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AHA ACLS Written Test Questions with
Complete Solution
1. 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?: Start chest compressions of at least 100 per min.
2. You are evaluating a 58 year old man with chest pain. The BP is 92/50 and a heart rate of 92/min, non-labored
respiratory rate is 14 breaths/min and the pulse O2 is 97%. What assessment step is most important now?: Obtaining a 12 lead ECG.
3. What is the preferred method of access for epi administration during cardiac arrest in most pts?: Peripheral IV
4. An AED does not promptly analyze a rythm. What is your next step?: Begin chest compressions.
5. You have completed 2 min of CPR. The ECG monitor displays the lead below (PEA) and the pt. has no pulse.
You partner resumes chest compressions and an IV is in place. What management step is your next priority?: Administer 1mg of epinepherine
6. During a pause in CPR, you see a narrow complex rythm on the monitor. The pt. has no pulse. What is the next
action?: Resume compressions
7. What is acommon but sometimes fatal mistake in cardiac arrest manage- ment?: Prolonged interruptions in
chest compressions.
8. Which action is a componant of high-quality chest comressions?: Allowing complete chest recoil
9. Which action increases the chance of successful conversion of ventricular fibrillation?: Providing quality
compressions immediately before a defibrillation attempt.
10. Which situation BEST describes PEA?: Sinus rythm without a pulse
11. What is the best strategy for perfoming high-quality CPR on a pt.with an advanced airway in place?:
Provide continuous chest compressionswithout pauses and 10 ventilations per minute.
12. 3 min after witnessing a cardiac arrest, one memeber of your team in- serts an ET tube while another
performs continuous chest compressions. During subsequent bentilation, you notice the presence of a wavefom on the capnography screen and a PETCO2 of 8 mm Hg. What is the significance of this finding?: Chest compressions may not be effective.
13. The use of quantitative capnography in intubated pt's does what?: Allows- for monitoring CPR quality
14. For the past 25 min, EMS crews have attempted resuscitation of a pt who originally presented with V-FIB.
After the 1st shock, the ECG screen displayed asystole which has persisted despite 2 doses of epi, a fluid bolus, and high quality CPR. What is your next treatment?: Consider terminating resuscitive efforts after consulting medical control.
15. Which is a safe and effective practice within the defibrillation sequence?-
: Be sure O2 is NOT blowing over the pt's chest during shock.
16. During your assessment, your pt suddenly loses consciousness. After calling for help and determining that
the pt. is not breathing, you are unsure whether the pt. has a pulse. What is your next action?: Begin chest compres- sions.
17. What is an advantage of using hands-free d-fib pads instead of d-fib paddles?: Hands-free allows for
more rapid d-fib.
18. What action is recommended to help minimize interruptions in chest com- pressions during CPR?: Continue
CPR while charging the defibrillator.
BP is 128/58, the PETCO2 is 38mm Hg, and the O2 sat is 98%. There is an EJ established for vascular access. The pt. denies taking any vasodialators. A 12 lead shows no ischemia or infarction. Vagal manuevers are ineffective. What is the next intervention?: Adenosine 12mg IV
30. You receiving a radio report from an EMS team enroute with a pt. who may be having a stroke. The
hospital CT scanner is broken. What should you do?: Divert the pt. to a hospital 15 min away with CT capabilities.
31. Choose an appropriate inidication to stop or withhold resuscitive efforts.-
: Evidence of rigor mortis.
32. A 49 y/ofmaile arrives in the ER with persistant epigastric pain. She has been taking antacids PO for the past
6 hours because she she had heartburn. BP is 118/72, heart rate is 92/min, resp. rate is 14 non-labored and O2 sat is 96%. What is the most appropriate next action?: Obtain a 12 lead ECG.
33. A pt. in respiratory failure becomes apneic but contineues to have a strong pulse. The heart rate is dropping
paridly and now shows a sinus brady rate at 30/min. What intervention has the highest priority?: Simple airway manuevers and assisted ventilations.
34. What is the appropriate procedure for ET suctioning after the catheter is selected?: Suction during
withdrawl, but not for longer than 10 seconds.
35. While treating a stable pt for dizziness, a BP of 68/30, cool and clammy, you see a brady rythm on the ECG.
How do you treat this?: Atropine 0.5mg
36. A 68 y/o female pt. experienced a sudden onset of right arm weakness. BP is 140/90, pulse is 78/min, resp rate
is non-labored 14/min, 02 sat is 97%. Lead 2 in the ECG shows a sinus rythm. What would be your next action?: Cinncinati Stroke Scale
37. You are transporting a pt. with a positive stroke assessment. BP is 138, pulse is 80/min, resp rate is 12/min,
02 sat is 95% room air. Glucose levels are normal and the ECG shows a sinus rythm. What is next.: Head CT scan
38. What is the proper ventilation rate for a pt. in cardiac arrest who has an advanced airway in place?: 8-
breaths per minute
39. A 62 y/o male pt. in the ER says his heart is beating fast. No chest pain or SOB. BP is 142/98, pulse rate is
200/min, reps rate is 14/min, O2 sats are 95 at room air. What should be the next evaluation?: Obtain a 12 lead ECG.
40. You are evaluating a 48 y/o male with crushing sub-sternal pain. He is cool, pale, diaphretic, and slow to
respond to your questions. BP is 58/32, pulse is 190/min, resp rate is 18, and you are unable to obtain an 02 sat due to no radial pulse. The ECG shows a wide complex tach rythm. What intervention should be next?: Syncronized cardioversion.
41. What is the initial priority for an unconscious pt. with any tachycardia on the monitor?: Determine if a pulse
is present.
42. Which rythm requires synchronized cardioversion?: Unstable SVT
43. What is the recommended dose for adenosine for pt's in refractory, but stable narrow complex
tachycardia?: 12mg
44. What is the usual post-cardiac arrest target range for PETCO2 who achieves return of
spontaneous circulation (ROSC)?: 35-40mm Hg
45. Which conditionis a contraindication to theraputic hypothermia during the post-cardiac arrest period
for pt's who achieve return of spontaneous circulation (ROSC)?: Responding to verbal commands
46. What is the potential danger to using ties that pass circumfrentially around the pt's neck when securing an
advanced airway?: Obstruction of veneous return from the brain
