Free ACLS Medical Training Question and Answers — Questions and Answers

Question 1: Adult chest compressions are performed as follows:

Approximately 100–120 compressions per minute (Correct answer)
Around 60–80 compressions per minute
A minimum of 80 compressions per minute
A rate of 80 to 100 compressions per minute.

Correct answer: Approximately 100–120 compressions per minute

For adult chest compressions, ACLS guidelines recommend a rate of approximately 100–120 compressions per minute. This rate, combined with adequate depth (at least 2 inches or 5 cm) and full chest recoil, is crucial for optimizing blood flow to the brain and heart during cardiac arrest. Maintaining this rate helps ensure continuous and effective perfusion.

Question 2: A bag valve mask is used to ventilate an adult patient who is in respiratory arrest and has a pulse:

12 to 14 times per minute
14 to 16 times per minute
8 to 10 times per minute
10 to 12 times per minute (Correct answer)

Correct answer: 10 to 12 times per minute

For an adult patient in respiratory arrest who still has a pulse, the recommended ventilation rate using a bag-valve-mask is one breath every 5 to 6 seconds, which equates to 10 to 12 breaths per minute. This rate provides adequate oxygenation and ventilation without causing hyperventilation, which can negatively impact cardiac output and cerebral blood flow.

Question 3: Following a cardiac arrest, hypotension is not treated with:

IV dopamine infusion
IV calcium infusion (Correct answer)
IV epinephrine infusion
IV Ringer’s lactate or IV normal saline

Correct answer: IV calcium infusion

Following a cardiac arrest, hypotension is typically treated with intravenous fluids (such as Ringer’s lactate or normal saline) and vasopressor infusions like dopamine or epinephrine to support blood pressure and organ perfusion. Intravenous calcium infusion is not a standard treatment for post-cardiac arrest hypotension, although it may be used in specific circumstances like hyperkalemia or calcium channel blocker overdose.

Question 4: The team resuscitation leader is required to:

Become a certified leader.
Be a physician.
Receive leadership development.
Possess the ability to use all skill when necessary. (Correct answer)

Correct answer: Possess the ability to use all skill when necessary.

An effective resuscitation team leader is required to possess the ability to use all skills necessary during a resuscitation effort. While their primary role is to direct and coordinate the team, a comprehensive understanding of all procedures allows them to guide team members, troubleshoot issues, and step in if needed. This ensures a high-performance resuscitation environment and optimal patient care.

Question 5: How soon after arriving at the emergency room is it advised that patients with an ST-segment elevation myocardial infarction be taken for a balloon procedure to the cardiac catheterization lab?

15 minutes
30 minutes
60 minutes
90 minutes (Correct answer)

Correct answer: 90 minutes

For patients presenting with an ST-segment elevation myocardial infarction (STEMI), the recommended goal for door-to-balloon time (time from emergency department arrival to primary percutaneous coronary intervention, or PCI) is within 90 minutes. This rapid intervention is critical to restore blood flow to the ischemic heart muscle, thereby minimizing cardiac damage and improving patient outcomes.

Question 6: It is possible to gauge CPR's efficacy by:

Arterial diastolic blood pressure
Quantitative waveform capnography
Central venous oxygen saturation
All of the above (Correct answer)

Correct answer: All of the above

The efficacy of CPR can be gauged by monitoring several physiological parameters. Quantitative waveform capnography (ETCO2) reflects cardiac output, arterial diastolic blood pressure correlates with coronary perfusion pressure, and central venous oxygen saturation (ScvO2) indicates tissue oxygen delivery. Monitoring all these parameters provides a comprehensive assessment of CPR quality and effectiveness, guiding resuscitation efforts.

Question 7: The best method for treating narrow-complex supraventricular tachycardia is:

Amiodarone
Atropine
Adenosine (Correct answer)
Epinephrine

Correct answer: Adenosine

Adenosine is the first-line pharmacologic treatment for stable narrow-complex supraventricular tachycardia (SVT) that does not respond to vagal maneuvers. It works by transiently blocking AV nodal conduction, which often terminates the re-entrant pathway responsible for SVT. Its rapid onset and short duration of action make it ideal for this condition.

Question 8: What is the treatment for pulseless electrical activity?

Magnesium
Epinephrine (Correct answer)
Atropine
Unsynchronized cardioversion

Correct answer: Epinephrine

The primary pharmacologic treatment for pulseless electrical activity (PEA) in the ACLS algorithm is epinephrine. Epinephrine's vasoconstrictive effects help to increase coronary and cerebral perfusion pressure during CPR, improving the chances of return of spontaneous circulation. While identifying and treating reversible causes is crucial, epinephrine is administered concurrently.

Question 9: When providing basic life support to an adult, the proper procedure is:

ABC - Airway, Breathing, Compressions
ACB - Airway, Compressions, Breathing
CAB - Compressions, Airway, Breathing (Correct answer)
BCA - Breathing, Compressions, Airway

Correct answer: CAB - Compressions, Airway, Breathing

The proper sequence for adult basic life support (BLS) is C-A-B: Chest Compressions, Airway, then Breathing. This sequence prioritizes immediate chest compressions to maintain vital organ perfusion, as delays in compressions significantly reduce survival rates. Establishing an airway and providing breaths follow after initiating compressions.

Question 10: How much adenosine should be given initially to treat supraventricular tachycardia?

100 mg IV
1 mg IV
12 mg IV
6 mg IV (Correct answer)

Correct answer: 6 mg IV

The initial recommended dose of adenosine for supraventricular tachycardia (SVT) is 6 mg, administered as a rapid intravenous (IV) push, followed immediately by a saline flush. If the rhythm does not convert, a second dose of 12 mg can be given. This dosing strategy is crucial for effectively terminating SVT.

Question 11: What is the typical heart rate at which tachycardia manifests symptoms?

150 bpm (Correct answer)
100 bpm
60 bpm
50 bpm

Correct answer: 150 bpm

While tachycardia is generally defined as a heart rate over 100 bpm, symptoms often become significant and require intervention when the heart rate exceeds 150 bpm. At rates above 150 bpm, ventricular filling time can be severely compromised, leading to decreased cardiac output and symptoms such as hypotension, altered mental status, or chest pain.

Question 12: You are the paramedic driving a 65-year-old woman in an ambulance. She has a perceptible pulse, and you can see this rhythm because the patient is attached to the monitor. What's the beat?

Sinus rhythm
PEA
Sinus bradycardia (Correct answer)
Second degree heart block

Correct answer: Sinus bradycardia

The scenario describes a patient with a perceptible pulse and a slow heart rate observed on the monitor. Sinus bradycardia is an organized rhythm originating from the sinus node with a heart rate less than 60 bpm. Given the presence of a pulse and a slow rate, sinus bradycardia is the most accurate description among the choices.

Question 13: True or False: Pulse checks need to last at least 10 seconds.

TRUE
FALSE (Correct answer)

Correct answer: FALSE

The statement 'Pulse checks need to last at least 10 seconds' is false. ACLS guidelines recommend that pulse checks should not exceed 10 seconds. Prolonged pulse checks lead to significant interruptions in chest compressions, which are detrimental to patient outcomes. If a pulse is not definitively felt within 10 seconds, chest compressions should be resumed immediately.

Question 14: True or False: For symptomatic bradycardia, 0.5 mg IV of atropine is the initial dosage that is advised.

TRUE
FALSE (Correct answer)

Correct answer: FALSE

The statement 'For symptomatic bradycardia, 0.5 mg IV of atropine is the initial dosage that is advised' is false. The initial recommended dose of atropine for symptomatic bradycardia is 1 mg IV. This dose can be repeated every 3 to 5 minutes, up to a maximum total dose of 3 mg, to increase heart rate and improve symptoms.

Question 15: When eligible stroke patients are treated with fibrinolytics, the following objectives are pursued:

Within 3 hours of arrival to the ED
Within 1 hour of arrival to the ED (Correct answer)
Within 4 hours of arrival to the ED
Within 6 hours of arrival to the ED

Correct answer: Within 1 hour of arrival to the ED

For eligible acute ischemic stroke patients, the objective for administering intravenous fibrinolytics (thrombolytics) is within 1 hour of arrival to the emergency department (door-to-needle time). This rapid treatment is critical to dissolve the clot and restore blood flow to the brain, thereby minimizing neurological damage and improving patient outcomes.

Question 16: The "H's and T's," or the most prevalent reversible causes of PEA, are the following, with the exception of:

Tamponade
Hypovolemia
Hypoxia
Hypocalcemia (Correct answer)

Correct answer: Hypocalcemia

The 'H's and T's' are a critical mnemonic in ACLS for identifying reversible causes of pulseless electrical activity (PEA). These include Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo-/Hyperkalemia, Hypothermia, Toxins, Tamponade (cardiac), Tension pneumothorax, and Thrombosis (coronary or pulmonary). Hypocalcemia is not typically recognized as one of the primary reversible causes in the ACLS algorithm.

Free ACLS Medical Training Question and Answers

Adult chest compressions are performed as follows: