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Advanced Medical Life Support
(AMLS) – Pretest & Post-Test
Questions & Verified Answers
(2023/2024)
Question 1
A 45-year-old patient is found supine on the floor with pinpoint pupils, shallow respirations, and
vomitus around the mouth. What is the next course of action?
a. Initiate an IV and administer naloxone
b. Supplemental oxygen and suction
c. Obtain a blood glucose level
d. Begin bag-valve-mask (BVM) ventilations
Correct Answer: b. Supplemental oxygen and suction
Explanation: The patient presents with signs of opioid overdose (pinpoint pupils, shallow
respirations, and altered mental status). The immediate priority is to address airway and
breathing by clearing vomitus with suction and providing supplemental oxygen to improve
oxygenation. Administering naloxone (option a) may be appropriate after securing the airway,
and obtaining a blood glucose level (option c) is secondary to addressing life threats. BVM
ventilations (option d) may be needed if respirations remain inadequate after initial interventions.
Question 2
Which condition is most likely to cause respiratory acidosis?
a. Anxiety/panic attack
b. Narcotic overdose
c. Methanol ingestion
d. Diabetic ketoacidosis
Correct Answer: b. Narcotic overdose
Explanation: Respiratory acidosis occurs due to hypoventilation, leading to increased pCO2
levels. Narcotic overdose causes respiratory depression, reducing ventilation and causing CO2
retention, which is the primary cause of respiratory acidosis. Anxiety/panic attack (option a)
leads to hyperventilation and respiratory alkalosis. Methanol ingestion (option c) causes
metabolic acidosis, and diabetic ketoacidosis (option d) also results in metabolic acidosis due to
ketone accumulation.
Question 3
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Patients with a history of COPD presenting with acute shortness of breath are most likely to have
which condition?
a. Pulmonary embolism
b. Angina pectoris
c. Angioedema
d. Hypertensive crisis
Correct Answer: a. Pulmonary embolism
Explanation: Acute onset of shortness of breath in a COPD patient suggests a pulmonary
embolism (PE), especially given the increased risk of thromboembolism in chronic lung disease.
PE presents with sudden dyspnea and clear breath sounds, which aligns with this scenario.
Angina pectoris (option b) typically presents with chest pain, angioedema (option c) involves
swelling and airway obstruction, and hypertensive crisis (option d) is associated with elevated
blood pressure, not primarily dyspnea.
Question 4
During compensatory shock, the renin-angiotensin-aldosterone system causes:
a. Increase in preload, afterload, and sodium reabsorption
b. Decrease in preload, afterload, and sodium reabsorption
c. Hypotension and bradycardia
d. Vasodilation and sodium retention
Correct Answer: a. Increase in preload, afterload, and sodium reabsorption
Explanation: In compensatory shock, the renin-angiotensin-aldosterone system (RAAS) is
activated to maintain blood pressure. It increases preload (via increased venous return), afterload
(via vasoconstriction from angiotensin II), and sodium reabsorption (via aldosterone), helping to
retain fluid and increase blood volume. Options b, c, and d do not accurately describe RAAS
effects in shock.
Question 5
What clinical findings are most commonly associated with a pulmonary embolus?
a. Clear breath sounds with tachypnea
b. Rhonchi auscultated bilaterally with hypercarbia
c. Crackles heard in the bases with bradycardia
d. Fever, tachycardia, and tachypnea with increased work of breathing
Correct Answer: a. Clear breath sounds with tachypnea
Explanation: Pulmonary embolism typically presents with clear breath sounds and tachypnea
due to impaired gas exchange from vascular obstruction. Rhonchi with hypercarbia (option b)
suggests obstructive lung disease, crackles with bradycardia (option c) is atypical, and while
fever and tachycardia (option d) may occur, clear breath sounds with tachypnea are more
specific.
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Question 6
A 55-year-old patient complains of aching chest discomfort persisting for several days with a
temperature of 101°F (38.3°C). Which finding narrows the diagnosis to pericarditis?
a. Pain relieved when supine
b. Pulsus alternans present
c. S3 gallop auscultated
d. ST-segment elevation in all leads
Correct Answer: d. ST-segment elevation in all leads
Explanation: Pericarditis is characterized by diffuse ST-segment elevation in nearly all ECG
leads due to widespread inflammation of the pericardium. Pain relief when supine (option a) is
not typical, as pericarditis pain often worsens when lying down. Pulsus alternans (option b) is
associated with heart failure, and an S3 gallop (option c) indicates fluid overload, not
pericarditis.
Question 7
Anaphylaxis is most associated with which physiological event?
a. Hemorrhage
b. Vasodilation
c. Bradycardia
d. Hypertension
Correct Answer: b. Vasodilation
Explanation: Anaphylaxis involves a massive release of histamine, leading to vasodilation,
increased vascular permeability, and hypotension. Hemorrhage (option a) is unrelated,
bradycardia (option c) is not typical (tachycardia is more common), and hypertension (option d)
is not a primary feature of anaphylaxis.
Question 8
Acute Respiratory Distress Syndrome (ARDS) is characterized by which pathological change?
a. Excessive mucous production
b. Inflammation of the visceral pleura
c. Breakdown of the alveolar-capillary membrane
d. Accumulation of fluid between the pleural layers
Correct Answer: c. Breakdown of the alveolar-capillary membrane
Explanation: ARDS is caused by diffuse alveolar damage, leading to breakdown of the alveolar-
capillary membrane, which allows fluid to leak into the alveoli, impairing gas exchange.
Excessive mucous production (option a) is more common in chronic lung diseases, inflammation
of the visceral pleura (option b) relates to pleuritis, and fluid between pleural layers (option d)
describes pleural effusion.
Advanced Medical Life Support
(AMLS) – Pretest & Post-Test
Questions & Verified Answers
(2023/2024)
Question 1
A 45-year-old patient is found supine on the floor with pinpoint pupils, shallow respirations, and
vomitus around the mouth. What is the next course of action?
a. Initiate an IV and administer naloxone
b. Supplemental oxygen and suction
c. Obtain a blood glucose level
d. Begin bag-valve-mask (BVM) ventilations
Correct Answer: b. Supplemental oxygen and suction
Explanation: The patient presents with signs of opioid overdose (pinpoint pupils, shallow
respirations, and altered mental status). The immediate priority is to address airway and
breathing by clearing vomitus with suction and providing supplemental oxygen to improve
oxygenation. Administering naloxone (option a) may be appropriate after securing the airway,
and obtaining a blood glucose level (option c) is secondary to addressing life threats. BVM
ventilations (option d) may be needed if respirations remain inadequate after initial interventions.
Question 2
Which condition is most likely to cause respiratory acidosis?
a. Anxiety/panic attack
b. Narcotic overdose
c. Methanol ingestion
d. Diabetic ketoacidosis
Correct Answer: b. Narcotic overdose
Explanation: Respiratory acidosis occurs due to hypoventilation, leading to increased pCO2
levels. Narcotic overdose causes respiratory depression, reducing ventilation and causing CO2
retention, which is the primary cause of respiratory acidosis. Anxiety/panic attack (option a)
leads to hyperventilation and respiratory alkalosis. Methanol ingestion (option c) causes
metabolic acidosis, and diabetic ketoacidosis (option d) also results in metabolic acidosis due to
ketone accumulation.
Question 3
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Patients with a history of COPD presenting with acute shortness of breath are most likely to have
which condition?
a. Pulmonary embolism
b. Angina pectoris
c. Angioedema
d. Hypertensive crisis
Correct Answer: a. Pulmonary embolism
Explanation: Acute onset of shortness of breath in a COPD patient suggests a pulmonary
embolism (PE), especially given the increased risk of thromboembolism in chronic lung disease.
PE presents with sudden dyspnea and clear breath sounds, which aligns with this scenario.
Angina pectoris (option b) typically presents with chest pain, angioedema (option c) involves
swelling and airway obstruction, and hypertensive crisis (option d) is associated with elevated
blood pressure, not primarily dyspnea.
Question 4
During compensatory shock, the renin-angiotensin-aldosterone system causes:
a. Increase in preload, afterload, and sodium reabsorption
b. Decrease in preload, afterload, and sodium reabsorption
c. Hypotension and bradycardia
d. Vasodilation and sodium retention
Correct Answer: a. Increase in preload, afterload, and sodium reabsorption
Explanation: In compensatory shock, the renin-angiotensin-aldosterone system (RAAS) is
activated to maintain blood pressure. It increases preload (via increased venous return), afterload
(via vasoconstriction from angiotensin II), and sodium reabsorption (via aldosterone), helping to
retain fluid and increase blood volume. Options b, c, and d do not accurately describe RAAS
effects in shock.
Question 5
What clinical findings are most commonly associated with a pulmonary embolus?
a. Clear breath sounds with tachypnea
b. Rhonchi auscultated bilaterally with hypercarbia
c. Crackles heard in the bases with bradycardia
d. Fever, tachycardia, and tachypnea with increased work of breathing
Correct Answer: a. Clear breath sounds with tachypnea
Explanation: Pulmonary embolism typically presents with clear breath sounds and tachypnea
due to impaired gas exchange from vascular obstruction. Rhonchi with hypercarbia (option b)
suggests obstructive lung disease, crackles with bradycardia (option c) is atypical, and while
fever and tachycardia (option d) may occur, clear breath sounds with tachypnea are more
specific.
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Question 6
A 55-year-old patient complains of aching chest discomfort persisting for several days with a
temperature of 101°F (38.3°C). Which finding narrows the diagnosis to pericarditis?
a. Pain relieved when supine
b. Pulsus alternans present
c. S3 gallop auscultated
d. ST-segment elevation in all leads
Correct Answer: d. ST-segment elevation in all leads
Explanation: Pericarditis is characterized by diffuse ST-segment elevation in nearly all ECG
leads due to widespread inflammation of the pericardium. Pain relief when supine (option a) is
not typical, as pericarditis pain often worsens when lying down. Pulsus alternans (option b) is
associated with heart failure, and an S3 gallop (option c) indicates fluid overload, not
pericarditis.
Question 7
Anaphylaxis is most associated with which physiological event?
a. Hemorrhage
b. Vasodilation
c. Bradycardia
d. Hypertension
Correct Answer: b. Vasodilation
Explanation: Anaphylaxis involves a massive release of histamine, leading to vasodilation,
increased vascular permeability, and hypotension. Hemorrhage (option a) is unrelated,
bradycardia (option c) is not typical (tachycardia is more common), and hypertension (option d)
is not a primary feature of anaphylaxis.
Question 8
Acute Respiratory Distress Syndrome (ARDS) is characterized by which pathological change?
a. Excessive mucous production
b. Inflammation of the visceral pleura
c. Breakdown of the alveolar-capillary membrane
d. Accumulation of fluid between the pleural layers
Correct Answer: c. Breakdown of the alveolar-capillary membrane
Explanation: ARDS is caused by diffuse alveolar damage, leading to breakdown of the alveolar-
capillary membrane, which allows fluid to leak into the alveoli, impairing gas exchange.
Excessive mucous production (option a) is more common in chronic lung diseases, inflammation
of the visceral pleura (option b) relates to pleuritis, and fluid between pleural layers (option d)
describes pleural effusion.
