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ACLS Pretest Questions with Answers
1. Sinus Bradycardia: Please identify the rhythm by selecting the best single an- swer.
2. Reentry supraventricular tachycardia: Please identify the rhythm by selecting the best single answer.
3. Second-degree AV block (Mobitz II block): Please identify the rhythm by select- ing the best single answer.
4. Agonal rhythm/asystole: Please identify the rhythm by selecting the best single answer.
5. Third-Degree AV block: Please identify the rhythm by selecting the best single answer.
6. Monomorphic Ventricular Tachycardia: Please identify the rhythm by selecting the best single answer.
7. Sinus Tachycardia: Please identify the rhythm by selecting the best single an- swer.
8. Sinus Bradycardia: Please identify the rhythm by selecting the best single an- swer.
9. Atrial Fibrillation: Please identify the rhythm by selecting the best single answer.
10. Course Ventricular Fibrillation: Please identify the rhythm by selecting the best single answer.
11. Polymorphic Ventricular Tachycardia: Please identify the rhythm by selecting the best single answer.
12. Second-degree AV block (Mobitz I Wenchebach): Please identify the rhythm by selecting the best single
answer.
13. Normal Sinus Rhythm: Please identify the rhythm by selecting the best single answer.
14. Pulseless electrical activity: Please identify the rhythm by selecting the best single answer.
15. Course Ventricular Fibrillation: Please identify the rhythm by selecting the best single answer.
16. Reentry supraventricular tachycardia: Please identify the rhythm by selecting the best single answer.
17. Fine Ventricular Fibrillation: Please identify the rhythm by selecting the best single answer.
18. Atrial Flutter: Please identify the rhythm by selecting the best single answer.
19. Second-degree AV block (Mobitz II block): Please identify the rhythm by selecting the best single answer.
20. Reentry supraventricular tachycardia: Please identify the rhythm by selecting the best single answer.
been administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 100/60 mm Hg. Which of the following is now indicated?
29. Epinephrine 1 mg: A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Of
the following, which drug and dose should be administered first by the IV/IO route?
30. Gain IV or IO access: You arrive on the scene with the code team. High-quality CPR is in progress. An AED has
previously advised, "no shock indicated." A rhythm check now finds asystole. After resuming high-quality compressions, your next action is to:
31. Give Aspirin 160 to 325 mg chewed immediately.: A patient with ST-segment elevation MI has ongoing chest
discomfort. Fibrinolytic therapy has been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion of 1000 units per hour is being administered. Aspirin was taken by the patient because he had a history of gastritis treated 5 years ago. Your next action is?
32. Chest pain or shortness of breath is present: Bradycardia requires treatment when:
33. Magnesium is indicated for VF/pulseless VT associated with torsades de pointes.: Which of the following
statements about the use of magnesium in cardiac arrest is most accurate?
34. Epinephrine 1 mg or vasopressin 40 units IV or IO: A patient is in cardiac arrest. High-quality chest
compressions are being given. The patient is intubated, and an IV has been started. The rhythm is asystole. Which is the first drug/dose to administer?
35. 0.5 mg: A patient has sinus bradycardia with a heart rate of 42/min has diaphore- sis and a blood pressure of 80/
mm Hg. What is the initial dose of atropine?
36. Second dose of epinephrine 1 mg: A patient is in refractory ventricular fibril- lation. High-quality CPR is in
progress, and shocks have been given. One dose of epinephrine was given after the second shock. An antiarrhythmic drug was given immediately after the third shock. What drug should the team leader request to be prepared for
administration next?
37. Do not give aspirin for at least 24 hours if rtPA is administered: A
62-year-old man suddenly experienced difficulty speaking and left-sided weakness. He was brought to the emergency department. He meets initial criteria for fibrinolytic therapy, and a CT scan of the brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy?
38. The correct dose of vasopressin is 40 units administered IV or IO.: Which of the following statements is most
accurate regarding the administration of vaso- pressin during cardiac arrest?
39. IV or IO: A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. What is the
recommended route for drug administration during CPR?
40. Lidocaine, epinephrine, vasopressin: Your patient has been intubated. IV/IO access is not available. Which
combination of drugs can be administered by the endotracheal route?
41. Give atropine 0.5 mg IV.: The patient suddenly becomes unconscious and has a weak carotid pulse. Cardiac
monitoring, supplementary oxygen, and an IV have been initiated. The code cart with all the drugs and a transcutaneous pacer are immediately available. Next you would?
42. Give epinephrine 1 mg IV.: You arrive on the scene to find CPR in progress. Nursing staff report that the patient
was recovering from a pulmonary embolism and suddenly collapsed. There is no pulse or spontaneous respirations. High-quality CPR and effective bag-mask ventilation are being provided. An IV has been initiated. What would you do now?
43. Seek expert consultation: Following resuscitation with CPR and a single shock, you observe this rhythm while
preparing the patient for transport. Your patient is stable, and blood pressure is 120/80 mg Hg. She is apprehensive but has no symptoms other than palpitations. At this time you would?
44. Prepare to give epinephrine 1 mg IV.: Following imitation of CPR and 1 shock for VF, this rhythm is present on
been administered. Your team looks to you for instructions. Your immediate next order is:
52. Sublingual nitroglycerin 0.4 mg: A patient in the emergency department devel- ops recurrent chest discomfort
(8/10) suspicious for ischemia. His monitored rhythm becomes irregular as seen above. Oxygen is being administered by nasal cannula at 4 L/min, and an IV line is in place. Blood pressure is 160/96 mm Hg. There are no allergies or contraindications to any medication. You would first order:
53. Administer adenosine 6 mg; seek expert consultation: You are monitoring a patient. He suddenly has the above
persistent rhythm. You ask about symptoms, and he reports that he has mild palpitations, but otherwise he is clinically stable with unchanged vital signs. What is your next action?
54. Give an immediate unsynchronized high-energy shock (defibrillation dose).: This patient has been resuscitated
from cardiac arrest. During the resus- citation, amiodarone 300 mg was administered. The patient developed severe chest discomfort with diaphoresis. He is now unresponsive. What is the next indicated action?
55. Reperfusion therapy: A patient's 12-lead ECG was transmitted by the para- medics and showed an acute MI. The
above findings are seen on a rhythm strip when a monitor is placed in the emergency department. The patient had resolution of moderate (5/10) chest pain with 3 does of sublingual nitroglycerin. Blood pressure is 104/70 mm Hg. Which intervention below is most important, reducing in-hospital and 30-day mortality?
56. Perform vagal maneuvers: A 35-year-old woman presents to the emergency department with a chief complaint
of palpations. She has no chest discomfort, shortness of breath, or light-headedness. Which of the following is indicated first?
57. Begin CPR, starting with high-quality chest compressions.: A patient be- comes unresponsive. You are
uncertain if a faint pulse is present with the above rhythm. What is your next action?
58. Administer epinephrine 1 mg.: You are the code team leader and arrive to find a patient with the above rhythm
and CPR in progress. Team members report that the patient was well but reported chest pain and then collapsed. She has no pulse or respirations. Bag-mask ventilations are producing visible chest rise, high-quality CPR is in progress, and an IV has been established. What would be your next order?
59. Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes.: A patient was
admitted to the general medical ward with a history of alcoholism. A code in progress, and he has recurrent episodes of the rhythm. You review his chart. Notes about the 12- lead ECG say that his baseline QT interval is high normal to slightly prolonged. He has received 2 doses of epinephrine 1 mg and 1 dose of aminodarone 300 mg IV so far. What would you order for his next medication?
60. Give atropine 0.5 mg IV: You are monitoring the patient and note the above rhythm on the cardiac monitor. She
has dizziness, and her blood pressure is 80/40 mm Hg. She has an IV in place. What is your next action?
