ACLS Certification Exam

The exam is contrived of 50 multiple-choice questions.
Questions are crafted in accordance with the most recent ACLS manual which is AHA endorsed.
There is no time limit. Additionally, there is no time frame requirements to submit your answer selection. Complete at the pace you choose.
You must click the “FINISH” button on the bottom of the exam in order for our advisors to receive your answer selection. Failure to do so will require you to retake the entire exam as the test selection cannot be saved.
You must score at least 80% to pass the exam.
Pay only after passing your exam to get your instant certification card on email and by post.
A free hard copy card will be mailed according to the shipping selection made by the individual.
You are not required to attend an in-person skills evaluation in order to receive your certification card.
If you score lower than 80%, you may study then retake the test and submit your new answer selection.

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#1. You are providing high quality chest compressions during a cardiac arrest in the hospital. The anesthesiologist has arrived to intubate the patient. The total amount of time for interruptions in chest compressions is which of the following?

Whatever amount of time it takes to secure a definitive airway

1 minute or less

10 seconds or less

30 seconds or less

#2. A patient has the following rhythm on the cardiac monitor, and nursing staff informs you that the patient is unconscious and does not have a pulse. The patient has received 2 minutes of high quality chest compressions and a peripheral IV has been placed. What rhythm is this patient in and what medication should you administer first?

PEA arrest, 300 mg amiodarone

Normal sinus rhythm, no medications needed

PEA arrest, 1 mg epinephrine

PEA arrest, no medications required, you must defibrillate

#3. A patient in cardiac arrest has received 2 unsynchronized defibrillations and 2 doses of epinephrine 1 mg but continues to be in ventricular fibrillation. Which of the following isrecommended next?

Amiodarone 300 mg IV

Amiodarone 150 mg

Lidocaine 1 mg

Epinephrine 1 mg

#4. High quality CPR in an adult includes…

Compressionsup to 2 inches in depth

Compressions up to a rate of 100/min

Compressions that involve placing the heel of the hand between the clavicles

None of the above

#5. High quality CPR in an adult includes…

Compressions 2 to 2.4 inches in depth

Compression rate between 100 and 120 per minute

Compressions that allow for full chest recoil

All of the above

#6. You witness an elderly gentleman collapse at a mall. After determining that the scene is safe, what is your next step?

Check for responsiveness

Start rescue breaths

Call 911

Get an AED

#7. For the gentleman in Question #6, you are helping to resuscitate the patient when a 2nd rescuer arrives to help resuscitate the patient. The two of you work together to alternate chest compressions and rescue breaths at which of the following rates?

30:2

15:2

100:2

100:2.4

#8. You are asked to evaluate a patient with a heart rate of 30 beats per minute. The patient is increasingly disoriented and hypotensive. While the ECG is being performed, what is your next step?

Synchronized defibrillation

Atropine 0.5 mg IV

Dopamine 1 mg IV

Atropine 1 mg IV

#9. A patient has been successfully resuscitated after a team provides ACLS. The patient is awake, answering questions appropriately, and following commands. What steps below are involved in the Return of Spontaneous Circulation (ROSC)?

Optimize ventilation and oxygenation

Give fluids for hypotension or systolic blood pressure <90 mmHg

Therapeutic temperature management (hypothermia)

A and B

#10. A patient on the general medical floor has a heart rate of 170 beats per minute that appears narrow and regular on the cardiac monitor. He is conversant and appropriate, with blood pressure 128/88 mmHg. The patient does not respond to vagal maneuvers or carotid massage. She has been given a 6 mg dose of adenosine but continues to have the same heart rate. The patient is stable otherwise. What is your next step?

Repeat adenosine dose at 6 mg IV

Adenosine 12 mg IV

Epinephrine 1 mg IV

Atropine 0.5 mg IV

#11. Emergency medical services responds to a call by a 60-year-old male with a 20 pack year smoking history, complaining of left-sided chest pain with radiation to his left arm and jaw. His pulse oximetry reading is 91% on room air. His blood pressure is 150/90 mmHg. You learn that the patient has no known drug allergies. What should be administered at this time?

Aspirin

Sublingual nitroglycerin

Oxygen

All of the above

#12. You are walking alone in the woods and find a person lying on the ground with no apparent visible trauma. The length of time down is unknown. The scene seems safe. Which of the following is the correct next step?

Check for a pulse

Check for responsiveness

Two minutes of chest compressions

Retrieve AED

#13. You determine that the victim in the last question is unresponsive. Which of the following is the correct next step?

Check for a pulse and breathing

Start rescue breathing

Two minutes of chest compressions

Retrieve AED

#14. You determine that the victim in the last two questions does not have a pulse and is not breathing. You look at your phone and find that you do not have cellphone service. Which of the following is the correct next step?

Check again for a pulse

Leave victim to activate EMS

Two minutes of chest compressions

Retrieve the AED

#15. True or false? Intravenous magnesium can be given for a patient with a cardiac rhythm of torsades de pointes?

TRUE

FALSE

#16. A patient with the following heart rhythm is seen in the Emergency Room. The patient’s systolic blood pressure is 70 mmHg, and he is complaining of shortness of breath and chest discomfort. He was talking normally when he came in, but now does not know where he is. What is your next step?

Adenosine 6 mg IV

Synchronized cardioversion

Atropine 0.5 mg IV

Vagal maneuvers or carotid massage

#17. During CPR you see an EtCO2 value of 5 mmHg on waveform capnography. You should assume…

CPR is adequate

CPR is inadequate

Return of Spontaneous Circulation (ROSC) has occurred

Supplemental CO2 is needed

#18. A patient has sinus bradycardia and is hemodynamically unstable. The patient has received 6 doses of atropine (total 3 mg) with little benefit. What should you do next?

Give additional dose of atropine

Dopamine 2 mcg/kg/min

Dopamine 2 mcg/L

Unsynchronized defibrillation (“shock”)

#19. Vasopressin is…

Recommended as a first line treatment for ventricular fibrillation

Recommended to replace the first or second dose of epinephrine during PEA arrest/asystole

Recommended as a first line treatment after Return of Spontaneous Circulation (ROSC)

No longer recommended for PEA arrest/asystole because it is no better than epinephrine

#20. You arrive to find a patient in cardiac arrest. A rescuer has started chest compressions and asks you to ventilate the patient with a bag valve mask. Ventilations should be delivered at what rate?

30 breaths per minute

1 breath every 10-12 seconds

1 breath every 5-6 seconds

Provide breaths as quickly as possible

#21. You are an emergency medical services (EMS) worker and you have been called to the home of a 70-year-old woman who has new onset slurred speech and facial droop. Her symptoms started 15 minutes ago. You are worried that she is having a stroke. You are 5 minutes away from a small local hospitalthat does not provide tPA. The closest hospital with tPA is 45 minutes away. What should you do?

Give the patient chewable aspirin and have her follow-up with her primary care physician

Take the patient to the closest hospital because this is an emergency

Take patient to the hospital with tPA

The stroke is too old; treatment will not be effective

#22. Epinephrine is used in several ACLS algorithms. Which condition should NOT be treated with epinephrine?

Asystole

Pulseless electrical activity (PEA)

Narrow QRS, monomorphic stable tachycardia

Pulseless ventricular tachycardia

#23. True or False? PEA arrest is first treated with unsynchronized defibrillation (shock).

TRUE

FALSE

#24. You are at the grocery store when you witness a shopper suddenly collapse and you are unable to feel a pulse. You and another customer begin Basic Life Support (BLS). Once emergency medical services (EMS) arrives the patient is intubated. With the establishment of an advanced airway, what is the new rate of delivery breaths?

After 300 chest compressions

1 breath every 10 seconds

1 breath every 6 seconds

1 breath every 8 seconds

#25. A cardiac arrest patient achieves Return of Spontaneous Circulation (ROSC). The patient does not respond to painful stimuli. True or false: Targeted temperature management is appropriate in the patient.

TRUE

FALSE

#26. The location to check for a pulse in an adult is which of the following?

Femoral

Brachial

Pedal

Carotid

#27. A patient with known hyperthyroidism presents with tachycardia. She is stable and does not even notice that her heart rate is fast. Which of the following is the first step to lower her heart rate?

Adenosine 6 mg IV

Synthroid (levothyroxine; synthetic thyroid hormone)

Vagal maneuvers/carotid massage

Bolus of normal saline

#28. A patient in pulseless ventricular tachycardia is refractory to unsynchronized defibrillation. He has received a total of 3 shocks, 1dose of epinephrine, and 1 dose of amiodarone. What should you consider next?

Amiodarone 150 mg IV

Atropine .5 mg IV

Lidocaine1 mg IV

Epinephrine 5 mg IV

#29. Which of the following is safe to do to a cardiac arrest patient while administering a shock?

Pulse check

Rescue breathing

Chest compression

None of the above

#30. A shock was administered. What is the next thing that should be done?

Pulse check

Rescue breathing

Chest compressions

None of the above

#31. A Code Blue is called in the hospital. Once you arrive you see the following rhythm on the cardiac monitor. The patient is unresponsive and does not have a pulse. Someone is performing chest compressions. What do you do next?

Give lidocaine 1 mg IV

Give epinephrine 1 mg IV

Unsynchronized defibrillation

Give vasopressin 40 mg IV

#32. After a patient develops Return of Spontaneous Circulation (ROSC), what is the goal for end-tidal CO2(EtCO2)

< 10 mmHg

35-40 mmHg

100 mmHg

> 10 mmHg

#33. The recommended definitive treatment for myocardial infarction is…

Tissue plasminogen activator (tPA)

Percutaneous coronary intervention (PCI)

Unsynchronized cardioversion

Pericardiocentesis

#34. True or false? An end-tidal CO2 during ACLS of <10 mmHg is indicative of high quality chest compressions?

TRUE

FALSE

#35. You are providing life support to an adult in cardiac arrest. The AED is in place, so you suspend chest compressions to analyze the rhythm. A shock is indicated. You are unsure how much energy the device should deliver. Which of the following is correct?

Use 360 J of monophasic energy

Simply press “”SHOCK”” (AED will deliver the correct energy)

Use 200 J of biphasic energy

Use 120 J of biphasic energy

#36. You are providing ACLS to an adult in cardiac arrest in a hospital. The rhythm is ventricular defibrillation and the manual defibrillator is in place. A shock is indicated. You are unsure how much energy the device should deliver. Which of the following is correct?

Use 50 J of monophasic energy

Simply press “”SHOCK”” (manual defibrillator will deliver the correct energy)

Use minimum energy dose available

Use maximum energy dose available

#37. You are called to the bedside of a 67-year-old male with the following rhythm on the monitor. The patient is diaphoretic and not answering any questions. The code team is setting up for ACLS. What medications should be administered first?

Epinephrine 1 mg IV

Magnesium sulfate 1 g IV

Vasopressin 40 mg IV

Amiodarone 300 mg IV

#38. In which of the following patients would an oropharyngeal airway be contraindicated?

Unconscious patient

A patient where the chin lift is not adequate enough

A semiconscious patient with intact cough and gag reflex

Patient with recent ischemic stroke

#39. For an unconscious patient with a pulse rate of 62 and no respirations, the rescuer may do all of the following EXCEPT:

Give 1 breath every 5-6 seconds

Initiate chest compressions

Insert an oropharyngeal airway

Administer 100% oxygen

#40. Return of Spontaneous Circulation (ROSC) may be recognized by all of the following signs EXCEPT:

Palpable pulse

Measurable blood pressure

Abrupt decrease in EtCO2 <10 mm Hg

Abrupt increase in EtCO2 >10 mm Hg

#41. Which of the following is NOT an H of the H’s and T’s?

Hypothermia

Hypovolemia

Hypothyroidism

Hypoxia

#42. Which of the following is NOT aT of the H’s and T’s?

Tension pneumothorax

Tracheotomy

Tamponade

Thrombosis

#43. You are caring for a patient with acute myocardial infarction. Her oxygen saturation by pulse oximetry is 95%. True or false: You should give her 100% supplemental oxygen.

TRUE

FALSE

#44. Which of the following indicates that someone with tachycardia is stable?

Altered mental status

Hypertension

Hypotension

Chest tightness and pressure

#45. You are jogging with a friend in an area free from cars or other dangers. Your friend suddenly falls over. You shake him and yell at him, but he appears to be unconscious. The nearest AED is at the ranger station about 2 miles away, which is where you parked your car. What should you do first?

Check breathing

Check pulse

Check breathing and pulse simultaneously

Use your cell phone to activate emergency medical services (call 911)

#46. Emergency help is on the way for your friend from the last question. What should you do next?

Check breathing

Check pulse

Check breathing and pulse simultaneously

Chest compressions

#47. Your friend from the previous questions is not breathing and has no palpable pulse after 10 seconds of palpating his carotid artery. What should you do next?

Provide rescue breathing

Check pulse for a little longer

Provide the Heimlich maneuver

Provide chest compressions

#48. A patient has wide QRS complex stable tachycardia that is regular and monomorphic. A previous ECG showed that his QT interval was prolonged. Which of the following would be an appropriate treatment for this patient?

Epinephrine

Procainamide

Sotalol

None of the above

#49. Which of the following ECG changes would prompt you to send a patient for emergent/urgent percutaneous coronary intervention (PCI)?

ST-segment elevation

ST-segment depression

T wave inversion

Peaked T waves

#50. You are on an ambulance crew that has pulled a car accident victim from a frozen lake. The person has no pulse after feeling the carotid artery for 10 seconds, but the cardiac monitor shows sinus bradycardia of a rate of 30 beats per minute. Which of the following is most likely?

The person has pulseless electrical activity

You did not check the pulse long enough to feel a heartbeat

The ECG leads are improperly placed

The person has asystole

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