ACLS Final Test | American Heart Association Standards Aligned | 2026/2027 Update | Questions and Correct Answers | 100 out of 100

1 /3 ACLS Final Test | American Heart Association Standards Aligned | 2026/2027 Update | Questions and Correct Answers | 100 out of 100 1. Which type of atrioventricular block best describes this rhythm? C) Second-degree type II 2. Your patient is in cardiac arrest and has been intubated. To assess CPR quality, which should you do? A) Monitor the patient's PETCO2 3. Which facility is the most appropriate EMS destination for a patient with sudden cardiac who achieved return of spontaneous circulation in the field? D) Coronary reperfusion-capable medical center 4. Which of the following signs is a likely indicator of cardiac arrest in an unresponsive patient? C) Agonal gasps 5. Which type of atrioventricular block best describes this rhythm? B) Second-degree atrioventricular block type I 6. To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag? B) Once every 5 to 6 seconds. 7. In addition to clinical assessment, which is the most reliable method to confirm and monitor correct placement of an endotracheal tube? C) Continuous waveform capnography 8. You are caring for a patient with a suspected stroke whose symptoms started 2 hours ago. The CT scan was normal, with no signs of hemorrhage. The patient does not have any contraindications to fibrinolytic therapy. Which treatment is the best for this patient? B) Start fibrinolytic therapy as soon as possible. 9. Which best describes this rhythm? D) Third-degree atrioventricular block. 10. What is the recommended range from which a temperature should be selected and maintained constantly to achieve targeted temperature management after cardiac arrest? C) 32 to 36 Degrees Celsius 11. Which is the recommended first intravenous dose of amiodarone for a patient with refractory ventricular fibrillation? D) 300 mg 12. What is the primary of a medical emergency team or B) Improving patient outcomes by identifying and treating early clinical deterioration. rapid response team? 13. What is the recommended next step after a defibrillation attempt? D) Resume CPR, starting with chest compressions 14. EMS providers are treating a patient with suspected stroke. According to the Adult Suspected Stroke Algorithm, which critical action performed by the EMS team will expedite this patient's care on arrival and reduce the time to treatment? A) Alert the hospital. 15. 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 mmHg, and a heart rate of 190/min. The patient's lead II ECG is displayed here. Which best characterizes this patient's rhythm? D) Unstable supraventricular tachycardia 2 /3 16. Your rescue team arrives to find a 59-year-old man lying on the kitchen floor. You determine that he is unresponsive. Which is the next step in your assessment and management of this patient? B) Check the patient's breathing and pulse. 17. Which best describes the length of time it should take to perform a pulse check during the BLS assessment? B) 5 to 10 seconds 18. You instruct a team member to give 1 mg Atropine IV. Which is the best example of closed-loop communication? C) I'll draw up 1 mg of Atropine. 19. What is an effect of excessive ventilation? A) Decreased cardiac output. 20. If a team member is about to make a mistake during a resuscitation attempt, which best describes the action that the team leader or other team members should take? C) Address the team members immediately. 21. Which best describes this rhythm? A) Monomorphic ventricular tachycardia. 22. For STEMI patient, which best describes the recommended maximum goal time for emergency department door-to-balloon inflation time for percutaneous coronary intervention? D) 90 minutes. 23. Which is the maximum interval you should allow for an interruption in chest compressions? A) 10 seconds. 24. Which is the one way to minimize interruptions in chest compressions during CPR? D) Continue CPR while the defibrillator charges. 25. Which best describes an action taken by the team leader to avoid insufficiencies during a resuscitation attempt? C) Clearly delegate tasks. 26. Which is an acceptable method of selecting an appropriately sized oropharyngeal airway? A) Measure the corner of the mouth to the angle of the mandible. 27. You are evaluating a 58-year-old man with chest discomfort. His blood pressure is 92/50 mm Hg, his heart rate is 92/min, his nonlabored respiratory rate is 14 breaths/min, and his pulse oximetry reading is 97%. Which assessment step is most important now? C) Obtaining a 12-lead ECG. 28. A patient in respiratory distress and with a blood pressure of 70/50 mmHg presents with the lead IIECG rhythm shown here. Which is the appropriate treatment? B) Performing synchronized cardioversion. 29. During post-cardiac arrest care, which is the recommended duration of targeted temperature management after reaching the correct temperature range? B) At least 24 hours. 30. Three minutes into a cardiac resuscitation attempt, one member of your team inserts an endotracheal tube while another performs chest compressions. Capnography shows a persistent waveform and a PETCO2 of 8 mmHg. Which is the significance of this finding? A) Chest compressions may not be effective. 31. Which is the recommended oral dose of aspirin for a patient with a suspected acute coronary syndrome? C) 160 to 325 mg. 32. A team member is unable to perform an assigned task because it is beyond the team member's scope of practice. Which action should the team member take? A) Ask for a new task or role. 33. As the team leader, when do you tell the chest compressors to switch? B) About every 2 minutes. 3 /3 34. You are performing chest compressions during an adult resuscitation attempt. Which rate should you use to perform the compressions? C) 100 to 120/min. 35. A patient is being resuscitated in a very noisy environment. A team member thinks he heard an order for 500 mg of amiodarone IV. Which is the best response? D) I have an order to give 500 mg of amiodarone IV. 36. A patient in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the first dose of adenosine. Which dose would you administer next? B) 12 mg. 37. A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm. Which is the appropriate treatment? C) Defibrillation 38. Which of these tests should be performed for a patient with suspected stroke within 25 minutes of hospital arrival? D) Noncontrast CT scan of the head. 39. What is the minimum systolic blood pressure one should attempt to achieve with fluid administration or vasoactive agents in a hypotensive post-cardiac arrest patient who achieves return of spontaneous circulation? D) 90 mm Hg. 40. You have completed 2 minutes of CPR. The ECG monitor displays the lead II rhythm shown here, and the patient has no pulse. Another member of your team resumes chest compressions, and an IV is in place. What do you do next? C) Give epinephrine 1 mg IV. 41. Based on this patient's initial presentation, which condition do you suspect led to the cardiac arrest? A) Acute Coronary Syndrome. 42. In addition to defibrillation, which intervention should be performed immediately? C) Chest Compressions. 43. Despite 2 Defibrillation attempts, the patient remains in ventricular fibrillation. Which drug and dose should you administer first to this patient? A) Epinephrine 1 mg. 44. Despite the drug provided above and continued CPR, the patient remains in ventricular fibrillation. Which other drug should be administered next? D) Amiodarone 300 mg. 45. The patient has return of spontaneous circulation and is not able to follow commands. Which immediate post- cardiac arrest care intervention do you choose for this patient? A) Initiate targeted temperature management. 46. Which would you have done first if the patient had not gone into ventricular fibrillation? D) Performed synchronized cardioversion. 47. Based on this patient's initial assessment, which adult ACLS algorithm should you follow? B) Tachycardia. 48. The patient's pulse oximeter shows a reading of 84% on room air. Which initial action do you take? C) Apply oxygen. 49. After your initial assessment of this patient, which intervention should be performed next? A) Synchronized cardioversion. 50. If the patient became apneic and pulseless but the rhythm remained the same, which would take the highest priority? D) Perform defibrillation. 1 /4 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? Start chest compressions at a rate of at least 100/min. 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? Obtaining a 12-lead ECG What is the preferred method of access for epinephrine administration during cardiac arrest in most patients? Peripheral intravenous An activated AED does not promptly analyze the rhythm. What is your next action? Begin chest compressions. 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? (strip missing displays a 3rd degree heart block) Administer 1 mg of epinephrine. 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? (strip missing displays tachycardic sinus rhythm) Resume chest compressions. What is a common but sometimes fatal mistake in cardiac arrest management? Prolonged interruptions in chest compressions Which action is a component of high-quality chest compressions? Allowing complete chest recoil Which action increases the chance of successful conversion of ventricular fibrillation? Providing quality compressions immediately before a defibrillation attempt Which situation BEST describes pulseless electrical activity? Sinus rhythm without a pulse What is the BEST strategy for performing high-quality CPR on a patient with an advanced airway in place? Provide continuous chest compressions without pauses and 10 ventilations per minute. Three minutes after witnessing a cardiac arrest, one member of your team inserts an endotracheal tube while another performs continuous chest compressions. During subsequent ventilation, you notice the presence of a waveform on the capnography screen and a PETCO2 level of 8 mm Hg. What is the significance of this finding? Chest compressions may not be effective The use of quantitative capnography in intubated patients allows for monitoring of CPR quality 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? Consider terminating resuscitative efforts after consulting medical control. Which is a safe and effective practice within the defibrillation sequence? Be sure oxygen is not blowing over the patient's chest during the shock. 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? Begin chest compressions. What is an advantage of using hands-free defibrillation pads instead of defibrillation paddles? Hands-free pads allow for a more rapid defibrillation. 2 /4 What action is recommended to help minimize interruptions in chest compressions during CPR? Continue CPR while charging the defibrillator. Which action is included in the BLS Survey? Early defibrillation Which drug and dose are recommended for the management of a patient in refractory ventricular fibrillation? Amiodarone 300 mg What is the appropriate interval for an interruption in chest compressions? 10 seconds or less Which of the following is a sign of effective CPR? PETCO2 ≥10 mm Hg What is the primary purpose of a medical emergency team (MET) or rapid response team (RRT)? Identifying and treating early clinical deterioration Which action improves the quality of chest compressions delivered during a resuscitation attempt? Switch providers about every 2 minutes or every 5 compression cycles. What is the appropriate ventilation strategy for an adult in respiratory arrest with a pulse rate of 80/min? 1 breath every 5 to 6 seconds 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? Atropine 0.5 mg 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? 2 to 10 mcg/kg per minute 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: (strip missing displays Tachycardic sinus rhythm with narrow QRS) Vagal maneuvers A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of 220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38 mm Hg, and the pulse oximetry reading is 98%. There is vascular access at the left internal jugular vein, and the patient has not been given any vasoactive drugs. A 12- lead ECG confirms a supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate has not responded to vagal maneuvers. What is the next recommended intervention? Adenosine 6 mg IV push You are receiving a radio report from an EMS team en route with a patient who may be having an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation? Divert the patient to a hospital 15 minutes away with CT capabilities. Choose an appropriate indication to stop or withhold resuscitative efforts. Evidence of rigor mortis A 49-year-old woman arrives in the emergency department with persistent epigastric pain. She had been taking oral antacids for the past 6 hours because she thought she had heartburn. The initial blood pressure is 118/72 mm Hg, the heart rate is 92/min and regular, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 96%. Which is the most appropriate intervention to perform next? Obtain a 12-lead ECG. 3 /4 A patient in respiratory failure becomes apneic but continues to have a strong pulse. The heart rate is dropping rapidly and now shows a sinus bradycardia at a rate of 30/min. What intervention has the highest priority? Simple airway maneuvers and assisted ventilation What is the appropriate procedure for endotracheal tube suctioning after the appropriate catheter is selected? Suction during withdrawal but for no longer than 10 seconds. 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: (strip missing displays a bradycardic 2nd degree AV block type 2) What is the most appropriate first intervention? Atropine 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? Cincinnati Prehospital Stroke Scale assessment 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? Head CT scan What is the proper ventilation rate for a patient in cardiac arrest who has an advanced airway in place? 8 to 10 breaths per minute 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? Obtain a 12-lead ECG. 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? Synchronized cardioversion What is the initial priority for an unconscious patient with any tachycardia on the monitor? Determine whether pulses are present. Which rhythm requires synchronized cardioversion? Unstable supraventricular tachycardia What is the recommended second dose of adenosine for patients in refractory but stable narrow-complex tachycardia? 12 mg What is the usual post-cardiac arrest target range for PETCO2 when ventilating a patient who achieves return of spontaneous circulation (ROSC)? 35 to 40 mm Hg Which condition is a contraindication to therapeutic hypothermia during the post-cardiac arrest period for patients who achieve return of spontaneous circulation ROSC? Responding to verbal commands What is the potential danger of using ties that pass circumferentially around the patient's neck when securing an advanced airway? Obstruction of venous return from the brain What is the most reliable method of confirming and monitoring correct placement of an endotracheal tube? Continuous waveform capnography 1 /4 What is the recommended IV fluid (normal saline or 1 to 2 L Ringer's lactate) bolus dose for a patient who achieves ROSC but is hypotensive during the post-cardiac arrest period? What is the minimum systolic blood pressure one should 90 mm Hg attempt to achieve with fluid, inotropic, or vasopressor administration in a hypotensive post-cardiac arrest patient who achieves ROSC? What is the first treatment priority for a patient who Optimizing ventilation and oxygenation achieves ROSC?