ACLS FINAL EXAM WITH VERIFIED ANSWERS
Which of the following statements about the use of magnesium in cardiac arrest is
most accurate? - ANSWER Magnesium is indicated for VF/pulseless VT associated
with torsades de pointes.
A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic
therapy has
been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion
of 1000 units per hour is
being administered. Aspirin was not taken by the patient because he had a history of
gastritis treated 5 years
ago. Your next action is to: - ANSWER Give aspirin 160 to 325 mg chewed
immediately.
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been
administered to a
total of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is
confused, and her blood pressure
is 110/60 mm Hg. Which of the following is now indicated? - ANSWER Start
epinephrine 2 to 10 mcg/min.
A 62-year-old man suddenly experienced difficulty speaking and left-side weakness.
He was
brought to the emergency department. He meets initial criteria for fibrinolytic therapy,
and a CT scan of the
brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy -
ANSWER Do not give aspirin for at least 24 hours if rtPA is administered
A patient with possible ST-segment elevation MI has ongoing chest discomfort.
Which of the
following would be a contraindication to the administration of nitrates? - ANSWER
Use of a phosphodiesterase inhibitor within 12 hours
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second
shock. Of the
following, which drug and dose should be administered first by the IV/IO route? -
ANSWER Epinephrine 1 mg
: A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia.
The monitor
shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have
not been effective in
terminating the rhythm. An IV has been established. What drug should be
administered IV? - ANSWER Adenosine 6 mg
A patient with sinus bradycardia and heart rate of 42/min has diaphoresis and a
blood pressure of
80/60 mm Hg. What is the initial dose of atropine? - ANSWER 0.5 mg
, A patient is in refractory ventricular fibrillation and has received multiple appropriate
defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg
amiodarone IV. The patient is
intubated. A second dose of amiodarone is now called for. The recommended
second dose of amiodarone is - ANSWER 150 mg IV push
A patient with a possible acute coronary syndrome has ongoing chest discomfort
unresponsive to
3 sublingual nitroglycerin tablets. There are no contraindications, and 4 mg of
morphine sulfate was
administered. Shortly afterward, blood pressure falls to 88/60 mm Hg, and the
patient has increased chest
discomfort. You should - ANSWER Give normal saline 250 mL to 500 mL fluid bolus
A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is
138/min. He is
asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina.
Which of the following actions is recommended? - ANSWER Seeking expert
consultation
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, your next action is to - ANSWER Gain IV or IO access
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of
epinephrine have been
given. Which is the next drug/dose to anticipate to administer - ANSWER
Amiodarone 300 mg
Your patient has been intubated. IV/IO access is not available. Which combination of
drugs can
be administered by the endotracheal route - ANSWER Lidocaine, epinephrine,
vasopressin
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial
shock. What
is the recommended route for drug administration during CPR? - ANSWER iv.oi
A patient is in refractory ventricular fibrillation. High-quality CPR is in progress, and
shocks have
been given. One dose of epinephrine was given after the second shock. An
antiarrhythmic drug was given
immediately after the third shock. What drug should the team leader request to be
prepared for administration
next? - ANSWER Second dose of epinephrine 1 mg
A 57-year-old woman has palpitations, chest discomfort, and tachycardia. The
monitor shows a
Which of the following statements about the use of magnesium in cardiac arrest is
most accurate? - ANSWER Magnesium is indicated for VF/pulseless VT associated
with torsades de pointes.
A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic
therapy has
been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion
of 1000 units per hour is
being administered. Aspirin was not taken by the patient because he had a history of
gastritis treated 5 years
ago. Your next action is to: - ANSWER Give aspirin 160 to 325 mg chewed
immediately.
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been
administered to a
total of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is
confused, and her blood pressure
is 110/60 mm Hg. Which of the following is now indicated? - ANSWER Start
epinephrine 2 to 10 mcg/min.
A 62-year-old man suddenly experienced difficulty speaking and left-side weakness.
He was
brought to the emergency department. He meets initial criteria for fibrinolytic therapy,
and a CT scan of the
brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy -
ANSWER Do not give aspirin for at least 24 hours if rtPA is administered
A patient with possible ST-segment elevation MI has ongoing chest discomfort.
Which of the
following would be a contraindication to the administration of nitrates? - ANSWER
Use of a phosphodiesterase inhibitor within 12 hours
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second
shock. Of the
following, which drug and dose should be administered first by the IV/IO route? -
ANSWER Epinephrine 1 mg
: A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia.
The monitor
shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have
not been effective in
terminating the rhythm. An IV has been established. What drug should be
administered IV? - ANSWER Adenosine 6 mg
A patient with sinus bradycardia and heart rate of 42/min has diaphoresis and a
blood pressure of
80/60 mm Hg. What is the initial dose of atropine? - ANSWER 0.5 mg
, A patient is in refractory ventricular fibrillation and has received multiple appropriate
defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg
amiodarone IV. The patient is
intubated. A second dose of amiodarone is now called for. The recommended
second dose of amiodarone is - ANSWER 150 mg IV push
A patient with a possible acute coronary syndrome has ongoing chest discomfort
unresponsive to
3 sublingual nitroglycerin tablets. There are no contraindications, and 4 mg of
morphine sulfate was
administered. Shortly afterward, blood pressure falls to 88/60 mm Hg, and the
patient has increased chest
discomfort. You should - ANSWER Give normal saline 250 mL to 500 mL fluid bolus
A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is
138/min. He is
asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina.
Which of the following actions is recommended? - ANSWER Seeking expert
consultation
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, your next action is to - ANSWER Gain IV or IO access
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of
epinephrine have been
given. Which is the next drug/dose to anticipate to administer - ANSWER
Amiodarone 300 mg
Your patient has been intubated. IV/IO access is not available. Which combination of
drugs can
be administered by the endotracheal route - ANSWER Lidocaine, epinephrine,
vasopressin
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial
shock. What
is the recommended route for drug administration during CPR? - ANSWER iv.oi
A patient is in refractory ventricular fibrillation. High-quality CPR is in progress, and
shocks have
been given. One dose of epinephrine was given after the second shock. An
antiarrhythmic drug was given
immediately after the third shock. What drug should the team leader request to be
prepared for administration
next? - ANSWER Second dose of epinephrine 1 mg
A 57-year-old woman has palpitations, chest discomfort, and tachycardia. The
monitor shows a
