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ACLS Practice Test

Sampling of 20 questions found on the certification

exam

1Recommended ED door to balloon inflation time for a STEMI patient is:

No longer than 60 minutes

No longer than 15 minutes

No longer than 30 minutes

No longer than 90 minutes

2The following drug used to be the drug of choice but is no longer recommended for
asystole or PEA:

Atropine

Epinephrine

Sodium Bicarbonate

Magnesium

3Narrow-complex Supraventricular tachycardia is best treated with:

Adenosine

Amiodarone

Epinephrine

Atropine

4The correct sequence for basic life support is:

BCA - Breathing, Compressions, Airway

ABC - Airway, Breathing, Compressions

ACB - Airway, Compressions, Breathing

CAB - Compressions, Airway, Breathing

5Team resuscitation is a focus in the 2010 guidelines. The role of the team leader is
different from the other team members in that a team leader is the person on the team
who must:

Be practiced in performing the skills of the role

Be able to perform all the skills if needed

Understand the ACLS sequences

Be willing and able to perform the role

6You are the paramedic on an ambulance transporting a 65-year-old female. The


patient is connected to the monitor and you see this rhythm; she has a palpable pulse.
What is the rhythm?

PEA

Sinus Rhythm

Sinus Bradycardia

Second Degree Heart Block

7This rhythm is characterized by a complete dissociation between the P wave and the
QRS:

First Degree AV Block

Third Degree AV Block

Second Degree AV Block Type 1

Second Degree AV Block Type 2

8True or False: Cricoid pressure is recommended when performing an emergent adult


airway intubation.

FALSE

TRUE

9True or False: Pulse checks should be done for at least 10 seconds.

TRUE

FALSE

10True or False: The initial recommended dose of atropine for symptomatic bradycardia
is 0.5 mg IV.

TRUE

FALSE

11During cardiopulmonary resuscitation, deliver oxygen at:

100%

Titrated to keep oxygen saturation 94%

2 Liters per minute via nasal cannula

Titrated to keep oxygen saturation 85%

12You are considering use of an oropharyngeal airway (OPA). You know that all of the
following are true EXCEPT:

A too-large OPA may obstruct the larynx

OPAs are safe to use in all patients

You should insert the OPA so that it curves upward and then rotate it 180
degrees to match the curve of the tongue and throat
A too-small OPA may obstruct the airway by pushing the tongue into the

throat

13The most common reversible causes of PEA are called the "H's and T's" and include
all of the following EXCEPT:

Hypoxia

Tamponade

Hypocalcemia

Hypovolemia

14A trained EMT discovers STEMI on a 12 lead ECG in the ambulance. The best option
is to:

Take the patient to a hospital capable of providing fibrinolysis only (not PCI),
5 minutes away

Take the patient to a hospital capable of providing PCI, 20 minutes away

Take the patient to a hospital capable of providing angiography, regardless of


fibrinolysis or PCI capability

Provide fibrinolysis in the ambulance then take the patient to a hospital


capable of providing PCI, 20 minutes away

15Your patient in the ED has a strong pulse and regular heart rate of 182 beats per
minute with a normal QRS on the cardiac monitor. Her blood pressure is 112/56. She is
awake and denies any pain. All of the following may be appropriate interventions
EXCEPT:

Administer adenosine

12 lead ECG

Attempt vagal maneuvers

Perform synchronized cardioversion

16A comatose patient with ROSC after cardiac arrest should be:

Cooled to between 32 and 34 C for at least 24 hours

Cooled to between 32 and 36 C for at least 24 hours

Cooled to between 32 and 34 C for 12 to 24 hours

Cooled to between 32 and 36 C for 12 to 24 hours

17Which of the following signs is NOT part of the Cincinnati Prehospital Stroke Scale?

Facial droop

Speech abnormality

Arm drift

Confusion or disorientation

18The goal for initiation of fibrinolytic therapy in appropriate stroke patients is:

Within 6 hours of arrival to the ED

Within 4 hours of arrival to the ED

Within 1 hour of arrival to the ED

Within 3 hours of arrival to the ED

19The medication that should NOT be given via endotracheal tube is:

Dopamine

Atropine

Epinephrine

Lidocaine

20The newest AHA ACLS guidelines discuss resuscitation team dynamics, including the
roles of team of team leader and team member. A team member should possess which
of the following?

A thorough understanding of all ACLS algorithms

The ability to perform all ACLS skills

The ability to insert an central venous catheter

The ability to insert an endotracheal tube

Recommended ED door to balloon inflation time for a STEMI patient is:

No longer than 15 minutes

No longer than 30 minutes

No longer than 60 minutes

No longer than 90 minutes

The following drug used to be the drug of choice but is no longer recommended for
asystole or PEA:

Epinephrine

Atropine

Sodium Bicarbonate

Magnesium

Narrow-complex Supraventricular tachycardia is best treated with:

Adenosine

Amiodarone

Atropine

Epinephrine

The correct sequence for basic life support is:

ABC - Airway, Breathing, Compressions

ACB - Airway, Compressions, Breathing

BCA - Breathing, Compressions, Airway

CAB - Compressions, Airway, Breathing

Team resuscitation is a focus in the 2010 guidelines. The role of the team leader is
different from the other team members in that a team leader is the person on the team
who must:

Be willing and able to perform the role

Be practiced in performing the skills of the role

Understand the ACLS sequences

Be able to perform all the skills if needed

You are the paramedic on an ambulance transporting a 65-year-old female. The patient is
connected to the monitor and you see this rhythm; she has a palpable pulse. What is the
rhythm?

Sinus Bradycardia

Sinus Rhythm

PEA

Second Degree Heart Block

This rhythm is characterized by a complete dissociation between the P wave and the
QRS:

First Degree AV Block

Second Degree AV Block Type 1

Second Degree AV Block Type 2

Third Degree AV Block

True or False: Cricoid pressure is recommended when performing an emergent adult


airway intubation.

TRUE

FALSE

True or False: Pulse checks should be done for at least 10 seconds.

TRUE

FALSE

True or False: The initial recommended dose of atropine for symptomatic bradycardia is
0.5 mg IV.

TRUE

FALSE

During cardiopulmonary resuscitation, deliver oxygen at:

2 Liters per minute via nasal cannula

Titrated to keep oxygen saturation 85%

Titrated to keep oxygen saturation 94%

100%

You are considering use of an oropharyngeal airway (OPA). You know that all of the
following are true EXCEPT:

A too-large OPA may obstruct the larynx

A too-small OPA may obstruct the airway by pushing the tongue into the throat

You should insert the OPA so that it curves upward and then rotate it 180 degrees to
match the curve of the tongue and throat

OPAs are safe to use in all patients

The most common reversible causes of PEA are called the "H's and T's" and include all
of the following EXCEPT:

Hypovolemia

Hypoxia

Hypocalcemia

Tamponade

A trained EMT discovers STEMI on a 12 lead ECG in the ambulance. The best option is to:

Take the patient to a hospital capable of providing fibrinolysis only (not PCI), 5 minutes
away

Take the patient to a hospital capable of providing PCI, 20 minutes away

Take the patient to a hospital capable of providing angiography, regardless of fibrinolysis


or PCI capability

Provide fibrinolysis in the ambulance then take the patient to a hospital capable of
providing PCI, 20 minutes away

Your patient in the ED has a strong pulse and regular heart rate of 182 beats per minute
with a normal QRS on the cardiac monitor. Her blood pressure is 112/56. She is awake
and denies any pain. All of the following may be appropriate interventions EXCEPT:

Attempt vagal maneuvers

12 lead ECG

Administer adenosine

Perform synchronized cardioversion

A comatose patient with ROSC after cardiac arrest should be:

Cooled to between 32 and 36 C for at least 24 hours

Cooled to between 32 and 34 C for at least 24 hours

Cooled to between 32 and 36 C for 12 to 24 hours

Cooled to between 32 and 34 C for 12 to 24 hours

Which of the following signs is NOT part of the Cincinnati Prehospital Stroke Scale?

Facial droop

Arm drift

Speech abnormality

Confusion or disorientation

The goal for initiation of fibrinolytic therapy in appropriate stroke patients is:

Within 1 hour of arrival to the ED

Within 3 hours of arrival to the ED

Within 4 hours of arrival to the ED

Within 6 hours of arrival to the ED

The medication that should NOT be given via endotracheal tube is:

Atropine

Dopamine

Epinephrine

Lidocaine

The newest AHA ACLS guidelines discuss resuscitation team dynamics, including the
roles of team of team leader and team member. A team member should possess which of
the following?

The ability to insert an endotracheal tube

The ability to insert an central venous catheter

A thorough understanding of all ACLS algorithms

The ability to perform all ACLS skills

Start Compressions at least 100 per minute (Push Fast, Push Hard).

Immediately utilize the AED.

Put the AED aside and continue with compressions.

Epinephrine.

Pulseless Electrical Activity (PEA).

Contact a medical command physician for possible termination orders

Defibrillate at 200 joules, or manufacturer guidelines.

Epinephrine.

Amiodarone.

Vasopressin or epinephrine

AACLS Pretest Overview

Question 1 of 10
You are in the library when a gentleman who was standing at the
desk collapses. He falls to the ground and does not appear to be

breathing. You send the clerk to call 911 and to get the AED.
Because he is not responding and doesn't appear to be breathing
normally you should immediately

Open the airway, deliver 4 breaths and await the arrival of the AED.Deliver 2 breaths followed by 15
compressions.Start Compressions at least 100 per minute (Push Fast, Push Hard).Do nothing until
the AED arrives.

ACLS Pretest Overview


Question 2 of 10
You have been doing compressions on the above patient for
about a minute when the clerk arrives with AED. You should

Continue compressions for at least 5 minutes.Immediately utilize the AED.Continue CPR and await
EMS to defibrillate the patient.Ventilate the patient twice immediately prior to defibrillation.

ACLS Pretest Overview


Question 3 of 10
You have turned the AED on and placed the electrodes. The AED
fails to analyze the rhythm. You should

Put the AED aside and continue with compressions.Call the manufacturer (listed on the back) to talk
you to fix it.Use the second set of pads located in the case.Turn it off and back on again.

ACLS Pretest Overview


Question 4 of 10
You are responding on an ambulance to a wedding where the
elderly father of the bride has collapsed while dancing.
Bystanders say he was complaining of chest pain earlier but didn't
want to mess up the celebration by going to the hospital. He was
dancing when he suddenly lost consciousness and fell to the
ground. Bystanders have started CPR. You arrived and placed the
patient on the monitor. It shows Sinus Bradycardia but the patient
has no palpable pulse. CPR continues with high quality
compressions and ventilation. You have established IV access.
The only drug appropriate in this scenario would be

Epinephrine.Atropine.Amiodarone.Lidocaine.

ACLS Pretest

Overview
Question 6 of 10
The above patient has had high quality CPR for 30 minutes. He
has received multiple doses of Epinephrine and the monitor now
shows Asystole. What would be appropriate at this point?

Contact a medical command physician for possible termination ordersAsk the family what they would
like you to doContinue CPR for an additional 10 minutesLoad the patient in the ambulance with CPR
in progress and transport to the nearest trauma center

ACLS Pretest Overview


Question 7 of 10
You are working in an Emergency Department. Your patient is a
69 year old male who is being treated for chest pain. He has an IV
in place and is on a bedside monitor. Diagnostic tests are
complete and he is awaiting the arrival of the cardiac
catheterization team. You go into his room to check on him and he
suddenly loses consciousness. You look up at the monitor and
see ventricular fibrillation. You are not sure whether you feel a
pulse or not. You should immediately

Have another nurse to double check the presence of a pulse.Precordial Thump.Defibrillate at 200
joules, or manufacturer guidelines.Ventilate using a BVM.

ACLS Pretest Overview


Question 8 of 10
Once the patient is defibrillated and high quality CPR is in
progress, the first drug you would expect to give would be

Magnesium Sulfate.Morphine.Epinephrine.Lidocaine.

ACLS Pretest Overview


Question 9 of 10
The antiarrhythmic drug that would be utilized if the patient
remained in ventricular fibrillation would be

Epinephrine.Cardizem.Adenosine.Amiodarone.

ACLS Pretest Overview


Question 10 of 10
You are on your way home when you are called to a wedding
reception at a local hotel. The 82-year-old grandfather of the bride
collapsed while standing in the reception line. He was discussing
his latest project when he started sweating and then lost
consciousness. A family friend started CPR. His son immediately
called 911. You quickly perform the BLS Primary Survey. You
immediately ask for a defibrillator. If the first shock is unsuccessful
and the patient is still unresponsive, which drugs should be
administered first?

Vasopressin or epinephrineAmiodarone, vasopressin, and epinephrineMagnesium sulfate,


epinephrine, and amiodaroneEpinephrine or lidocaine

ACLS Pretest Overview


Question 5 of 10
Because this patient has an organized rhythm on the monitor but
remains pulseless, we call this rhythm

Pulseless Electrical Activity (PEA).Sinus Bradycardia.Ventricular Fibrillation.Ventricular Tachycardia.