ACLS Certification Exam
What is the maximum time allowed for interruptions in CPR such as checking for breathing and pulse in order to maximize time spent on compressions?
10 seconds
Signs of unstable tachycardia may include all of the following EXCEPT:
Abdominal tenderness
The ACLS Survey includes assessing which of the following?
Airway, Breathing, Circulation, Differential Diagnosis
Bradycardia is defined as any rhythm disorder with a heart rate less than: A) 50 beats per minute B) 60 beats per minute C) 70 beats per minute D) 40 beats per minute
B) 60 beats per minute
What item is NOT an example of Advanced Airways? A) Esophageal-tracheal tube (combitube) B) Oropharyngeal airway (OPA) C) Endotracheal tube (ET tube) D) Laryngeal mask airway (LMA)
B) Oropharyngeal airway (OPA)
According to the 2015 ILCOR Guidelines, stopping chest compressions for any reason, such as pulse checks, should be limited to less than: A) 30 seconds B) 60 seconds C) 10 seconds D) 3 seconds
C) 10 seconds
Symptoms suggestive of ACS may include all of the following EXCEPT:
Chest discomfort with lightheadedness, sweating, or nausea
All of the following are found within the 8 D's of Stroke Care EXCEPT: A) Delivery B) Detection C) Decision D) Debilitation
D) Debilitation
The following drugs and/or interventions may be used in the ACS individual for cardiac reperfusion: A. Fibrinolytic therapy B. Atropine C. Percutaneous coronary intervention (PCI) D. Both A and C
D. Both A and C
Which of the following can represent a correct treatment choice for an individual in asystole? A. Synchronized shock with an AED B. Epinephrine C. Vasopressin D. Both B and C
D. Both B and C
Medication is the only treatment for an unstable tachycardic individual.
False
Supplemental oxygen should never be given to an individual with acute stroke .
False
The aorta is the wall that separates the ventricles of the heart.
False
Which of the following is the primary treatment in management of ventricular fibrillation?
INCORRECT: all of the above
In confirming and monitoring placement of the ET tube, the 2015 ACLS guidelines suggest what?
INCORRECT: pulse oximetry
The proper steps for operating an AED are:
Power on the AED, attach electrode pads, analyze the rhythm, and shock the individual.
Hyperventillation (over ventillation) can be harmful because it:
All of the above
If an individual suffering from tachycardia loses their pulse, the following should be done: A) Administer atropine B) Immediate defibrillation C) CPR until pulse is detectable D) Immediately resume CPR and switch to ACLS cardiac arrest algorithm
D) Immediately resume CPR and switch to ACLS cardiac arrest algorithm
An individual should be cleared-Ñ prior to a shock only when convenient.
False
Tachycardia is defined as a heart rate greater than:
INCORRECT: 120
Defibrillators have two different designs for delivering energy. What are they?
Monophasic & Biphasic
Medications administered in the early treatment of suspected ACS include:
Oxygen, aspirin, nitroglycerin, and morphine
According to the 2015 ILCOR update, high-quality CPR is defined as: A) 100 chest compressions per minute at a depth of at least one inch B) 100-120 chest compressions per minute at a depth of at least two inches, but not greater than 2.4 inches C) 80 chest compressions per minute at a depth of at least two inches D) 80 chest compressions per minute at a depth of at least one inch
100-120 chest compressions per minute at a depth of at least two inches, but not greater than 2.4 inches
What is the only means of identifying ST-elevation MI (STEMI)?
12-lead ECG
Critical in-hospital goals of stroke care include a neurological assessment by the stroke team and a CT scan performed within ________ of hospital arrival.
25 minutes
In the absence of immediately reversible causes, what is the first-line drug given for symptomatic bradycardia? A) Atropine B) Metoprolol C) Nitroglycerine D) Albuterol
A) Atropine
Thirty ____________ and two ____________ equal one cycle of CPR. A) Chest compressions, ventilations B) Ventilations, compressions C) Chest compressions, pulse checks D) Chest compressions, jaw lifts
A) Chest compressions, ventilations
Which item is NOT a basic airway skill? A) Placement of endotracheal tube (ET tube) B) Bag-mask ventilation C) Jaw-thrust maneuver without head extension D) Head-tilt-chin-lift maneuver
A) Placement of endotracheal tube (ET tube)
Why should therapeutic hypothermia be considered in an adult comatose person during the post-cardiac arrest period? A) To protect the brain/organs B) To re-establish circulation C) To prevent sepsis D) To prevent tachycardia
A) To protect the brain/organs
Upon assessment, the individiual is confused and complains of a headache and the left side of his body being numb. What do you suspect is the most likely diagnosis? A) Sepsis B) Unstable tachycardia C) Acute coronary syndrome D) Acute stroke
Acute stroke
The BLS Survey changed in the 2010 ILCOR update. Which of the following describes this change? A) Start with chest compressions instead of two rescue breaths. B) Survey is no longer represented by the mnemonic ABCD; instead, it is represented by the numbers 1, 2, 3, 4. C) Chest compressions should be continued while preparing the AED to minimize breaks. D) All of the above
All of the above
For an individiual in respiratory arrest with a pulse, how often should they be ventilated? A) Give two breaths every 8 to 9 seconds, or 13 to 15 breaths per minute. B) Give one breath every 5 to 6 seconds, or 10 to 12 breaths per minute. C) Give one breath every 3 to 4 seconds, or 15 to 20 breaths per minute. D) Give one breath every 8 to 9 seconds, or 6 to 8 breaths per minute.
B) Give one breath every 5 to 6 seconds, or 10 to 12 breaths per minute.
True statements about AED use in special situations include all of the following EXCEPT: A) Do not use an AED in water. B) Leave medication patches in place and place the AED electrode pads directly over the patch. C) Do not place the AED electrode pads directly over an implanted defibrillator or pacemaker. D) Extra care in placing electrode pads may be needed in individuals with a hairy chest.
B) Leave medication patches in place and place the AED electrode pads directly over the patch.
Where is the start of the mechanical movement of the heart generally thought to begin? A) Left atrium B) Right atrium C) Left ventricle D) Right ventricle
B) Right atrium
The chambers of the heart responsible for circulating deoxygenated blood from the systemic circulation to the pulmonary circulation are the following: A) Left ventricle and right atrium B) Right atrium and right ventricle C) Left atrium and right ventricle D) Left atrium and left ventricle
B) Right atrium and right ventricle
Where does sinus tachycardia originate? A) Atrioventricular node B) Sinoatrial node C) Purkinje system D) Septum wall
B) Sinoatrial node
Which of the following is true concerning ischemic strokes? A) They account for 50% of all strokes and are caused by an occlusion of a vein to a region of the brain. B) They account for 87% of all strokes and are usually caused by an occlusion of an artery to a region of the brain. C) They account for 80% of all strokes and are caused by an occlusion of a vein to a region of the brain. D) They account for 13% of all strokes and are caused by an occlusion of an artery to a region of the brain.
B) They account for 87% of all strokes and are usually caused by an occlusion of an artery to a region of the brain.
Within what time period of arrival to the ED is percutaneous coronary intervention (PCI) recommended for STEMI individuals? A) 10 minutes B) 150 minutes C) 90 minutes D) 20 minutes
C) 90 minutes
Which of the following basic airway adjuncts can be used in a conscious or semiconscious indivudual (with an intact cough and gag reflex)? A)Oropharyngeal airway (OPA) B) Endotracheal tube (ET tube) C) Nasopharyngeal airway (NPA) D) Esophageal-tracheal tube (combitube)
C) Nasopharyngeal airway (NPA)
Early access to medical care, from EMS through reperfusion, improves overall outcomes by: A) Increased access to social support services B) Delaying onset of hypothermia C) Saving more heart tissue from cell death D) Faster access to medications that increase blood clotting
C) Saving more heart tissue from cell death
Which of the following may be essential to maintain an individual's airway open? A) Rescue breaths B) Chest thrusts C) Suctioning D) O2 administration
C) Suctioning
Which of the following is a correct statement regarding sinus tachycardia? A) Sinus tachycardia only results from strenuous exercise or high stress situations. B) Sinus tachycardia is a normal rhythm and never considered dangerous. C) The goal of treatment is to identify and correct the underlying cause. D) Sinus tachycardia should always be treated with shock therapy.
C) The goal of treatment is to identify and correct the underlying cause.
This is an example of which type of heart rhythm? A) Atrial fibrillation B) Pulseless electrical activity C) Ventricular fibrillation D) Atrial flutter
C) Ventricular fibrillation
The compression-to-ventilation ratio during CPR prior to placement of an advanced airway is: A) 15:02 B) 20:01 C) 30:01:00 D) 30:02:00
D) 30:02:00
All of the following statements regarding asystole are correct EXCEPT: A) Vital organs can be permanently damaged. B) Asystolic rhythms can result in severe myocardial ischemia. C) A pulse will not be present in an asystolic individual. D) All heart tissue immediately dies when an individual enters asystole.
D) All heart tissue immediately dies when an individual enters asystole.
During the post-cardiac arrest phase, which of the following medications can be used to treat hypotension? A) Dopamine B) Epinephrine C) Norepinephrine D) All of the above
D) All of the above
Signs and symptoms of a stroke may include: A) Sudden weakness or numbness of the face, arm, or leg B) Sudden trouble seeing in one or both eyes C) Dizziness or loss of balance or coordination D) All of the above
D) All of the above
Symptoms of bradycardia may include: A) Chest pain B) Shortness of breath C) Dizziness D) All of the above
D) All of the above
Which of the following is an alternative to atropine in treating bradycardia? A) Dopamine B) Epinephrine C) Transcutaneous pacing D) All of the above are alternatives.
D) All of the above are alternatives.
If bradycardia is symptomatic, what is the most likely heart rate exhibited? A) Above 50 bpm B) Above 60 bpm C) Below 100 bpm D) Below 50 bpm
D) Below 50 bpm
All of the following are goals of resuscitation EXCEPT: A) Maintain blood pressure. B) Obtain normal sinus rhythm. C) Adequate perfusion. D) Decrease glucose level.
D) Decrease glucose level.
What does the QRS represent? A) Repolarization of the ventricular B) SA node C) Conduction through the AV node D) Depolarization of the ventricular
D) Depolarization of the ventricular
All of the following are appropriate actions by first responders EXCEPT: A) Transport to a nearby stroke center. B) Administer oxygen. C) Check glucose level. D) Find IV access immediately.
D) Find IV access immediately.
You are alone when you encounter an individual in cardiac arrest. They are not breathing, have no pulse, and have no suspected cervical spine trauma. Which maneuver should you use to open the airway? A) Jaw-thrust maneuver B) Blind finger-sweeps C) Head-tilt only D) Head-tilt-chin-lift maneuver
D) Head-tilt-chin-lift maneuver
Fast coronary reperfusion times are associated with: A) Atrioventricular block B) Increased risk of preeclampsia C) Sinus bradycardia D) Improved outcomes
D) Improved outcomes
During a tachycardic episode, if the individual ____________ at any point, you must switch algorithms. A) Salivates B) C) Urinates Vomits D) Loses a pulse
D) Loses a pulse
Blood or secretions in the mouth or upper respiratory tract may threaten the airway. How can they be removed? A) Bag-mask ventllation B) Laryngeal tube C) None of the above D) Suctioning
D) Suctioning
For appropriate treatment, it is vital to discern if the QRS wave is ___________in a tachycardic individual. A) Present or absent B) Right or left C) Positive or negative D) Wide or narrow
D) Wide or narrow
Cardioversion should not be delayed if: A. The individual suddenly deteriorates B. Tachycardia is causing the instability C. The individual becomes pulseless D. Both A and B
D. Both A and B
Acute strokes are a result of:
Either B or C: Blockage of an artery in the brain Rupture of an artery in the brain
Any bradycardia less than 60 beats per minute is a pathologic event.
False
Fibrinolytic therapy is the treatment of choice for hemorrhagic stroke.
False
If the AED advises no shock, you should still defibrillate because defibrillation often restarts the heart with no pulse.
False
If transcutaneous pacing fails, there are no other options to consider.
False
In a suspected acute stroke individual, you must always immediately obtain IV access.
False
Interruptions in CPR for repeated consecutive defibrillator shocks always provide better resuscitation.
False
There is never a pulse associated with VF; therefore, you should follow the PEA algorithm with individuals in VF.
False
Transcutaneous pacing is recommended for asystolic individuals who fail to respond to pharmacological interventions.
False
Urgent defibrillation is essential for survival in the management of acute strokes.
False
Serious signs and symptoms of unstable tachycardia are usually NOT seen with ventricular rates less than: A) 150 beats per minute B) 200 beats per minute C) 120 beats per minute D) 250 beats per minute
INCORRECT: C) 120 beats per minute CORRECT:
Individuals experiencing a suspected ACS should be transported to: A) An appropriate center for triage B) A center that has a dedicated stroke team C) A facility that performs PCI D) A facility with trauma care
INCORRECT: A) An appropriate center for triage
The two most common and easily reversible causes of PEA are:
INCORRECT: Acidosis, hypokalemia
After arrival of an acute stroke individual in the ED, in what time frame should an assessment and an order for a CT scan be completed? A) 60 minutes B) 30 minutes C) 10 minutes D) 90 minutes
INCORRECT: B) 30 minutes
Treatment of PEA should include the following EXCEPT: A) Identify and reverse etiologies of the arrest B) Epinephrine C) Effective CPR D) Defibrillation
INCORRECT: B) Epinephrine CORRECT:
What is the first step in the treatment of persistent tachycardia (heart rate > 150 bpm) causing hypotension, altered mental status, and signs of shock? A) Defibrillation B) Obtain a 12-lead ECG C) Synchronized cardioversion D) Administer a calcium channel blocker
INCORRECT: B) Obtain a 12-lead ECG D) Administer a calcium channel blocker CORRECT:
After performing CPR for two minutes on an individual in asystole, what is the ACLS trained provider's next intervention? A) IV or IO access for atropine administration B) Advanced airway insertion C) IV or IO access for epinephrine administration D) AED shock administration
INCORRECT: D) AED shock administration CORRECT:
Treatment of PEA should include the following EXCEPT: A) Defibrillation B) Epinephrine C) Effective CPR D) Identify and reverse etiologies of the arrest
INCORRECT: D) Identify and reverse etiologies of the arrest CORRECT:
You are alone when you encounter an individual in what appears to be cardiac or respiratory arrest. What are the first three steps you should take to stabilize them? Check for danger, check for response, and ____________. A) Insert an advanced airway. B) Administer an initial shock. C) Send for help. D) Start CPR.
INCORRECT: D) Start CPR. CORRECT:
An important link in the STEMI Chain of Survival is improving myocardial perfusion by:
INCORRECT: Defibrillation
Antiarrhythmic drugs to consider for persistent VF/pulseless VT include all of the following EXCEPT: A) Lidocaine B) Amiodarone C) Atropine D) Magnesium
INCORRECT: Lidocaine, Magnesium
What reason is NOT valid during the critical early defibrillation for individuals experiencing sudden cardiac arrest?
INCORRECT: The probability of successful defibrillation decreases quickly over time.
All of the following are considered classic symptoms of an acute stroke EXCEPT:
INCORRECT: all of the above
Which of the following would be your next action if the rhythm is unshockable, and there is no pulse?
Immediately resume CPR.
In an individual with ventricular fibrillation (VF), what should occur immediately following a shock? A) Resume CPR. B) Give epinephrine. C) Analyze rhythm. D) Check pulse.
Resume CPR
If uncertain whether or not an individual is an appropriate candidate for synchronized cardioversion, the ACLS trained provider should: A) Seek expert consultation. B) Provide increased oxygenation. C) Obtain a coronary CT scan. D) Defer cardioversion until symptoms become irreversible.
Seek expert consultation
Which wave represents repolarization of the ventricles?
T wave
100% oxygen is acceptable for early intervention but not for extended periods of time.
True
Any organized rhythm without a pulse is defined as pulseless electrical activity (PEA).
True
Fibrinolytic therapy within three hours (in some cases 4.5 hours) of first onset of symptoms is the standard when treating ischemic stroke.
True
Low blood pressure may be an indication of hemodynamic instability.
True
Nausea in conjunction with chest pain may be indicative of myocardial ischemia.
True
PEA and asystole are considered non-shockable rhythms and follow the same ACLS algorithm.
True
Symptomatic bradycardia and poor perfusion may degrade into cardiac arrest.
True
Synchronized cardioversion is appropriate for treating an unknown wide complex tachycardia.
True
The most effective treatment for ventricular fibrillation is defibrillation.
True
The right side of the heart is responsible for pulmonary circulation.
True
Therapeutic hypothermia should be considered in the comatose adult after cardiac arrest.
True
Transcutaneous pacing should be used on an individual with bradycardia and inadequate perfusion if atropine is ineffective and the individual is exhibiting severe symptoms.
True
Ventricular fibrillation can be a life-threatening complication of ACS.
True
