Advanced Cardiac Life Support Pharmacology: Emergency Medications Exam – 150 Questions Answers And Rationale 2025/2026

Advanced Cardiac Life Support
Pharmacology: Emergency Medications Exam
– 150 Questions Answers And Rationale
2025/2026

1. Which drug is considered first-line for ventricular fibrillation (VF)
and pulseless ventricular tachycardia (pVT)?
a) Amiodarone
b) Lidocaine
c) Epinephrine
d) Atropine
a) Amiodarone
Rationale: Amiodarone is the first-line antiarrhythmic for refractory
VF/pVT according to ACLS guidelines.
2. What is the initial dose of epinephrine for adult cardiac arrest?
a) 0.01 mg/kg IV
b) 1 mg IV every 3–5 min
c) 0.5 mg IV every 10 min
d) 2 mg IV push
b) 1 mg IV every 3–5 min
Rationale: Epinephrine 1 mg IV/IO every 3–5 minutes is recommended
to improve coronary and cerebral perfusion during cardiac arrest.
3. Which drug is used for symptomatic bradycardia if atropine is
ineffective?
a) Dopamine
b) Amiodarone

, c) Lidocaine
d) Magnesium
a) Dopamine
Rationale: Dopamine infusion can be used in bradycardia
unresponsive to atropine to increase heart rate and cardiac output.
4. What is the recommended dose of atropine for symptomatic
bradycardia in adults?
a) 0.5 mg IV every 3–5 min (max 3 mg)
b) 1 mg IV once
c) 0.25 mg IV every 10 min
d) 2 mg IV bolus
a) 0.5 mg IV every 3–5 min (max 3 mg)
Rationale: Atropine is given at 0.5 mg IV every 3–5 min with a max
dose of 3 mg for symptomatic bradycardia.
5. Which drug is preferred for torsades de pointes?
a) Amiodarone
b) Magnesium sulfate
c) Lidocaine
d) Adenosine
b) Magnesium sulfate
Rationale: Magnesium sulfate is the treatment of choice for torsades
de pointes, regardless of magnesium serum levels.
6. For adult pulseless electrical activity (PEA), the initial drug of
choice is:
a) Atropine
b) Epinephrine
c) Amiodarone
d) Dopamine

,b) Epinephrine
Rationale: Epinephrine 1 mg IV/IO is recommended immediately for
PEA to improve perfusion during resuscitation.
7. What is the primary action of adenosine in supraventricular
tachycardia (SVT)?
a) Sodium channel blockade
b) AV node conduction inhibition
c) Beta-adrenergic stimulation
d) Calcium channel activation
b) AV node conduction inhibition
Rationale: Adenosine transiently blocks AV nodal conduction,
terminating re-entrant SVT.
8. In ACLS, which antiarrhythmic is recommended for refractory
VF/pVT after defibrillation and epinephrine?
a) Lidocaine
b) Amiodarone
c) Magnesium
d) Digoxin
b) Amiodarone
Rationale: Amiodarone is used for refractory VF/pVT when initial
defibrillation and epinephrine have failed.
9. What is the correct adult dose of adenosine for SVT?
a) 6 mg rapid IV push followed by 12 mg if needed
b) 12 mg IV every 3 min
c) 0.5 mg IV bolus
d) 50 mg IV over 10 min

, a) 6 mg rapid IV push followed by 12 mg if needed
Rationale: Adenosine is given as a 6 mg rapid IV push; if ineffective, 12
mg may be repeated once.
10. Which vasopressor is preferred for anaphylactic shock?
a) Epinephrine
b) Norepinephrine
c) Dopamine
d) Phenylephrine
a) Epinephrine
Rationale: Epinephrine is first-line in anaphylaxis due to its alpha- and
beta-adrenergic effects that increase vascular tone and
bronchodilation.
11. The first-line drug for stable monomorphic VT with a pulse
is:
a) Amiodarone
b) Lidocaine
c) Adenosine
d) Epinephrine
a) Amiodarone
Rationale: Amiodarone is preferred for stable monomorphic VT to
control ventricular rhythm.
12. Which drug is indicated for hypotension due to bradycardia
when atropine is ineffective?
a) Epinephrine infusion
b) Dopamine infusion
c) Both a and b
d) Lidocaine