ACLS PreTest: Pharmacology and
Practical Application
You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage
2 months ago. He is being evaluated for another acute stroke. The CT scan is negative
for hemorrhage. The patient is receiving oxygen via nasal cannula at 2 L/min, and an IV
has been established. His blood pressure is 180/100 mm Hg. Which drug do you
anticipate giving to this patient?
Aspirin
Glucose (D50)
Nicardipiner
tPA - Aspirin
In which situation does bradycardia require treatment?
12-lead ECG showing a normal sinus rhythm
Hypotension
Diastolic blood pressure greater than 90 mm Hg
Systolic blood pressure greater than 100 mm Hg - Hypotension
Which intervention is most appropriate for the treatment of a patient in asystole?
Atropine
Defibrillation
Epinephrine
Transcutaneous pacing - Epinephrine
A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a
heparin infusion of 1000 units per hour are being administered. The patient did not take
aspirin because he has a history of gastritis, which was treated 5 years ago. What is
your next action?
Give aspirin 160 to 325 mg to chew
Give clopidogrel 300 mg orally
Give enteric-coated aspirin 75 mg orally
Give enteric-coated aspirin 325 mg rectally - Give aspirin 160 to 325 mg to chew
, A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One
dose of epinephrine was given after the second shock. An antiarrhythmic drug was
given immediately after the third shock. You are the team leader. Which medication do
you order next?
Epinephrine 1 mg
Epinephrine 3 mg
Sodium bicarbonate 50 mEq
A second dose of the antiarrhythmic drug - Epinephrine 1 mg
A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood
pressure of 80/60 mm Hg. What is the initial dose of atropine?
0.1 mg
0.5 mg
1 mg
3 mg - 0.5 mg
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
in the left arm, 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 your next action?
Administer adenosine 6 mg IV push
Administer amiodarone 300 mg IV push
Perform synchronized cardioversion at 50 J
Perform synchronized cardioversion at 200 J - Administer adenosine 6 mg IV push
You arrive on the scene with the code team. High-quality CPR is in progress. An AED
has previously advised "no shock indicated." A rhythm check now finds asystole. After
resuming high-quality compressions, which action do you take next?
Call for a pulse check
Establish IV or IO access
Insert a laryngeal airway
Perform endotracheal intubation - Establish IV or IO access
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine
have been given. Which drug should be given next?
Practical Application
You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage
2 months ago. He is being evaluated for another acute stroke. The CT scan is negative
for hemorrhage. The patient is receiving oxygen via nasal cannula at 2 L/min, and an IV
has been established. His blood pressure is 180/100 mm Hg. Which drug do you
anticipate giving to this patient?
Aspirin
Glucose (D50)
Nicardipiner
tPA - Aspirin
In which situation does bradycardia require treatment?
12-lead ECG showing a normal sinus rhythm
Hypotension
Diastolic blood pressure greater than 90 mm Hg
Systolic blood pressure greater than 100 mm Hg - Hypotension
Which intervention is most appropriate for the treatment of a patient in asystole?
Atropine
Defibrillation
Epinephrine
Transcutaneous pacing - Epinephrine
A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a
heparin infusion of 1000 units per hour are being administered. The patient did not take
aspirin because he has a history of gastritis, which was treated 5 years ago. What is
your next action?
Give aspirin 160 to 325 mg to chew
Give clopidogrel 300 mg orally
Give enteric-coated aspirin 75 mg orally
Give enteric-coated aspirin 325 mg rectally - Give aspirin 160 to 325 mg to chew
, A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One
dose of epinephrine was given after the second shock. An antiarrhythmic drug was
given immediately after the third shock. You are the team leader. Which medication do
you order next?
Epinephrine 1 mg
Epinephrine 3 mg
Sodium bicarbonate 50 mEq
A second dose of the antiarrhythmic drug - Epinephrine 1 mg
A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood
pressure of 80/60 mm Hg. What is the initial dose of atropine?
0.1 mg
0.5 mg
1 mg
3 mg - 0.5 mg
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
in the left arm, 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 your next action?
Administer adenosine 6 mg IV push
Administer amiodarone 300 mg IV push
Perform synchronized cardioversion at 50 J
Perform synchronized cardioversion at 200 J - Administer adenosine 6 mg IV push
You arrive on the scene with the code team. High-quality CPR is in progress. An AED
has previously advised "no shock indicated." A rhythm check now finds asystole. After
resuming high-quality compressions, which action do you take next?
Call for a pulse check
Establish IV or IO access
Insert a laryngeal airway
Perform endotracheal intubation - Establish IV or IO access
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine
have been given. Which drug should be given next?
