Advanced Cardiac Life Support - 2024 Practice Test

ACLS Exam Format | Course Contents | Course Outline | Exam Syllabus | Exam Objectives

EXAM NUMBER : ACLS
EXAM NAME : Advanced Cardiac Life Support
Grading Scale:
91-100% = A
83-90% = B
75-82% = C
67-81% = D
Below 67 = F

Skill development for professional personnel practicing in critical care units, emergency departments, and paramedic ambulances. Establishes a system of protocols for management of the patient experiencing cardiac difficulties.

COURSE CONTENTS, COURSE OBJECTIVES, SYLLABUS
- Integrate knowledge of EMS systems, safety/well being of the paramedic, and medical/legal and ethical issues, which is intended to improve the health of EMS personnel, patients, and the community.
- Integrate knowledge of pharmacology to formulate a treatment plan intended to mitigate emergencies and improve the overall health of the patient.
- Integrate knowledge of anatomy, physiology, and pathophysiology into the assessment to develop and implement a treatment plan with the goal of assuring a patent airway, adequate mechanical ventilation and respiration for all patients.
- Integrate scene and patient assessment findings with knowledge of epidemiology and pathophysiology to form a field impression, differential diagnosis and formulate a treatment plan.
- Integrate comprehensive knowledge of causes and pathophysiology into the management of cardiac arrest and peri-arrest states.
- Integrate a comprehensive knowledge of the causes and pathophysiology into the management of shock, respiratory failure or arrest with an emphasis on early intervention to prevent arrest.
- Safely and effectively perform all psychomotor skills within the scope of the Paramedic practice.
- Integrates comprehensive knowledge of EMS systems, the safety/well-being of the paramedic, and medical/legal and ethical issues which is intended to improve the health of EMS personnel, patients, and the community.
- Integrates a complex depth and comprehensive breadth of knowledge of the anatomy and physiology of all human systems.
- Integrates comprehensive anatomical and medical terminology and abbreviations into the written and oral communication with colleagues and other health care professionals.
- Integrates comprehensive knowledge of pathophysiology of major human systems.
- Integrates comprehensive knowledge of life span development.
- Applies fundamental knowledge of principles of public health and epidemiology including public health emergencies, health promotion, and illness and injury prevention.
- Integrates comprehensive knowledge of pharmacology to formulate a treatment plan intended to mitigate emergencies and improve the overall health of the patient.
- Integrates complex knowledge of anatomy, physiology, and pathophysiology into the assessment to develop and implement a treatment plan with the goal of assuring a patent airway, adequate mechanical ventilation, and respiration for patients of all ages.
- Integrate scene and patient assessment findings with knowledge of pathophysiology to form a field impression. This includes development of a list of differential diagnoses through clinical reasoning to modify the assessment and formulate a treatment plan.
- Integrates assessment findings with principles of epidemiology and pathophysiology to formulate a field impression and implement a comprehensive treatment/disposition plan for a patient with a medical complaint.
- Integrates comprehensive knowledge of causes and pathophysiology into the management of the cardiac arrest and peri-arrest states.
- Integrates a comprehensive knowledge of the causes and pathophysiology into the management of shock, respiratory failure or arrest with an emphasis on early intervention to prevent arrest.
- Integrates assessment findings with principles of epidemiology and pathophysiology to formulate a field impression to implement a comprehensive treatment/disposition plan for an acutely injured patient.
- Integrates assessment findings with principles of pathophysiology and knowledge of psychosocial needs to formulate a field impression and implement a comprehensive treatment/disposition plan for patients with special needs.
- Knowledge of operational roles and responsibilities to ensure patient, public and personnel safety.
- Communicate in a culturally sensitive manner.
- Demonstrate professional behavior including but not limited to; integrity, empathy, self-motivation, appearance and personal hygiene, self confidence, communications, time-management, teamwork, diplomacy and respect, patient advocacy and the safe delivery of care.
- Safely and effectively perform all psychomotor skills within the National EMS Scope of Practice Model and state scope of practice at the Paramedic level
- Perform basic and advanced interventions as a part of a treatment plan intended to mitigate the emergency, provide symptom relief, and improve the overall health of the patient and evaluate the effectiveness of interventions and modify the treatment plan accordingly.
- Report and document assessment findings and interventions. Collect and report data to be used for epidemiological and research purposes.
- Function as the team leader of a routine, single patient advanced life support emergency call.

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Advanced Cardiac Life Support - 2023
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Question #342
A patient has been resuscitated from cardiac arrest and is being prepared for transport. She is incubated and is receiving 100% oxygen.
During the resuscitation she received 2 doses of epinephrine 1 mg, atropine 1 mg, and lidocaine 100 mg IV. You now observe the above
rhythm on the cardiac monitor. The rhythm abnormality is becoming more frequent and increasing in number.
You should order:
A. Give amiodarone 300 mg IV, start infusion
B. Give lidocaine 1 to 1.5 mg IV
C. Repeat epinephrine 1 mg IV
D. Give lidocaine 0.5 to 0.75 mg/kg IV, start lidocaine infusion
E. Give amiodarone 150 mg IV, start infusion
Answer: D
Question #343
A patient was in refractory ventricular fibrillation. A third shock has just been administered. Your team looks at you for instruction.
Your immediate next order is:
A. Give atropine 1 mg IV
B. Resume high-quality chest compressions
C. Give amiodarone 300 mg IV
D. Perform endotracheal intubation
E. Give epinephrine 1 mg IV
Answer: B
Question #344
A patient presents with the above rhythm complaining of an irregular heartbeat. She has no other complaints. Past medical history is
significant for a myocardial infarction 7 years ago. Blood pressure is 110/70 mmHg. At this time you would
A. Continue monitoring and seek expert consultation
B. Administer nitroglycerin 0.4 mg sublingual or spray
C. Perform emergency synchronized cardioversion
D. Administer lidocaine 1 mo/kg IV
E. Perform elective synchronized cardioversion with presedation
Answer: A
Question #345
You arrive on-scene to find CPR in progress. Nursing staff report that the patient was recovering from a pulmonary embolism and
suddenly collapsed. There is no pulse or spontaneous respirations. High-quality CPR is in progress, and effective ventilation is being
provided with bag-mask. An IV has been initiated. You would now
A. Initiate transcutaneous pacing
B. Give epinephrine 1.0 mg IV
C. Order immediate endotracheal intubation
D. Give atropine 0.5 mg IV
E. Give atropine 1 mg IV
Answer: B
Question #346
A 45-year-old woman with a history of palpitations develops lightheadedness and palpitations. She has received adenosine 6 mg IV for
the rhythm shown above without conversion of the rhythm. She is now extremely apprehensive. Blood pressure is 108/70 mmHg. The
next appropriate intervention is
A. Perform vagal maneuvers and repeat adenosine 6 mg IV
B. Perform immediate unsynchronized cardioversion
C. Repeat adenosine 12 mg IV
D. Repeat adenosine 3 mg IV
E. Sedate and perform synchronized cardioversion
Answer: C
Question #347
You arrive on-scene and find a 56-year-old diabetic woman complaining of chest discomfort. She is pale and diaphoretic, complaining
of lightheadedness. Her blood pressure is 80/60 mmHg. The cardiac monitor documents the rhythm above. She is receiving oxygen at 4
L/min by nasal cannula, and an IV has been established. Transcutaneous pacing has been requested but is not yet available.
Your next order is -
A. Give morphine sulfate 4 mg IV
B. Start dopamine at 2 to 10 ug/kg per minute
C. Give atropine 0.5 mg IV
D. Give atropine 1 mg IV
E. Give nitroglycerin 0.4 mg SL
Answer: C
Question #348
You are evaluating a patient with 15-minute duration of chest pain during transportation to the emergency department. He is receiving
oxygen, and 2 sublingual nitroglycerin tablets have relieved his chest discomfort. He has no complaints but appears anxious. Blood
pressure is 130/70 mmHg. You observe the above rhythm on the monitor and your next action is
A. Give atropine 0.5 mg IV
B. Initiate transcutaneous pacing (TCP)
C. Continue monitoring patient, prepare for TCP
D. Administer nitroglycerin 0.4 mg SL
E. Start epinephrine 2 to 10 ug/min and titrate
Answer: C
Question #349
Following resuscitation with CPR and a single shock, you observe this rhythm while preparing the patient for transport. Your patient is
stable and blood pressure is
120/80 mmHg. She is apprehensive but has no complaints other than palpitations. At this time you would
A. Give magnesium sulfate 1 to 2 g over 20 minutes
B. Seek expert consultation
C. Give amiodarone 300 mg IV, start infusion
D. Give lidocaine 1 to 1.5 mg IV, start lidocaine infusion
Answer: B
Question #350
A patient in the ED develops recurrent chest discomfort (8/10) suspicious for ischemia. His monitored rhythm becomes irregular as seen
above. Oxygen is being administered by nasal cannula at 4 L/min and an intravenous line is patent. Blood pressure is 160/96 mmHg.
There are no allergies or contraindications to any medication. You would first order
A. Lidocaine 1 mg/kg IV and infusion 2 mg/min
B. Morphine sulfate 2 to 4 mg IV
C. Nitroglycerin 0.4 mg SL
D. Amiodarone 150 mg IV
E. Intravenous nitroglycerin initiated at 10 ug/min and titrated
Answer: C
Question #351
This patient was admitted to the general medical ward with a history of alcoholism. A code is in progress and he has recurrent episodes
of this rhythm. You review his chart. Notes about the 12- lead ECG say that his baseline QT-interval is top normal to slightly prolonged.
He has received 2 doses of epinephrine 1 mg and 1 dose of amiodarone 300 mg IV so far. For his next medication you would now order
A. Repeat amiodarone 150 mg IV
B. Lidocaine 1 to 1.5 mg IV and start infusion 2 mg/minute
C. Repeat amiodarone 300 mg IV
D. Give magnesium sulfate 1 to 2 g IV diluted in 10 ml_ D5W given over 5 to 20 minutes
E. Give sodium bicarbonate 50 mEq IV
Answer: D
Question #352
This patient suddenly collapsed and is poorly responsive. The patient has a weak carotid pulse. A cardiac monitor, oxygen, and an
intravenous line have been initiated. The code cart with all drugs and pF transcutaneous pacer is immediately available. Next you would
A. Initiate dopamine at 10 to 20 ug/kg per minute and titrate heart rate
B. Give atropine 1 mg IV up to a total dose of 3 mg
C. Initiate epinephrine at 2 to 10 ug per minute and titrate heart rate
D. Initiate dopamine at 2 to 10 ug/kg per minute and titrate heart rate
E. Begin transcutaneous pacing
Answer: E
Question #353
Following initiation of CPR and one shock for VF, this rhythm is present on the next rhythm check. A second shock is given and chest
compressions are immediately resumed. An IV is in place and no drugs have been given. Bag-mask ventilations are producing visible
chest rise. What is your next order?
A. Prepare to give amiodarone 300 mg IV
B. Administer 3 sequential (stacked) shocks at 360 Joules (monophasic defibrillator)
C. Perform endotracheal intubation; administer 100% oxygen
D. Administer 3 sequential (stacked) shocks at 200 Joules (biphasic defibrillator)
E. Prepare to give epinephrine 1 mg IV
Answer: E
Question #354
A patient with an acute Ml on a 12-lead ECG transmitted by the paramedics has the above findings on a rhythm strip when a monitor is
placed in the ED. The patient had resolution of moderate (5/10) chest pain with three doses of sublingual nitroglycerin. Blood pressure is
104/70 mmHg. Which intervention below is most important, reducing in-hospital and 30-day mortality?
A. Atropine 1 mg IV, total dose 3 mg as needed
B. Intravenous nitroglycerin for 24 hours
C. Reperfusion therapy
D. Atropine 0.5 mg IV, total dose 2 mg as needed
E. Temporary pacing
Answer: C

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