Free ACLS Practice Test Question and Answers — Questions and Answers

Question 1: The QRS complex on an ECG stands for the following.

AV valve closure
Septum relaxation
Ventricular contraction (Correct answer)
Atrial contraction

Correct answer: Ventricular contraction

On an electrocardiogram (ECG), the QRS complex represents ventricular depolarization, which is the electrical activation of the ventricles. This electrical event immediately precedes and initiates ventricular contraction (systole), the mechanical pumping action that ejects blood from the heart. The P wave represents atrial contraction, and the T wave represents ventricular relaxation.

Question 2: What is the BLS Chain of Survival's appropriate order?

Check responsiveness, call EMS and get AED, defibrillation, and circulation
Call for help, shock, check pulse, shock, and transport
Look, listen, and feel
Check responsiveness, call EMS and get AED, chest compressions, and early defibrillation (Correct answer)

Correct answer: Check responsiveness, call EMS and get AED, chest compressions, and early defibrillation

The American Heart Association's (AHA) BLS Chain of Survival for adults emphasizes early recognition and activation of the emergency response system, followed by immediate high-quality chest compressions, and rapid defibrillation. The correct sequence is: Check responsiveness, call EMS and get AED, initiate chest compressions, and perform early defibrillation. This prioritizes rapid assessment and intervention for cardiac arrest.

Question 3: If a known alcoholic collapses and is discovered to be experiencing torsades de pointes, what course of action would you follow to address the underlying problem?

Administer magnesium sulfate 1 to 2 gm IV diluted in 10 mL D5W to correct low magnesium. (Correct answer)
Administer naloxone to correct narcotic overdose.
Rewarm the individual to correct hypothermia.
Administer glucose to correct hypoglycemia.

Correct answer: Administer magnesium sulfate 1 to 2 gm IV diluted in 10 mL D5W to correct low magnesium.

Torsades de Pointes (TdP) is a polymorphic ventricular tachycardia often associated with a prolonged QT interval, and hypomagnesemia is a common underlying cause, especially in chronic alcoholics. Magnesium sulfate is the first-line treatment for TdP, regardless of serum magnesium levels, as it helps stabilize cardiac cell membranes and shorten the QT interval, thereby correcting the arrhythmia.

Question 4: What would you do if you were transferring someone who had suffered a cardiac arrest and it was unable to get them an IV?

Place a central line
Administer all medications through ET tube
Terminate resuscitation
Obtain intraosseous access (Correct answer)

Correct answer: Obtain intraosseous access

In a cardiac arrest situation where intravenous (IV) access cannot be rapidly established, intraosseous (IO) access is the preferred alternative for administering medications and fluids. IO access provides a non-collapsible route into the bone marrow, allowing for rapid absorption of drugs directly into the systemic circulation. This makes it a critical intervention when peripheral IV access is difficult or impossible, ensuring timely drug delivery.

Question 5: What would you do if a 79-year-old man was in SVT, had a blood pressure of 80/50, complained of chest pain, and wanted to pass out?

Synchronized cardioversion (Correct answer)
Lidocaine
Carotid massage
Amiodarone

Correct answer: Synchronized cardioversion

A patient in SVT with signs of instability (hypotension, chest pain, altered mental status) requires immediate intervention. Synchronized cardioversion is the definitive treatment for unstable supraventricular tachycardia because it delivers a controlled electrical shock synchronized with the R wave, effectively resetting the heart's electrical activity and restoring a normal rhythm. Medications or vagal maneuvers are typically reserved for stable arrhythmias.

Question 6: What treatment is prohibited in the case of a 55-year-old male with stroke symptoms and multilobar infarction (affecting more than one-third of the cerebral hemisphere) as seen on a CT scan?

Blood pressure monitoring
Oxygen
Monitoring glucose
Thrombolytic therapy (Correct answer)

Correct answer: Thrombolytic therapy

Thrombolytic therapy (e.g., tPA) is contraindicated in stroke patients with multilobar infarction, defined as affecting more than one-third of the cerebral hemisphere, as seen on a CT scan. This finding indicates a large area of ischemic brain tissue that is at high risk for hemorrhagic transformation if reperfused too rapidly. Administering thrombolytics in this scenario significantly increases the risk of intracranial hemorrhage and worsens patient outcomes.

Question 7: What would you do after performing CPR on a person who was in ventricular fibrillation, one attempt at defibrillation, and the person's new rhythm had third-degree AV block?

Vasopressin
High dose epinephrine
Repeat defibrillation
Transcutaneous pacing (Correct answer)

Correct answer: Transcutaneous pacing

After resuscitation from ventricular fibrillation and defibrillation, if the patient develops a new rhythm of third-degree AV block, this indicates a complete block of electrical impulses from the atria to the ventricles, leading to severe bradycardia and hemodynamic instability. Transcutaneous pacing is the appropriate immediate intervention to establish an adequate heart rate and maintain cardiac output until a more definitive solution can be implemented.

Question 8: Which of the following should you evaluate according to the BLS Survey?

Airway, Breathing, Circulation, Defibrillation
Airway, Blood Pressure, CPR, Differential Diagnosis
Responsiveness, Activate EMS and get AED, Circulation, Defibrillation (Correct answer)
Circulation, Breathing, Cardiac Assessment, Drugs

Correct answer: Responsiveness, Activate EMS and get AED, Circulation, Defibrillation

The BLS Survey, according to AHA guidelines, focuses on immediate life-saving actions for cardiac arrest. It involves quickly assessing for responsiveness, activating the emergency medical services (EMS) and retrieving an AED, initiating high-quality chest compressions to ensure circulation, and performing early defibrillation if a shockable rhythm is present. This sequence prioritizes rapid assessment and intervention.

Question 9: How long should ACLS practitioners keep interruptions to a minimum when performing chest compressions?

20 seconds
10 seconds (Correct answer)
30 seconds
60 seconds

Correct answer: 10 seconds

High-quality chest compressions are crucial for maintaining vital organ perfusion during cardiac arrest. ACLS guidelines emphasize minimizing interruptions in chest compressions to less than 10 seconds to maximize coronary and cerebral perfusion pressure. Longer interruptions significantly reduce the effectiveness of CPR and decrease the chances of survival, highlighting the importance of continuous compressions.

Question 10: Which of the following is assessed as part of the ACLS Survey?

Airway, Breathing, Circulation, Differential Diagnosis (Correct answer)
Airway, Breathing, Chest Compressions, Deformity
Airway, Breathing, Circulation, Defibrillation
Airway, Blood Pressure, CPR, Differential Diagnosis

Correct answer: Airway, Breathing, Circulation, Differential Diagnosis

The ACLS Survey expands upon the BLS Survey by incorporating advanced assessment and management. It follows the A-B-C-D approach: Airway (ensuring patency), Breathing (assessing and supporting ventilation), Circulation (monitoring rhythm, blood pressure, and providing medications/defibrillation), and Differential Diagnosis (identifying and treating reversible causes, often referred to as the H's and T's). This comprehensive approach guides advanced resuscitation efforts.

Question 11: Which of the following DOES NOT constitute an essential component of a dynamic resuscitation team?

Closed-loop communication
Precise roles and obligations
Knowing one's own limitations
The team has multiple leaders. (Correct answer)

Correct answer: The team has multiple leaders.

An essential component of a dynamic and effective resuscitation team is having a single, clear team leader who directs actions, assigns roles, and ensures smooth communication. Multiple leaders can lead to confusion, conflicting instructions, and disorganization, hindering efficient patient care during a critical event. Clear roles, closed-loop communication, and knowing one's limitations are all vital for team success.

Question 12: What harm might hyperventilation cause?

Increase intrathoracic pressure
Reduce the heart's venous return
Reduce cardiac output
All of the above (Correct answer)

Correct answer: All of the above

Hyperventilation during CPR is detrimental because it increases intrathoracic pressure, which in turn reduces venous return to the heart. This decreased venous return leads to a reduction in cardiac output and cerebral perfusion, effectively counteracting the benefits of chest compressions. Therefore, excessive ventilation should be avoided to optimize blood flow and improve outcomes during resuscitation efforts.

Question 13: What doesn't constitute a fundamental airway skill?

Head tilt-chin-lift maneuver
Placement of laryngeal mask airway (LMA) (Correct answer)
Jaw-thrust maneuver without head extension
Bag-mask ventilation

Correct answer: Placement of laryngeal mask airway (LMA)

Fundamental airway skills are basic maneuvers and devices used to open and maintain an airway, typically taught in Basic Life Support (BLS). Head tilt-chin-lift, jaw thrust, and bag-mask ventilation are considered basic skills. Placement of a laryngeal mask airway (LMA) is an advanced airway technique requiring specialized training beyond basic life support.

Question 14: What type of suction catheter offers the most proficient oropharynx and heavy particulate matter suctioning?

Pediatric soft flexible catheter
Laryngeal tube
Rigid catheter (Yankauer) (Correct answer)
None of the above

Correct answer: Rigid catheter (Yankauer)

The rigid catheter, commonly known as a Yankauer, is specifically designed for effective suctioning of the oropharynx. Its wide bore and rigid tip make it ideal for removing thick secretions, vomitus, and particulate matter that softer, more flexible catheters might struggle with. This makes it the most proficient choice for heavy particulate suctioning in the mouth and throat.

Question 15: Which of the following is NOT an example of Advanced Airways?

Esophageal-tracheal tube (combitube)
Nasopharyngeal airway (NPA) (Correct answer)
Laryngeal mask airway (LMA)
Endotracheal tube (ET tube)

Correct answer: Nasopharyngeal airway (NPA)

Advanced airways are devices that isolate the trachea and provide a secure, definitive airway, often requiring specialized training for placement. Examples include endotracheal tubes, laryngeal mask airways (LMAs), and esophageal-tracheal tubes (Combitubes). A nasopharyngeal airway (NPA) is considered a basic airway adjunct, used to maintain an open airway in conscious or semiconscious patients, and does not provide the same level of airway control as advanced devices.

Question 16: What justification is inadmissible when doing essential early defibrillation on people who are undergoing sudden cardiac arrest?

Ventricular fibrillation is a typical first rhythm in out-of-hospital observed sudden cardiac arrest (VF).
Electrical defibrillation is the most effective VF treatment.
Late defibrillation works effectively for asystole patients. (Correct answer)
With time, the likelihood of a successful defibrillation falls rapidly.

Correct answer: Late defibrillation works effectively for asystole patients.

Early defibrillation is crucial because ventricular fibrillation (VF) is a common initial rhythm in sudden cardiac arrest, and the success rate of defibrillation decreases significantly with time. Defibrillation is the definitive treatment for VF. However, asystole is a non-shockable rhythm, meaning defibrillation is ineffective for asystole patients, regardless of how early or late it is applied.

Free ACLS Practice Test Question and Answers

The QRS complex on an ECG stands for the following.