2025 ACLS
A 49 year old female patient arrives at the hospital, saying she has chest discomfort and
palpitations that have occurred for the past several hours. She feels cold, sweaty, and
weak.
The patient is awake and alert. She states that she does not have any medical history
and has never felt like this before. She mentions that she feels like she may pass out.
Which of the following are initial steps of the primary assessment? - ANS - Assess
ABCs
Establish IV access
Obtain a 12-lead ECG
Monitor heart rhythm and vital signs
A 59 year old patient is reporting difficulty breathing. Physical exam reveals nasal
flaring, intercostal interaction and use of accessory muscles. RR is 28 breaths per
minute. O2 sat is 92% PETCO2 is 36 mmHg.
How would you categorize this patent's condition? - ANS - Respiratory distress
A 70 year old woman suffered a sudden cardiac arrest. After a 10 minute resuscitation
attempt, she is showing signs of ROSC. She is intubated and has an IV established.
She has a palpable pulse of 65/min, SpO2 94%, ETCO2 of 38 mmHg, and BP 82/55
mm Hg.
What are your highest priorities? - ANS - Maintaining SpO2 92-98%
Maintaining PaCO2 35-45
Ventilating patient-10 breaths/minute
A 72 year old male patient has been suffering from progressive dizziness and bouts of
palpitations after exercising last night. His symptoms reappeared and worsened this
morning.
,The patient is conscious and alert, HR 180/min, a weak radial pulse, BP 110/78 mm Hg,
and SpO2 96%.
What are the most appropriate initial interventions? - ANS - Attach a 12-lead ECG
Maintain a patent airway and monitor
A 74- year old man was brought to the hospital by his wife. She states that her husband
started having sudden-left arm weakness and left-sided facial paralysis during lunch. He
has a past medical history of poor controlled hypertension.
The patient's vital signs show HR 92/min, RR 14/min, BP 130/86 mmHG, SpO2 97%
and atrial fibrillation on the monitor.
What additional assessment and stabilization activities should be completed within the
first 10 min after the patient's arrival? - ANS - Check glucose
Complete neurologic screening
Order an emergent CT scan or MRI of the brain and review pt history
Establish IV access
Activate the stroke team
A 75 year old man presents to the emergency department. His wife states that he
fainted 45 minutes ago, while watching TV. She said he has had episodes of confusion
and fatigue during the past week. The patient presents with HR 30/min (weak pulse),
BP 66/43 mmHG, RR of 20/min, SpO2 89%. He is alert and responsive.
What should your next steps be to assess and treat this patient? - ANS - Establish IV
Obtain 12 lead
Maintain airway and administer O2 as needed
A 75 year old patient is having difficulty breathing, with increased respiratory effort.
The patient has history of emphysema. The patient is drowsy.
Auscultation reveals bilateral wheezing, although the lung sounds are difficult to
auscultate.
RR is 38/min.
O2 sat = 85%,
PETCO2= 49mmHg.
How would you categorize this patient's condition? - ANS - Respiratory failure
, A BLS team is bringing a 70 year old woman, who suddenly collapsed while on her
morning jog, to your department. CPR is in progress.
As Team Leader, you conduct the primary assessment, including rhythm analysis, while
high-quality BLS continues.
What type of rhythm is being displayed on the monitor? - ANS - Ventricular fibrillation
A patient with a ventricular assist device (VAD) is not breathing, has signs of inadequate
perfusion, and is unconscious. You determine the VAD is functioning. After endotracheal
intubation, the patient has a PETCO2 of 12mm Hg.
What is your next action? - ANS - Perform external chest compressions
A patient with suspected opioid poisoning is not breathing normally but has a pulse.
What is your next step? - ANS - Provide rescue breathing and give naloxone
After 2 minutes of CPR, you conduct another rhythm check and determine that the
patient has the following rhythm and is showing signs of ROSC.
How do you continue treating this patient? - ANS - Move to the Adult Post-Cardiac
Arrest Care Algorithm
After 2 minutes, the team pauses CPR for a rhythm check.
What rhythm is now being demonstrated by the patient? - ANS - Ventricular
tachycardia
After 2 more minutes of CPR, you conduct a rhythm check and pulse check, confirming
absence of a pulse.
Based on the organized rhythm below, describe the patient's condition? - ANS - PEA
After a shock is delivered, CPR resumes immediately. What action also needs to be
performed at this time?q - ANS - Establish IV/IO access
After activating the sync control button in preparation for delivering electrical cardio
version, what is the most important next step? - ANS - Look for markers on the R
wave indicating sync mode
A 49 year old female patient arrives at the hospital, saying she has chest discomfort and
palpitations that have occurred for the past several hours. She feels cold, sweaty, and
weak.
The patient is awake and alert. She states that she does not have any medical history
and has never felt like this before. She mentions that she feels like she may pass out.
Which of the following are initial steps of the primary assessment? - ANS - Assess
ABCs
Establish IV access
Obtain a 12-lead ECG
Monitor heart rhythm and vital signs
A 59 year old patient is reporting difficulty breathing. Physical exam reveals nasal
flaring, intercostal interaction and use of accessory muscles. RR is 28 breaths per
minute. O2 sat is 92% PETCO2 is 36 mmHg.
How would you categorize this patent's condition? - ANS - Respiratory distress
A 70 year old woman suffered a sudden cardiac arrest. After a 10 minute resuscitation
attempt, she is showing signs of ROSC. She is intubated and has an IV established.
She has a palpable pulse of 65/min, SpO2 94%, ETCO2 of 38 mmHg, and BP 82/55
mm Hg.
What are your highest priorities? - ANS - Maintaining SpO2 92-98%
Maintaining PaCO2 35-45
Ventilating patient-10 breaths/minute
A 72 year old male patient has been suffering from progressive dizziness and bouts of
palpitations after exercising last night. His symptoms reappeared and worsened this
morning.
,The patient is conscious and alert, HR 180/min, a weak radial pulse, BP 110/78 mm Hg,
and SpO2 96%.
What are the most appropriate initial interventions? - ANS - Attach a 12-lead ECG
Maintain a patent airway and monitor
A 74- year old man was brought to the hospital by his wife. She states that her husband
started having sudden-left arm weakness and left-sided facial paralysis during lunch. He
has a past medical history of poor controlled hypertension.
The patient's vital signs show HR 92/min, RR 14/min, BP 130/86 mmHG, SpO2 97%
and atrial fibrillation on the monitor.
What additional assessment and stabilization activities should be completed within the
first 10 min after the patient's arrival? - ANS - Check glucose
Complete neurologic screening
Order an emergent CT scan or MRI of the brain and review pt history
Establish IV access
Activate the stroke team
A 75 year old man presents to the emergency department. His wife states that he
fainted 45 minutes ago, while watching TV. She said he has had episodes of confusion
and fatigue during the past week. The patient presents with HR 30/min (weak pulse),
BP 66/43 mmHG, RR of 20/min, SpO2 89%. He is alert and responsive.
What should your next steps be to assess and treat this patient? - ANS - Establish IV
Obtain 12 lead
Maintain airway and administer O2 as needed
A 75 year old patient is having difficulty breathing, with increased respiratory effort.
The patient has history of emphysema. The patient is drowsy.
Auscultation reveals bilateral wheezing, although the lung sounds are difficult to
auscultate.
RR is 38/min.
O2 sat = 85%,
PETCO2= 49mmHg.
How would you categorize this patient's condition? - ANS - Respiratory failure
, A BLS team is bringing a 70 year old woman, who suddenly collapsed while on her
morning jog, to your department. CPR is in progress.
As Team Leader, you conduct the primary assessment, including rhythm analysis, while
high-quality BLS continues.
What type of rhythm is being displayed on the monitor? - ANS - Ventricular fibrillation
A patient with a ventricular assist device (VAD) is not breathing, has signs of inadequate
perfusion, and is unconscious. You determine the VAD is functioning. After endotracheal
intubation, the patient has a PETCO2 of 12mm Hg.
What is your next action? - ANS - Perform external chest compressions
A patient with suspected opioid poisoning is not breathing normally but has a pulse.
What is your next step? - ANS - Provide rescue breathing and give naloxone
After 2 minutes of CPR, you conduct another rhythm check and determine that the
patient has the following rhythm and is showing signs of ROSC.
How do you continue treating this patient? - ANS - Move to the Adult Post-Cardiac
Arrest Care Algorithm
After 2 minutes, the team pauses CPR for a rhythm check.
What rhythm is now being demonstrated by the patient? - ANS - Ventricular
tachycardia
After 2 more minutes of CPR, you conduct a rhythm check and pulse check, confirming
absence of a pulse.
Based on the organized rhythm below, describe the patient's condition? - ANS - PEA
After a shock is delivered, CPR resumes immediately. What action also needs to be
performed at this time?q - ANS - Establish IV/IO access
After activating the sync control button in preparation for delivering electrical cardio
version, what is the most important next step? - ANS - Look for markers on the R
wave indicating sync mode
