Download ACLS Exam Questions and Answers: Version A and B (2025-2026) LASTEST UPDATE and more Exams Nursing in PDF only on Docsity!
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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 in 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.
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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? A. Give 0.5 mg of atropine. B. Insert an advanced airway. C. Administer 1 mg of epinephrine. D. Administer a dopamine infusion. 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? A. Establish vascular access. B. Obtain the patient’s history. C. Resume chest compressions. D. Terminate the resuscitative effort. 7. What is a common but sometimes fatal mistake in cardiac arrest management? A. Failure to obtain vascular access B. Prolonged periods of no ventilations C. Failure to perform endotracheal intubation D. Prolonged interruptions in chest compressions 8. Which action is a component of high-quality chest compressions? A. Allowing complete chest recoil B. Chest compressions without ventilation C. 60 to 100 compressions per minute with a 15:2 ratio D. Uninterrupted compressions at a depth of 1½ inches
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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? 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 CPR? 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
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C. Rapid medication administration D. Preparation for therapeutic hypothermia
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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
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26. A patient presents to the emergency department with new onset of dizziness and fatigue. On 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 appropriate 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 with a 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 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: 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
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B. Epinephrine IV infusion C. Application of a transcutaneous pacemaker D. Simple airway maneuvers and assisted ventilation
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34. What is the appropriate procedure for endotracheal tube suctioning after the appropriate catheter is selected? A. Suction during insertion but for no longer than 30 seconds. B. Suction the mouth and nose for no longer than 30 seconds. C. Suction during withdrawal but for no longer than 10 seconds. D. Hyperventilate before catheter insertion, and then suction during withdrawal. 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 most appropriate first intervention? A. Aspirin B. Atropine C. Lidocaine D. Nitroglycerin 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? A. 12-lead ECG assessment B. Administration of 100% supplementary oxygen C. Cincinnati Prehospital Stroke Scale assessment D. Administration of a low-dose aspirin 37. EMS is transporting a patient with a positive prehospital stroke assessment. 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 intervention should you perform next? A. Head CT scan B. Transfer to the stroke unit C. Immediate rtPA administration
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38. What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in place? A. 4 to 6 breaths per minute B. 8 to 10 breaths per minute C. 12 to 14 breaths per minute D. 16 to 18 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? A. Obtain a 12-lead ECG. B. Give 150 mg of amiodarone. C. Administer 160 mg of aspirin. D. Administer 6 mg of adenosine. 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? A. Procedural sedation B. 12-lead ECG C. Amiodarone administration D. Synchronized cardioversion 41. What is the initial priority for an unconscious patient with any tachycardia on the monitor? A. Review the patient’s home medications. B. Evaluate the breath sounds. C. Determine whether pulses are present. D. Administer sedative drugs. 42. Which rhythm requires synchronized cardioversion? A. Unstable supraventricular tachycardia B. Atrial fibrillation C. Sinus tachycardia D. NSR on monitor but no pulse
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43. What is the recommended second dose of adenosine for patients in refractory but stable narrow-complex tachycardia? A. 3 mg B. 6 mg C. 9 mg D. 12 mg 44. What is the usual post–cardiac arrest target range for PETCO 2 when ventilating a patient who achieves return of spontaneous circulation (ROSC)? A. 30 to 35 mm Hg B. 35 to 40 mm Hg C. 40 to 45 mm Hg D. 45 to 50 mm 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? A. Initial rhythm of asystole B. Responding to verbal commands C. Patient age greater than 60 years D. Desire to provide coronary reperfusion (eg, PCI) 46. What is the potential danger of using ties that pass circumferentially around the patient’s neck when securing an advanced airway? A. May interfere with effective ventilation B. Places the patient’s cervical spine at risk C. Obstruction of venous return from the brain D. Does not adequately secure the airway device 47. What is the most reliable method of confirming and monitoring correct placement of an endotracheal tube? A. 5-point auscultation B. Colorimetric capnography C. Continuous waveform capnography D. Use of esophageal detection devices 48. What 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–cardiac arrest period? A. 250 to 500 mL
ACLS Exam Version B 2023-2024 questions with answers
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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? A. 90 mm Hg B. 85 mm Hg C. 80 mm Hg D. 75 mm Hg 50. What is the first treatment priority for a patient who achieves ROSC? A. Coronary reperfusion B. Therapeutic hypothermia C. Maintaining blood glucose <185 mg/dL D. Optimizing ventilation and oxygenation
ACLS Exam Version B 2023-2024 questions with answers
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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. The patient’s lead II ECG appears below. What is your next action?
ACLS Exam Version B 2023-2024 questions with answers
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5. What is the recommendation on the use of cricoid pressure to prevent aspiration during cardiac 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 9. A patient remains in ventricular fibrillation despite 1 shock and 2 minutes of continuous CPR. The next intervention is to A. administer amiodarone.
ACLS Exam Version B 2023-2024 questions with answers
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B. administer a second shock. C. administer epinephrine. D. insert an advanced airway.
