ACLS PRETEST
1. A patient is in refractory ventricular fibrillation and has received multiple appropriate
defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amidarone IV.
The patient is intubated. A second does of amiodarone is now called for.The recommended
second dose of amiodaroneis
Answer: 150 mg IV push
2. A 35-year-old woman has palpitations, light-headiness, and a stable tachy- cardia. The
monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not
been effective in terminated the rhythm. An IV has been established. What drug should be
administered IV?
Answer: Adenosine 6 mg
3. 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.
Which of the following actions is recommended?-
Answer: Seeking expert consultation
4. A patient with possible ST-segment elevation MI has ongoing chest dis- comfort.Which
of the following would be a contraindication to the administration of nitrates?
Answer: Use of phosphodiesterase inhibitor within 12 hours.
5. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been
administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The
patient is confused, and her blood pressure is 100/60 mm Hg. Which of the following is now
indicated?
Answer: Start epinephrine 2 to 10 mcg/min
6. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to asecond shock. Of
the following, which drug and dose should be administeredfirst by the IV/IO route?
Answer: Epinephrine 1 mg
7. You arrive on the scene with the code team. High-quality CPR is in progress. An AED
has previously advised, "no shock indicated." A rhythmcheck now finds asystole. After
resuming high-quality compressions, yournext action is to:
Answer: Gain IV or IO access
8. A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic
therapy has been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion
of 1000 units per hour is being administered. Aspirin was taken by the patient because he had a
history of gastritis treated 5years ago.Your next action is?
Answer: Give Aspirin 160 to 325 mg chewed immediately.
9. Bradycardia requires treatment when:
, Answer: Chest pain or shortness of breath ispresent
10. Which of the following statements about the use of magnesium in cardiac arrest is most
accurate?
Answer: Magnesium is indicated for VF/pulseless VT associatedwith torsades de pointes.
11. 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. Which is the first drug/dose
to administer?
Answer: Epinephrine 1 mg or vasopressin 40 units IV or IO
12. A patient has sinus bradycardia with a heart rate of 42/min has diaphoresis and a blood
pressure of 80/60 mm Hg.What is the initial dose of atropine?
Answer: 0.5mg
13. A patient is in refractory ventricular fibrillation. High-quality CPR is in progress, and
shocks have been given. One dose of epinephrine was given after the second shock. An
antiarrhythmic drug was given immediately after the third shock. What drug should the team
leader request to be prepared foradministration next?
Answer: Second dose of epinephrine 1 mg
14. A 62-year-old man suddenly experienced difficulty speaking and left-sidedweakness. He
was brought to the emergency department. He meets initial criteria for fibrinolytic therapy,
and a CT scan of the brain is ordered. What are the guidelines for antiplatelet and fibrinolytic
therapy?
Answer: Do not give aspirinfor at least 24 hours if rtPA is administered
15. Which of the following statements is most accurate regarding the administration of
vasopressin during cardiac arrest?
Answer: The correct dose of vasopressinis 40 units administered IV or IO.
16. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock.
What is the recommended route for drug administrationduring CPR?
Answer: IV or IO
17. Your patient has been intubated. IV/IO access is not available. Which com- bination of
drugs can be administered by the endotracheal route?
Answer: Lidocaine,epinephrine, vasopressin
18. The patient suddenly becomes unconscious and has a weak carotid pulse. Cardiac
monitoring, supplementary oxygen, and an IV have been initiated.
The code cart with all the drugs and a transcutaneous pacer are immediatelyavailable. Next
you would?
Answer: Give atropine 0.5 mg IV.
19. You arrive on the scene to find CPR in progress. Nursing staff report thatthe patient was
1. A patient is in refractory ventricular fibrillation and has received multiple appropriate
defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amidarone IV.
The patient is intubated. A second does of amiodarone is now called for.The recommended
second dose of amiodaroneis
Answer: 150 mg IV push
2. A 35-year-old woman has palpitations, light-headiness, and a stable tachy- cardia. The
monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not
been effective in terminated the rhythm. An IV has been established. What drug should be
administered IV?
Answer: Adenosine 6 mg
3. 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.
Which of the following actions is recommended?-
Answer: Seeking expert consultation
4. A patient with possible ST-segment elevation MI has ongoing chest dis- comfort.Which
of the following would be a contraindication to the administration of nitrates?
Answer: Use of phosphodiesterase inhibitor within 12 hours.
5. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been
administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The
patient is confused, and her blood pressure is 100/60 mm Hg. Which of the following is now
indicated?
Answer: Start epinephrine 2 to 10 mcg/min
6. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to asecond shock. Of
the following, which drug and dose should be administeredfirst by the IV/IO route?
Answer: Epinephrine 1 mg
7. You arrive on the scene with the code team. High-quality CPR is in progress. An AED
has previously advised, "no shock indicated." A rhythmcheck now finds asystole. After
resuming high-quality compressions, yournext action is to:
Answer: Gain IV or IO access
8. A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic
therapy has been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion
of 1000 units per hour is being administered. Aspirin was taken by the patient because he had a
history of gastritis treated 5years ago.Your next action is?
Answer: Give Aspirin 160 to 325 mg chewed immediately.
9. Bradycardia requires treatment when:
, Answer: Chest pain or shortness of breath ispresent
10. Which of the following statements about the use of magnesium in cardiac arrest is most
accurate?
Answer: Magnesium is indicated for VF/pulseless VT associatedwith torsades de pointes.
11. 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. Which is the first drug/dose
to administer?
Answer: Epinephrine 1 mg or vasopressin 40 units IV or IO
12. A patient has sinus bradycardia with a heart rate of 42/min has diaphoresis and a blood
pressure of 80/60 mm Hg.What is the initial dose of atropine?
Answer: 0.5mg
13. A patient is in refractory ventricular fibrillation. High-quality CPR is in progress, and
shocks have been given. One dose of epinephrine was given after the second shock. An
antiarrhythmic drug was given immediately after the third shock. What drug should the team
leader request to be prepared foradministration next?
Answer: Second dose of epinephrine 1 mg
14. A 62-year-old man suddenly experienced difficulty speaking and left-sidedweakness. He
was brought to the emergency department. He meets initial criteria for fibrinolytic therapy,
and a CT scan of the brain is ordered. What are the guidelines for antiplatelet and fibrinolytic
therapy?
Answer: Do not give aspirinfor at least 24 hours if rtPA is administered
15. Which of the following statements is most accurate regarding the administration of
vasopressin during cardiac arrest?
Answer: The correct dose of vasopressinis 40 units administered IV or IO.
16. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock.
What is the recommended route for drug administrationduring CPR?
Answer: IV or IO
17. Your patient has been intubated. IV/IO access is not available. Which com- bination of
drugs can be administered by the endotracheal route?
Answer: Lidocaine,epinephrine, vasopressin
18. The patient suddenly becomes unconscious and has a weak carotid pulse. Cardiac
monitoring, supplementary oxygen, and an IV have been initiated.
The code cart with all the drugs and a transcutaneous pacer are immediatelyavailable. Next
you would?
Answer: Give atropine 0.5 mg IV.
19. You arrive on the scene to find CPR in progress. Nursing staff report thatthe patient was
