephrine 2 to 10 mcg/min
24. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second
shock. Which drug should be administered first?
Answer: Epinephrine 1 mgIV/IO
25. A 62-year-old man suddenly experienced difficulty speaking and left-sidedweakness. He
meets initial criteria for fibrinolytic therapy, and a CT scan of the brain si ordered. Which best
describes the guidelines for antiplatelet andfibrinolytic therapy?
Answer: Hold aspirin for at least 24 hours if rtPA is administered
26. A patient is in refractory ventricular fibrillation and has received multipleappropriate
defribillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300mg
IV. The patient is intubated. Which best describethe recommended second does of amiodarone
for this patient?
Answer: 150 mg IV push
27. A patient with sinus bradycardia and a heart rate of 42/min has diaphoresisand a blood
pressure of 80/60mm Hg. What is the initial does of atropine?
Answer: - 0.5mg
28. 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?
, Answer: Adenosine6mg
29. A patient is in cardiac arrest. Ventricular fibrillation has been refractory toan initial shock.
If no pathway for medication administration is in place, whichmethod is preferred?
Answer: IV or IO
30. What is the indication for the use of magnesium in cardiac arrest?
Answer: Pulse-less ventricular tachycardia-associated torsades de pointes
31. 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?
Answer: Seeking expertconsultation
32. A patient is in cardiac arrest. High-quality chest compressions are beinggiven. The patient
is intubated, and an IV has been started. The rhythm is asystole. What is the first drug/dose to
administer?
Answer: Epinephrine 1mg IV/IO
33. 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 theteam leader. Which medication do you order
next.
Answer: Epinephrine 1 mg
34. A patient with possible STEMI has ongoing chest discomfort. What is a contraindication
to nitrate administration?
Answer: Use of a phosphodiestrase inhibitorwithin the previous 24 hours
35. 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 takenext?
Answer: Perform electrical cardioversion
36. A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IVbolus 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 wastreated 5 years ago. What is your next action?
Answer: Give aspirin 160-325 mg to chew
37. You are caring for a 66-year-old man with a history of a large intracerebralhemorrhage 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?
Answer: Aspirin
1. You are providing bag-mask ventilations to a patient in respiratory arrest.How often
should you provide ventilation?
Answer: About every 5-6 seconds
2. 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 havebeen given. Bag-mask ventilations are
producing visible chest rise. What is your next intervention?
Answer: Give epinephrine 1mg IV/IO
3. 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
reducingthis patient's in-hospital and 30-day mortality rate?
Answer: Repersfusion therapy
4. A patient was in refractory ventricular fibrillation. A thrid shock has just been
administered. Your team looks to you for instructions. What is your nextaction?
Answer: Resume high quality chest compressions
5. Which action is likely to cause air to enter the victim's stomach (gastricinflation) during
bag-mask ventilation?
Answer: Ventilating too quickly
6. 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 ap-prehensive. Her blood pressure si 128/70mm
Hg. What is the next appropriateintervention?
Answer: Administer adenosine 12 mg IV
7. Your patient is not responsive and is not breathing, You can palpate acarotid pulse. Which
action do you take next?
Answer: Start rescue breathing
8. 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?
Answer: Epinephrine 1 mg IV
,9. 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 ventilationsare producing visible chest rise, and IV access has been established,
Whichintervention would be your next action?
Answer: Epinephrine 1mg
10. What is recommended depth of chest compressions for an adult victim?-
Answer: At least 2 inches
11. How does complete chest recoil contribute to effective CPR?
Answer: Allows maximum blood return to the heart
12. What is the recommended compression rate for high-quality CPR?
Answer: -100-120 compressions per minute
13. A patient becomes unresponsive. You are uncertain if a faint pulse is present. They
rhythm shown here is seen on the cardiac monitor. An IV is inpace. Which action do you take
next?
Answer: Start high-quality CPR
14. A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the
patient becomes unresponsive, with the rhythm shown here. Which action is indicated next?
Answer: Give an immediate unsynchronized high-energyshock (defibrillation dose)
15. How often should you switch chest compressors to avoid fatigue?
Answer: Aboutevery 2 minutes
16. You find an unresponsive pt. who is not breathing. After activating the emergency
response system, you determine there is no pulse. What is yournext action?
Answer: Start chest compressions of at least 100 per min.
17. You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm
Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse
oximetry reading is 97%. What assessment step ismost important now?
Answer: Obtaining a 12 lead ECG.
18. What is the preferred method of access for epi administration duringcardiac arrest in most
pts?
Answer: Peripheral IV
19. In which situation does bradycardia require treatment?
Answer: Hypotension
,20. Which intervention is most appropriate for the treatment of a patient inasystole?
Answer: Epinephrine
21. 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?
Answer: Establish IV or IO access
22. A monitored patient in the ICU developed a sudden onset of narrow-complextachycardia 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 withno evidence of ischemia or infarction. The heart rate has not responded to
vagal maneuvers. what is your next action?
Answer: Administer adenosine 6mg IV push
23. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been
administered to a total does of 3 mg. A transcutaneous pacemaker has failed to capture. The
patient is confused, and her blood pressure is 88/56 mmHg. Which therapy is now indicated?
Answer: Epinephrine 2 to 10 mcg/min
24. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second
shock. Which drug should be administered first?
Answer: Epinephrine 1 mgIV/IO
25. A 62-year-old man suddenly experienced difficulty speaking and left-sidedweakness. He
meets initial criteria for fibrinolytic therapy, and a CT scan of the brain si ordered. Which best
describes the guidelines for antiplatelet andfibrinolytic therapy?
Answer: Hold aspirin for at least 24 hours if rtPA is administered
26. A patient is in refractory ventricular fibrillation and has received multipleappropriate
defribillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300mg
IV. The patient is intubated. Which best describethe recommended second does of amiodarone
for this patient?
Answer: 150 mg IV push
27. A patient with sinus bradycardia and a heart rate of 42/min has diaphoresisand a blood
pressure of 80/60mm Hg. What is the initial does of atropine?
Answer: - 0.5mg
28. 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?
, Answer: Adenosine6mg
29. A patient is in cardiac arrest. Ventricular fibrillation has been refractory toan initial shock.
If no pathway for medication administration is in place, whichmethod is preferred?
Answer: IV or IO
30. What is the indication for the use of magnesium in cardiac arrest?
Answer: Pulse-less ventricular tachycardia-associated torsades de pointes
31. 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?
Answer: Seeking expertconsultation
32. A patient is in cardiac arrest. High-quality chest compressions are beinggiven. The patient
is intubated, and an IV has been started. The rhythm is asystole. What is the first drug/dose to
administer?
Answer: Epinephrine 1mg IV/IO
33. 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 theteam leader. Which medication do you order
next.
Answer: Epinephrine 1 mg
34. A patient with possible STEMI has ongoing chest discomfort. What is a contraindication
to nitrate administration?
Answer: Use of a phosphodiestrase inhibitorwithin the previous 24 hours
35. 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 takenext?
Answer: Perform electrical cardioversion
36. A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IVbolus 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 wastreated 5 years ago. What is your next action?
Answer: Give aspirin 160-325 mg to chew
37. You are caring for a 66-year-old man with a history of a large intracerebralhemorrhage 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?
Answer: Aspirin
