ACLS COMPLETE EXAM QUESTIONS AND
ANSWERS
1.In which situation does bradycardia require treatment?
Answer Hypotension
2.Which intervention is most appropriate for the treatment of a patient
in asystole?
Answer Epinephrine
3.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
4.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 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 with
no 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
5.A patient has sinus bradycardia with a heart rate of 36/min. Atropine has
been administered to a toal does of 3 mg. A transcutaneous pacemaker has
failed to capture. The patient is confused, and her blood pressure is 88/56
mm Hg. Which therapy is now indicated?
Answer Epinephrine 2 to 10 mcg/min
6.A patient is in cardiac arrest. Ventricular fibrillation has been refractory
to a second shock. Which drug should be administered first?
Answer Epinephrine 1 mg IV/IO
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 si ordered. Which best describes the guidelines for
antiplatelet and fibrinolytic therapy?
Answer Hold aspirin for at least 24 hours if rtPA is administered
8.A patient is in refractory ventricular fibrillation and has received multiple
appropriate defribillation shocks, epinephrine 1 mg IV twice, and an initial
dose of amiodarone 300mg IV. The patient is intubated. Which best
describe the recommended second does of amiodarone for this patient?
Answer 150 mg IV push
,9. A patient with sinus bradycardia and a heart rate of 42/min has
diaphoresis and a blood pressure of 80/60mm Hg. What is the initial does of
atropine?
Answer - 0.5mg
10.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 Adenosine 6mg
11.A patient is in cardiac arrest. Ventricular fibrillation has been refractory
to an initial shock. If no pathway for medication administration is in place,
which method is preferred?
Answer IV or IO
12.What is the indication for the use of magnesium in cardiac arrest?
Answer Pulse- less ventricular tachycardia-associated torsades de
pointes
13.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 expert consultation
, 14.A patient is in cardiac arrest. High-quality chest compressions are
being given. 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
15.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
the team leader. Which medication do you order next.
Answer Epinephrine 1 mg
16.A patient with possible STEMI has ongoing chest discomfort. What is a
contraindication to nitrate administration?
Answer Use of a phosphodiestrase inhibitor within the previous 24 hours
17.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
take next?
Answer Perform electrical cardioversion
18.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 aspirin because he has a history of
ANSWERS
1.In which situation does bradycardia require treatment?
Answer Hypotension
2.Which intervention is most appropriate for the treatment of a patient
in asystole?
Answer Epinephrine
3.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
4.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 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 with
no 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
5.A patient has sinus bradycardia with a heart rate of 36/min. Atropine has
been administered to a toal does of 3 mg. A transcutaneous pacemaker has
failed to capture. The patient is confused, and her blood pressure is 88/56
mm Hg. Which therapy is now indicated?
Answer Epinephrine 2 to 10 mcg/min
6.A patient is in cardiac arrest. Ventricular fibrillation has been refractory
to a second shock. Which drug should be administered first?
Answer Epinephrine 1 mg IV/IO
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 si ordered. Which best describes the guidelines for
antiplatelet and fibrinolytic therapy?
Answer Hold aspirin for at least 24 hours if rtPA is administered
8.A patient is in refractory ventricular fibrillation and has received multiple
appropriate defribillation shocks, epinephrine 1 mg IV twice, and an initial
dose of amiodarone 300mg IV. The patient is intubated. Which best
describe the recommended second does of amiodarone for this patient?
Answer 150 mg IV push
,9. A patient with sinus bradycardia and a heart rate of 42/min has
diaphoresis and a blood pressure of 80/60mm Hg. What is the initial does of
atropine?
Answer - 0.5mg
10.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 Adenosine 6mg
11.A patient is in cardiac arrest. Ventricular fibrillation has been refractory
to an initial shock. If no pathway for medication administration is in place,
which method is preferred?
Answer IV or IO
12.What is the indication for the use of magnesium in cardiac arrest?
Answer Pulse- less ventricular tachycardia-associated torsades de
pointes
13.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 expert consultation
, 14.A patient is in cardiac arrest. High-quality chest compressions are
being given. 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
15.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
the team leader. Which medication do you order next.
Answer Epinephrine 1 mg
16.A patient with possible STEMI has ongoing chest discomfort. What is a
contraindication to nitrate administration?
Answer Use of a phosphodiestrase inhibitor within the previous 24 hours
17.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
take next?
Answer Perform electrical cardioversion
18.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 aspirin because he has a history of
