ACLS Exam Questions and Answers 3 Versions A B and C LATEST
UPDATE 2025-2026
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 a
IV has been established. His blood pressure is 180/100 mm Hg. Which drug do you anticipate giving to this patient?
A. aspirin
B. glucose (D50)
C. nicardipine
D. rtPA
A. aspirin
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?
A. 0.1 mg
B. 0.5 mg
C. 1 mg
D. 3 mg
B. 0.5 mg
A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin infusion of 1000 unit 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?
A. give aspirin 160 to 325 mg to chew
B. give clopidogrel 300 mg orally
C. give enteric-coated aspirin 75 mg orally
,D. give enteric-coated aspirin 325 mg rectally
A. give aspirin 160 to 325 mg to chew
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which drug should be
given next?
A. adenosine 6 mg
B. amiodarone 300 mg
C. epinephrine 3 mg
D. lidocaine 0.5 mg/kg
B. amiodarone 300 mg
What is the indication for the us of magnesium in cardiac arrest?
A. ventricular tachycardia associated with a normal QT interval
B. shock-refractory monomorphic ventricular tachycardia C. pulseless ventricular
tachycardia-associated torsades de pointes
D. shock-refractory ventricular fibrillation
C. pulseless ventricular tachycardia-associated torsades de pointes
In which situation does bradycardia require treatment?
A. 12-lead ECG showing a normal sinus rhythm
B. hypotension
C. diastolic blood pressure greater than 90 mm Hg
D. systolic blood pressure greater than 100 mm Hg
B. hypotension
You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previously advised "no shock indicated."
rhythm check now finds asystole. After resuming high-quality compressions, which action do you take next?
A. call for a pulse check
B. establish IV or IO access
C. insert a laryngeal airway
D. perform endotracheal intubation
B. establish IV or IO access
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. What action is recommended next?
A. giving adenosine 6 mg IV bolus
B. giving lidocaine 1 to 1.5 mg IV bolus
C. performing synchronized cardioversion
D. seeking expert consultation
D. seeking expert consultation
,A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One dose of epinephrine was given after the seco
shock. An antiarrhythmic drug was given immediately after the third shock. You are the team leader. Which medication do you
order next?
A. epinephrine 1 mg
B. epinephrine 3 mg
C. sodium bicarbonate 50 mEq
D. a second dose of the antiarrhythmic drug
A. epinephrine 1 mg
A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of 220/min. The patient's bloo
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 ar
and the patient has not been given any vasoactive drugs. A 12-lead ECG confirms a supraventricular tachycardia with no evidence
ischemia or infarction. The heart rate has no responded to vagal maneuvers. What is your next action?
A. administer adenosine 6 mg IV push
B. administer amiodarone 300 mg IV push
C. perform synchronized cardioversion at 50 J
D. perform synchronized cardioversion at 200 J
A. administer adenosine 6 mg IV push
A 62-year-old man suddenly experienced difficulty speaking and left-sided weakness. he meets initial criteria for fibrinolytic
therapy, and a CT scan of the brain is ordered. Which best describes the guidelines for antiplatelet and fibrinolytic therapy?
A. give aspirin 160 to 325 mg to be chewed immediately
B. give aspirin 160 mg and clopidogrel 75 mg orally
C. give heparin if the CT scan is negative for hemorrhage
D. hold aspirin for at least 24 hours if rtPA is administered
D. hold aspirin for at least 24 hours if rtPA is administered
A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor show a regular narrow-complex
QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has ben established. Which
drug should be administered?
A. adenosine 6 mg
B. atropine 0.5 mg
C. epinephrine 2 to 10 mcg/kg per minute
D. lidocaine 1 mg/kg
A. adenosine 6 mg
Which intervention is most appropriate for the treatment of a patient in asystole?
A. atropine
B. defibrillation
C. epinephrine
D. transcutaneous pacing
C. epinephrine
, A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is intubated, and an IV has been starte
The rhythm is asystole. What is the first drug/dose to administer?
A. atropine 0.5 mg IV / IO
B. atropine 1 mg IV / IO
C. dopamine 2 to 20 mcg/kg per minute IV / IO
D. epinephrine 1 mg IV / IO
D. epinephrine 1 mg IV / IO
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to second shock. Which drug should be administered firs
A. atropine 1 mg IV / IO
B. epinephrine 1 mg IV / IO
C. lidocaine 1 mg/kg IV / IO
D. sodium bicarbonate 50 mEq IV / IO
B. epinephrine 1 mg IV / IO
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total dose of 3 mg. A
transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 88/56 mm Hg. Which therapy
now indicated?
A. atropine 1 mg
B. epinephrine 2 to 10 mcg/min
C. adenosine 6 mg
D. normal saline 250 ml to 500 ml bolus B. epinephrine 2 to 10 mcg/min
a 57 year-old-woman has palpitations, chest discomfort, and tachycardia. The monitor show a regular wide-complex QRS at a rat
of 180/min. she becomes diaphoretic, and her blood pressure is 80/60 mm Hg. Which action do you take next?
A. establish IV access
B. obtain a 12-lead ECG
C. perform electrical cardioversion
D. seek expert consultation
C. perform electrical cardioversion
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. If no pathway for medication
administration is in place, which method is preferred?
A. central line
B. endotracheal tube
C. external jugular vein
D. IV or IO
D. IV or IO
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate administration?
A. anterior wall myocardial infarction
B. heart rate less than 90/min
UPDATE 2025-2026
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 a
IV has been established. His blood pressure is 180/100 mm Hg. Which drug do you anticipate giving to this patient?
A. aspirin
B. glucose (D50)
C. nicardipine
D. rtPA
A. aspirin
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?
A. 0.1 mg
B. 0.5 mg
C. 1 mg
D. 3 mg
B. 0.5 mg
A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin infusion of 1000 unit 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?
A. give aspirin 160 to 325 mg to chew
B. give clopidogrel 300 mg orally
C. give enteric-coated aspirin 75 mg orally
,D. give enteric-coated aspirin 325 mg rectally
A. give aspirin 160 to 325 mg to chew
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which drug should be
given next?
A. adenosine 6 mg
B. amiodarone 300 mg
C. epinephrine 3 mg
D. lidocaine 0.5 mg/kg
B. amiodarone 300 mg
What is the indication for the us of magnesium in cardiac arrest?
A. ventricular tachycardia associated with a normal QT interval
B. shock-refractory monomorphic ventricular tachycardia C. pulseless ventricular
tachycardia-associated torsades de pointes
D. shock-refractory ventricular fibrillation
C. pulseless ventricular tachycardia-associated torsades de pointes
In which situation does bradycardia require treatment?
A. 12-lead ECG showing a normal sinus rhythm
B. hypotension
C. diastolic blood pressure greater than 90 mm Hg
D. systolic blood pressure greater than 100 mm Hg
B. hypotension
You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previously advised "no shock indicated."
rhythm check now finds asystole. After resuming high-quality compressions, which action do you take next?
A. call for a pulse check
B. establish IV or IO access
C. insert a laryngeal airway
D. perform endotracheal intubation
B. establish IV or IO access
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. What action is recommended next?
A. giving adenosine 6 mg IV bolus
B. giving lidocaine 1 to 1.5 mg IV bolus
C. performing synchronized cardioversion
D. seeking expert consultation
D. seeking expert consultation
,A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One dose of epinephrine was given after the seco
shock. An antiarrhythmic drug was given immediately after the third shock. You are the team leader. Which medication do you
order next?
A. epinephrine 1 mg
B. epinephrine 3 mg
C. sodium bicarbonate 50 mEq
D. a second dose of the antiarrhythmic drug
A. epinephrine 1 mg
A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of 220/min. The patient's bloo
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 ar
and the patient has not been given any vasoactive drugs. A 12-lead ECG confirms a supraventricular tachycardia with no evidence
ischemia or infarction. The heart rate has no responded to vagal maneuvers. What is your next action?
A. administer adenosine 6 mg IV push
B. administer amiodarone 300 mg IV push
C. perform synchronized cardioversion at 50 J
D. perform synchronized cardioversion at 200 J
A. administer adenosine 6 mg IV push
A 62-year-old man suddenly experienced difficulty speaking and left-sided weakness. he meets initial criteria for fibrinolytic
therapy, and a CT scan of the brain is ordered. Which best describes the guidelines for antiplatelet and fibrinolytic therapy?
A. give aspirin 160 to 325 mg to be chewed immediately
B. give aspirin 160 mg and clopidogrel 75 mg orally
C. give heparin if the CT scan is negative for hemorrhage
D. hold aspirin for at least 24 hours if rtPA is administered
D. hold aspirin for at least 24 hours if rtPA is administered
A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor show a regular narrow-complex
QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has ben established. Which
drug should be administered?
A. adenosine 6 mg
B. atropine 0.5 mg
C. epinephrine 2 to 10 mcg/kg per minute
D. lidocaine 1 mg/kg
A. adenosine 6 mg
Which intervention is most appropriate for the treatment of a patient in asystole?
A. atropine
B. defibrillation
C. epinephrine
D. transcutaneous pacing
C. epinephrine
, A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is intubated, and an IV has been starte
The rhythm is asystole. What is the first drug/dose to administer?
A. atropine 0.5 mg IV / IO
B. atropine 1 mg IV / IO
C. dopamine 2 to 20 mcg/kg per minute IV / IO
D. epinephrine 1 mg IV / IO
D. epinephrine 1 mg IV / IO
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to second shock. Which drug should be administered firs
A. atropine 1 mg IV / IO
B. epinephrine 1 mg IV / IO
C. lidocaine 1 mg/kg IV / IO
D. sodium bicarbonate 50 mEq IV / IO
B. epinephrine 1 mg IV / IO
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total dose of 3 mg. A
transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 88/56 mm Hg. Which therapy
now indicated?
A. atropine 1 mg
B. epinephrine 2 to 10 mcg/min
C. adenosine 6 mg
D. normal saline 250 ml to 500 ml bolus B. epinephrine 2 to 10 mcg/min
a 57 year-old-woman has palpitations, chest discomfort, and tachycardia. The monitor show a regular wide-complex QRS at a rat
of 180/min. she becomes diaphoretic, and her blood pressure is 80/60 mm Hg. Which action do you take next?
A. establish IV access
B. obtain a 12-lead ECG
C. perform electrical cardioversion
D. seek expert consultation
C. perform electrical cardioversion
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. If no pathway for medication
administration is in place, which method is preferred?
A. central line
B. endotracheal tube
C. external jugular vein
D. IV or IO
D. IV or IO
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate administration?
A. anterior wall myocardial infarction
B. heart rate less than 90/min
