ACLS Exam A 2020
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1. Which of these tests should be performed for a pt with Noncontrast CT
suspected stroke as early as possible but no more scan of head
than 20 min after hospital arrival?
2. Which best describes this rhythm? Monomorphic
Vent Tach
3. Which is an acceptable method of selecting an appro- Measure from the
priately sized oropharyngeal airway? corner of the
mouth to the angle
of mandible
4. You are caring for a pt with a suspected stroke whose Give fibrinolytic
symptoms started 2 hours ago. The CT scan was therapy as soon as
normal, with no signs of hemorrhage. The pt does possible and con-
not have any contraindications to fibrinolytic therapy. sider endovascu-
Which treatment is best for this pt? lar therapy
5. Which is the recommended next step after a defibril- Resume CPR,
lation attempt? starting with chest
compressions
6. Which of the following signs is a likely indicator of Agonal gasps
cardiac arrest in an unresponsive pt?
7. You are evaluating a 58YO man with chest discomfort. Obtaining a
His BP is 92/50 mmHG, his HR is 92/min, his nonla- 12-lead ECG
bored RR is 14/min, and his pulse ox is 97%. Which
assessment step is most important now?
8. During post-cardiac arrest care, which is the recom- At least 24 hours
mended duration of targeted temperature manage-
ment after reaching the correct temperature range?
9. Your rescue team arrives to find a 59YO man lying on Check the pt's
the kitchen floor. You determine that he is unrespon- breathing and
sive. What is the next step in your assessment and pulse
management of this pt?
10.
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(SET) A 45YO man had coronary stents placed 2 days Acute Coronary
ago. Today he is in severe distress and is reporting Syndrome
"crushing" chest discomfort. Pale, diaphoretic, cool to
touch, weak radial pulse, BP 64/40 mmHg, RR 28/min,
89% RA. VTach changed to VFib.
On the basis of this pt's initial presentation, which
condition do you suspect led to the cardiac arrest?
11. (SET) A 45YO man had coronary stents placed 2 days Chest compres-
ago. Today he is in severe distress and is reporting sions
"crushing" chest discomfort. Pale, diaphoretic, cool to
touch, weak radial pulse, BP 64/40 mmHg, RR 28/min,
89% RA. VTach changed to VFib.
In addition to defibrillation, which intervention should
be performed immediately?
12. (SET) A 45YO man had coronary stents placed 2 days Epi 1mg
ago. Today he is in severe distress and is reporting
"crushing" chest discomfort. Pale, diaphoretic, cool to
touch, weak radial pulse, BP 64/40 mmHg, RR 28/min,
89% RA. VTach changed to VFib.
Despite 2 defib attempts, the pt remains in VFib. Which
drug and dose should you administer FIRST to this
pt?
13. (SET) A 45YO man had coronary stents placed 2 days Lido 1 to 1.5mg/kg
ago. Today he is in severe distress and is reporting
"crushing" chest discomfort. Pale, diaphoretic, cool to
touch, weak radial pulse, BP 64/40 mmHg, RR 28/min,
89% RA. VTach changed to VFib.
Despite the drug provided above and continued CPR,
the pt remains in VFib. Which other drug should be
administered NEXT?
14. (SET) A 45YO man had coronary stents placed 2 days
ago. Today he is in severe distress and is reporting
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"crushing" chest discomfort. Pale, diaphoretic, cool to Initiate targeted
touch, weak radial pulse, BP 64/40 mmHg, RR 28/min, temperature man-
89% RA. VTach changed to VFib. agement
The pt has ROSC and is not able to follow commands.
Which immediate post-cardiac arrest care interven-
tion do you choose for this pt?
15. (SET) A 45YO man had coronary stents placed 2 days Performed syn-
ago. Today he is in severe distress and is reporting chronized car-
"crushing" chest discomfort. Pale, diaphoretic, cool to dioversion
touch, weak radial pulse, BP 64/40 mmHg, RR 28/min,
89% RA. VTach changed to VFib.
Which would you have done first if the pt had not gone
into VFib?
16. How can you increase chest compression fraction Charge the defib
during a code? 15s before con-
ducting a rhythm
check
17. A team member is unable to perform an assigned task Ask for a new task
because it is beyond the team member's scope of or role
practice. Which action should the team member take?
18. In addition to clinical assessment, which is the most Continuous wave-
reliable method to confirm and monitor correct place- form capnography
ment of the ET tube?
19. Your pt is in cardiac arrest and has been intubated. To Monitor the pt's
assess CPR quality, which should you do? PETCO2
20. Three minutes into a cardiac arrest resuscitation at- Chest compres-
tempt, one member of your team inserts an ET tube sions may not be
while another performs chest compressions. Capnog- effective
raphy shows a persistent waveform and a PETCO2 of
8mmHg. Which is the significance of this finding?
21.
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If a team member is about to make a mistake during a Address the team
resuscitation attempt, which best describes the action member immedi-
that the Team Leader or other team members should ately
take?
22. A pt in stable narrow-complex tachycardia with a pe- 12mg
ripheral IV in place is refractory to the first dose of
adenosine. Which dose would you administer next?
23. Which is the primary purpose of a medical emergency Improving pt out-
team or rapid response team? comes by identi-
fying and treating
early clinical dete-
rioration
24. A pt is being resuscitated in a very noisy environment. "I have an order
A team member thinks he heard an order for 500mg to give 500mg of
of amiodarone IV. Which is the best response from the amiodarone. Is this
team member? correct?"
25. Which is the recommended oral dose of aspirin for a 162-325mg
pt with a suspected acute coronary syndrome?
26. What is the minimal SBP one should attempt to 90 mmHg
achieve with fluid administration or vasoactive agents
in a hypotensive post-cardiac arrest pt who achieves
spontaneous circulation?
27. What should be the primary focus of the CPR Coach To ensure
on a resuscitation team? high-quality CPR
28. (SET) A 68YO woman presents with light-headedness, Adult Tachycardia
nausea and chest discomfort. Your assessment finds With a Pulse
her awake and responsive but appearing ill, pale and
grossly diaphoretic. Weak, thready, fast radial pulse.
Unable to obtain BP. No obvious dependent edema,
flat neck veins. Her lung sounds are equal, with mod-
erate rales bilaterally.
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On the basis of this pt's initial assessment, which
ACLS algorithm should you follow?
29. (SET) A 68YO woman presents with light-headedness, Apply oxygen
nausea and chest discomfort. Your assessment finds
her awake and responsive but appearing ill, pale and
grossly diaphoretic. Weak, thready, fast radial pulse.
Unable to obtain BP. No obvious dependent edema,
flat neck veins. Her lung sounds are equal, with mod-
erate rales bilaterally.
The pt's pulse ox shows a reading of 84% on room air.
Which initial action should you take?
30. (SET) A 68YO woman presents with light-headedness, Synchronized car-
nausea and chest discomfort. Your assessment finds dioversion
her awake and responsive but appearing ill, pale and
grossly diaphoretic. Weak, thready, fast radial pulse.
Unable to obtain BP. No obvious dependent edema,
flat neck veins. Her lung sounds are equal, with mod-
erate rales bilaterally.
After your initial assessment of this pt, which inter-
vention should be performed next?
31. (SET) A 68YO woman presents with light-headedness, Perform defibrilla-
nausea and chest discomfort. Your assessment finds tion
her awake and responsive but appearing ill, pale and
grossly diaphoretic. Weak, thready, fast radial pulse.
Unable to obtain BP. No obvious dependent edema,
flat neck veins. Her lung sounds are equal, with mod-
erate rales bilaterally.
If the pt became apneic and pulseless but the rhythm
remained the same, which would take the highest pri-
ority?
32. You instruct a team member to give 1mg atropine IV. "I'll draw up 1mg of
Which response is an example of closed-loop commu- atropine."
nication?
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33. Which best describes an action taken by the Team Clearly delegate
Leader to avoid inefficiencies during a resuscitation tasks
attempt?
34. What is an effect of excessive ventilation? Decreased car-
diac output
35. Which best describes the length of time it should take 5-10 seconds
to perform a pulse check during the BLS assessment?
36. Which is the recommended FIRST IV dose of amio- 300mg
darone for a patient with refractory VFib?
37. Which facility is the most appropriate EMS destina- Coronary reperfu-
tion for a pt with sudden cardiac arrest who achieved sion-capable med-
ROSC in the field? ical center
38. A pt has a witnessed LOC. The lead II ECG reveals this Defibrillation
rhythm (VFib). Which is the appropriate treatment?
39. For STEMI pt's, which best describes the recommend- 90 minutes
ed maximum goal time for first medical contact-to-bal-
loon inflation time for PCI?
40. You are performing chest compressions during an 100-120/min
adult resuscitation attempt. Which rate should you
use to perform the compressions?
41. Which is the maximum interval you should allow for 10 seconds
an interruption in chest compressions?
42. To properly ventilate a pt with a perfusing rhythm, how Once every 6 sec-
often do you squeeze the bag? onds
43. EMS providers are treating a pt with a suspected Provide prehospi-
stroke. According to the Adult Suspected Stroke Al- tal notification
gorithm, which critical action performed by the EMS
team will expedite this pt's care on arrival and reduce
the time to treatment?
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44. What is the recommended range from which a temper- 32C to 36C
ature should be selected and maintained constantly
to achieve targeted temperature management after
cardiac arrest?
45. A responder is caring for a pt with a history of CHF. Unstable SVT
The pt is experiencing shortness of breath, a BP of
68/50 mmHg, and a HR of 190/min. The pt's lead II ECG
is displayed.
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