ACLS 2015 to 2020 Study Guide
1. Which of the following statements about about the science of CPR is NOT correct in regards to the 2015
AHA guidelines?
a) a rate of 100 to 120 chest compressions per minute
b) a compression depth of at least 2 inches in adults?
c) switch compressor about every 5 minutes
d) chest compression fraction of at least 60% but ideally greater than 80 %
e) allow complete chest recoil after each compression: c - switch compressor about every 2 minutes or sooner if
fatigued
page 173
2. When administering epinephrine to a patient in cardiac arrest, the MAIN desired effect is:·
A: vasoconstriction, which improves coronary and cerebral perfusion.·
B: beta-1 receptor stimulation, which increases cardiac contractility.· C: coro- nary artery dilation, which decreas
the myocardial workload.·
D: bronchodilation, which facilitates positive-pressure ventilation.: answer is A;
Reason: Epinephrine stimulates alpha and beta receptors. However, it is used during cardiac arrest because of its
vasopressor effects that result from stimulation of alpha-1 receptors. In conjunction with high-quality CPR, epinephrine's
vasoconstric- tive effects improve coronary and cerebral perfusion, thus keeping these organs viable until the underlying
cardiac dysrhythmia can be terminated
3. A 54-year-old woman is pulseless and apneic. Your partner and an emer- gency medical responder are
performing well-coordinated CPR. After 2 min- utes of CPR, the cardiac monitor reveals coarse ventricular
fibrillation. You should:·
A: deliver a single shock and immediately resume CPR.·
B: shock the patient three times with 360 monophasic joules.· C: defibrillate at once and then
reassess the rhythm and pulse.·
D: assess for a carotid pulse for no longer than 10 seconds.: answer is A; Reason: A single shock (360 monophasic
joules or the biphasic equivalent) should be administered to the patient with V-Fib or pulseless V-Tach cardiac arrest.
Imme- diately following this single shock, begin or resume CPR, starting with chest com- pressions. Assessing the
patient's cardiac rhythm and pulse immediately following defibrillation causes an unnecessary delay in CPR, and delays
in CPR have been directly linked to poor patient outcomes. Most patients who are defibrillated—espe- cially if their
arrest interval is prolonged—remain in V-Fib/pulseless V-Tach or convert to another non-perfusing rhythm (ie, asystole,
PEA). Either way, the patient is still in cardiac arrest and needs immediate CPR. After 2 minutes of CPR, reassess the
, ACLS 2015 to 2020 Study Guide
patient's rhythm, and if necessary, a pulse (if an organized cardiac rhythm appears), and repeat defibrillation (single shock
if indicated, followed immediately by CPR.
4. Your first action after establishing return of spontaneous circulation (ROSC) in a patient—regardless of his or
her arrest rhythm and duration—is to assess the patient's .
a) ventilatory status
b) cardiac status
c) level of consciousness
d) none of the above: Answer is A
Your first action after establishing return of spontaneous circulation (ROSC) in a patient—regardless of his or her
arrest rhythm and duration—is to assess the patient's ventilatory status.
5. During the cycles of CPR, vascular access can be ob- tained, cardiac drugs
can be administered, and the patient's airway can be se- cured with an advanced device if necessary. It is
absolutely critical to minimize interruptions in chest compressions; if you must interrupt compressions, do so for
no longer than seconds.
a) 2 minute; 10 seconds
b) 4 minute; 15 seconds
c) 6 minute; 10 seconds
d) immediate obtain vascular access; 15 seconds: During the 2-minute cycles of CPR, vascular access can be
obtained, cardiac drugs can be administered, and the patient's airway can be secured with an advanced device if
necessary. It is absolutely critical to minimize interruptions in chest compressions; if you must interrupt compressions,
do so for no longer than 10 seconds.
6. More than 500,000 deaths occur each year as the result of acute myocardial infarction (AMI). Sixty to seventy
percent of these deaths occur outside the hospital, usually during the after the onset of symptoms.
Of all deaths from AMI, 90% are due to dysrhythmias—usually ventricular fibrillation—which typically occur
during the early hours of the infarct; this should be the paramedic's primary concern.
a) first thirty minutes
b) first few hours
c) first 12 hours
d) first 1 to 2 days: Answer is b
More than 500,000 deaths occur each year as the result of acute myocardial infarction (AMI). Sixty to seventy percent of
these deaths occur outside the hospital,
, ACLS 2015 to 2020 Study Guide
usually during the first few hours after the onset of symptoms. Of all deaths from AMI, 90% are due to dysrhythmias—
usually ventricular fibrillation—which typically occur during the early hours of the infarct; this should be the paramedic's
primary concern.
7. This drug stimulates alpha and beta receptors. However, it is used during cardiac arrest because of its
vasopressor effects that result from stimulation of alpha-1 receptors. In conjunction with high-quality CPR, this
drug's vaso- constrictive effects improve coronary and cerebral perfusion, thus keeping these organs viable until
the underlying cardiac dysrhythmia can be terminat- ed
a) atropine
b) dopamine
c) epinephrine
d) bicarbonate: answer c
Epinephrine stimulates alpha and beta receptors. However, it is used during cardiac arrest because of its vasopressor effec
that result from stimulation of alpha-1 re- ceptors. In conjunction with high-quality CPR, epinephrine's vasoconstrictive
effects improve coronary and cerebral perfusion, thus keeping these organs viable until the underlying cardiac dysrhythm
can be terminated
8. What is the IO dose of epinephrine in adult cardiac arrest resuscitation?: - Answer: IV/IO dose 1 mg (10 mL of
1:10,000 solution) administered every 3 to 5 minutes during resuscitation.
page 171 ACLS Provider Manual 2015)
9. Which of the following statements is NOT true regarding Dopamine in ACLS protocols?
a) First line drug for symptomatic sinus bradycardia
b) given after atropine as a second-line drug for symptomatic bradycardia
c) use for hypotension (systolic blood pressure =/<70 to 100 mm Hg) with signs and symptoms of shock
d) usual infusion rate is 2 to 20 mcg/kg per minute; titrate to patient responses; taper slowly
e) do not mix with sodium bicarbonate: Answer is a
- Dopamine is a second-line drug for symptomatic bradycardia after atropine. (page 171 ACLS manual 2015)
10.Precautions that the ACLS provider should consider when using Dopamine include all of the
following except?
1. Which of the following statements about about the science of CPR is NOT correct in regards to the 2015
AHA guidelines?
a) a rate of 100 to 120 chest compressions per minute
b) a compression depth of at least 2 inches in adults?
c) switch compressor about every 5 minutes
d) chest compression fraction of at least 60% but ideally greater than 80 %
e) allow complete chest recoil after each compression: c - switch compressor about every 2 minutes or sooner if
fatigued
page 173
2. When administering epinephrine to a patient in cardiac arrest, the MAIN desired effect is:·
A: vasoconstriction, which improves coronary and cerebral perfusion.·
B: beta-1 receptor stimulation, which increases cardiac contractility.· C: coro- nary artery dilation, which decreas
the myocardial workload.·
D: bronchodilation, which facilitates positive-pressure ventilation.: answer is A;
Reason: Epinephrine stimulates alpha and beta receptors. However, it is used during cardiac arrest because of its
vasopressor effects that result from stimulation of alpha-1 receptors. In conjunction with high-quality CPR, epinephrine's
vasoconstric- tive effects improve coronary and cerebral perfusion, thus keeping these organs viable until the underlying
cardiac dysrhythmia can be terminated
3. A 54-year-old woman is pulseless and apneic. Your partner and an emer- gency medical responder are
performing well-coordinated CPR. After 2 min- utes of CPR, the cardiac monitor reveals coarse ventricular
fibrillation. You should:·
A: deliver a single shock and immediately resume CPR.·
B: shock the patient three times with 360 monophasic joules.· C: defibrillate at once and then
reassess the rhythm and pulse.·
D: assess for a carotid pulse for no longer than 10 seconds.: answer is A; Reason: A single shock (360 monophasic
joules or the biphasic equivalent) should be administered to the patient with V-Fib or pulseless V-Tach cardiac arrest.
Imme- diately following this single shock, begin or resume CPR, starting with chest com- pressions. Assessing the
patient's cardiac rhythm and pulse immediately following defibrillation causes an unnecessary delay in CPR, and delays
in CPR have been directly linked to poor patient outcomes. Most patients who are defibrillated—espe- cially if their
arrest interval is prolonged—remain in V-Fib/pulseless V-Tach or convert to another non-perfusing rhythm (ie, asystole,
PEA). Either way, the patient is still in cardiac arrest and needs immediate CPR. After 2 minutes of CPR, reassess the
, ACLS 2015 to 2020 Study Guide
patient's rhythm, and if necessary, a pulse (if an organized cardiac rhythm appears), and repeat defibrillation (single shock
if indicated, followed immediately by CPR.
4. Your first action after establishing return of spontaneous circulation (ROSC) in a patient—regardless of his or
her arrest rhythm and duration—is to assess the patient's .
a) ventilatory status
b) cardiac status
c) level of consciousness
d) none of the above: Answer is A
Your first action after establishing return of spontaneous circulation (ROSC) in a patient—regardless of his or her
arrest rhythm and duration—is to assess the patient's ventilatory status.
5. During the cycles of CPR, vascular access can be ob- tained, cardiac drugs
can be administered, and the patient's airway can be se- cured with an advanced device if necessary. It is
absolutely critical to minimize interruptions in chest compressions; if you must interrupt compressions, do so for
no longer than seconds.
a) 2 minute; 10 seconds
b) 4 minute; 15 seconds
c) 6 minute; 10 seconds
d) immediate obtain vascular access; 15 seconds: During the 2-minute cycles of CPR, vascular access can be
obtained, cardiac drugs can be administered, and the patient's airway can be secured with an advanced device if
necessary. It is absolutely critical to minimize interruptions in chest compressions; if you must interrupt compressions,
do so for no longer than 10 seconds.
6. More than 500,000 deaths occur each year as the result of acute myocardial infarction (AMI). Sixty to seventy
percent of these deaths occur outside the hospital, usually during the after the onset of symptoms.
Of all deaths from AMI, 90% are due to dysrhythmias—usually ventricular fibrillation—which typically occur
during the early hours of the infarct; this should be the paramedic's primary concern.
a) first thirty minutes
b) first few hours
c) first 12 hours
d) first 1 to 2 days: Answer is b
More than 500,000 deaths occur each year as the result of acute myocardial infarction (AMI). Sixty to seventy percent of
these deaths occur outside the hospital,
, ACLS 2015 to 2020 Study Guide
usually during the first few hours after the onset of symptoms. Of all deaths from AMI, 90% are due to dysrhythmias—
usually ventricular fibrillation—which typically occur during the early hours of the infarct; this should be the paramedic's
primary concern.
7. This drug stimulates alpha and beta receptors. However, it is used during cardiac arrest because of its
vasopressor effects that result from stimulation of alpha-1 receptors. In conjunction with high-quality CPR, this
drug's vaso- constrictive effects improve coronary and cerebral perfusion, thus keeping these organs viable until
the underlying cardiac dysrhythmia can be terminat- ed
a) atropine
b) dopamine
c) epinephrine
d) bicarbonate: answer c
Epinephrine stimulates alpha and beta receptors. However, it is used during cardiac arrest because of its vasopressor effec
that result from stimulation of alpha-1 re- ceptors. In conjunction with high-quality CPR, epinephrine's vasoconstrictive
effects improve coronary and cerebral perfusion, thus keeping these organs viable until the underlying cardiac dysrhythm
can be terminated
8. What is the IO dose of epinephrine in adult cardiac arrest resuscitation?: - Answer: IV/IO dose 1 mg (10 mL of
1:10,000 solution) administered every 3 to 5 minutes during resuscitation.
page 171 ACLS Provider Manual 2015)
9. Which of the following statements is NOT true regarding Dopamine in ACLS protocols?
a) First line drug for symptomatic sinus bradycardia
b) given after atropine as a second-line drug for symptomatic bradycardia
c) use for hypotension (systolic blood pressure =/<70 to 100 mm Hg) with signs and symptoms of shock
d) usual infusion rate is 2 to 20 mcg/kg per minute; titrate to patient responses; taper slowly
e) do not mix with sodium bicarbonate: Answer is a
- Dopamine is a second-line drug for symptomatic bradycardia after atropine. (page 171 ACLS manual 2015)
10.Precautions that the ACLS provider should consider when using Dopamine include all of the
following except?
