ACLS Emergency Pharmacology 3 — Questions and Answers
Question 1: Which route is preferred for epinephrine administration during cardiac arrest when IV access is unavailable?
- Endotracheal (ET)
- Intraosseous (IO) (Correct answer)
- Sublingual
- Intramuscular (IM)
Correct answer: Intraosseous (IO)
Intraosseous (IO) access is the preferred alternative to IV during cardiac arrest when IV cannot be rapidly established.
Question 2: A patient with anaphylaxis is unresponsive with no pulse. Which medication takes priority?
- Diphenhydramine 50 mg IV
- Epinephrine 1 mg (1:10,000) IV every 3–5 min (Correct answer)
- Methylprednisolone 125 mg IV
- Albuterol nebulizer treatment
Correct answer: Epinephrine 1 mg (1:10,000) IV every 3–5 min
Standard ACLS epinephrine 1 mg (1:10,000) IV every 3–5 minutes takes priority when anaphylaxis progresses to cardiac arrest.
Question 3: What is the correct dose of lidocaine for pulseless VT/VF when amiodarone is unavailable?
- 0.5 mg/kg IV push
- 1–1.5 mg/kg IV push (Correct answer)
- 2–3 mg/kg IV push
- 3 mg/kg IV push
Correct answer: 1–1.5 mg/kg IV push
Lidocaine is dosed at 1–1.5 mg/kg IV push as an alternative to amiodarone for pulseless VT/VF.
Question 4: Calcium gluconate is indicated during cardiac arrest caused by which electrolyte abnormality?
- Hyponatremia
- Hypermagnesemia
- Hypokalemia
- Hyperkalemia (Correct answer)
Correct answer: Hyperkalemia
Calcium gluconate (or calcium chloride) stabilizes cardiac membranes in hyperkalemia-induced cardiac arrest.
Question 5: Which statement about amiodarone administration for cardiac arrest is correct?
- It should be mixed with D5W before administration
- The second dose is 150 mg IV push if VF persists (Correct answer)
- It must be given as a slow infusion over 10 minutes
- The first dose is 150 mg IV push
Correct answer: The second dose is 150 mg IV push if VF persists
The second dose of amiodarone in refractory VF/pulseless VT is 150 mg IV push after the initial 300 mg dose.
Question 6: A patient receives epinephrine 1 mg IV for cardiac arrest. When should the next dose be given?
- Every 1–2 minutes
- Every 3–5 minutes (Correct answer)
- Every 5–10 minutes
- Every 10 minutes
Correct answer: Every 3–5 minutes
Epinephrine 1 mg IV/IO is repeated every 3–5 minutes during cardiac arrest.
Question 7: Which drug is used to reverse the effects of a benzodiazepine overdose causing respiratory depression?
- Naloxone
- Flumazenil (Correct answer)
- N-acetylcysteine
- Physostigmine
Correct answer: Flumazenil
Flumazenil is the reversal agent for benzodiazepine toxicity, but must be used cautiously due to seizure risk.
ACLS Emergency Pharmacology 3
Which route is preferred for epinephrine administration during cardiac arrest when IV access is unavailable?