ACLS Precourse Self-Assessment

Section 2: Pharmacology (Question: 3 of 20)
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?
Choose the correct option and select submit.
A. Give aspirin 162 to 325 mg to chew 
B. Give enteric-coated aspirin 325 mg rectally 
C. Give enteric-coated aspirin 75 mg orally 
D. Give clopidogrel 300 mg orally
Which intervention is most appropriate for the treatment of a patient in asystole?
Choose the correct option and select submit.
A. Defibrillation 
B. Epinephrine 
C. Transcutaneous pacing 
D. Atropine 
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 is now indicated?
Choose the correct option and select submit.
A. Epinephrine 2 to 10 mcg/min 
B. Normal saline 250 mL to 500 mL bolus 
C. Atropine 1 mg 
D. Adenosine 6 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 amiodarone 300 mg IV. The patient is intubated. Which best describes the recommended second dose of amiodarone for this patient?
Choose the correct option and select submit.
A. 1 to 2 mg/min infusion 
B. 1 mg/kg IV push 
C. 300 mg IV push 
D. 150 mg IV push 
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?
Choose the correct option and select submit.
A. Administer adenosine 6 mg IV push 
B. Administer amiodarone 300 mg IV push 
C. Perform synchronized cardioversion at 200 J 
D. Perform synchronized cardioversion at 50 J
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?
Choose the correct option and select submit.
A. A second dose of the antiarrhythmic drug 
B. Epinephrine 3 mg 
C. Epinephrine 1 mg 
D. Sodium bicarbonate 50 mEq 
In which situation does bradycardia require treatment?
Choose the correct option and select submit.
A. Hypotension 
B. Diastolic blood pressure greater than 90 mm Hg 
C. 12-lead ECG showing a normal sinus rhythm 
D. Systolic blood pressure greater than 100 mm Hg 
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?
Choose the correct option and select submit.
A. Give heparin if the CT scan is negative for hemorrhage 
B. Hold aspirin for at least 24 hours if rtPA is administered 
C. Give aspirin 162 to 325 mg to be chewed immediately 
D. Give aspirin 120 mg and clopidogrel 75 mg orally
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?
Choose the correct option and select submit.
A. Aspirin 
B. Nicardipine 
C. rtPA 
D. Glucose (D50) 
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?
Choose the correct option and select submit.
A. Perform endotracheal intubation 
B. Call for a pulse check 
C. Establish IV or IO access 
D. Insert a laryngeal airway 
A 57-year-old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular wide-complex QRS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60 mm Hg. Which action do you take next?
Choose the correct option and select submit.
A. Establish IV access 
B. Perform electrical cardioversion 
C. Obtain a 12-lead ECG 
D. Seek expert consultation 
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. Which drug should be administered?
Choose the correct option and select submit.
A. Lidocaine 1 mg/kg 
B. Atropine 0.5 mg 
C. Adenosine 6 mg 
D. Epinephrine 2 to 10 mcg/kg per minute
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?
Choose the correct option and select submit.
A. IV or IO 
B. Endotracheal tube  C
. External jugular vein 
D. Central line 
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate administration?
Choose the correct option and select submit.
A. Anterior wall myocardial infarction 
B. Use of a phosphodiesterase inhibitor within the previous 24 hours 
C. Systolic blood pressure greater than 180 mm Hg 
D. Heart rate less than 90/min
A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is intubated, and an IV has been started. The rhythm is asystole. What is the first drug/dose to administer?
Choose the correct option and select submit.
A. Atropine 1 mg IV/IO 
B. Atropine 0.5 mg IV/IO 
C. Epinephrine 1 mg IV/IO 
D. Dopamine 2 to 20 mcg/kg per minute IV/IO
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug should be administered first?
Choose the correct option and select submit.
A. Sodium bicarbonate 50 mEq IV/IO 
B. Lidocaine 1 mg/kg IV/IO 
C. Epinephrine 1 mg IV/IO 
D. Atropine 1 mg IV/IO
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which drug should be given next?
Choose the correct option and select submit.
A. Amiodarone 300 mg 
B. Lidocaine 0.5 mg/kg 
C. Epinephrine 3 mg  D.
6 mg
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?
Choose the correct option and select submit.
A. Giving adenosine 6 mg IV bolus  ]
B. Giving lidocaine 1 to 1.5 mg IV bolus 
C. Seeking expert consultation 
D. Performing synchronized cardioversion
Section 3: Practical Application (Question: 1 of 20)
How often should you switch chest compressors to avoid fatigue?
Choose the correct option and select submit.
A. About every 2 minutes 
B. About every 5 minutes 
C. About every 3 minutes 
D. About every 4 minutes 
What is the recommended depth of chest compressions for an adult victim?
Choose the correct option and select submit.
A. At least 1.5 inches 
B. At least 3 inches 
C. At least 2.5 inches 
D. At least 2 inches
Which action should you take immediately after providing an AED shock?
Choose the correct option and select submit.
A. Start rescue breathing 
B. Prepare to deliver a second shock  C. Check the pulse rate  D. Resume chest compressions 
A patient becomes unresponsive. You are uncertain if a faint pulse is present. The rhythm shown here is seen on the cardiac monitor. An IV is in place. Which action do you take next?
Choose the correct option and select submit.

A. Administer atropine 1 mg  B. Begin transcutaneous pacing  C. Administer epinephrine 1 mg IV  D. Start high-quality CPR
What action minimizes the risk of air entering the victim’s stomach during bag-mask ventilation?
Choose the correct option and select submit.
A. Squeezing the bag with both hands  B. Ventilating as quickly as you can  C. Delivering the largest breath you can  D. Ventilating until you see the chest rise
Your patient is a 56-year-old woman with a history of type 2 diabetes who reports feeling dizzy. She is pale and diaphoretic. Her blood pressure is 80/60 mm Hg. The cardiac monitor documents the rhythm shown here. She is receiving oxygen at 4 L/min by nasal cannula, and an IV has been established. What do you administer next?
Choose the correct option and select submit.

A. Atropine 1 mg IV  B. Dopamine at 2 to 10 mcg/kg per minute  C. Morphine sulfate 4 mg IV  D. Glucose 50% IV push 
ou are providing bag-mask ventilations to a patient in respiratory arrest. How often should you provide ventilations?
Choose the correct option and select submit.
A. Every 6 seconds  B. Every 12 seconds  C. Every 14 seconds  D. Every 10 seconds 
A patient was in refractory ventricular fibrillation. A third shock has just been administered. Your team looks to you for instructions. What is your next action?
Choose the correct option and select submit.

A. Give atropine 1 mg IV  B. Give amiodarone 300 mg IV  C. Check the carotid pulse  D. Resume high-quality chest compressions 
What is the recommended compression rate for high-quality CPR?
Choose the correct option and select submit.
A. 90 to 100 compression per minute  B. 50 to 20 compressions per minute  C. 70 to 80 compressions per minute  D. 100 to 120 compressions per minute
How does complete chest recoil contribute to effective CPR?
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A. Reduces rescuer fatigue  B. Increases the rate of chest compressions  C. Allows maximum blood return to the heart  D. Reduces the risk of rib fractures 
A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the patient becomes unresponsive, with the rhythm shown here. Which action is indicated next?
Choose the correct option and select submit.

A. Give an immediate unsynchronized high-energy shock (defibrillation dose)  B. Perform synchronized cardioversion  C. Repeat amiodarone 300 mg IV  D. Give lidocaine 1 to 1.5 mg/kg IV
A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She has received adenosine 6 mg IV for the rhythm shown here, without conversion of the rhythm. She is now extremely apprehensive. Her blood pressure is 128/70 mm Hg. What is the next appropriate intervention?
Choose the correct option and select submit.

A. Perform vagal maneuvers  B. Perform synchronized cardioversion  C. Administer adenosine 12 mg IV  D. Perform unsynchronized cardioversion 
A patient’s 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the patient arrives in the emergency department, the rhythm shown here is seen on the cardiac monitor. The patient has resolution of moderate (5/10) chest pain after 3 doses of sublingual nitroglycerin. Blood pressure is 104/70 mm Hg. Which intervention is most important in reducing this patient’s in-hospital and 30-day mortality rate?
Choose the correct option and select submit.

A. Nitroglycerin administration  B. Application of transcutaneous pacemaker  C. Atropine administration  D. Reperfusion therapy
After initiation of CPR and 1 shock for ventricular fibrillation, this rhythm is present on the next rhythm check. A second shock is given, and chest compressions are resumed immediately. An IV is in place, and no drugs have been given. Bag-mask ventilations are producing visible chest rise. What is your next intervention?
Choose the correct option and select submit.

A. Give epinephrine 1 mg IV/IO  B. Intubate and administer 100% oxygen  C. Give amiodarone 300 mg IV/IO  D. Administer 3 sequential (stacked) shocks at 320 J (monophasic defibrillator)
A 35-year-old woman presents with a chief complaint of palpitations. She has no chest discomfort, shortness of breath, or light-headedness. Her blood pressure is 120/78 mm Hg. Which intervention is indicated first?
Choose the correct option and select submit.

A. Adenosine 12 mg IV slow push (over 1 to 2 minutes)  B. Vagal maneuvers  C. Metoprolol 5 mg IV and repeat if necessary  D. Adenosine 3 mg IV bolus 
You arrive on the scene to find CPR in progress. Nursing staff report the patient was recovering from a pulmonary embolism and suddenly collapsed. Two shocks have been delivered, and an IV has been initiated. What do you administer now?
Choose the correct option and select submit.

A. Epinephrine 1 mg IV  B. Endotracheal intubation  C. Transcutaneous pacing  D. Atropine 0.5 mg IV
Which action is likely to cause air to enter the victim’s stomach (gastric inflation) during bag-mask ventilation?
Choose the correct option and select submit.
A. Providing a good seal between the face and the mask  B. Providing just enough volume for the chest to rise  C. Giving breaths over 1 second  D. Ventilating too quickly
You are the code team leader and arrive to find a patient with CPR in progress. On the next rhythm check, you see the rhythm shown here. Team members tell you that the patient was well but reported chest discomfort and then collapsed. She has no pulse or respirations. Bag-mask ventilations are producing visible chest rise, and IO access has been established. Which intervention would be your next action?
Choose the correct option and select submit.

A. Intubation and administration of 100% oxygen  B. Epinephrine 1 mg  C. Dopamine at 10 to 20 mcg/kg per minute  D. Atropine 1 mg 
What is the maximum interval for pausing chest compressions?
Choose the correct option and select submit.
A. 10 seconds  B. 20 seconds  C. 25 seconds  D. 15 seconds
Your patient is not responsive and is not breathing. You can palpate a carotid pulse. Which action do you take next?
Choose the correct option and select submit.
A. Apply an AED  B. Start an IV  C. Start rescue breathing  D. Obtain a 12-lead ECG