ACLS Written Exam
You find an unresponsive pt. who is not breathing. After activating the emergency response
system, you determine there is no pulse. What is your next action? -correct answer_Start chest
compressions of at least 100 per min. You are evaluating a 58-year-old man with chest pain.
The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is
14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most
important now? -correct answer_Obtaining a 12 lead ECG. What is the preferred method of
access for epi administration during cardiac arrest in most pts? -correct answer_Peripheral IV
An AED does not promptly analyze a rythm. What is your next step? -correct answer_Begin
chest compressions. You have completed 2 minutes of CPR. The ECG monitor displays the
lead II rhythm below, and the patient has no pulse. Another member of your team resumes
chest compressions, and an IV is in place. What management step is your next priority?
-correct answer_Administer 1mg of epinephrine During a pause in CPR, you see this lead II
ECG rhythm on the monitor. The patient has no pulse. What is the next action? -correct
answer_Resume compressions What is a common but sometimes fatal mistake in cardiac
arrest management? -correct answer_Prolonged interruptions in chest compressions. Which
action is a componant of high-quality chest comressions? -correct answer_Allowing complete
chest recoil Which action increases the chance of successful conversion of ventricular
fibrillation? -correct answer_Providing quality compressions immediately before a defibrillation
attempt. Which situation BEST describes pulseless electrical activity? -correct answer_Sinus
rythm without a pulse What is the BEST strategy for performing high-quality CPR on a patient
with an advanced airway in place? -correct answer_Provide continuous chest compressions
without pauses and 10 ventilations per minute. Three minutes after witnessing a cardiac arrest,
one member of your team inserts an endotracheal tube while another performs continuous
chest compressions. During subsequent ventilation, you notice the presence of a waveform on
the capnography screen and a PETCO2 level of 8 mm Hg. What is the significance of this
finding? -correct answer_Chest compressions may not be effective. The use of quantitative
capnography in intub--5i8 ated patients -correct answer_allows for monitoring of CPR
quality. For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who
originally presented in ventricular fibrillation. After the first shock, the ECG screen displayed
asystole, which has persisted despite 2 doses of epinephrine, a fluid bolus, and high-quality
CPR. What is your next treatment? -correct answer_Consider terminating resuscitive efforts
after consulting medical control. Which is a safe and effective practice within the defibrillation
sequence? -correct answer_Be sure oxygen is not blowing over the patient's chest during the
shock. During your assessment, your patient suddenly loses consciousness. After calling for
help and determining that the patient is not breathing, you are unsure whether the patient has
a pulse. What is your next action? -correct answer_Begin chest compressions. What is an
advantage of using hands-free defibrillation pads instead of defibrillation paddles? -correct
answer_Hands-free pads allow for a more rapid defibrillation. What action is recommended to
, help minimize interruptions in chest compressions during CPR? -correct answer_Continue
CPR while charging the defibrillator. Which action is included in the BLS survey? -correct
answer_Early defibrillation Which drug and dose are recommended for the management of a
patient in refractory ventricular fibrillation? -correct answer_Amioderone 300mg What is the
appropriate interval for an interruption in chest compressions? -correct answer_10 seconds or
less Which of the following is a sign of effective CPR? -correct answer_PETCO2 ≥10 mm Hg
What is the primary purpose of a medical emergency team (MET) or rapid response team
(RRT)? -correct answer_Identifying and treating early clinical deterioration. Which action
improves the quality of chest compressions delivered during a resuscitation attempt? -correct
answer_Switch providers about every 2 minutes or every 5 compression cycles. What is the
appropriate ventilation strategy for an adult in respiratory arrest with a pulse rate of 80/min?
-correct answer_1 breath every 5-6 seconds A patient presents to the emergency department
with new onset of dizziness and fatigue. On examination, the patient's heart rate is 35/min, the
blood pressure is 70/50 mm Hg, the respiratory rate is 22 breaths/min, and the oxygen
saturation is 95%. What is the appropriate first medication? -correct answer_Atropine 0.5mg A
patient with dizziness and shortness of breath with a sinus bradycardia of 40/min. The initial
atropine dose was ineffective, and your monitor/defibrillator is not equipped with a
transcutaneous pacemaker. What is the appropriate dose of dopamine for this patient?
-correct answer_2 to 10 mcg/kg per minute A patient has sudden onset of dizziness. The
patient's heart rate is 180/min, blood pressure is 110/70 mm Hg, respiratory rate is 18
breaths/min, and pulse oximetry reading is 98% on room air. The lead II ECG is shown below:
-correct answer_Vagal manuever. 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 38 mm Hg, and the pulse oximetry reading is 98%. There is vascular
access at the left internal jugular vein, and the patient has not been given any vasoactive
drugs. A 12-lead ECG confirms a supraventricular tachycardia with no evidence of ischemia or
infarction. The heart rate has not responded to vagal maneuvers. What is the next
recommended intervention? -correct answer_Adenosine 6mg IV push You are receiving a
radio report from an EMS team en route with a patient who may be having an acute stroke.
The hospital CT scanner is not working at this time. What should you do in this situation?
-correct answer_Divert the patient to a hospital 15 minutes away with CT capabilities. Choose
an appropriate indication to stop or withhold resuscitative efforts. -correct answer_Evidence of
rigor mortis. A 49-year-old woman arrives in the emergency department with persistent
epigastric pain. She had been taking oral antacids for the past 6 hours because she thought
she had heartburn. The initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and
regular, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is
96%. Which is the most appropriate intervention to perform next? -correct answer_Obtain a 12
lead ECG. A patient in respiratory failure becomes apneic but continues to have a strong pulse.
The heart rate is dropping rapidly and now shows a sinus bradycardia at a rate of 30/min.
What intervention has the highest priority? -correct answer_Simple airway manuevers and
You find an unresponsive pt. who is not breathing. After activating the emergency response
system, you determine there is no pulse. What is your next action? -correct answer_Start chest
compressions of at least 100 per min. You are evaluating a 58-year-old man with chest pain.
The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is
14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most
important now? -correct answer_Obtaining a 12 lead ECG. What is the preferred method of
access for epi administration during cardiac arrest in most pts? -correct answer_Peripheral IV
An AED does not promptly analyze a rythm. What is your next step? -correct answer_Begin
chest compressions. You have completed 2 minutes of CPR. The ECG monitor displays the
lead II rhythm below, and the patient has no pulse. Another member of your team resumes
chest compressions, and an IV is in place. What management step is your next priority?
-correct answer_Administer 1mg of epinephrine During a pause in CPR, you see this lead II
ECG rhythm on the monitor. The patient has no pulse. What is the next action? -correct
answer_Resume compressions What is a common but sometimes fatal mistake in cardiac
arrest management? -correct answer_Prolonged interruptions in chest compressions. Which
action is a componant of high-quality chest comressions? -correct answer_Allowing complete
chest recoil Which action increases the chance of successful conversion of ventricular
fibrillation? -correct answer_Providing quality compressions immediately before a defibrillation
attempt. Which situation BEST describes pulseless electrical activity? -correct answer_Sinus
rythm without a pulse What is the BEST strategy for performing high-quality CPR on a patient
with an advanced airway in place? -correct answer_Provide continuous chest compressions
without pauses and 10 ventilations per minute. Three minutes after witnessing a cardiac arrest,
one member of your team inserts an endotracheal tube while another performs continuous
chest compressions. During subsequent ventilation, you notice the presence of a waveform on
the capnography screen and a PETCO2 level of 8 mm Hg. What is the significance of this
finding? -correct answer_Chest compressions may not be effective. The use of quantitative
capnography in intub--5i8 ated patients -correct answer_allows for monitoring of CPR
quality. For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who
originally presented in ventricular fibrillation. After the first shock, the ECG screen displayed
asystole, which has persisted despite 2 doses of epinephrine, a fluid bolus, and high-quality
CPR. What is your next treatment? -correct answer_Consider terminating resuscitive efforts
after consulting medical control. Which is a safe and effective practice within the defibrillation
sequence? -correct answer_Be sure oxygen is not blowing over the patient's chest during the
shock. During your assessment, your patient suddenly loses consciousness. After calling for
help and determining that the patient is not breathing, you are unsure whether the patient has
a pulse. What is your next action? -correct answer_Begin chest compressions. What is an
advantage of using hands-free defibrillation pads instead of defibrillation paddles? -correct
answer_Hands-free pads allow for a more rapid defibrillation. What action is recommended to
, help minimize interruptions in chest compressions during CPR? -correct answer_Continue
CPR while charging the defibrillator. Which action is included in the BLS survey? -correct
answer_Early defibrillation Which drug and dose are recommended for the management of a
patient in refractory ventricular fibrillation? -correct answer_Amioderone 300mg What is the
appropriate interval for an interruption in chest compressions? -correct answer_10 seconds or
less Which of the following is a sign of effective CPR? -correct answer_PETCO2 ≥10 mm Hg
What is the primary purpose of a medical emergency team (MET) or rapid response team
(RRT)? -correct answer_Identifying and treating early clinical deterioration. Which action
improves the quality of chest compressions delivered during a resuscitation attempt? -correct
answer_Switch providers about every 2 minutes or every 5 compression cycles. What is the
appropriate ventilation strategy for an adult in respiratory arrest with a pulse rate of 80/min?
-correct answer_1 breath every 5-6 seconds A patient presents to the emergency department
with new onset of dizziness and fatigue. On examination, the patient's heart rate is 35/min, the
blood pressure is 70/50 mm Hg, the respiratory rate is 22 breaths/min, and the oxygen
saturation is 95%. What is the appropriate first medication? -correct answer_Atropine 0.5mg A
patient with dizziness and shortness of breath with a sinus bradycardia of 40/min. The initial
atropine dose was ineffective, and your monitor/defibrillator is not equipped with a
transcutaneous pacemaker. What is the appropriate dose of dopamine for this patient?
-correct answer_2 to 10 mcg/kg per minute A patient has sudden onset of dizziness. The
patient's heart rate is 180/min, blood pressure is 110/70 mm Hg, respiratory rate is 18
breaths/min, and pulse oximetry reading is 98% on room air. The lead II ECG is shown below:
-correct answer_Vagal manuever. 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 38 mm Hg, and the pulse oximetry reading is 98%. There is vascular
access at the left internal jugular vein, and the patient has not been given any vasoactive
drugs. A 12-lead ECG confirms a supraventricular tachycardia with no evidence of ischemia or
infarction. The heart rate has not responded to vagal maneuvers. What is the next
recommended intervention? -correct answer_Adenosine 6mg IV push You are receiving a
radio report from an EMS team en route with a patient who may be having an acute stroke.
The hospital CT scanner is not working at this time. What should you do in this situation?
-correct answer_Divert the patient to a hospital 15 minutes away with CT capabilities. Choose
an appropriate indication to stop or withhold resuscitative efforts. -correct answer_Evidence of
rigor mortis. A 49-year-old woman arrives in the emergency department with persistent
epigastric pain. She had been taking oral antacids for the past 6 hours because she thought
she had heartburn. The initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and
regular, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is
96%. Which is the most appropriate intervention to perform next? -correct answer_Obtain a 12
lead ECG. A patient in respiratory failure becomes apneic but continues to have a strong pulse.
The heart rate is dropping rapidly and now shows a sinus bradycardia at a rate of 30/min.
What intervention has the highest priority? -correct answer_Simple airway manuevers and
