ACLS Prep: ECG
Final Test Review (Qns & Ans)
2025
1. Ventricular Fibrillation Recognition
A 62‐year‐old male collapses in the emergency department. The
monitor displays a chaotic, irregular waveform with no
identifiable QRS complexes or organized deflections. Which
rhythm is most consistent with this description?
A) Ventricular tachycardia
B) Pulseless electrical activity
C) Ventricular fibrillation
D) Asystole
©2025
, ANS: C
Rationale: Ventricular fibrillation is characterized by chaotic,
disorganized electrical activity with no clear QRS complexes. It is
a shockable rhythm representing instantaneous, ineffective
myocardial contractions.
---
2. Asystole Identification
During a code, the ECG monitor shows a near-flatline with only
occasional small, irregular deflections that do not represent
organized activity. What is the most appropriate identification of
this rhythm?
A) Ventricular fibrillation
B) Asystole
C) Pulseless electrical activity
D) Bradycardia
ANS: B
Rationale: Asystole consists of an almost complete absence of
electrical activity (a flatline) on the monitor, not to be confused
with PEA, where organized electrical activity may be present
despite the absence of a palpable pulse.
©2025
,---
3. Pulseless Electrical Activity (PEA)
After defibrillation attempts, a patient remains unresponsive while
the monitor shows organized electrical activity and a regular
rhythm. However, no pulse is palpable. This best describes:
A) Ventricular tachycardia
B) Pulseless electrical activity (PEA)
C) Asystole
D) Artifact
ANS: B
Rationale: PEA is defined as organized electrical activity on
the monitor without a corresponding effective mechanical
contraction resulting in a palpable pulse.
---
4. Monomorphic Ventricular Tachycardia
©2025
, A 55‐year‐old patient with ischemic heart disease shows a regular,
wide complex tachycardia at a rate of 150 bpm on the monitor
with no visible P waves. Which rhythm does this represent?
A) Supraventricular tachycardia with aberrancy
B) Monomorphic ventricular tachycardia
C) Polymorphic ventricular tachycardia
D) Accelerated idioventricular rhythm
ANS: B
Rationale: A regular, wide complex tachycardia with uniform
QRS morphology and no P waves is most consistent with
monomorphic VT, often related to scar tissue from previous MI.
---
5. Polymorphic Ventricular Tachycardia (Torsades de
Pointes)
During resuscitation, the monitor shows a wide complex
tachycardia with a twisting QRS axis and varying amplitudes.
Which rhythm is this?
A) Ventricular fibrillation
B) Polymorphic ventricular tachycardia (Torsades de pointes)
©2025
Final Test Review (Qns & Ans)
2025
1. Ventricular Fibrillation Recognition
A 62‐year‐old male collapses in the emergency department. The
monitor displays a chaotic, irregular waveform with no
identifiable QRS complexes or organized deflections. Which
rhythm is most consistent with this description?
A) Ventricular tachycardia
B) Pulseless electrical activity
C) Ventricular fibrillation
D) Asystole
©2025
, ANS: C
Rationale: Ventricular fibrillation is characterized by chaotic,
disorganized electrical activity with no clear QRS complexes. It is
a shockable rhythm representing instantaneous, ineffective
myocardial contractions.
---
2. Asystole Identification
During a code, the ECG monitor shows a near-flatline with only
occasional small, irregular deflections that do not represent
organized activity. What is the most appropriate identification of
this rhythm?
A) Ventricular fibrillation
B) Asystole
C) Pulseless electrical activity
D) Bradycardia
ANS: B
Rationale: Asystole consists of an almost complete absence of
electrical activity (a flatline) on the monitor, not to be confused
with PEA, where organized electrical activity may be present
despite the absence of a palpable pulse.
©2025
,---
3. Pulseless Electrical Activity (PEA)
After defibrillation attempts, a patient remains unresponsive while
the monitor shows organized electrical activity and a regular
rhythm. However, no pulse is palpable. This best describes:
A) Ventricular tachycardia
B) Pulseless electrical activity (PEA)
C) Asystole
D) Artifact
ANS: B
Rationale: PEA is defined as organized electrical activity on
the monitor without a corresponding effective mechanical
contraction resulting in a palpable pulse.
---
4. Monomorphic Ventricular Tachycardia
©2025
, A 55‐year‐old patient with ischemic heart disease shows a regular,
wide complex tachycardia at a rate of 150 bpm on the monitor
with no visible P waves. Which rhythm does this represent?
A) Supraventricular tachycardia with aberrancy
B) Monomorphic ventricular tachycardia
C) Polymorphic ventricular tachycardia
D) Accelerated idioventricular rhythm
ANS: B
Rationale: A regular, wide complex tachycardia with uniform
QRS morphology and no P waves is most consistent with
monomorphic VT, often related to scar tissue from previous MI.
---
5. Polymorphic Ventricular Tachycardia (Torsades de
Pointes)
During resuscitation, the monitor shows a wide complex
tachycardia with a twisting QRS axis and varying amplitudes.
Which rhythm is this?
A) Ventricular fibrillation
B) Polymorphic ventricular tachycardia (Torsades de pointes)
©2025
