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ACLS Written Exam Questions with Correct Answers 100% Verified 2025, Exams of Nursing

ACLS Written Exam Questions with Correct Answers 100% Verified 2025

Typology: Exams

2024/2025

Available from 09/23/2024

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Download ACLS Written Exam Questions with Correct Answers 100% Verified 2025 and more Exams Nursing in PDF only on Docsity!

ACLS Written Exam Questions with Correct Answers

100% Verified 2025

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 blood pressure is 92/

mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading 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 minutes of CPR. The ECG monitor displays the lead II rhythm

below, and the patient has no pulse. Another member of your team resumes chest compressions, and an IV is in place. What management step is your next priority?: Administer 1mg of epinephrine

6. During a pause in CPR, you see this lead II ECG rhythm on the monitor. The patient

has no pulse. What is the next action?: Resume compressions

7. What is a common 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 pulseless electrical activity?: Sinus rythm

without a pulse

11.What is the BEST strategy for performing high-quality CPR on a patient with an

advanced airway in place?: Provide continuous chest compressions without pauses and 10 ventilations per minute.

12.Three minutes after witnessing a cardiac arrest, one member of your team inserts

an endotracheal tube while another performs continuous chest compressions. During subsequent ventilation, you notice the presence of a waveform on the capnography screen and a PETCO2 level 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 patients: allows for mon- itoring

of CPR quality.

14. For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who

originally presented in ventricular fibrillation. After the first shock, the ECG screen displayed asystole, which has persisted despite 2 doses of epinephrine, 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 oxygen is not blowing over the patient's chest during the shock.

16.During your assessment, your patient suddenly loses consciousness. After calling

for help and determining that the patient is not breathing, you are unsure whether the patient has a pulse. What is your next action?: Begin chest compressions.

17.What is an advantage of using hands-free defibrillation pads instead of

defibrillation paddles?: Hands-free pads allow for a more rapid defibrillation.

18.What action is recommended to help minimize interruptions in chest com-

pressions during CPR?: Continue CPR while charging the defibrillator.

19.Which action is included in the BLS survey?: Early defibrillation

20.Which drug and dose are recommended for the management of a patient in

refractory ventricular fibrillation?: Amioderone 300mg

21.What is the appropriate interval for an interruption in chest compres- sions?:

10 seconds or less

22.Which of the following is a sign of effective CPR?: PETCO2 e10 mm Hg

23.What is the primary purpose of a medical emergency team (MET) or rapid response

team (RRT)?: Identifying and treating early clinical deterioration.

24.Which action improves the quality of chest compressions delivered during a

resuscitation attempt?: Switch providers about every 2 minutes or every 5 compression cycles.

25.What is the appropriate ventilation strategy for an adult in respiratory arrest

with a pulse rate of 80/min?: 1 breath every 5-6 seconds

26.A patient presents to the emergency department with new onset of dizzi- ness and

fatigue. On examination, the patient's heart rate is 35/min, the blood pressure is 70/ mm Hg, the respiratory rate is 22 breaths/min, and the oxygen saturation is 95%. What is the appropriate first medication?: Atropine 0.5mg

27.A patient with dizziness and shortness of breath with a sinus bradycardia of 40/min.

The initial atropine dose was ineffective, and your monitor/defibrilla- tor is not equipped with a transcutaneous pacemaker. What is the appropriate dose of dopamine for this patient?: 2 to 10 mcg/kg per minute

28.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:: Vagal manuever.

29. A monitored patient in the ICU developed a sudden onset of narrow-com- plex

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?- : Adenosine 6mg IV push

30.You are receiving a radio report from an EMS team en route with a patient who may

be having an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation?: Divert the patient to a hospital 15 minutes away with CT capabilities.

31. Choose an appropriate indication to stop or withhold resuscitative efforts.-

: Evidence of rigor mortis.

32. 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?: Obtain a 12 lead ECG.

33.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 brady- cardia at a rate of 30/min. What intervention has the highest priority?: Simple airway manuevers and assisted ventilations.

34.What is the appropriate procedure for endotracheal tube suctioning after the

appropriate catheter is selected?: Suction during withdrawal but for no longer than 10 seconds.

35.While treating a patient with dizziness, a blood pressure of 68/30 mm Hg, and cool,

clammy skin, you see this lead II ECG rhythm:What is the first intervention ?: Atropine 0.5mg

36.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?: Cincinnati Prehospital Stroke Scale assessment

37. EMS is transporting a patient with a positive prehospital stroke assess- ment.

Upon arrival in the emergency department, the initial blood pressure is 138/78 mm Hg, the pulse rate is 80/min, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95% on room air. The lead II ECG displays sinus rhythm. The blood glucose level is within normal limits. What interven- tion should you perform next?: Head CT scan

38.What is the proper ventilation rate for a patient in cardiac arrest who has an

advanced airway in place?: 8-10 breaths per minute

39.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?: Obtain a 12 lead ECG.

40. You are evaluating a 48-year-old man with crushing substernal chest pain. The

patient is pale, diaphoretic, cool to the touch, and slow to respond to your questions. The blood pressure is 58/32 mm Hg, the heart rate is 190/min, the respiratory rate is 18 breaths/min, and the pulse oximeter is unable to obtain a reading because there is no radial pulse. The lead II ECG displays a regular wide-complex tachycardia. What intervention should you perform next?: Synchronized cardioversion

41.What is the initial priority for an unconscious patient with any tachycardia on the

monitor?: Determine whether pulses are present.

42.Which rhythm requires synchronized cardioversion?: Unstable supraven-

tricular tachycardia

43.What is the recommended second dose of adenosine for patients in refrac- tory but

stable narrow-complex tachycardia?: 12mg

44.What is the usual post-cardiac arrest target range for PETCO2 when ven- tilating a

patient who achieves return of spontaneous circulation (ROSC)?: - 35-40mm Hg

45.Which condition is a contraindication to therapeutic hypothermia during the post-

cardiac arrest period for patients who achieve return of spontaneous circulation ROSC?: Responding to verbal commands

46.What is the potential danger of using ties that pass circumferentially around the

patient's neck when securing an advanced airway?: Obstruction of venous return from the brain

47.What is the most reliable method of confirming and monitoring correct

placement of an endotracheal tube?: Continuous waveform capnography

48.hat is the recommended IV fluid (normal saline or Ringer's lactate) bolus dose for a

patient who achieves ROSC but is hypotensive during the post-car- diac arrest period?: 1 to 2 Liters

49.What is the minimum systolic blood pressure one should attempt to achieve with

fluid, inotropic, or vasopressor administration in a hypotensive post-cardiac arrest patient who achieves ROSC?: 90mm Hg

50.What is the first treatment priority for a patient who achieves ROSC?: Op- timizing

ventilation and oxygenation.

51.What should be done to minimize interruptions in chest compressions during

CPR?: Continue CPR while the defibrillator is charging.

52. Which condition is an indication to stop or withhold resuscitative efforts?-

: Safety threat to providers

53.After verifying the absence of a pulse, you initiate CPR with adequate bag-mask

ventilation. The patient's lead II ECG appears below. What is your next action?: IV or IO access

54.After verifying unresponsiveness and abnormal breathing, you activate the

emergency response team. What is your next action?: Check for a pulse.

55.What is the recommendation on the use of cricoid pressure to prevent

aspiration during cardiac arrest?: Not recommended for routine use

56.What survival advantages does CPR provide to a patient in ventricular

fibrillation?: Produces a small amount of blood flow to the heart

57.What is the recommended compression rate for performing CPR?: At least 100

per minute

58.EMS personnel arrive to find a patient in cardiac arrest. Bystanders are performing

CPR. After attaching a cardiac monitor, the responder observes the following rhythm strip. What is the most important early intervention?: de- fibrillation

59.A patient remains in ventricular fibrillation despite 1 shock and 2 minutes of

continuous CPR. The next intervention is to: administer a second shock.

60.What is the recommended next step after a defibrillation attempt?: Begin CPR,

starting with chest compressions.

61.Which of the following is the recommended first choice for establishing

intravenous access during the attempted resuscitation of a patient in cardiac arrest?: Antecubital vein

62.Which finding is a sign of ineffective CPR?: PETCO2 <10 mm Hg

63.How often should the team leader switch chest compressors during a

resuscitation attempt?:. Every 2 minutes

64.IV/IO drug administration during CPR should be: given rapidly during com-

pressions

65.What is the recommended first intravenous dose of amiodarone for a patient

with refractory ventricular fibrillation?: 300 mg

66.A team leader orders 1 mg of epinephrine, and a team member verbally

acknowledges when the medication is administered. What element of effective resuscitation team dynamics does this represent?: Closed-loop communication

67. How long should it take to perform a pulse check during the BLS Survey?-

: 5 to 10 seconds

68.Your rescue team arrives to find a 59-year-old man lying on the kitchen floor.You

determine that he is unresponsive and notice that he is taking agonal breaths. What is the next step in your assessment and management of this patient?: Check the patient's pulse.

69.An AED advises a shock for a pulseless patient lying in snow. What is the next

action?: Administer the shock immediately and continue as directed by the AED.

70.Which treatment or medication is appropriate for the treatment of a patient in

asystole?: Epinephrine

71.What is the minimum depth of chest compressions for an adult in cardiac arrest?:

2 inches

72.A patient with pulseless ventricular tachycardia is defibrillated. What is the next

action?: Start chest compressions at a rate of at least 100/min.

73.You have completed your first 2-minute period of CPR. You see an orga- nized,

nonshockable rhythm on the ECG monitor. What is the next action?: - Have a team member attempt to palpate a carotid pulse.

74.Emergency medical responders are unable to obtain a peripheral IV for a patient

in cardiac arrest. What is the next most preferred route for drug administration?: Intraosseous (IO)

75.What is the appropriate rate of chest compressions for an adult in cardiac arrest?:

At least 100/min

76.A 53-year-old man has shortness of breath, chest discomfort, and weak- ness. 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?: Vagal maneuvers

77. 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 ad- ministered 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?: Administer 2 to 4 mg of morphine by slow IV bolus.

78.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?: Seeking expert consultation

79.A postoperative patient in the ICU reports new chest pain. What actions have the

highest priority?: Obtain a 12-lead ECG and administer aspirin if not contraindicated.

80.An 80-year-old woman presents to the emergency department with dizzi- ness. She

now states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She is alert and oriented. Her lead II ECG is below. After you start an IV, what is the next action?: Conduct a problem-focused history and physical examination.

81.What is the recommended oral dose of aspirin for patients suspected of having

one of the acute coronary syndromes?: 160 to 325 mg

82.A responder is caring for a patient with a history of congestive heart failure. The

patient is experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of 190/min. The patient's lead II ECG is displayed below.: stable supraventricular tachycardia

83.What is the most appropriate intervention for a rapidly deteriorating patient who has

this lead II ECG?: Synchronized cardioversion

84.What is the purpose of a medical emergency team (MET) or rapid response team

(RRT)?: Improving patient outcomes by identifying and treating early clinical deterioration

85.What is the recommended assisted ventilation rate for patients in respira- tory

arrest with a perfusing rhythm?: 10 to 12 breaths per minute

86.Family members found a 45-year-old woman unresponsive in bed. The patient is

unconscious and in respiratory arrest. What is the recommended initial airway management technique?: Performing a head tilt-chin lift maneuver

87. 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?: Synchronized cardioversion

88. A patient has a witnessed loss of consciousness. The lead II ECG reveals this

rhythm: What is the appropriate next intervention?: Defibrillation

89.What is the recommended energy dose for biphasic synchronized car-

dioversion of atrial fibrillation?: 120to200J

90.Which of the following is an acceptable method of selecting an appropri- ately

sized oropharyngeal airway (OPA)?: Measure from the corner of the mouth to the angle of the mandible.

91.Which is a contraindication to nitroglycerin administration in the manage- ment of

acute coronary syndromes?: Right ventricular infarction and dysfunction

92.What is the recommended initial intervention for managing hypotension in the

immediate period after return of spontaneous circulation (ROSC)?: Admin- istration of IV or IO fluid bolus

93.Which is an appropriate and important intervention to perform for a patient who

achieves ROSC during an out-of-hospital resuscitation?: Transport the patient to a

facility capable of performing PCI.

94.What is the immediate danger of excessive ventilation during the post-car- diac

arrest period for patients who achieve ROSC?: Decreased cerebral blood flow

95.What is the recommended target temperature range for achieving thera- peutic

hypothermia after cardiac arrest?: 32°C to 34°C

96.What is the recommended duration of therapeutic hypothermia after reach- ing the

target temperature?: 12 to 24 hours

97.What is the danger of routinely administering high concentrations of oxy- gen

during the post- cardiac arrest period for patients who achieve ROSC?: - Potential oxygen toxicity

98.What is the recommended dose of epinephrine for the treatment of hy-

potension in a post- cardiac arrest patient who achieves ROSC?: 0.1 to 0.5 mcg/kg per minute IV infusion

99. You have completed 2 min of CPR. The ECG monitor displays the lead below (PEA)

and the patient has no pulse. You partner resumes chest com- pressions and an IV is in place. What management step is your next priority?- : Administer 1mg of epinephrine

100. 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 ?: 150 mg IV push

101. 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?: second dose of epinephrine 1 mg

102. 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 admin- ister?: amiodarone 300 mg

103. You are monitoring a patient with chest discomfort who suddenly be- comes

unresponsive. You observe the following rhythm on the cardiac moni- tor. A defibrillator is present. What is your first action?: Give a single shock

104. what do you do after return of spontaneous circulation: maintain O2 sat at

94%

treat hypotension (fluids vasopressor) 12 lead EKG if in coma consider hypothermia if not in coma and ekg shows STEMI or AMI consider re-perfusion

105. what are the 5 h's and 5 t's:

hypovolemia hypoxia hydrogen ion (acidosis) hypo/hyperkalemia hypothermia tension pneumothorax tamponade, cardiac toxins thrombosis, pulmonary thrombosis, coronary

106. Bradycardia require treatment when?: chest pain or shortness of breath is

present

107. how do you treat non-symptomatic bradycardia: monitor and observe

108. what constitutes symptomatic bradycardia: hypotension

altered mental status signs of shock chest pain acute heart failure

109. 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?: 0.5 mg

110. how do you treat symptomatic bradycardia: give 0.5mg atropine every 3-

mins to max of 3mg if that doesn't work try one of the following: transcutaneous pacing 2-10mcg/kg / minute dopamine infusion 2-10mcg per minute epinephrine infusion

111. what is considered a tachycardia requiring treatment: over 150 per minute

112. when do you consider cardioversion: if persistent tachycardia is causing:

hypotension altered mental status signs of shock chest pain acute heart failure

113. if persistent tachycardia does not present with symptoms what do you

need to consider: wide QRS? greater than 0.12 seconds

114. Your patient has been intubated. IV/IVO access is not available. Which

combination of drugs can be administered by endotracheal route?: Lidocaine, epinephrine, vasopressin

115. reentry supraventricular tachycardia:

116. polymorphic ventricular tachycardia - aka torsades:

117. atrial fibrilation:

118. sinus tachycardia:

119. coarse ventricular fibrillation:

120. atrial flutter:

121. sinus bradycardia:

122. monomorphic ventricular tachycardia:

123. fine ventricular fibrillation:

124. second degree AV block type 1 wenckenbach:

125. second degree AV block mobitz type 2:

126. third degree AV block:

127. asystole:

128. normal sinus rhythm:

129. pulseless electrical activity:

130. agonal rhythm/asystole:

131. The five links in the adult Chain of Survival: 1- Immediate activation of EMS

2- Early CPR 3- Rapid defibrillation (not in peds) 4- Effective advanced life support 5- Integrated post-cardiac arrest care

132. Type of breaths (not normal) that may be present in the first minutes after

sudden cardiac arrest: Agonal gasps

133. To place the pads on the victims bare chest, Place one pad on the

upper-right chest (below the collarbone) and place the other pad: to the side of the left nipple, with the top edge of the pad a few inches below the armpit

134. If the heart muscle resets and initiates an organized rhythm this is called-

: ROSC return of spontaneous circulation