ACLS WRITTEN EXAM
1. You are receiving a radio report from an EMS team en route with a patient who may be
having an acute stroke. The hospital CT scanner is not working atthis time. What should you do
in this situation?
Answer: Divert the patient to a hospital15 minutes away with CT capabilities.
2. Choose an appropriate indication to stop or withhold resuscitative efforts.-
Answer: Evidence of rigor mortis.
3. A 49-year-old woman arrives in the emergency department with persistent epigastric pain.
She had been taking oral antacids for the past 6 hours becauseshe thought she had heartburn. The
initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and regular, the nonlabored
respiratory rate is 14 breaths/min, and the pulse oximetry reading is 96%. Which is the most
appropriate intervention to perform next?
Answer: Obtain a 12 lead ECG.
4. A patient in respiratory failure becomes apneic but continues to have a strong pulse.The
heart rate is dropping rapidly and now shows a sinus brady-cardia at a rate of 30/min. What
intervention has the highest priority?
Answer: Simpleairway manuevers and assisted ventilations.
5. What is the appropriate procedure for endotracheal tube suctioning after the appropriate
catheter is selected?
Answer: Suction during withdrawal but for no longerthan 10 seconds.
6. While treating a patient with dizziness, a blood pressure of 68/30 mm Hg,and cool,
clammy skin, you see this lead II ECG rhythm: What is the first intervention ?
Answer: Atropine 0.5mg
7. A 68-year-old woman experienced a sudden onset of right arm weakness.EMS personnel
measure a blood pressure of 140/90 mm Hg, a heart rate of 78/min, a nonlabored respiratory
rate of 14 breaths/min, and a pulse oximetryreading of 97%. The lead II ECG displays sinus
rhythm. What is the most appropriate action for the EMS team to perform next?
Answer: Cincinnati Prehospital Stroke Scale assessment
8. EMS is transporting a patient with a positive prehospital stroke assessment. Upon arrival
in the emergency department, the initial blood pressure is138/78 mm Hg, the pulse rate is
80/min, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95% on room
air. The lead II ECG displayssinus rhythm. The blood glucose level is within normal limits.
What intervention should you perform next?
, Answer: Head CT scan
9. What is the proper ventilation rate for a patient in cardiac arrest who hasan advanced
airway in place?
Answer: 8-10 breaths per minute
10. A 62-year-old man in the emergency department says that his heart is beating fast. He
says he has no chest pain or shortness of breath. The bloodpressure is 142/98 mm Hg, the
pulse is 200/min, the respiratory rate is 14 breaths/min, and pulse oximetry is 95% on room air.
What intervention shouldyou perform next?
Answer: Obtain a 12 lead ECG.
11. You are evaluating a 48-year-old man with crushing substernal chest pain.The patient is
pale, diaphoretic, cool to the touch, and slow to respond to your questions. The blood pressure
is 58/32 mm Hg, the heart rate is 190/min,the respiratory rate is 18 breaths/min, and the pulse
oximeter is unable to obtain a reading because there is no radial pulse. The lead II ECG
displays a regular wide-complex tachycardia. What intervention should you performnext?
Answer: Synchronized cardioversion
12. What is the initial priority for an unconscious patient with any tachycardiaon the monitor?
Answer: Determine whether pulses are present.
13. Which rhythm requires synchronized cardioversion?
Answer: Unstable supraventricular tachycardia
14. What is the recommended second dose of adenosine for patients in refractory but stable
narrow-complex tachycardia?
Answer: 12mg
15. What is the usual post-cardiac arrest target range for PETCO2 when ventilating a patient
who achieves return of spontaneous circulation (ROSC)?
Answer: -35-40mm Hg
16. Which condition is a contraindication to therapeutic hypothermia during the post-cardiac
arrest period for patients who achieve return of spontaneouscirculation ROSC?
Answer: Responding to verbal commands
17. What is the potential danger of using ties that pass circumferentially around the patient's
neck when securing an advanced airway?
Answer: Obstruction ofvenous return from the brain
18. What is the most reliable method of confirming and monitoring correctplacement of an
endotracheal tube?
Answer: Continuous waveform capnography
1. You are receiving a radio report from an EMS team en route with a patient who may be
having an acute stroke. The hospital CT scanner is not working atthis time. What should you do
in this situation?
Answer: Divert the patient to a hospital15 minutes away with CT capabilities.
2. Choose an appropriate indication to stop or withhold resuscitative efforts.-
Answer: Evidence of rigor mortis.
3. A 49-year-old woman arrives in the emergency department with persistent epigastric pain.
She had been taking oral antacids for the past 6 hours becauseshe thought she had heartburn. The
initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and regular, the nonlabored
respiratory rate is 14 breaths/min, and the pulse oximetry reading is 96%. Which is the most
appropriate intervention to perform next?
Answer: Obtain a 12 lead ECG.
4. A patient in respiratory failure becomes apneic but continues to have a strong pulse.The
heart rate is dropping rapidly and now shows a sinus brady-cardia at a rate of 30/min. What
intervention has the highest priority?
Answer: Simpleairway manuevers and assisted ventilations.
5. What is the appropriate procedure for endotracheal tube suctioning after the appropriate
catheter is selected?
Answer: Suction during withdrawal but for no longerthan 10 seconds.
6. While treating a patient with dizziness, a blood pressure of 68/30 mm Hg,and cool,
clammy skin, you see this lead II ECG rhythm: What is the first intervention ?
Answer: Atropine 0.5mg
7. A 68-year-old woman experienced a sudden onset of right arm weakness.EMS personnel
measure a blood pressure of 140/90 mm Hg, a heart rate of 78/min, a nonlabored respiratory
rate of 14 breaths/min, and a pulse oximetryreading of 97%. The lead II ECG displays sinus
rhythm. What is the most appropriate action for the EMS team to perform next?
Answer: Cincinnati Prehospital Stroke Scale assessment
8. EMS is transporting a patient with a positive prehospital stroke assessment. Upon arrival
in the emergency department, the initial blood pressure is138/78 mm Hg, the pulse rate is
80/min, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95% on room
air. The lead II ECG displayssinus rhythm. The blood glucose level is within normal limits.
What intervention should you perform next?
, Answer: Head CT scan
9. What is the proper ventilation rate for a patient in cardiac arrest who hasan advanced
airway in place?
Answer: 8-10 breaths per minute
10. A 62-year-old man in the emergency department says that his heart is beating fast. He
says he has no chest pain or shortness of breath. The bloodpressure is 142/98 mm Hg, the
pulse is 200/min, the respiratory rate is 14 breaths/min, and pulse oximetry is 95% on room air.
What intervention shouldyou perform next?
Answer: Obtain a 12 lead ECG.
11. You are evaluating a 48-year-old man with crushing substernal chest pain.The patient is
pale, diaphoretic, cool to the touch, and slow to respond to your questions. The blood pressure
is 58/32 mm Hg, the heart rate is 190/min,the respiratory rate is 18 breaths/min, and the pulse
oximeter is unable to obtain a reading because there is no radial pulse. The lead II ECG
displays a regular wide-complex tachycardia. What intervention should you performnext?
Answer: Synchronized cardioversion
12. What is the initial priority for an unconscious patient with any tachycardiaon the monitor?
Answer: Determine whether pulses are present.
13. Which rhythm requires synchronized cardioversion?
Answer: Unstable supraventricular tachycardia
14. What is the recommended second dose of adenosine for patients in refractory but stable
narrow-complex tachycardia?
Answer: 12mg
15. What is the usual post-cardiac arrest target range for PETCO2 when ventilating a patient
who achieves return of spontaneous circulation (ROSC)?
Answer: -35-40mm Hg
16. Which condition is a contraindication to therapeutic hypothermia during the post-cardiac
arrest period for patients who achieve return of spontaneouscirculation ROSC?
Answer: Responding to verbal commands
17. What is the potential danger of using ties that pass circumferentially around the patient's
neck when securing an advanced airway?
Answer: Obstruction ofvenous return from the brain
18. What is the most reliable method of confirming and monitoring correctplacement of an
endotracheal tube?
Answer: Continuous waveform capnography
