ACLS Final Exam Questions With
100% Pass
/.A patient in cardiac arrest experiences return of spontaneous circulation. As par/t of post-cardiac
arrest care, the patient is receiving mechanical ventilation at an initial rate of 10 breaths/min and a
fraction of inspired oxygen (FiO2) of 0.30. Which finding(s) would indicate the need for change in the
ventilator settings to optimize the patient's ventilation and oxygenation? - Answer-ETCO2 55mmHg
PaCO2 48 mmHg
SaO2 90%
- Mechanical ventilation should be started at a rate of 10 breaths per minute and adjusted as necessary
to keep carbon dioxide levels in physiologic range (PaCO2 between 35 and 45 mmHg or monitored using
ETCO2). The minimum fraction of inspired oxygen necessary to maintain an SaO2 of 94% to 99% is used.
/.A 28-year-old pregnant patient who resides in transitional housing presents to the emergency
department with complaints of feeling feverish and very faint. The patient tells the emergency nurse
that she does not know when she became pregnant. Upon palpation, the fundus is not at or above the
umbilicus. The patient's condition quickly deteriorates and she goes into cardiac arrest. If available and
able to be used without impeding or delaying the resuscitation effort, what diagnostic tool could be
used to guide decision-making in the care of this patient? - Answer-Point of care US
- Gestational age is an important consideration when determining the approach to a pregnant patient in
cardiac arrest. If the gestational age is not known and point-of-care ultrasound is available and able to
be performed without impeding or delaying the resuscitation effort, it can be used to quickly estimate
gestational age and guide decision-making.
/.A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a narrow-complex
supraventricular tachyarrhythmia. The patient is not showing signs of hemodynamic compromise. Which
intervention would be initiated first if it does not delay other interventions? - Answer-Vagal Maneuver
- For a patient who is not showing signs of hemodynamic compromise and is experiencing a narrow-
complex supraventricular tachyarrhythmia, vagal maneuvers are attempted first. If ineffective,
adenosine is given.
, /.A patient is in cardiac arrest. The underlying cause is thought to be opioid toxicity. Which statement
accurately describes the use of naloxone for this patient? - Answer-Naloxone should be administered as
soon as possible but is not a priority over high-quality CPR and AED use.
- High-quality CPR and AED use are the priority interventions for cardiac arrest caused by suspected or
known opioid toxicity. When opioid toxicity is the suspected or known cause of cardiac arrest, naloxone
should be administered as soon as possible without disrupting or delaying high-quality CPR and AED use.
The recommended dose of naloxone is 0.4 to 2 mg IV/IO/IM/IN/SC, repeated every 2 to 3 minutes as
needed. A continuous naloxone infusion may be considered if there is the potential for recurrence of
respiratory depression (for example, if the cause of the opioid toxicity was an extended-release or long-
acting opioid) but is not indicated in the immediate treatment of suspected or known opioid toxicity.
/.For a patient with third-degree atrioventricular (AV) block and a blood pressure of 70/48 mmHg, what
interventions should be considered? - Answer-Atropine
Dopamine infusion
Transcut. Pacing
- For a patient with third-degree atrioventricular (AV) block and signs of hemodynamic compromise,
first-line therapy is with atropine. Second-line therapies include transcutaneous pacing and β-adrenergic
agonists, such as dopamine. Second-line therapies should be considered immediately if the patient has
third-degree AV block. Adenosine is not used in the treatment of bradyarrhythmia.
/.A 20-year-old man with respiratory depression is brought to the emergency department by his
parents. Opioid overdose is suspected, and an initial dose of naloxone is administered at 10 p.m. The
patient does not respond to this initial dose. The team would expect to administer a second dose after
how many minutes? - Answer-2-3 minutes
/.A patient is in cardiac arrest. The cardiac monitor shows asystole. In addition to providing continuous
high-quality CPR, what is the other priority intervention for this patient? - Answer-Administer Epi ASAP
- For cardiac arrest with a nonshockable rhythm, epinephrine (1 mg IV/IO) should be administered as
early as possible and repeated every 3 to 5 minutes. Although inserting an advanced airway may be
considered for this patient, this is not a priority intervention. Defibrillation and amiodarone are not
appropriate interventions for asystole.
100% Pass
/.A patient in cardiac arrest experiences return of spontaneous circulation. As par/t of post-cardiac
arrest care, the patient is receiving mechanical ventilation at an initial rate of 10 breaths/min and a
fraction of inspired oxygen (FiO2) of 0.30. Which finding(s) would indicate the need for change in the
ventilator settings to optimize the patient's ventilation and oxygenation? - Answer-ETCO2 55mmHg
PaCO2 48 mmHg
SaO2 90%
- Mechanical ventilation should be started at a rate of 10 breaths per minute and adjusted as necessary
to keep carbon dioxide levels in physiologic range (PaCO2 between 35 and 45 mmHg or monitored using
ETCO2). The minimum fraction of inspired oxygen necessary to maintain an SaO2 of 94% to 99% is used.
/.A 28-year-old pregnant patient who resides in transitional housing presents to the emergency
department with complaints of feeling feverish and very faint. The patient tells the emergency nurse
that she does not know when she became pregnant. Upon palpation, the fundus is not at or above the
umbilicus. The patient's condition quickly deteriorates and she goes into cardiac arrest. If available and
able to be used without impeding or delaying the resuscitation effort, what diagnostic tool could be
used to guide decision-making in the care of this patient? - Answer-Point of care US
- Gestational age is an important consideration when determining the approach to a pregnant patient in
cardiac arrest. If the gestational age is not known and point-of-care ultrasound is available and able to
be performed without impeding or delaying the resuscitation effort, it can be used to quickly estimate
gestational age and guide decision-making.
/.A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a narrow-complex
supraventricular tachyarrhythmia. The patient is not showing signs of hemodynamic compromise. Which
intervention would be initiated first if it does not delay other interventions? - Answer-Vagal Maneuver
- For a patient who is not showing signs of hemodynamic compromise and is experiencing a narrow-
complex supraventricular tachyarrhythmia, vagal maneuvers are attempted first. If ineffective,
adenosine is given.
, /.A patient is in cardiac arrest. The underlying cause is thought to be opioid toxicity. Which statement
accurately describes the use of naloxone for this patient? - Answer-Naloxone should be administered as
soon as possible but is not a priority over high-quality CPR and AED use.
- High-quality CPR and AED use are the priority interventions for cardiac arrest caused by suspected or
known opioid toxicity. When opioid toxicity is the suspected or known cause of cardiac arrest, naloxone
should be administered as soon as possible without disrupting or delaying high-quality CPR and AED use.
The recommended dose of naloxone is 0.4 to 2 mg IV/IO/IM/IN/SC, repeated every 2 to 3 minutes as
needed. A continuous naloxone infusion may be considered if there is the potential for recurrence of
respiratory depression (for example, if the cause of the opioid toxicity was an extended-release or long-
acting opioid) but is not indicated in the immediate treatment of suspected or known opioid toxicity.
/.For a patient with third-degree atrioventricular (AV) block and a blood pressure of 70/48 mmHg, what
interventions should be considered? - Answer-Atropine
Dopamine infusion
Transcut. Pacing
- For a patient with third-degree atrioventricular (AV) block and signs of hemodynamic compromise,
first-line therapy is with atropine. Second-line therapies include transcutaneous pacing and β-adrenergic
agonists, such as dopamine. Second-line therapies should be considered immediately if the patient has
third-degree AV block. Adenosine is not used in the treatment of bradyarrhythmia.
/.A 20-year-old man with respiratory depression is brought to the emergency department by his
parents. Opioid overdose is suspected, and an initial dose of naloxone is administered at 10 p.m. The
patient does not respond to this initial dose. The team would expect to administer a second dose after
how many minutes? - Answer-2-3 minutes
/.A patient is in cardiac arrest. The cardiac monitor shows asystole. In addition to providing continuous
high-quality CPR, what is the other priority intervention for this patient? - Answer-Administer Epi ASAP
- For cardiac arrest with a nonshockable rhythm, epinephrine (1 mg IV/IO) should be administered as
early as possible and repeated every 3 to 5 minutes. Although inserting an advanced airway may be
considered for this patient, this is not a priority intervention. Defibrillation and amiodarone are not
appropriate interventions for asystole.
