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2025 ACLS
COMPLETE QUESTIONS AND CORRECT VERIFIED ANSWERS
"What is the primary purpose of a rapid response team (RRT) or medical emergency team (MET)?
- CORRECT ANSWER To improve patient outcomes by identifying and treating early clinical
deterioration" "What happens when teams rapidly assess and intervene when patients have abnormal vital
signs? - CORRECT ANSWER The number of in hospital cardiac arrest decreases"
"In addition to decreased IHCA, what are some other benefits of implementing a rapid response
system? Select all that apply. - CORRECT ANSWER Decrease ICU length of stay.
Decreased in total hospital length of stay."
"What are the 6 positions for high performance teams in resuscitation? - CORRECT ANSWER
Team leader Airway Timer/recorder Compressor (rotate every 2 minutes) Monitor/defibrillator/cpr coach IV/IO/Medications" "Which member of the high performance team has the responsibility for assigning roles
(positions)? - CORRECT ANSWER Team leader"
"Which high performance team member is part of the resuscitation triangle? - CORRECT
ANSWER Monitor/defibrillator/cpr coach"
"What are the components of high quality CPR? Select all that apply: - CORRECT ANSWER
Compression depth of at least 2 inches (5cm) Switching compressors every 2 minutes Avoiding excessive ventilation Complete chest recoil after each compression Interruption limited to under 10 seconds"
"How do you calculate the chest compression fraction (CCF)? What is ideal percentage? -
CORRECT ANSWER Divide chest compression time by total code time. You want this at least
60% but ideally greater than 80%" "Which component of effective high-performance teams is represented by the use of real-time
feedback devices? - CORRECT ANSWER Quality"
"What is the maximum amount of time you should simultaneously perform pulse and breathing
checks? - CORRECT ANSWER 10 seconds"
"While performing the BLS Assessment, you initiate high- quality CPR and assist ventilation with a bag mask device. The AED does not recommend a shock.
Which action in the Primary assessment should you perform first? - CORRECT ANSWER
Determine is the patients airway is patent" "The initial assessment reveals a conscious patient. The patients airway is patent and an advanced airway is not indicated.
Which action in the primary assessment should you perform next? - CORRECT ANSWER
Administer oxygen as needed"
"Which action is part of secondary assessment of a conscious patient? - CORRECT ANSWER
Formulate a differential diagnosis" "Which demographic group experiencing acute coronary syndromes is more likely to present
without chest pain? - CORRECT ANSWER Females"
"Oxygen should be delivered to a patient who has obvious signs of heart failure if the oxygen
saturation is less than? - CORRECT ANSWER 90%"
"Obtaining a what is the most important assessment tool for a patient displaying signs and
symptoms of acute coronary syndrome? - CORRECT ANSWER 12 lead ekg"
"What is the time goal for how quickly you should complete a fibrinolytic checklist once the
patient arrives in the emergency department? - CORRECT ANSWER 10 minutes"
"Which action is part of the secondary assessment of a conscious patient? - CORRECT
ANSWER Formulate a different diagnosis"
"What is the most common type of stroke? - CORRECT ANSWER Ischemic stroke"
"What type of stroke occurs when a blood vessel in the brain suddenly ruptures into the
surrounding tissue? - CORRECT ANSWER Hemorrhagic stroke"
"Which is a sign of a stroke? - CORRECT ANSWER Trouble speaking"
"Which is a symptom of stroke? - CORRECT ANSWER Sudden trouble seeing"
"What are the 3 components of the Cincinnati Prehospital stroke scale? - CORRECT ANSWER
Facial droop Arm drift Abnormal speech" "What is the time for neurological assessment by the stroke team or designee and noncontrast
computed tomography or magnetic resonance imaging performed after the hospital arrival? -
CORRECT ANSWER 20 min"
"What is the time goal for initiation of fibrinolytic therapy for patients w/o contraindications after
hospital arrival - CORRECT ANSWER 45 min"
"What is the door-to device time for direct-arriving patients with acute ischemic stroke treated
with endovascular therapy? - CORRECT ANSWER 90 min"
"Evidence suggest that there is a higher likelihood of good to excellent functional outcome when
alteplase is given to adults with an acute ischemic stroke within what time frame? - CORRECT
ANSWER 3 hours"
"What is the maximum time for last known normal when endovascular therapy can be
performed? - CORRECT ANSWER 24 hours"
"What is the maximum time from last known normal when intra arterial thrombolysis for select
patients can be used for treatment? - CORRECT ANSWER 6 hours"
"What is the time goal for initiation of fibrinolytic therapy in appropriate patients without
contraindications after hospital arrival? - CORRECT ANSWER 45 min"
"In which of the following patients can nasopharyngeal airways be used? - CORRECT ANSWER
Unconscious Semiconscious Conscious"
"Select the first step in the use of an oropharyngeal airway - CORRECT ANSWER Clear the
mouth and pharynx" "What is the recommended ventilation for an adult in cardiac arrest with an advanced airway
device in place? - CORRECT ANSWER Once every 6 seconds"
"The EMS team brings a 54 year old patient to the emergency department who had been experiencing severe shortness of breath and difficulty breathing. The patient loses consciousness on arrival.
What initial actions should be taken? - CORRECT ANSWER Check for responsiveness Assess
ABCs Call for additional help" "The pt is unresponsive and not breathing but has a strong pulse.
What should your initial actions include? - CORRECT ANSWER Open the pt's airway via a head
tilt-chin lift or jaw thrust Initiate ventilation with a bag-mask device attached to supplemental oxygen" "The pt's signs are HR 84/min, BP 124/73 mmHg, SpO2 is 66%, and the skin is cyanotic around the mouth and extremities.
What is the recommended rate for rescue breaths? - CORRECT ANSWER 1 breath every 6
seconds" "While ventilating the pt, you hear loud gurgling sounds coming from the airway.
What is your next action? - CORRECT ANSWER Suction the airway."
"You are treating a patient with a heart rate of 186/min. Which symptom (if present) suggest
unstable tachycardia? - CORRECT ANSWER Hypotension"
"What is the first-line treatment for unstable tachycardia? - CORRECT ANSWER
Cardioversion" "The width of the QRS in a patient presenting with tachycardia is 0.16 seconds. Each QRS complex has a visible P wave.
How would you classify this tachycardia? - CORRECT ANSWER Wide-complex tachycardia"
"The width of the QRS in a patient presenting with tachycardia is 0.10 second. There are no clearly discernable P waves.
How would you classify this tachycardia - CORRECT ANSWER Narrow-complex tachycardia"
"What is the upper heart rate limit for a patient with sinus tachycardia? - CORRECT ANSWER
130/min"
"What is the lower heart rate limit for a patient with sinus tachycardia? - CORRECT ANSWER
100/min" "What is the recommended initial therapy for a patient with stable narrow-complex tachycardia,
after establishing an IV and acquiring a 12 lead EKG? - CORRECT ANSWER Vagal maneuvers"
"What procedure used in the management of stable narrow complex tachycardia forces a patient
to strain against a closed glottis? - CORRECT ANSWER Valsalva maneuver"
"What is the recommended initial dose of adenosine for the management of supraventricular
tachycardia unresponsive to vagal maneuvers? - CORRECT ANSWER 6 mg IV"
"What is the recommended follow-up dose of adenosine for the management of supraventricular
tachycardia unresponsive to the first adenosine dose? - CORRECT ANSWER 12 mg IV"
"If a patient is conscious, establish IV access prior to synchronized cardioversion and administer
___. - CORRECT ANSWER sedation"
"Generally speaking, electrical cardioversion is not recommended as the initial therapy for
patients unless the HR is above ___. - CORRECT ANSWER 150/min"
"After activating the sync control button in preparation for delivering electrical cardio version,
what is the most important next step? - CORRECT ANSWER Look for markers on the R wave
indicating sync mode" "Symptoms of instability are not usually caused by HR less than ______ unless ventricular
function is impaired. - CORRECT ANSWER 150/min"
"A 74- year old man was brought to the hospital by his wife. She states that her husband started having sudden-left arm weakness and left-sided facial paralysis during lunch. He has a past medical history of poor controlled hypertension. The patient's vital signs show HR 92/min, RR 14/min, BP 130/86 mmHG, SpO2 97% and atrial fibrillation on the monitor. What additional assessment and stabilization activities should be completed within the first 10
min after the patient's arrival? - CORRECT ANSWER Check glucose
Complete neurologic screening Order an emergent CT scan or MRI of the brain and review pt history Establish IV access Activate the stroke team" "Within 45 mins, the neuroimaging interpretation of the CT scan of the brain suggests an acute ischemic infarction. There are no signs of hemorrhage or mass lesions. Is this pt a potential
candidate for fibrinolytic therapy? - CORRECT ANSWER Yes"
"To determine whether the pt is a candidate for fibrinolytic therapy, what actions should be
taken? - CORRECT ANSWER Repeat neurologic exam"
"You find that the pt's neurologic function is rapidly improving. Is this pt still a candidate for
fibrinolytic therapy? - CORRECT ANSWER No"
"Because this pt is no longer a candidate for fibrinolytic therapy, what are your next steps for
him? - CORRECT ANSWER Begin the stroke pathway
Admit the patient to an ICU Support ABCs"
"What is the recommended first dose of amiodarone for management of stable wide complex
tachycardia? - CORRECT ANSWER 150 mg IV"
"A 72 year old male patient has been suffering from progressive dizziness and bouts of palpitations after exercising last night. His symptoms reappeared and worsened this morning. The patient is conscious and alert, HR 180/min, a weak radial pulse, BP 110/78 mm Hg, and SpO 96%.
What are the most appropriate initial interventions? - CORRECT ANSWER Attach a 12-lead
ECG
Maintain a patent airway and monitor"
"Would you consider the patient stable or unstable? - CORRECT ANSWER Stable"
"What rhythm is shown on the monitor? - CORRECT ANSWER Supraventricular tachycardia"
"What do your next steps include? - CORRECT ANSWER IV access
12-lead EKG Vagal Maneuvers" "Vagal maneuvers are unsuccessful. His vital signs are HR 178/min, RR 24/min, and BP 110/ mmHg.
What medication is appropriate for this patient? - CORRECT ANSWER Adenosine 6 mg IV
(follow with saline flush)." "After administration of adenosine, the patient's vital signs are now HR 184/min, RR 26/min, and BP 78/54 mmHg. He now responds only to noxious stimuli.
What is your next action? - CORRECT ANSWER Perform synchronized cardioversion"
"What is the recommended dose of epinephrine during a resuscitation effort? - CORRECT
ANSWER 1 mg IV every 3 to 5 minutes"
"What is the recommended first IV/IO dose of amiodarone for patients in cardiac arrest with
VF/pVT that is unresponsive to defibrillation? - CORRECT ANSWER 300 mg"
"What is the recommended first IV/IO dose of lidocaine for patient in cardiac arrest with VF/pVT
that is unresponsive to defibrillation? - CORRECT ANSWER 1 to 1.5 mg/kg"
"What term best describes an organized rhythm without a pulse? - CORRECT ANSWER PEA"
"PEA can present as which of the following organized rhythms? - CORRECT ANSWER Sinus
rhythm Atrial fibrillation or flutter Bundle branch blocks"
"What is the recommended point to administer epinephrine to a patient with asystole? -
CORRECT ANSWER As soon as IV/IO access is available"
"In addition to hypoxia, what is the most common underlying, potentially reversible cause of
pulseless electrical activity? - CORRECT ANSWER Hypovolemia"
"You are preparing to provide electrical cardioversion. You are monitoring the patient's ECG and have applied the defibrillation pads to the patient's bare chest. You have delivered sufficient sedation and have turned the defibrillator on.
What is the next step you should perform? - CORRECT ANSWER Activate the sync control
button."
"What roles does ECPR fill in the management of cardiac arrest? - CORRECT ANSWER Provides
vital organ support while treating reversible causes. Serves as a bridge for left ventricular assist device implantation." "How will the current generation of continuous-flow left ventricular assist devices complicate the
BLS assessment? - CORRECT ANSWER The device will not produce a pulse."
"You are assessing an unresponsive pt known to have an implanted left Ventricular assist device (LVAD). The pt is not breathing, the pts skin is pale and cool, the cap refill is inadequate.
How do you assess whether the LAD is functioning? - CORRECT ANSWER Listen for device
hum"
As Team Leader, you conduct the primary assessment, including rhythm analysis, while high- quality BLS continues.
What type of rhythm is being displayed on the monitor? - CORRECT ANSWER Ventricular
fibrillation"
"Based on the patient's condition, what is your next action? - CORRECT ANSWER Shock
immediately" "After a shock is delivered, CPR resumes immediately. What action also needs to be performed at
this time?q - CORRECT ANSWER Establish IV/IO access"
"After 2 minutes, the team pauses CPR for a rhythm check.
What rhythm is now being demonstrated by the patient? - CORRECT ANSWER Ventricular
tachycardia" "The patient is showing persistent pulseless ventricular tachycardia. What actions need to be
completed next by the team? - CORRECT ANSWER Shock immediately
Resume CPR Administer epinephrine 1mg IV Consider an advanced airway" "At the next pulse check, compressors are switched, and rhythm continues to be refractory ventricular fibrillation/ventricular tachycardia. A shock is delivered and CPR is resumed.
What is your next intervention? - CORRECT ANSWER Administer amiodarone 300mg IV"
"After 2 more minutes of CPR, you conduct a rhythm check and pulse check, confirming absence of a pulse.
Based on the organized rhythm below, describe the patient's condition? - CORRECT ANSWER
PEA"
"Once PEA is identified and there are no signs of ROSC, you continue CPR. What is your next step
for appropriate care for this patient? - CORRECT ANSWER Administer epinephrine 1mg IV"
"After 2 minutes of CPR, you conduct another rhythm check and determine that the patient has the following rhythm and is showing signs of ROSC.
How do you continue treating this patient? - CORRECT ANSWER Move to the Adult Post-
Cardiac Arrest Care Algorithm" "A 70 year old woman suffered a sudden cardiac arrest. After a 10 minute resuscitation attempt, she is showing signs of ROSC. She is intubated and has an IV established. She has a palpable pulse of 65/min, SpO2 94%, ETCO2 of 38 mmHg, and BP 82/55 mm Hg.
What are your highest priorities? - CORRECT ANSWER Maintaining SpO2 92-98%
Maintaining PaCO2 35- Ventilating patient-10 breaths/minute" "In addition to managing the airway and respiratory parameters, which step is also prioritized
during the initial stabilization phase? - CORRECT ANSWER Treating hypotension"
"Match the treatment for hypotension to the proper initial dosage for an adult based on the AHA
guidelines. - CORRECT ANSWER NS or LR --> 1 to 2 L
Epinephrine --> 2 to 10 mcg per minute Dopamine --> 5 to 20 mcg/kg per minute Norepinephrine IV --> 0.1 to 0.5 mcg/kg per minute" "The patient's ventilation and BP have responded to treatment. What other lab or diagnostic tests
would be appropriate to consider at this time for reversible causes? - CORRECT ANSWER
Temperature 12 lead ECG Troponin Test"
"You obtain a 12-lead ECG. What is the most appropriate action to take next? - CORRECT
ANSWER Transfer the patient to a cardiac cath lab for percutaneous coronary intervention"
"The patient is unable to follow verbal commands. What intervention should the team consider?
CORRECT ANSWER Targeted temperature management"
"Which of the following are immediately available as feedback from CPR performance monitors?
- CORRECT ANSWER Chest compression rate Compression depth
What steps should be followed to start pacing? - CORRECT ANSWER Ideally, administer a
sedative and analgesic for conscious patients. Set the demand rate Attach pacing electrodes on the chest according to package instructions Turn the pacer on Set the current"
"What is an appropriate demand rate for the transcutaneous pacer? - CORRECT ANSWER 60
to 80/min" "You initiated transcutaneous pacing but are unable to palpate a pulse that matches vour electrical capture.
Do you have mechanical capture? - CORRECT ANSWER No"
"The patient suddenly loses consciousness and stops breathing. You assess the underlying ECG rhythm.
What is this rhythm? - CORRECT ANSWER Ventricular fibrillation"
"What is the most important next action for this patient? - CORRECT ANSWER Deliver a shock"
"The team started CPR immediately after delivering the shock. After 2 minutes, the rhythm was unchanged and a second shock was delivered.
What medication can be administrated at this time. - CORRECT ANSWER Epinephrine 1 mg IV"
"After securing the ET tube, what ration of compressions to the ventilations should you deliver?
CORRECT ANSWER Continuous compressions with 1 breath every 6 seconds"
"The patient remains in ventricular fibrillation after another 2 minutes of CPR.
What additional medication can you administer? - CORRECT ANSWER Amiodarone 300mg IV"
"The patient is showing signs of ROSC. She has a palpable pulse, HR 65/min, SpO2 94%, ETCO 38mm Hg, and BP 82/55 mmHg.
Which are the highest priority interventions per the adult post cardiac arrest care algorithm? -
CORRECT ANSWER Maintaining a target PaCO2 between 35 and 45 mmHg
Maintaining SpO2 92 to 98% Ventilating the patient with 10 breaths per minute" "In addition to managing the airway and respiratory parameters, which step is also prioritized
during the initial stabilization phase? - CORRECT ANSWER Treating hypotension"
“What element of a system of care is represented by properly functioning resuscitation
equipment? - CORRECT ANSWER Structure"
"What is the first link in the out-of-hospital cardiac arrest (OHCA) chain of survival? - CORRECT
ANSWER Activation of emergency reponse"
"What are signs of clinical deterioration that would prompt the activation of rapid response
system? - CORRECT ANSWER Symptomatic hypertension
Seizure Unexplained agitation"
"Which is the main advantage of effective teamwork? - CORRECT ANSWER Division of tasks"
"Which is the best example of a role of the team leader? - CORRECT ANSWER Models
excellent team behavior"
"Which is the best example of a role of a team member? - CORRECT ANSWER Prepared to
fulfill their role responsibilities"
"What is the primary purpose of the CPR coach on a resuscitation team? - CORRECT ANSWER
Increasing CPR quality"
"Which is an example of knowledge sharing by a team leader? - CORRECT ANSWER Asking for
suggestions about interventions"
"Which is an example of summarizing and reevaluating? - CORRECT ANSWER Increasing
monitoring of the patients condition deteriorates"
"Which is a step of closed-loop communication? - CORRECT ANSWER Confirming task
completion before assigning another task"
"Which are examples of mutual respect? Select all that apply: - CORRECT ANSWER
Acknowledging correctly completed tasks in a positive way Ensuring that only one person talks at a time"
"If someone starts developing hypotension after giving morphine or nitroglycerin? - CORRECT
ANSWER Administer fluids"
"Which class of medications commonly given to patients with acute coronary syndrome may be
adversely affected by morphine administration? - CORRECT ANSWER Oral anti platelet meds"
"What is the benefit of morphine when given for management of acute coronary syndrome? -
CORRECT ANSWER Central nervous system analgesic"
"You obtain a 12-lead ECG in a patient with retrosternal chest pain. Which ECG finding is suggestive of high risk non-ST-segment elevation acute coronary syndrome?
- CORRECT ANSWER Dynamic t wave inversion" "Upon reviewing a patients 12 lead ECG, you note ST segment elevation of 2mm in leads 2, 3, and aVF.
"Which action is part of the secondary assessment of a conscious patient? - CORRECT
ANSWER Formulate a differential diagnosis"
"Upon reviewing a patients 12-lead ECG, you note ST-segment elevation of 2mm in leads II, III and aVF.
How would you classify these ECG findings? - CORRECT ANSWER ST-segment elevation
myocardial infarction" "What is the goal for first medical contact-to-balloon inflation time for a patient receiving
percutaneous coronary intervention? - CORRECT ANSWER 90 min"
"What is the longest acceptable emergency door to needle time when fibrinolysis is the indented
reperfusion strategy? - CORRECT ANSWER 30 min"
"What is the recommended window after symptoms onset for early fibrinolytic therapy or direct catheter based reperfusion for patients ST segment elevation myocardial infarction and no
contraindications? - CORRECT ANSWER Within 12 hours"
"Within the first 10 minutes, on the basis of the patient showing symptoms suggestive of
myocardial ischemia, what will your first actions include? Select all that apply - CORRECT
ANSWER Administer aspirin
Assess ABCs If considering prehospital fibrinolysis, perform fibrinolytic checklist Provide prehospital notification to the reveiving hospital Consider 02, nitro and morphine Obtain a 12 lead ECG" "What is the estimated probability of the prehospital stroke scale with 1 abnormal finding when
scored by prehospital providers? - CORRECT ANSWER 72%"
"What is a stroke severity tool that helps EMS differentiate a large vessel occlusion stroke from a
non-large vessel occlusion stroke? - CORRECT ANSWER Los Angeles motor scale"
"What is the primary advantage of using a stroke severity tool? - CORRECT ANSWER It helps
identify large vessel occlusion stroke"
"What is the most appropriate destination for patients with suspected acute ischemic stroke? -
CORRECT ANSWER Certified stroke center"
"What is the highest level of stroke center certification? - CORRECT ANSWER Comprehensive
stroke center" "Which is an advantage of EMS transport to a stroke hospital for a patient with a suspected acute
ischemic stroke? - CORRECT ANSWER Responding providers can stabilize critical issues"
"What is an advantage of EMS alerting the receiving facility of the impending arrival of a patient
with suspected acute ischemic stroke? - CORRECT ANSWER The hospital can perform more
efficient evaluation and management" "Identify the systolic blood pressure threshold for withholding fibrinolytic therapy to otherwise
eligible patients with acute ischemic stroke. - CORRECT ANSWER 185"
"Identify the diastolic blood pressure threshold for withholding fibrinolytic therapy to otherwise
eligible patients with acute ischemic stroke. - CORRECT ANSWER 110"
"What blood glucose level should trigger administration of IV or subq insulin for a patient with
acute ischemic stroke? - CORRECT ANSWER 180"
"What tidal volume typically maintains normal oxygenation and elimination of carbon dioxide? -
CORRECT ANSWER 6-8"
