ACLS Exam Latest Update Questions
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A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is diaphoretic, with
associated shortness of breath. The blood pressure is 130/88 mm Hg, the heart rate is 110/min, the
respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. The patient's 12-lead ECG shows
ST-segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is a
patent peripheral IV. The pain is described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of
nitroglycerin. What is the next action? - Correct Answers-Administer 2 to 4 mg of morphine by slow
IV bolus.
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 Answers-Obtain a 12 lead ECG.
A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient's blood pressure
is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16 breaths/min, and the pulse oximetry
reading is 96%. The lead II ECG is displayed below. A patent peripheral IV is in place. What is the next
action? - Correct Answers-Vagal maneuvers
A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing. The blood
pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate is 12 breaths/min, and the
pulse oximetry reading is 95%. The lead II ECG displays a wide-complex tachycardia. What is the next
action after establishing an IV and obtaining a 12-lead ECG? - Correct Answers-Seeking expert
consultation
A 62-year-old man in the emergency department says that his heart is beating fast. He says he has no
chest pain or shortness of breath. The blood pressure is 142/98 mm Hg, the pulse is 200/min, the
respiratory rate is 14 breaths/min, and pulse oximetry is 95% on room air. What intervention should you
perform next? - Correct Answers-Obtain a 12 lead ECG.
A 68-year-old woman experienced a sudden onset of right arm weakness. EMS personnel measure a
blood pressure of 140/90 mm Hg, a heart rate of 78/min, a nonlabored respiratory rate of 14 breaths/min,
and a pulse oximetry reading of 97%. The lead II ECG displays sinus rhythm. What is the most
appropriate action for the EMS team to perform next? - Correct Answers-Cincinnati Prehospital
Stroke Scale assessment
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 Answers-Adenosine 6mg IV push
A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm:
What is the appropriate next intervention? - Correct Answers-Defibrillation
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 Answers-Vagal manuever.
A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the following
lead II ECG rhythm:
What is the appropriate next intervention? - Correct Answers-Synchronized cardioversion
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 Answers-Simple airway manuevers and assisted ventilations.
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine has been given.
Which is the next drug to anticipate to administer? - Correct Answers-amiodarone 300 mg
A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillation
shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amiodarone IV. The patient is intubated.
A second dose of amiodarone is now called for. The recommend second dose of amiodarone is ? -
Correct Answers-150 mg IV push
A patient is in refractory ventricular fibrillation. High CPR is in progress and shocks have been given.
One dose of epinephrine was given after the second shock. An anti arrhythmic drug was given
immediately after the the third shock. What drug should the team leader request to be prepared for
administration next? - Correct Answers-second dose of epinephrine 1 mg
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
Answers-Atropine 0.5mg
A patient remains in ventricular fibrillation despite 1 shock and 2 minutes of continuous CPR. The next
intervention is to - Correct Answers-administer a second shock.
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 Answers-2 to 10 mcg/kg per
minute
A patient with pulseless ventricular tachycardia is defibrillated. What is the next action? - Correct
Answers-Start chest compressions at a rate of at least 100/min.
A patient with sinus bradycardia and a heart rate of 42 has diaphoresis and blood pressure of 80/60. What
is the initial dose of atropine? - Correct Answers-0.5 mg
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A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is diaphoretic, with
associated shortness of breath. The blood pressure is 130/88 mm Hg, the heart rate is 110/min, the
respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. The patient's 12-lead ECG shows
ST-segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is a
patent peripheral IV. The pain is described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of
nitroglycerin. What is the next action? - Correct Answers-Administer 2 to 4 mg of morphine by slow
IV bolus.
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 Answers-Obtain a 12 lead ECG.
A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient's blood pressure
is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16 breaths/min, and the pulse oximetry
reading is 96%. The lead II ECG is displayed below. A patent peripheral IV is in place. What is the next
action? - Correct Answers-Vagal maneuvers
A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing. The blood
pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate is 12 breaths/min, and the
pulse oximetry reading is 95%. The lead II ECG displays a wide-complex tachycardia. What is the next
action after establishing an IV and obtaining a 12-lead ECG? - Correct Answers-Seeking expert
consultation
A 62-year-old man in the emergency department says that his heart is beating fast. He says he has no
chest pain or shortness of breath. The blood pressure is 142/98 mm Hg, the pulse is 200/min, the
respiratory rate is 14 breaths/min, and pulse oximetry is 95% on room air. What intervention should you
perform next? - Correct Answers-Obtain a 12 lead ECG.
A 68-year-old woman experienced a sudden onset of right arm weakness. EMS personnel measure a
blood pressure of 140/90 mm Hg, a heart rate of 78/min, a nonlabored respiratory rate of 14 breaths/min,
and a pulse oximetry reading of 97%. The lead II ECG displays sinus rhythm. What is the most
appropriate action for the EMS team to perform next? - Correct Answers-Cincinnati Prehospital
Stroke Scale assessment
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 Answers-Adenosine 6mg IV push
A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm:
What is the appropriate next intervention? - Correct Answers-Defibrillation
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 Answers-Vagal manuever.
A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the following
lead II ECG rhythm:
What is the appropriate next intervention? - Correct Answers-Synchronized cardioversion
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 Answers-Simple airway manuevers and assisted ventilations.
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine has been given.
Which is the next drug to anticipate to administer? - Correct Answers-amiodarone 300 mg
A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillation
shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amiodarone IV. The patient is intubated.
A second dose of amiodarone is now called for. The recommend second dose of amiodarone is ? -
Correct Answers-150 mg IV push
A patient is in refractory ventricular fibrillation. High CPR is in progress and shocks have been given.
One dose of epinephrine was given after the second shock. An anti arrhythmic drug was given
immediately after the the third shock. What drug should the team leader request to be prepared for
administration next? - Correct Answers-second dose of epinephrine 1 mg
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
Answers-Atropine 0.5mg
A patient remains in ventricular fibrillation despite 1 shock and 2 minutes of continuous CPR. The next
intervention is to - Correct Answers-administer a second shock.
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 Answers-2 to 10 mcg/kg per
minute
A patient with pulseless ventricular tachycardia is defibrillated. What is the next action? - Correct
Answers-Start chest compressions at a rate of at least 100/min.
A patient with sinus bradycardia and a heart rate of 42 has diaphoresis and blood pressure of 80/60. What
is the initial dose of atropine? - Correct Answers-0.5 mg
