ACLS Practice Exam Questions & Answers
1.A monitored patient in the ICU developed a sudden onset of narrow-
complex tachycardia at a rate of 220/min. The patient's blood pressure is
128/58 mm Hg, the PETCO2 is 38 mm 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 confirms a superventricular
tachycardia with no evidence of ischemia or infarction. The heart rate has
not responded to vagal maneuvers. What is your next action?
a) Administer adenosine 6 mg IV push
b) Administer adenosine 300 mg IV push
c) Perform synchronized cardioversion at 50 J
d) Perform synchronized cardioversion at 200 J
Answer a) Administer adenosine 6 mg IV push
2.A patient is in pulseless ventricular tachycardia.Two shocks and 1 dose
of epinephrine have been given. Which drug should be given next?
a) Adenosine 6 mg
b) Amiodarone 300 mg
c) Epinephrine 3 mg
d) Lidocaine 0.5 mg/kg
Answer b) Amiodarone 300 mg
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,3.Which intervention is more appropriate for the treatment of a patient
in asystole?
a) Atropine
b) Defibrillation
c) Epinephrine
d) Transcutaneous pacing
Answer c) Epinephrine
4.A 35-year-old woman has palpitations, light-headedness, 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 terminating the rhythm.
An IV has been established. Which drug should be administered?
a) Adenosine 6 mg
b) Atropine 0.5 mg
c) Epinephrine 2 to 10 mcg/kg per minute
d) Lidocaine 1 mg/kg
Answer a) Adenosine 6 mg
5.You arrive on the scene with the code team. High-quality CPR is in
progress. An AED has previously advised "no shock indicated." A rhythm
check now finds asystole. After resuming high-quality compressions, which
action do
you take next?
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174
,a) Call for a pulse check
b) Establish IV or IO access
c) Insert a laryngeal airway
d) Perform endotracheal intubation
Answer b) Establish IV or IO access
6.What is the indication for the use of magnesium in cardiac arrest?
a) Ventricular tachycardia associated with a normal QT interval
b) Shock-refractory monomorphic ventricular tachycardia
c) Pulseless ventricular tachycardia-associated torsades de pointes
d) Shock-refractory ventricular fibrillation
Answer c) Pulseless ventricular tachycar- dia-associated torsades de
pointes
7.A 62-year-old man suddenly experienced difficulty speaking and left-
sided weakness. He meets initial criteria for fibrinolytic therapy, and a CT
scan of the brain is ordered. Which best describes the guidelines for
antiplatelet and fibrinolytic therapy?
a) Give asprin 160 to 325 mg to be chewed immediately
b) Give asprin 160 mg and clopidogrel 75 mg orally
c) Give heprin if the CT scan is negative for hemorrhage
d) Hold asprin for at least 24 hours if rtPA is administered
Answer d) Hold asprin for at least 24 hours if rtPA is administered
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, 8.In which situation does bradycardia require treatment?
a) 12-lead ECG showing a normal sinus rhythm
b) Hypertension
c) Diastolic blood pressure greater than 90 mm Hg
d) Systolic blood pressure greater than 100 mm Hg
Answer b) Hypertension
9.A 57-year-old woman has palpitations, chest discomfort, and
tachycardia. The monitor shows a regular wide-complex QRS at a rate of
100/min. She becomes diaphoretic, and her blood pressure is 80/60 mm
Hg. Which action do you take next?
a) Establish IV access
b) Obtain a 12-lead ECG
c) Perform electrical cardioversion
d) Seek expert consultation
Answer c) Perform electrical cardioversion
10.A patient with STEMI has ongoing chest discomfort. Heparin 4000 units
IV bolus and a heparin infusion of 1000 units per hour are being
administered. The patient did not take asprin because he has a history of
gastritis, which was treated 5 years ago. What is your next action?
a) Give asprin 160 to 325 mg to chew
b) Give clopidogrel 300 mg orally
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1.A monitored patient in the ICU developed a sudden onset of narrow-
complex tachycardia at a rate of 220/min. The patient's blood pressure is
128/58 mm Hg, the PETCO2 is 38 mm 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 confirms a superventricular
tachycardia with no evidence of ischemia or infarction. The heart rate has
not responded to vagal maneuvers. What is your next action?
a) Administer adenosine 6 mg IV push
b) Administer adenosine 300 mg IV push
c) Perform synchronized cardioversion at 50 J
d) Perform synchronized cardioversion at 200 J
Answer a) Administer adenosine 6 mg IV push
2.A patient is in pulseless ventricular tachycardia.Two shocks and 1 dose
of epinephrine have been given. Which drug should be given next?
a) Adenosine 6 mg
b) Amiodarone 300 mg
c) Epinephrine 3 mg
d) Lidocaine 0.5 mg/kg
Answer b) Amiodarone 300 mg
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174
,3.Which intervention is more appropriate for the treatment of a patient
in asystole?
a) Atropine
b) Defibrillation
c) Epinephrine
d) Transcutaneous pacing
Answer c) Epinephrine
4.A 35-year-old woman has palpitations, light-headedness, 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 terminating the rhythm.
An IV has been established. Which drug should be administered?
a) Adenosine 6 mg
b) Atropine 0.5 mg
c) Epinephrine 2 to 10 mcg/kg per minute
d) Lidocaine 1 mg/kg
Answer a) Adenosine 6 mg
5.You arrive on the scene with the code team. High-quality CPR is in
progress. An AED has previously advised "no shock indicated." A rhythm
check now finds asystole. After resuming high-quality compressions, which
action do
you take next?
2/
174
,a) Call for a pulse check
b) Establish IV or IO access
c) Insert a laryngeal airway
d) Perform endotracheal intubation
Answer b) Establish IV or IO access
6.What is the indication for the use of magnesium in cardiac arrest?
a) Ventricular tachycardia associated with a normal QT interval
b) Shock-refractory monomorphic ventricular tachycardia
c) Pulseless ventricular tachycardia-associated torsades de pointes
d) Shock-refractory ventricular fibrillation
Answer c) Pulseless ventricular tachycar- dia-associated torsades de
pointes
7.A 62-year-old man suddenly experienced difficulty speaking and left-
sided weakness. He meets initial criteria for fibrinolytic therapy, and a CT
scan of the brain is ordered. Which best describes the guidelines for
antiplatelet and fibrinolytic therapy?
a) Give asprin 160 to 325 mg to be chewed immediately
b) Give asprin 160 mg and clopidogrel 75 mg orally
c) Give heprin if the CT scan is negative for hemorrhage
d) Hold asprin for at least 24 hours if rtPA is administered
Answer d) Hold asprin for at least 24 hours if rtPA is administered
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, 8.In which situation does bradycardia require treatment?
a) 12-lead ECG showing a normal sinus rhythm
b) Hypertension
c) Diastolic blood pressure greater than 90 mm Hg
d) Systolic blood pressure greater than 100 mm Hg
Answer b) Hypertension
9.A 57-year-old woman has palpitations, chest discomfort, and
tachycardia. The monitor shows a regular wide-complex QRS at a rate of
100/min. She becomes diaphoretic, and her blood pressure is 80/60 mm
Hg. Which action do you take next?
a) Establish IV access
b) Obtain a 12-lead ECG
c) Perform electrical cardioversion
d) Seek expert consultation
Answer c) Perform electrical cardioversion
10.A patient with STEMI has ongoing chest discomfort. Heparin 4000 units
IV bolus and a heparin infusion of 1000 units per hour are being
administered. The patient did not take asprin because he has a history of
gastritis, which was treated 5 years ago. What is your next action?
a) Give asprin 160 to 325 mg to chew
b) Give clopidogrel 300 mg orally
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174
