ACLS Pretest Questions & Answers
1. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has
been administered to a total of 3 mg. A transcutaneous pacemaker has
failed to capture. The patient is confused, and her blood pressure is 110/60
mm Hg. Which of the following is now indicated?
1. Give additional 1 mg atropine.
2. Start dopamine 10 to 20 mcg/kg per minute.
3. Give normal saline bolus 250 mL to 500 mL.
4. Start epinephrine 2 to 10 mcg/min
Answer 4. Start epinephrine 2 to 10 mcg/min.
2. A 62-year-old man suddenly experienced difficulty speaking and left-
side weakness. 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?
1. Do not give aspirin for at least 24 hours if rtPA is administered.
2. Give aspirin 160 mg and clopidogrel 75 mg orally.
3. Administer heparin if CT scan is negative for hemorrhage.
4. Administer aspirin 160 to 325 mg chewed immediately
Answer 1. Do not give aspirin for at least 24 hours if rtPA is
administered.
3. A patient with possible ST-segment elevation MI has ongoing chest dis-
comfort. Which of the following would be a contraindication to the
,administra- tion of nitrates?
1. Heart rate 90/min.
2. Left ventricular infarct with bilateral rales.
3. Blood pressure greater than 180 mm Hg.
4. Use of a phosphodiesterase inhibitor within 12 hours
Answer 4. Use of a phospho- diesterase inhibitor within 12 hours
4. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to
a second shock. Of the following, which drug and dose should be
administered
first by the IV/IO route?
1. Epinephrine 1 mg
2. Vasopressin 20 units
3. Sodium bicarbonate 50 mEq
4. Atropine 1 mg
Answer 1. Epinephrine 1 mg
5. 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. What drug should be administered IV?
1. Lidocaine 1mg/kg
2. Adenosine 6 mg
3. Epinephrine 2 to 10 mcg/kg per minute
4. Atropine 0.5 mg
, Answer 2. Adenosine 6 mg
6. A patient with sinus bradycardia and heart rate of 42/min has
diaphoresis and a blood pressure of 80/60 mm Hg. What is the initial dose of
atropine?
1. Dose of 0.1mg
2. Dose of 3 mg
3. Dose of 1 mg
4. Dose of 0.5mg
Answer 4. Dose of 0.5mg
7. 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 amiodarone IV. The patient is intubated. A second dose of
amiodarone is now called for. The recommended second dose of
amiodarone is
1. An endotracheal dose of 2 to 4 mg/kg.
2. 300 mg IV push.
3. 1 mg/kg IV push.
4. An infusion of 1 to 2 mg/min.
5. 150 mg IV push
Answer 5. 150 mg IV push.
8. A patient with a possible acute coronary syndrome has ongoing chest
discomfort unresponsive to 3 sublingual nitroglycerin tablets. There are no
1. A patient has sinus bradycardia with a heart rate of 36/min. Atropine has
been administered to a total of 3 mg. A transcutaneous pacemaker has
failed to capture. The patient is confused, and her blood pressure is 110/60
mm Hg. Which of the following is now indicated?
1. Give additional 1 mg atropine.
2. Start dopamine 10 to 20 mcg/kg per minute.
3. Give normal saline bolus 250 mL to 500 mL.
4. Start epinephrine 2 to 10 mcg/min
Answer 4. Start epinephrine 2 to 10 mcg/min.
2. A 62-year-old man suddenly experienced difficulty speaking and left-
side weakness. 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?
1. Do not give aspirin for at least 24 hours if rtPA is administered.
2. Give aspirin 160 mg and clopidogrel 75 mg orally.
3. Administer heparin if CT scan is negative for hemorrhage.
4. Administer aspirin 160 to 325 mg chewed immediately
Answer 1. Do not give aspirin for at least 24 hours if rtPA is
administered.
3. A patient with possible ST-segment elevation MI has ongoing chest dis-
comfort. Which of the following would be a contraindication to the
,administra- tion of nitrates?
1. Heart rate 90/min.
2. Left ventricular infarct with bilateral rales.
3. Blood pressure greater than 180 mm Hg.
4. Use of a phosphodiesterase inhibitor within 12 hours
Answer 4. Use of a phospho- diesterase inhibitor within 12 hours
4. A patient is in cardiac arrest. Ventricular fibrillation has been refractory to
a second shock. Of the following, which drug and dose should be
administered
first by the IV/IO route?
1. Epinephrine 1 mg
2. Vasopressin 20 units
3. Sodium bicarbonate 50 mEq
4. Atropine 1 mg
Answer 1. Epinephrine 1 mg
5. 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. What drug should be administered IV?
1. Lidocaine 1mg/kg
2. Adenosine 6 mg
3. Epinephrine 2 to 10 mcg/kg per minute
4. Atropine 0.5 mg
, Answer 2. Adenosine 6 mg
6. A patient with sinus bradycardia and heart rate of 42/min has
diaphoresis and a blood pressure of 80/60 mm Hg. What is the initial dose of
atropine?
1. Dose of 0.1mg
2. Dose of 3 mg
3. Dose of 1 mg
4. Dose of 0.5mg
Answer 4. Dose of 0.5mg
7. 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 amiodarone IV. The patient is intubated. A second dose of
amiodarone is now called for. The recommended second dose of
amiodarone is
1. An endotracheal dose of 2 to 4 mg/kg.
2. 300 mg IV push.
3. 1 mg/kg IV push.
4. An infusion of 1 to 2 mg/min.
5. 150 mg IV push
Answer 5. 150 mg IV push.
8. A patient with a possible acute coronary syndrome has ongoing chest
discomfort unresponsive to 3 sublingual nitroglycerin tablets. There are no
