ACLS 2026/2027 ACTUAL EXAM STUDY
GUIDE COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+||NEWEST VERSION
What is the goal for neurologic assessment by the stroke team or design, and non-
contrast computed tomography or magnetic resonance imaging performed after
hospital arrival? - ANSWER 20 minutes
What is the time goal for initiation of fibrinolytic therapy in appropriate patients
without contraindications after hospital arrival? - ANSWER 45 minutes
What is the door-to-needle time goal for 85% or more of acute ischemic stroke
patients treated with IV thrombolytics? - ANSWER 60 minutes
What is the door-to-device time goal for direct-arriving patients with acute
ischemic stroke treated with endovascular therapy? - ANSWER 90 minutes
Evidence suggests that there is a higher likelihood of a good to excellent
functional outcome when alteplase is given to adults with an acute ischemic stroke
within what time frame? - ANSWER 3 hours
What is the maximum time from the last known normal when endovascular
therapy can be performed? - ANSWER 24 hours
, What is the maximum time from last known normal when intra-arterial
thrombolysis for select patients can be used for treatment? - ANSWER 6 hours
Identify the systolic BP threshold for withholding fibrinolytic therapy to otherwise
eligible patients with acute ischemic stroke. - ANSWER 185mmHg
What is the diastolic blood pressure times hold for withholding fibrinolytic
therapy to otherwise eligible patients with acute ischemic stroke? -
ANSWER 110mmHg
Which action is NOT part of the acute stroke pathway? - ANSWER Seizure
prophylaxis
What blood glucose level should trigger the administration of IV or subcutaneous
insulin for a patient with acute ischemic stroke? - ANSWER 180mg/dl
What is the average RR for an adult at rest? - ANSWER 12 to 20/min
What is tidal volume typically maintained for normal oxygenation and elimination
of carbon dioxide? - ANSWER 6 to 8 mL/kg
An 18 yo patient is reporting difficulty breathing and is displaying increased
respiratory effort. Auscultation reveals bilateral wheezing; the respiratory rate is 28
breaths per minute. Oxygen saturation is 91%. PETCO2 is 44 mmHg. How would
you categorize this patient's condition? - ANSWER Respiratory distress
, A 59 yo patient is reporting difficulty breathing. Physical exam reveals nasal
flaring, intercostal interaction and use of accessory muscles. RR is 28 breaths per
minute. O2 saturation is 92% PTCO2 is 36 mmHg. How would you categorize this
patent's condition? - ANSWER Respiratory distress
A 75 yo 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 appreciate. RR is
38/min. O2 sat = 85%, PETCO2= 49mmHg. How would you categorize this
patient's condition? - ANSWER Respiratory failure
What is the term of the rise in arterial CO2 levels typically associated with
respiratory failure? - ANSWER Hypercapnia
How much tidal volume must provide with a bag-mask device to produce visible
chest rise for an adult patient in respiratory arrest? - ANSWER 6 to 7 mL/kg
What device on a resuscitation bag-mask device may prevent sufficient tidal
volume in patients with poor lung compliance? - ANSWER Pressure-relief
value
Patients with perfusing rhythms should receive ventilations once every -
ANSWER 6 seconds
What is the most effective way to deliver bag-mask ventilation? -
ANSWER Using a 2-person technique
, How long should the second rescuer squeeze the bag mask device when providing
2-rescuer ventilation? - ANSWER 1 second
When performing the jaw-thrust maneuver on patients with suspected cervical
spine injury, where should you place your fingers? - ANSWER Just under the
angle of the lower jaw
When you use a bag-mask device, you should deliver approximately ---tidal
volume. - ANSWER 500 to 600 mL
What is a contraindication to the use of an oropharyngeal airway? -
ANSWER Conscious patient
In which of the following patients can nasopharyngeal airways be used? -
ANSWER Unconscious, semiconscious, conscious
Select the first step in the use of an oropharyngeal airway - ANSWER Clear the
mouth and pharynx
What is a potential complication of inserting an oropharyngeal airway that is too
small? - ANSWER Pushing the base of the tongue back
The length of a correctly sized nasopharyngeal airway is the same as the distance
from the tip of the patient's nose to the - ANSWER earlobe
GUIDE COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+||NEWEST VERSION
What is the goal for neurologic assessment by the stroke team or design, and non-
contrast computed tomography or magnetic resonance imaging performed after
hospital arrival? - ANSWER 20 minutes
What is the time goal for initiation of fibrinolytic therapy in appropriate patients
without contraindications after hospital arrival? - ANSWER 45 minutes
What is the door-to-needle time goal for 85% or more of acute ischemic stroke
patients treated with IV thrombolytics? - ANSWER 60 minutes
What is the door-to-device time goal for direct-arriving patients with acute
ischemic stroke treated with endovascular therapy? - ANSWER 90 minutes
Evidence suggests that there is a higher likelihood of a good to excellent
functional outcome when alteplase is given to adults with an acute ischemic stroke
within what time frame? - ANSWER 3 hours
What is the maximum time from the last known normal when endovascular
therapy can be performed? - ANSWER 24 hours
, What is the maximum time from last known normal when intra-arterial
thrombolysis for select patients can be used for treatment? - ANSWER 6 hours
Identify the systolic BP threshold for withholding fibrinolytic therapy to otherwise
eligible patients with acute ischemic stroke. - ANSWER 185mmHg
What is the diastolic blood pressure times hold for withholding fibrinolytic
therapy to otherwise eligible patients with acute ischemic stroke? -
ANSWER 110mmHg
Which action is NOT part of the acute stroke pathway? - ANSWER Seizure
prophylaxis
What blood glucose level should trigger the administration of IV or subcutaneous
insulin for a patient with acute ischemic stroke? - ANSWER 180mg/dl
What is the average RR for an adult at rest? - ANSWER 12 to 20/min
What is tidal volume typically maintained for normal oxygenation and elimination
of carbon dioxide? - ANSWER 6 to 8 mL/kg
An 18 yo patient is reporting difficulty breathing and is displaying increased
respiratory effort. Auscultation reveals bilateral wheezing; the respiratory rate is 28
breaths per minute. Oxygen saturation is 91%. PETCO2 is 44 mmHg. How would
you categorize this patient's condition? - ANSWER Respiratory distress
, A 59 yo patient is reporting difficulty breathing. Physical exam reveals nasal
flaring, intercostal interaction and use of accessory muscles. RR is 28 breaths per
minute. O2 saturation is 92% PTCO2 is 36 mmHg. How would you categorize this
patent's condition? - ANSWER Respiratory distress
A 75 yo 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 appreciate. RR is
38/min. O2 sat = 85%, PETCO2= 49mmHg. How would you categorize this
patient's condition? - ANSWER Respiratory failure
What is the term of the rise in arterial CO2 levels typically associated with
respiratory failure? - ANSWER Hypercapnia
How much tidal volume must provide with a bag-mask device to produce visible
chest rise for an adult patient in respiratory arrest? - ANSWER 6 to 7 mL/kg
What device on a resuscitation bag-mask device may prevent sufficient tidal
volume in patients with poor lung compliance? - ANSWER Pressure-relief
value
Patients with perfusing rhythms should receive ventilations once every -
ANSWER 6 seconds
What is the most effective way to deliver bag-mask ventilation? -
ANSWER Using a 2-person technique
, How long should the second rescuer squeeze the bag mask device when providing
2-rescuer ventilation? - ANSWER 1 second
When performing the jaw-thrust maneuver on patients with suspected cervical
spine injury, where should you place your fingers? - ANSWER Just under the
angle of the lower jaw
When you use a bag-mask device, you should deliver approximately ---tidal
volume. - ANSWER 500 to 600 mL
What is a contraindication to the use of an oropharyngeal airway? -
ANSWER Conscious patient
In which of the following patients can nasopharyngeal airways be used? -
ANSWER Unconscious, semiconscious, conscious
Select the first step in the use of an oropharyngeal airway - ANSWER Clear the
mouth and pharynx
What is a potential complication of inserting an oropharyngeal airway that is too
small? - ANSWER Pushing the base of the tongue back
The length of a correctly sized nasopharyngeal airway is the same as the distance
from the tip of the patient's nose to the - ANSWER earlobe
