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Basic Life Support Exam A AND B American Heart
Association Basic Life Support Exam
Advanced Cardiovascular Life Support Exam Version B (50 questions) Please do not mark on this exam. Record the best answer on the separate answer sheet. 1.What should be done to minimize interruptions in chest compressions during CPR? A. Perform pulse checks only after defibrillation. B. Continue CPR while the defibrillator is charging. C. Administer IV medications only when breaths are given. D. Continue to use AED even after the arrival of a manual defibrillator. 2.Which condition is an indication to stop or withhold resuscitative efforts? A. Unwitnessed arrest B. Safety threat to providers C. Patient age greater than 85 years D. No return of spontaneous circulation after 10 minutes of CPR
3. After verifying the absence of a pulse, you initiate CPR with adequate bag-mask ventilation. T patient’s lead II ECG appears below. What is your next action? A. IV or IO access B. Endotracheal tube placement C. Consultation with cardiology for possible PCI D. Application of a transcutaneous pacemaker 4. After verifying unresponsiveness and abnormal breathing, you activate the emergency response team. What is your next action? A. Retrieve an AED.
B. Check for a pulse. C. Deliver 2 rescue breaths. D. Administer a precordial thump.
5. What is the recommendation on the use of cricoid pressure to prevent aspiration during card arrest? A. Not recommended for routine use B. Recommended during every resuscitation attempt C. Recommended when the patient is vomiting D. Recommended only for supraglottic airway insertion 6.What survival advantages does CPR provide to a patient in ventricular fibrillation? A. Increases the defibrillation threshold B. Directly restores an organized rhythm C. Opposes the harmful effects of epinephrine D. Produces a small amount of blood flow to the heart 7.What is the recommended compression rate for performing CPR? A. 60 to 80 per minute B. 80 to 100 per minute C. About 100 per minute D. At least 100 per minute 8. 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? A. Defibrillation B. Endotracheal intubation C. Epinephrine administration D. Antiarrhythmic administration
15.Which finding is a sign of ineffective CPR? A. PETCO 2 <10 mm Hg B. Patient temperature >32°C (89.6°F) C. Diastolic intra-arterial pressure ≥20 mm Hg D. Measured patient urine output of 1 mL/kg per hour
16. 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 doe this represent? A. Clear messages B. Knowing one’s limitations C. Closed-loop communication D. Clear roles and responsibilities 17.How long should it take to perform a pulse check during the BLS Survey? A. 1 to 5 seconds B. 5 to 10 seconds C. 10 to 15 seconds D. 15 to 20 seconds 18. 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? A. Apply the AED. B. Check the patient’s pulse. C. Open the patient’s airway. D. Check for the presence of breathing. 19.Which treatment or medication is appropriate for the treatment of a patient in asystole? A. Atropine B. Epinephrine C. Defibrillation D. Transcutaneous pacing 20.An AED advises a shock for a pulseless patient lying in snow. What is the next action? A. Place a backboard beneath the patient and administer the shock. B. Move the patient off the snow to bare ground and deliver the shock. C. Remove any snow beneath the patient and then administer the shock. D. Administer the shock immediately and continue as directed by the AED. 21.What is the minimum depth of chest compressions for an adult in cardiac arrest? A. 1 inch B. 1½ inches
22.A patient with pulseless ventricular tachycardia is defibrillated. What is the next action? A. Check for a pulse. B. Administer an IV antiarrhythmic. C. Start chest compressions at a rate of at least 100/min. D. Repeat the unsynchronized shock, increasing to 200 J.
23. You have completed your first 2-minute period of CPR. You see an organized, nonshockable rhythm on the ECG monitor. What is the next action? A. Administer normal saline at 20 mL/kg. B. Administer epinephrine at 1 mg/kg IV. C. Obtain a blood pressure and oxygen saturation. D. Have a team member attempt to palpate a carotid pulse. 24. 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? A. I ntraosseous (IO) B. Endotracheal (ET) C. Intramuscular (IM) D. Central venous access 25.What is the appropriate rate of chest compressions for an adult in cardiac arrest? A. At least 150/min B. At least 100/min C. Approximately 100/min D. Approximately 120/min 26. You are receiving a radio report from an EMS team en route with a patient who may be havi an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation? A. Contact the patient’s family to see what they would prefer. B. Have the EMS crew choose an appropriate patient disposition. C. Accept the report and provide care within your present capability. D. Divert the patient to a hospital 15 minutes away with CT capabilities. 27. A 53-year-old man has shortness of breath, chest discomfort, and weakness. 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?
A. Acquisition of a 12-lead ECG B. Vagal maneuvers C. Procedural sedation D. Immediate defibrillation
28. 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 STsegment elevation in the anterior leads. First responders administered 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? A. Administer an additional dose of aspirin. B. Administer an additional nitroglycerin tablet. C. Administer high-flow oxygen via an oxygen mask. D. Administer 2 to 4 mg of morphine by slow IV bolus. 29. 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? A. Administration of IV epinephrine B. Seeking expert consultation C. Procedural sedation D. Synchronized cardioversion 30. A postoperative patient in the ICU reports new chest pain. What actions have the highest priority? A. Administer an IV fluid bolus and obtain arterial blood gas. B. Start dopamine at 2 mcg/kg per minute and obtain a chest x-ray. C. Send blood to the laboratory for chemistry and cardiac enzymes. D. Obtain a 12-lead ECG and administer aspirin if not contraindicated.
34. What is the most appropriate intervention for a rapidly deteriorating patient who has this lead ECG? A. Valsalva maneuver B. Synchronized cardioversion C. Intravenous administration of adenosine D. Immediate unsynchronized countershock 35.What is the purpose of a medical emergency team (MET) or rapid response team (RRT)? A. Providing online consultation to EMS personnel in the field B. Providing diagnostic consultation to emergency department patients C. Improving care for deteriorating patients admitted to critical care units D. Improving patient outcomes by identifying and treating early clinical deterioration 36. What is the recommended assisted ventilation rate for patients in respiratory arrest with a perfusing rhythm? A. 4 to 6 breaths per minute B. 10 to 12 breaths per minute C. 14 to 16 breaths per minute D. 16 to 18 breaths per minute 37. You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 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? A. PETCO 2 B. Chest x-ray C. Laboratory testing D. Obtaining a 12-lead ECG 38. Family members found a 45-year-old woman unresponsive in bed. The patient is unconsciou and in respiratory arrest. What is the recommended initial airway management technique? A. Placing a nasopharyngeal airway B. Using an advanced airway device C. Performing a head tilt–chin lift maneuver D. Performing a jaw thrust without head extension
39. 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? A. Defibrillation B. Amiodarone 150 mg IV C. Adenosine 6 mg IV push D. Synchronized cardioversion 40.A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm: What is the appropriate next intervention? A. Defibrillation B. Adenosine 6 mg IV push C. Epinephrine 1 mg IV push D. Synchronized cardioversion 41. What is the recommended energy dose for biphasic synchronized cardioversion of atrial fibrillation? A. 50 to 75 J B. 75 to 100 J C. 120 to 200 J D. 200 to 300 J
D. 35 C to 37 C
48. What is the recommended duration of therapeutic hypothermia after reaching the target temperature? A. 0 to 12 hours B. 12 to 24 hours C. 24 to 36 hours D. 36 to 48 hours 49. What is the danger of routinely administering high concentrations of oxygen during the pos cardiac arrest period for patients who achieve ROSC? A. Potential oxygen toxicity B. Adverse hemodynamic effects C. Decrease in cerebral blood flow D. Increased intrathoracic pressure 50. What is the recommended dose of epinephrine for the treatment of hypotension in a post– cardiac arrest patient who achieves ROSC? A. 2 to 10 mg/min IV infusion B. 0.1 to 0.5 mcg/kg per minute IV infusion C. 1 mg IV push every 3 to 5 minutes D. 10 mg IV push every 3 to 5 minutes
Advanced Cardiovascular Life Support Written Exam Version B American Heart Association Advanced Cardiovascular Life Support Exam Version A (50 questions) Please do not mark on this exam. Record the best answer on the separate answer sheet.
1. You find an unresponsive patient who is not breathing. After activating the emergency response system, you determine that there is no pulse. What is your next action? A. Open the airway with a head tilt–chin lift. B. Administer epinephrine at a dose of 1 mg/kg. C. Deliver 2 rescue breaths each over 1 second. D. Start chest compressions at a rate of at least 100/min. 2. You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 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? A. PETCO 2 B. Chest x-ray C. Laboratory testing D. Obtaining a 12-lead ECG 3. What is the preferred method of access for epinephrine administration during cardiac arrest most patients? A. Intraosseous B. Endotracheal C. Central intravenous D. Peripheral intravenous 4. An activated AED does not promptly analyze the rhythm. What is your next action? A. Begin chest compressions. B. Discontinue the resuscitation attempt. C. Check all AED connections and reanalyze. D. Rotate AED electrodes to an alternate position.
B. Administering 4 quick ventilations immediately before a defibrillation attempt C. Using manual defibrillator paddles with light pressure against the chest D. Providing quality compressions immediately before a defibrillation attempt
10. Which situation BEST describes pulseless electrical activity? A. Asystole without a pulse B. Sinus rhythm without a pulse C. Torsades de pointes with a pulse D. Ventricular tachycardia with a pulse 11. What is the BEST strategy for performing high-quality CPR on a patient with an advanced airway in place? A. Provide compressions and ventilations with a 15:2 ratio. B. Provide compressions and ventilations with a 30:2 ratio. C. Provide a single ventilation every 6 seconds during the compression pause. D. 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 subsequ ventilation, you notice the presence of a waveform on the capnography screen and a PETCO 2 level of 8 mm Hg. What is the significance of this finding? A. Chest compressions may not be effective. B. The endotracheal tube is no longer in the trachea. C. The patient meets the criteria for termination of efforts. D. The team is ventilating the patient too often (hyperventilation). 13. The use of quantitative capnography in intubated patients A. allows for monitoring of CPR quality. B. measures oxygen levels at the alveoli level. C. determines inspired carbon dioxide relating to cardiac output. D. detects electrolyte abnormalities early in code management. 14. For the past 25 minutes, an EMS crew has attempted resuscitation of a patient who originall 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. Wha is your next treatment? A. Apply a transcutaneous pacemaker. B. Administer 1 mg of intravenous atropine. C. Administer 40 units of intravenous vasopressin. D. Consider terminating resuscitative efforts after consulting medical control.
15. Which is a safe and effective practice within the defibrillation sequence? A. Stop chest compressions as you charge the defibrillator. B. Be sure oxygen is not blowing over the patient’s chest during the shock. C. Assess for the presence of a pulse immediately after the shock. D. Commandingly announce “clear” after you deliver the defibrillation 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? A. Leave and get an AED. B. Begin chest compressions. C. Deliver 2 quick ventilations. D. Check the patient’s mouth for the presence of a foreign body. 17. What is an advantage of using hands-free defibrillation pads instead of defibrillation paddles? A. Hands-free pads deliver more energy than paddles. B. Hands-free pads increase electrical arc. C. Hands-free pads allow for a more rapid defibrillation. D. Hands-free pads have universal adaptors that can work with any machine. 18. What action is recommended to help minimize interruptions in chest compressions during CP A. Continue CPR while charging the defibrillator. B. Perform pulse checks immediately after defibrillation. C. Administer IV medications only when delivering breaths. D. Continue to use an AED even after the arrival of a manual defibrillator. 19. Which action is included in the BLS Survey? A. Early defibrillation B. Advanced airway management C. Rapid medication administration
20. Which drug and dose are recommended for the management of a patient in refractory ventricular fibrillation? A. Atropine 2 mg B. Amiodarone 300 mg C. Vasopressin 1 mg/kg D. Dopamine 2 mg/kg per minute 21. What is the appropriate interval for an interruption in chest compressions? A. 10 seconds or less B. 10 to 15 seconds C. 15 to 20 seconds D. Interruptions are never acceptable 22. Which of the following is a sign of effective CPR? A. PETCO 2 ≥10 mm Hg B. Measured urine output of 1 mL/kg per hour C. Patient temperature >32°C (89.6°F) D. Diastolic intra-arterial pressure <20 mm Hg 23. What is the primary purpose of a medical emergency team (MET) or rapid response team (RRT)? A. Identifying and treating early clinical deterioration B. Rapidly intervening with patients admitted through emergency department triage C. Responding to patients during a disaster or multiple-patient situation D. Responding to patients after activation of the emergency response system 24. Which action improves the quality of chest compressions delivered during a resuscitation attempt? A. Observe ECG rhythm to determine depth of compressions. B. Do not allow the chest to fully recoil with each compression. C. Compress the upper half of the sternum at a rate of 150 compressions per minute. D. 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 ra of 80/min? A. 1 breath every 3 to 4 seconds B. 1 breath every 5 to 6 seconds C. 2 breaths every 5 to 6 seconds D. 2 breaths every 6 to 8 seconds 26. A patient presents to the emergency department with new onset of dizziness and fatigue. O examination, the patient’s heart rate is 35/min, the blood pressure is 70/50 mm Hg, the
respiratory rate is 22 breaths/min, and the oxygen saturation is 95%. What is the appropriat first medication? A. Atropine 0.5 mg B. Oxygen 12 to 15 L/min C. Epinephrine 0.5 mg D. Aspirin 160 mg chewed
27. A patient presents to the emergency department with dizziness and shortness of breath wi sinus bradycardia of 40/min. The initial atropine dose was ineffective, and your monitor/defibrillator is not equipped with a transcutaneous pacemaker. What is the appropriate dose of dopamine for this patient? A. 2 to 10 mg/min B. 2 to 10 mcg/kg per minute C. 10 to 15 mg/min D. 10 to 15 mcg/kg per minute 28. A patient has sudden onset of dizziness. The patient’s heart rate is 180/min, blood pressure i 110/70 mm Hg, respiratory rate is 18 breaths/min, and pulse oximetry reading is 98% on roo air. The lead II ECG is shown below: What is the next appropriate intervention? A. Vagal maneuvers B. Metoprolol 5 mg IV C. Adenosine 6 mg IV D. Normal saline 1 L bolus
