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INSTANT PDF DOWNLOAD. ACLS Post Test with 50 actual questions and answers. Multiple-choice format with expert-verified explanations. Requires 90% passing score. Perfect for AHA ACLS certification and recertification prep. ACLS post test 2026, ACLS exam answers, AHA ACLS certification test, ACLS practice test 50 questions, ACLS post test expert explanation, Advanced cardiac life support exam, ACLS recertification prep, ACLS multiple choice, ACLS algorithms, American Heart Association ACLS, ACLS test bank, ACLS final exam, ACLS post test passing score 90%, ACLS question bank, ACLS megacode, ACLS pretest
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1. You are caring for a patient with a suspected stroke whose symptoms started 2 hours ago. The CT was normal with no sign of hemorrhage. The patient does not have any contraindications to fibrinolytic therapy. Which treatment is best?
A. Start fibrinolytic therapy ASAP
B. Hold fibrinolytic therapy for 24 hours
C. Order an echo before fibrinolytic administration
D. Wait for MRI result
****Answer:** A. Start fibrinolytic therapy ASAP**
****Expert Explanation:**** The patient presents with symptoms of an acute ischemic stroke (AIS), and the CT scan has ruled out hemorrhagic stroke. The current guidelines suggest initiating fibrinolytic therapy within 3 to 4.5 hours of symptom onset for eligible patients without contraindications. Given that the CT is normal and there are no contraindications, administering fibrinolytics is appropriate to restore blood flow and minimize brain damage.
2. For a STEMI patient, what is the maximum goal time for ED door-to-balloon inflation time for PCI?
A. 150 mins
B. 180 mins
C. 120 mins
D. 90 mins
****Answer:** D. 90 mins**
****Expert Explanation:**** The American College of Cardiology and the American Heart Association set a goal of 90 minutes for door-to-balloon time in patients with ST-
C. Increased perfusion pressure
D. Increased venous return
****Answer:** A. Decreased cardiac output**
****Expert Explanation:**** Excessive ventilation can lead to increased intrathoracic pressure, reducing venous return to the heart and subsequently decreasing cardiac output. The optimal ventilation rate during CPR is critical to balance oxygen delivery and minimize interruptions to chest compressions.
6. What is the target temperature to achieve during targeted temperature management after cardiac arrest?
****Answer:** 32 - 36°C**
****Expert Explanation:**** Targeted temperature management aimed to reduce neurological damage after cardiac arrest typically involves maintaining a patient's temperature between 32 to 36°C. This hypothermic approach can protect the brain after global anoxia.
7. Three minutes into cardiac arrest resuscitation attempt, one member of your team inserts an endotracheal tube while another performs chest compressions. Capnography shows a persistent waveform & a PETCO2 of 8 mmHg. What is the significance of this finding?
A. Chest compression may not be effective
B. The endotracheal tube is in the esophagus
C. The team is ventilating the patient too often
D. The patient meets the criteria for termination of efforts
****Answer:** A. Chest compression may not be effective**
****Expert Explanation:**** A very low PETCO2 level, such as 8 mmHg, typically indicates poor circulation and ineffective chest compressions, as PETCO2 reflects cardiac output during CPR. It may suggest that chest compressions are not sufficiently delivering blood to the lungs to produce a measurable end-tidal CO2 level.
8. Your patient is in cardiac arrest and has been intubated. To assess CPR quality, you should:
****Answer:** Monitor the patient's PETCO2**
****Expert Explanation:**** PETCO2 (end-tidal CO2) levels are a reliable indicator of CPR quality and can help assess the effectiveness of chest compressions. Maintaining an appropriate PETCO2 level can indicate adequate perfusion during resuscitation efforts.
9. In addition to clinical assessment, which is the most reliable method to confirm & monitor correct placement of an endotracheal tube?
****Answer:** Continuous waveform capnography**
****Expert Explanation:**** Continuous waveform capnography provides real-time confirmation of endotracheal tube placement by measuring exhaled CO2 levels, ensuring the tube is correctly placed in the trachea rather than the esophagus.
10. A 45-year-old male had coronary artery stents placed 2 days ago. Today he is in severe distress and reporting "crushing" chest discomfort. He is pale, diaphoretic, and cool to the touch. His radial pulse is very weak, blood pressure is 64/40, respiratory rate is 28 bpm, and O2 saturation is 89% on room air. What should be suspected?
D. Atropine 1 mg
****Answer:** C. Epinephrine 1 mg**
****Expert Explanation:**** In cases of persistent ventricular fibrillation or pulseless ventricular tachycardia after defibrillation attempts, epinephrine is indicated to increase coronary perfusion pressure and improve the chance of restoring a normal rhythm.
13. Despite the drug provided above and continuous CPR, the patient remains in ventricular fibrillation. Which drug should be given next?
A. Atropine 1 mg
B. Magnesium sulfate 1 g
C. Amiodarone 300 mg
D. Epinephrine 1 mg
****Answer:** C. Amiodarone 300 mg**
****Expert Explanation:**** After administering epinephrine, if the patient remains in ventricular fibrillation, the next step in advanced cardiac life support (ACLS) protocol is to administer amiodarone, which is an antiarrhythmic drug effective for refractory VF/pulseless VT.
14. The patient has returned of spontaneous circulation (ROSC) & is not able to follow commands. Which immediate post-cardiac arrest care intervention do you choose for the patient?
A. Extubate
B. Check glucose
C. Give epinephrine
D. Initiate targeted temperature management
****Answer:** D. Initiate targeted temperature management**
****Expert Explanation:**** After ROSC, it is important to initiate targeted temperature management to reduce the risk of neurological damage. Ensuring normothermia or hypothermia is key during the immediate post-arrest care phase.
15. If the patient had not gone into ventricular fibrillation, what would you have done first?
A. Give atropine 1 mg
B. Establish IV
C. Do a 12-lead ECG
D. Perform synchronized cardioversion
****Answer:** D. Perform synchronized cardioversion**
****Expert Explanation:**** If the patient was not in VF or pulseless VT but was experiencing unstable tachycardia, synchronized cardioversion would be indicated as the primary treatment for restoring normal rhythm.
16. During post-cardiac arrest, which is the recommended duration of targeted temperature management after reaching the correct temperature range?
A. At least 24 hours
B. 0-8 hours
A. Defibrillation
B. Perform synchronized cardioversion
C. Administer adenosine 6 mg IV push
D. Perform vagal maneuvers
****Answer:** B. Perform synchronized cardioversion**
****Expert Explanation:**** In cases of unstable tachycardia with symptoms such as low blood pressure and respiratory distress, synchronized cardioversion is the appropriate intervention to restore a normal rhythm while considering the hemodynamic status of the patient.
19. Which of these tests should be performed for a patient with a suspected stroke within 25 minutes of hospital arrival?
A. Coagulation studies
B. Cardiac enzymes
C. Non-contrast CT scan of the head
D. 12-lead ECG
****Answer:** C. Non-contrast CT scan of the head**
****Expert Explanation:**** The primary diagnostic tool in the emergency department for a suspected stroke is a non-contrast CT scan to rule out hemorrhage and to determine eligibility for thrombolytic therapy if it is an ischemic stroke.
20. Which of the following signs is a likely indicator of cardiac arrest in an unresponsive patient?
A. Slow, weak pulse rate
B. Cyanosis
C. Irregular, weak pulse
D. Agonal gasps
****Answer:** D. Agonal gasps**
****Expert Explanation:**** Agonal gasps are often present in patients who are in cardiac arrest. They are not effective breaths and indicate that the patient is in a critical condition, warranting immediate intervention.
21. A patient is being resuscitated in a very noisy environment. A team member thinks he heard an order for 500 mg of amiodarone IV. What is the best response from the team member?
****Answer:** ** "I have an order to give 500 mg of amiodarone IV. Is this correct?"
****Expert Explanation:**** Closed-loop communication is vital in emergency situations to ensure clarity and accuracy. The team member must verify the order before administering the medication, reducing the risk of errors.
22. What is the recommended next step after a defibrillation attempt?
25. A 68-year-old female presents with lightheadedness, nausea, and chest discomfort. She is awake, responsive, and appears ill. The monitor shows a specific rhythm. Based on her assessment, what ACLS algorithm should you follow?
****Answer:** ** Tachycardia
****Expert Explanation:**** The presentation indicates that the patient may be experiencing a type of tachycardia. Following the appropriate ACLS algorithm for tachycardia will guide the management and interventions required.
26. In this same patient (previous question), after your initial assessment, which intervention should be performed?
****Answer:** ** Synchronized cardioversion
****Expert Explanation:**** For patients presenting with unstable tachycardia, synchronized cardioversion is often necessary to restore a normal heart rhythm and improve hemodynamic stability.
27. If the patient became apneic and pulseless but the rhythm remained the same, which action would take the highest priority?
****Answer:** ** Perform defibrillation
****Expert Explanation:**** In the case of a pulseless rhythm (such as unresponsive ventricular tachycardia), immediate defibrillation is a priority intervention to restore effective cardiac rhythm and blood flow.
28. Which is the recommended oral dose of ASA for a patient with suspected ACS?
A. 81 mg
B. 325-650 mg
C. 160-325 mg
D. 40 mg
****Answer:** C. 160-325 mg**
****Expert Explanation:**** In the setting of acute coronary syndrome (ACS) symptoms, an initial loading dose of aspirin is recommended to prevent platelet aggregation. The recommended dose ranges between 160 to 325 mg for rapid antiplatelet effect. Lower doses are typically used for maintenance therapy, but the higher loading dose is indicated in ACS.
****Expert Explanation:**** A witnessed collapse with a potentially lethal arrhythmia often requires immediate defibrillation to restore effective cardiac rhythm.
32. Following 2 minutes of CPR, the ECG monitor shows a lead 2 rhythm, and the patient has no pulse. Another team member resumes chest compressions, and an IV line is established. What do you do next?
****Answer:** ** Give epinephrine 1 mg IV
****Expert Explanation:**** In the absence of a pulse, administering epinephrine is critical in advanced cardiac life support to promote coronary perfusion during CPR.
33. To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag?
****Answer:** ** Once every 5-6 seconds
****Expert Explanation:**** The recommended rate for ventilating an adult patient with a perfusing rhythm is once every 5-6 seconds to prevent hyperventilation and maintain adequate oxygenation without compromising circulation.
34. Which is the recommended 1st IV dose of amiodarone for a patient with refractory ventricular fibrillation?
****Answer:** ** 300 mg
****Expert Explanation:**** For patients in refractory ventricular fibrillation or pulseless VT, the initial dose of amiodarone is 300 mg, administered during resuscitation efforts.
35. Which best describes how long it should take to perform a pulse check during BLS assessment?
****Answer:** ** 5-10 seconds
****Expert Explanation:**** During BLS assessment, checking for a pulse should be efficient, taking no longer than 10 seconds to prevent unnecessary delays in CPR.
36. What is an action taken by the team leader to avoid inefficiencies during a resuscitation attempt?
****Answer:** ** Clearly delegate tasks
****Expert Explanation:**** Ensuring every team member has a clear role enhances efficiency and organizational flow during a high-stress resuscitation scenario.
37. What is the maximum interval you should allow for an interruption in chest compression?
****Answer:** ** 10 seconds
****Expert Explanation:**** To maintain circulation and perfusion, interruptions in chest compressions should not exceed 10 seconds during cardiopulmonary resuscitation.
****Answer:** ** Ask for a new task or role
****Expert Explanation:**** It is essential for team members to work within their scope and to recognize when to seek assistance or clarification regarding roles in a clinical setting.
42. What is the minimum systolic blood pressure one should attempt to achieve with fluid administration or vasoactive agents in a hypotensive post-cardiac arrest patient who achieves return of spontaneous circulation?
****Answer:** ** 90 mmHg
****Expert Explanation:**** Maintaining a minimum systolic blood pressure of 90 mmHg is vital in post-cardiac arrest management to ensure adequate perfusion to vital organs.
43. You are evaluating a 58-year-old male with chest discomfort, BP 92/50, heart rate 92/min. What assessment step is most important now?
****Answer:** ** Obtaining a 12-lead ECG
****Expert Explanation:**** Achieving timely ECG acquisition is crucial in diagnosing the underlying cardiac condition and guiding further management for this patient presenting with angina or potential myocardial infarction.
44. As a team leader, when do you tell the chest compressors to switch?
****Answer:** ** About every 2 minutes
****Expert Explanation:**** To maintain high-quality compressions, team members should switch roles approximately every 2 minutes to reduce fatigue and ensure continued effective CPR.
45. The patient's pulse ox shows a reading of 84% on room air. What initial action do you take?
****Answer:** ** Apply oxygen
****Expert Explanation:**** An SpO2 reading of 84% indicates significant hypoxemia; therefore, supplemental oxygen should be provided immediately to improve oxygenation.
of fatigue, shortness of breath, back pain, and nausea. A 12-lead ECG is obtained and shows ST-segment depression in leads II, III, and aVF and intermittent runs of nonsustained ventricular tachycardia. Cardiac serum markers are elevated. These findings suggest which condition? A) High-risk non-ST-segment elevation ACS (NSTE-ACS) B) Low-risk non-ST-segment elevation ACS (NSTE-ACS) C) Intermittent-risk non-ST-segment elevation ACS (NSTE-ACS) D) ST-segment elevation myocardial infarction (STEMI)
****Answer:** A) High-risk non-ST-segment elevation ACS (NSTE-ACS).**
****Expert Explanation:**** The combination of ST-segment depression across contiguous leads along with elevated cardiac biomarkers suggests significant ischemia, characteristic of high-risk NSTE-ACS. The presence of nonsustained ventricular tachycardia raises the alarm for potential adverse events, necessitating aggressive management and intervention to prevent further cardiac complications and address the underlying coronary artery disease.
