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(ACLS)ADVANCED CARDIOVASCULAR LIFE
SUPPORT EXAM VERSION B ||2025-
2026||QUESTIONS WITH CORRECT ANSWERS
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? 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 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. B. administer a second shock. C. administer epinephrine. D. insert an advanced airway.
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 does 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 C. 2 inches D. 2½ inches
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 ST- segment 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.
31. An 80-year-old woman presents to the emergency department with dizziness. 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? A. Give an IV fluid bolus. B. Give atropine and monitor for changes in mental status. C. Start an epinephrine infusion and titrate to patient response. D. Conduct a problem-focused history and physical examination. 32. What is the recommended oral dose of aspirin for patients suspected of having one of the acute coronary syndromes? A. 2 to 4 mg B. 80 to 120 mg C. 160 to 325 mg D. 400 to 600 mg 33. 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. Which of the following terms best describes this patient? A. Sinus tachycardia B. Perfusing ventricular tachycardia C. Stable supraventricular tachycardia D. Unstable supraventricular tachycardia
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
42. Which of the following is an acceptable method of selecting an appropriately sized oropharyngeal airway (OPA)? A. Estimate by using the size of the patient’s thumb. B. Estimate by using the formula Weight (kg)/8 + 2. C. Measure from the thyroid cartilage to the angle of the mandible. D. Measure from the corner of the mouth to the angle of the mandible. 43. Which is a contraindication to nitroglycerin administration in the management of acute coronary syndromes? A. Heart rate greater than 80/min B. Right ventricular infarction and dysfunction C. Phosphodiesterase inhibitor use more than 72 hours ago D. Systolic blood pressure greater than 100 mm Hg 44. What is the recommended initial intervention for managing hypotension in the immediate period after return of spontaneous circulation (ROSC)? A. Atropine bolus B. Administration of IV or IO fluid bolus C. Placement of a central line to monitor pulmonary wedge pressure D. Phenylephrine hydrochloride titrated to keep systolic blood pressure >100 mm Hg 45. Which is an appropriate and important intervention to perform for a patientwho achieves ROSC during an out-of-hospital resuscitation? A. Initiate an antiarrhythmic infusion. B. Transport the patient to a facility capable of performing PCI. C. Replace any supraglottic airway with an endotracheal tube. D. Place a central venous catheter for hemodynamic monitoring. 46. What is the immediate danger of excessive ventilation during the post–cardiac arrest period for patients who achieve ROSC? A. Oxygen toxicity B. Pulmonary hypertension C. Decreased cerebral blood flow D. Ventilation/perfusion mismatch 47. What is the recommended target temperature range for achieving therapeutichypothermia after cardiac arrest? A. 26 C to 28 C B. 29 C to 31 C C. 32 C to 34 C D. 35 C to 37 C
