ACLS Practice Test2

7/28/2019 ACLS Practice Test2

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ACLS Provider Course Practice Test January 2007

This is a single-answer multiple-choice examination. There is only one correct answer to each question.

1. CPR has been started on an elderly female. After attaching a monitor, it shows fine VF.Which action would you take next?

a. Deliver up to 3 precordial thumps while observing the patients response on the monitor.b. Perform at least 5 minutes of vigorous CPR before attempting defibrillation.c. Deliver about 2 minutes or 5 cycles of CPR, and deliver a 360-J monophasic or

equivalent-current biphasic shock.d. Insert an endotracheal tube, administer 2 to 2.5 mg epinephrine in 10 mL NS through the

tube and then defibrillate.

2. Which of the following facts about identification of VF is true?

a. Turning the signal amplitude (gain) to zero can enhance the VF signalb. A sudden drop in blood pressure indicates VFc. Artifact signals displayed on the monitor can look like VFd. A peripheral pulse that is both weak and irregular indicated VF

3. After a cardiac arrest, the patient is assessed as having PEA at 30 bpm. CPR continues,an airway is placed and confirmed and an IV has been established. Which of the followingmedications is most appropriate to give next?

a. Sodium bicarbonate 1 mEq/kg IVb. Synchonized cardioversion at 200 Jc. Epinephrine 1 mg IVd. Calcium chloride 5 mL/kg IV

4. Which of the following causes of PEA is most likely to respond to quick treatment?

a. Massive pulmonary embolismb. Hypovolemiac. Massive acute myocardial infarctiond. Myocardial rupture

5. Identify the true statement about IV administration of medications during attemptedresuscitation.

a. Run normal saline missed with sodium bicarbonate (100 mEq/l) while continuing CPRb. Follow IV medications through peripheral veins with a fluid bolusc. Give epinephrine via the intracardiac route if IV access is not obtained within 3 minutesd. Do not follow IV medications through central veins with a fluid bolus

6. An elderly woman with a history of narrow-complex PSVT has just arrived in the ED. She

is alert and oriented but very pale. Her HR is 165 bpm, and the ECG documents SVT. BPis 105/70 mm Hg. Supplemental oxygen is being provided, and IV has been started. Whichof the following drug-dose combinations is the most appropriate first treatment?

a. Adenosine 6 mg rapic IV pushb. Atropine 1 mg IV pushc. Synchronized cardioversion with 25 to 50 Jd. Epinephrine 1 mg IV push


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7. A patient in the ED is reporting 30 minutes of severe, crushing substernal chest pain. HisBP is 110/70, his heart rate is 58 and the monitor shows regular sinus bradycardia. He hasalready been given 325 mg of aspirin PO, has oxygen via nasal cannula at 4 L/min and hasalready received 3 sublingual nitroglycerin 5 minutes apart, but he continues to havesevere pain. Which should be given next?

a. Atropine 0.5 sto 1 mg IVb. Furosemide 20 to 40 mg IVc. Lidocaine 1 to 1.5 mg/kgd. Morphine sulfate 2 to 4 mg IV

8. Early management of acute cardiac ischemia frequently can be handled by using.

a. Calcium channel blockers plus IV furosemideb. Bolus of amiodarone followed by an oral ACE inhibitorc. Chewable aspirin, sublingual nitroglycerine and IV morphined. Lidocaine bolus followed by a continuous infusion of lidocaine.

9. Transcutaneous cardiac pacing is indicated for which of the following rhythms?

a. Asystole that follows 6 or more defibrillation shocksb. Normal sinus rhythm with hypotension and shock

c. Complete heart block with pulmonary edemad. Sinus bradycardia with no symptoms

10. Which of the following causes of out-of-hospital asystole is most likely to respond totreatment?

a. Blunt multisystem traumab. Drug overdosec. Prolonged submersion in warm waterd. Prolonged cardiac arrest

11. You are working with an unstable 49 year-old woman with tachycardia. Themonitor/defibrillator is in synchronization mode. The patient suddently becomesunresponsive and pulseless and then the rhythm changes to an irregular, chaotic, VF-likepattern. You charge to 200 J and then press the SHOCK button, but the defibrillator doesnot deliver a shock. Why?

a. A monitor lead has lost contact, producing the pseudo-VF rhythmb. You cannot shock VF in sync modec. The defibrillator/monitor battery failedd. The sync switch failed

12. For which of the following arrest patterns would you recommend Vasopressin?

a. VFb. Asystolec. PEAd. All of the above


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13. The patient is in cardiac arrest. One of the team members is providing effective bag-maskventilations. Compressions are adequate. The ECG documents asystole. Two minuteshas passed since epinephrine 1 mg has been given. Which of the following actionsshould be done next?

a. Administer atropine 1 mg IVb. Initiate transcutaneous pacing at a rate of 60 bpmc. Start a dopamine IV at 15 to 20 g/kg per minuted. Give epinephrine (1 mL of 1:10 000 solution) IV bolus

14. Each of the following patients were diagnosed with acute ischemic stroke. Which of thesepatients has NO stated contraindication for IV fibrinolytic therapy?

a. A 65 year old who lives along and was found unresponsive by a neighborb. A 65 year old man presenting approximately 4 hours after onset of symptomsc. A 65 year old woman presenting 1 hour after onset of symptomsd. A 65 year old man diagnosed with bleeding ulcers 1 week before the onset of symptoms

15. When a 25 year old woman presents to the ED, she says that she is having anotherepisode of PSVT. Her medical history includes a electrophysiologic stimulation study(EPS) that confirmed that there was a reentry tachycardia, no Wolfe-Parkinson-Whitesyndrome and no preexcitation. Heart rate is 180 bpm. The patient tells you that she hasjpalpitations and mild shortness of breath. Vagal maneuvers with carotid sinus massage

have no effect on HR or rhythm. Which of the following actions is your best intervention?

a. IV adenosineb. IV propranololc. IV diltiazemd. DC cardioversion

16. A patient with a heart rate of 30 to 40 bpm complains of feeling dizzy, cool and has clammyextremities and short of breath. He is in third-degree AV block. All treatment modalitiesare present. What would you do first?

a. Give epinephrine 1 mg IV pushb. Start dopamine infusion 1 to 10 g/min

c. Begin immediate transcutaneous pacing, sedate if possibled. Give atropine 0.5 to 1 mg IV

IDENTIFY THE FOLLOWING RHYTHMS:17.

Normal Sinus Rhythm Monomorphic Ventricular Tachycardia Sinus Tachycardia Polymorphic Ventricular Tachycardia Sinus Bradycardia Ventricular Fibrillation Atrial Fibrillation Second-Degree Atrioventricular Block Atrial Flutter Third-Degree Atrioventricular Block Reentry Supraventricular Tachycardia


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18.

19.

20.


Normal Sinus Rhythm Monomorphic Ventricular Tachycardia Sinus Tachycardia Polymorphic Ventricular Tachycardia Sinus Bradycardia Ventricular Fibrillation

Atrial Fibrillation Second-Degree Atrioventricular Block Atrial Flutter Third-Degree Atrioventricular Block Reentry Supraventricular Tachycardia



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21.

22.

Normal Sinus Rhythm Monomorphic Ventricular Tachycardia Sinus Tachycardia Polymorphic Ventricular Tachycardia Sinus Bradycardia Ventricular Fibrillation Atrial Fibrillation Second-Degree Atrioventricular Block

Atrial Flutter

Third-Degree Atrioventricular Block Reentry Supraventricular Tachycardia



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23.

Normal Sinus Rhythm Monomorphic Ventricular Tachycardia Sinus Tachycardia Polymorphic Ventricular Tachycardia Sinus Bradycardia Ventricular Fibrillation Atrial Fibrillation Second-Degree Atrioventricular Block Atrial Flutter Third-Degree Atrioventricular Block

Reentry Supraventricular Tachycardia

Answers:

1. C 2. C 3. C 4. B 5. B 6. A 7. D 8. C 9. C 10. B 11. B 12. D 13. A14. C 15. A 16. C17. Normal Sinus Rhythm 18. Sinus Bradycardia 19. Atrial Flutter20. Third-Degree Atrioventricular Block 21. Atrial Fibrillation22. Monomorphic Ventricular Tachycardia 23. Ventricular Fibrillation

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