Prepare for your Advanced Cardiac Life Support (ACLS) certification exam with these practice questions and answers. This guide covers cardiac arrest algorithms, arrhythmia recognition, emergency medications, and team dynamics.
Q: Which one of the following is not considered a potential cause of cardiac arrest in a pregnant patient?
Answer: Premature labor
Q: A 49-year-old patient is stable but experiencing supraventricular tachycardia (SVT). Vagal maneuvers are not effective. Which pharmacologic treatment should be initiated?
Answer: Adenosine 6mg to start
Q: Which medication may be administered when caring for a patient in cardiac arrest with a nonshockable rhythm?
Answer: Epinephrine
Q: You witness a woman collapse at the movie theater. You shout for help; and as you reach the woman’s side, you are prepared to do what?
Answer: Rapid assessment.
Q: If utilizing wave form capnography/end tidal CO2 to evaluate ventilation, what will you notice if the patient’s respiratory status worsens?
Answer: A rise in value
Q: What should waveform capnography look like?
Answer: A rounded rectangle and should be between 35 and 45
Q: Which of the following is not in the refractory bradycardia treatment sequence?
Answer: Norepinephrine
Q: In which of the following situations would a resuscitative cesarean delivery (RCD) be indicated?
Answer: If you’ve performed cpr more than 5 min
Q: A third shock has just been delivered to a patient in cardiac arrest. Which of the following medications would be appropriate to administer to the patient at this time?
Answer: Amiodarone
Q: A 65-year old woman presents to the emergency department complaining of dyspnea and exhaustion. She is pale and diaphoretic, with weak pulses, and the cardiac monitor shows a bradyarrhythmia. What is the first-line therapy for this patient?
Answer: Atropine 1mg
Q: An adult male next to you at a ballgame starts choking on a hot dog. Holding his throat and nods yes to help. What type of assistance might you offer him first?
Answer: Back blows
Q: Pick the statements that is true regarding cardiac arrest
Answer: Flush IV or IO medications with 10-20 ml’s of NS
Q: End perfusion (blood pressure) maintenance is a critical component in maintaining and keeping hemodynamic stability in a patient experiencing an acute coronary syndrome or dysrhythmia. Such medications that may lower blood pressure should be avoided or discontinued if the patient’s blood pressure is 90 mmHg systolic or below. Some medications of concernare (Choose all that apply)
Answer: Beta blockers, opioid, nitrates
Q: Which of the patient’s home medications could cause an unwanted bradycardia in the patient? (Choose all that apply)
Answer: Beta BlockersCardiac glycoside such as digitalisCalcium Channel Blockers
Q: The earliest stage of respiratory compromise is known as?
Answer: Respiratory distress
Q: Choose all that apply regarding the care of the post arrest patient
Answer: Assess and maintain optimal perfusion and circulationUse ABG’s as a guide to oxygen delivery
Q: A patient presents with syncope. Identify this rhythm:
Answer: A flutter
Q: Which medication is used to treat stable wide-complex ventricular tachycardia?
Answer: Amiodorone 300 mg
Q: Which cardiac rhythm is identified by the absence of discernible P waves, and is always irregular?Your AnswerAtrial fibrillation
Answer: The respiratory distress is worsening
Q: An asthma patient is being evaluated for an acute episode.The end tidal CO2 value has suddenly increased from 32 to 40 mmHg? What does this indicate?
Answer: Fibrinolytic therapy
Q: For a patient experiencing ST-segment elevation myocardial infarction (STEMI), care management could focus on early reperfusion therapy with:
Answer: Initiate synchronized cardioversion
Q: A 68-year old patient is in distress. The cardiac monitor shows supraventricular tachycardia. His heart rate is 210 bpm, his respiratory rate is 36 breaths/minute, and he is confused and agitated. What intervention is most appropriate for this patient?
Answer: Pain, Anxiety ,Hypoxia, Hypovolemia/Dehydration
Q: Sinus tachycardia, rates of under 150 are often caused by non-cardiac systemic issues rather than cardiac events. Which of the following should be ruled out before considering a “cardiac cause”?
Answer: Transcutaneous pacing
Q: The healthcare provider is caring for a patient with unstable bradycardia and pharmacologic interventions have failed. What action should the provider implement?
Answer: Adenosine
Q: A patient is brought to the emergency department with a primary complaint of a rapid heart rate. The patient is diaphoretic. Cardiac monitoring reveals supraventricular tachycardia. Cardioversion is unsuccessful, and the patient is displaying hemodynamic instability. Which intervention should be performed next?
Answer: PEA
Q: While providing care for a patient in cardiac arrest, the resuscitation team notes a change in the cardiac rhythm on the monitor:A team member assesses for a central pulse but notes that no pulse is present. The team correctly identifies this as which condition?
Answer: Support Ventilations with a BVM
Q: A COPD patient is brought to the emergency department in respiratory failure. The team can palpate a pulse, but the patient is not breathing. How should the team proceed with treatment?
Answer: Hyperkalemia
Q: A patient arrives after missing his dialysis appointment. He is weak with stable vital signs other than a heart rate of 120. You notice his ECG is a bit wide with peaked T waves. This describes?
Answer: Provide the minimal level of supplemental oxygen needed to maintain an oxygen saturation of at least 94-99%
Q: Pulse oximetry on an acute chest pain patient shows the oxygen saturation on room air is 90%. What intervention would be appropriate for this patient?
Answer: 100-120/min
Q: What is the proper rate for compressions for an adult?
Answer: 2 to 2.4 inch
Q: When providing high-quality CPR to an adult, what is the proper depth for chest compressions?
Answer: High risk non-ST segment elevation (NSTE-ACS)
Q: Other than STEMI, the 12 lead ECG may demonstrate ST depression or T wave inversion in the setting of a patient whose symptoms persist or return with increased cardiac serum markers. This may indicate?
Answer: Ventricular tachycardia
Q: Specifically, regarding a patient with a high risk NSTEMI, which of the following rhythms may be an indication for early invasive therapy?
Answer: 20 min
Q: A Stroke is considered a time dependent emergency. In the hospital setting the patient should have a bedside stroke (neurological) exam and brain imaging (CT scan) completed within what time frame?
Answer: 1 hour
Q: A patient is diagnosed with ischemic stroke and has no contraindications to fibrinolytic therapy. For best patient outcomes, when should fibrinolytic therapy be initiated after arrival to the hospital
Answer: 90 min
Q: A patient with onset of chest pain 2 hours prior to arrival in the emergency department is found to have ST – segment elevation on his ECG. What is the goal for providing percutaneous coronary intervention (PCI)?
Answer: ETCO2 35 to 45 mmHg, PaCO2 35-45 mmHg, and SpO2 94-99%
Q: Emergency medical services (EMS) arrives with a post-cardiac arrest patient. He is intubated and being ventilated and has adequate perfusion. After the team confirms correct endotracheal tube placement, the patient is placed on a ventilator, and oxygen saturation and end-tidal carbon dioxide (ETCO2) monitoring are initiated. What are the overall goals for respiratory management?
Answer: Left ventricular distention
Q: A STEMI patient presents with rales, hypotension, and weak peripheral pulses. These are classic signs of:
Answer: 3rd degree heart block
Q: A 50-year-old female patient presents to the emergency department with a chief complaint of dizziness that has been present for the last hour. What is the EKG pattern displayed?
Answer: Respiratory failure
Q: A 69-year-old female patient with a history of asthma presents to the emergency department. Thepatientisalert.Herrespiratorypatternisirregular.Heroxygensaturationis88%,ETCO2 is 55 mmHg. How would you categorize her respiratory status?
Answer: Level of consciousness, Speech ability, Visual Disturbances
Q: Bedside stroke scales are designed to be quick and effective at evaluating many types of Strokes (Cincinnati stroke scale, MEND, FAST, ECT.) The more thorough Stroke scale from the National Institute of Health (NIHSS), which is performed afterwards, evaluates the following (Choose all that apply)
Answer: 120-200 joules
Q: A patient develops ventricular fibrillation. The team prepares to shock the patient immediately. Depending on the brand of their defibrillator, their initial defibrillation should be delivered at?
Answer: SaO2 89%,ETCO2 50mmHg
Q: Post cardiac arrest a patient is said to be in respiratory failure though you can see him breathing 14 times per minute. Which of the following is indicating he is in respiratory failure?
Answer: D, A and B
Q: TheCO2 waveformisusedtoevaluateeffectivenessofchestcompressions(perfusion)and placement of an advanced airway device in ACLS. The ____point/wave represents the end of ventilationwheretheETCO2 levelisderivedfrom.The____point/waverepresentsthebeginningof exhalation.
Answer: Overventilation can cause a pneumothoraxOverventilation can decrease cardiac outputVentilate 1 breath every 6 seconds with an ET tube in place
Q: Which of the following are true in relation to ventilating a patient with an ET tube in respiratory arrest? (Choose all that apply)
Answer: 0.4 mg may repeat after 2-3 min
Q: While naloxone is effective in managing respiratory depression/arrest in opioid overdoses it has minimal if any effect on cardiac arrest from the same cause. That said it may still be used as an adjunct to good CPR and the standard algorithms, but it is NOT a priority over high quality CPR. If utilized, the initial dose starts at?
Answer: 1.5 mm in height (0.15 mV)
Q: ST – segment elevated myocardial infarction (STEMI) is diagnosed on the 12 lead ECG rather than the standard lead rhythm strip. The elevation must be in 2 contiguous leads and generally in V leads (II and III) must be at least _____ in amplitude in a female to be considered a STEMI.
Answer: Cardiac enzyme markers
Q: In a patient with cardiac symptoms and a normal ECG a secondary cardiac exam is completed to diagnose a non – ST segment elevated myocardial infarction (N-STEMI). The common test is?
Answer: Point of care ultrasound
Q: A pregnant woman collapses in the grocery store. CPR is in progress when medics arrive. What tool might be used to determine fetal gestational age if unknown?
Answer: Tension pneumothorax