ACLS Practice Test

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  • Which of the following is most likely the result of an untreated arrhythmia?

    • Embolic CVA
    • Thrombotic CVA
    • Hemorrhagic CVA
    • Pulmonary Embolus
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About This Quiz

This pretest is designed to prepare you for the ACLS certification and re-certification exams.
After you have answered the questions and read the comments on each, you will be more than prepared to take and pass the ACLS exams.

ACLS Practice Test - Quiz
Questions and Answers
  • 2. 
    Which of the following is not in the differential for causing this rhythm? - ProProfs

    Which of the following is not in the differential for causing this rhythm?

    • Fever

    • Anemia

    • Anxiety

    • Dehydration

    • Hypoxia

    • Pulmonary Embolus

    • Response to Medications

    • All are in the Differential

    Correct Answer
    A. All are in the Differential
    Explanation
    The above rhythm is Sinus Tachycardia.
    Of note, had the rhythm been over 150 bpm,
    the P waves would have been harder to see,
    merging with the preceding T wave, and
    other rhythms would need to be considered,
    such as SVT or Atrial flutter with 2:1 block.
    The first four items on the above differential
    are unlikely to cause a Sinus Tachycardia
    above 150 bpm.

    Rate this question:

  • 3. 
    Your patient has unstable vital signs and is in the following rhythm.  What would be the next appropriate intervention? - ProProfs

    Your patient has unstable vital signs and is in the following rhythm.  What would be the next appropriate intervention?

    • Adenosine 6 mg

    • Synchronized Cardioversion

    • Agressive Hydration

    • A or B

    Correct Answer
    A. A or B
    Explanation
    This patient is in an SVT.
    Because his vital are unstable,
    he needs to be returned to sinus
    rhythm immediately. Either Adenosine or
    Electrical Synchronized cardioversion would
    be appropriate.

    Rate this question:

  • 4. 
    Your patient has unstable vital signs and is in the following rhythm.  What would be the next appropriate intervention? - ProProfs

    Your patient has unstable vital signs and is in the following rhythm.  What would be the next appropriate intervention?

    • Synchronized Cardioversion

    • Unsynchronized Defibrillation

    Correct Answer
    A. Unsynchronized Defibrillation
    Explanation
    In an unstable patient in whom you are not sure if the Ventricular Tachycardia
    is monomorphic or polymorphic, assume it is polymorphic and defibrillate.

    Rate this question:

  • 5. 
    Your patient is in the following rhythm and has no pulse. - ProProfs

    Your patient is in the following rhythm and has no pulse.

    • Treat with synchronized Cardioversion

    • Treat with unsynchronized Defibrillation

    Correct Answer
    A. Treat with unsynchronized Defibrillation
    Explanation
    This is a wide complex tachycardia and is most likely Ventricular
    tachycardia. While it appears monomorphic, since the patient is
    pulseless, it should be defibrillated.

    In synchronized cardioversion, a lower energy is used and it is
    timed to the QRS. In unsynchronized defibrillation, a higher
    energy is used and the shock is applied immediately, without
    being timed to the QRS complex.

    Rate this question:

  • 6. 
    Your patient has stable vitals and is in the following rhythm. - ProProfs

    Your patient has stable vitals and is in the following rhythm.

    • Ask the patient to Valsalva.

    • Attempt Carotid Massage

    • Treat with Adenosine 6mg Fast IV push

    • All of the above

    Correct Answer
    A. All of the above
    Explanation
    This pt is stable, in SVT. Treatment with vagal maneuvers, as well
    as adenosine are appropriate interventions.

    Rate this question:

  • 7. 

    A patient presents to an Emergency Department unable to speak or to move her right arm.  Her symptoms began approximately 6 hours ago.   This patient is an appropriate candidate for tPA.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    tPA should be given as treatment for an acute CVA when the
    patient presents within 3 hours of the onset of symptoms,
    and there are no contraindications. In some circumstances,
    with input from neurology, the window may be pushed back
    to 4.5 hours.
    Outside of this 4.5 hour window, there is no literature to show
    that the benefits outweigh the risks of treating a CVA with
    tPA and it should not be done.

    Rate this question:

  • 8. 
    A patient presents within 60 minutes of an acute neurologic event.  A CT of her brain reveals an acute hemorrhagic CVA. Is the patient a candidate for tPA? - ProProfs

    A patient presents within 60 minutes of an acute neurologic event.  A CT of her brain reveals an acute hemorrhagic CVA. Is the patient a candidate for tPA?

    • Yes

    • No

    Correct Answer
    A. No
    Explanation
    80% of acute strokes are ischemic.
    The above patient had a hemorrhagic stroke.
    This is an absolute contraindication to tPA.

    Rate this question:

  • 9. 

    In a potential stroke patient, what is the NINDS recommendation for the length of time from ED presentation to performing a CT?

    • 5 Minutes

    • 25 Minutes

    • 1 Hour

    • As quickly as possible

    Correct Answer
    A. 25 Minutes
  • 10. 

    Which of the following is not part of the Cincinnati Prehospital Stroke Scale?

    • Facial Droop (Is the face symmetrical? Have the patient smile)

    • Arm Weakness (Have the patient close his eyes and hold out both hands, palms up)

    • Abnormal Speech (Have the patient say, "You can't teach an old dog new tricks")

    • Poor Balance (Have the patient stand on one foot.)

    Correct Answer
    A. Poor Balance (Have the patient stand on one foot.)
    Explanation
    The Cincinnati Prehospital Stroke Scale is a tool to detect stroke
    in the prehospital setting. If any one of its three components are
    positive, the pt has a 72% likelihood of having an acute CVA.
    If all three are positive, there is an 85% likelihood of the patient
    having an acute CVA.

    Remember, Face/Arm/Speech. Balance is not tested.

    Rate this question:

  • 11. 

    In a patient who presents with new neurologic symptoms, which would not be an absolute contraindication to tPA?

    • A history of a GI bleed in the distant past.

    • Patient presented with a seizure.

    • Patient awakened with symptoms.

    • Minor, resolving symptoms.

    Correct Answer
    A. A history of a GI bleed in the distant past.
    Explanation
    Treatment with tPA comes with a real risk of bleeding and
    it should only be given where appropriate.
    If the patient presents with a seizure, it is not possible to
    differentiate between an Acute CVA and a Todd's Paralysis.
    If the patient awakened with symptoms, the time of onset
    cannot be established.
    If the symptoms are minor and quickly resolving, the risks of
    tPA will exceed its benefits.

    A distant history of GI is not a contraindication.

    Rate this question:

  • 12. 

    As per most recent BLS guidelines, what is the appropriate order of intervention in an adult victim?

    • Airway-Breathing-Chest Compressions (ABC's)

    • Chest Compressions-Airway-Breathing (CAB's)

    Correct Answer
    A. Chest Compressions-Airway-Breathing (CAB's)
    Explanation
    This is a HUGE change in BLS.
    Since adults have approximately 5 minutes of oxygen reserve,
    newer recommendations are to begin chest compressions and
    restore circulation before addressing oxygenation.

    Rate this question:

  • 13. 

    An advanced airways is imperative, as per most recent ACLS guidelines.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    An advanced airway, i.e. and ET tube, is NOT necessary, as per ACLS
    guidelines. As long as the patient is being ventilated adequately, any method
    is acceptable.

    Rate this question:

  • 14. 

    What is the recommended ratio of chest compressions to breaths in CPR?

    • 30:2

    • It depends on the age of the victim.

    • It depends on the size of the victim.

    • It depends on the sex of the victim.

    Correct Answer
    A. 30:2
    Explanation
    To avoid confusion, the universal ratio of chest compression to
    CPR is 30:2, regardless.

    Rate this question:

  • 15. 

    In post cardiac arrest care, the oxygen saturation should be kept at 100%.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    An oxygen saturation of 100% is unnecessary and potentially harmful. Supplemental oxygen should be given until the oxygen saturation is approximately 94%.

    Rate this question:

  • 16. 

    Hyperventilation during resuscitation can cause and increase in intrathorasic pressure and a decrease in cardiac output.

    • True

    • False

    Correct Answer
    A. True
  • 17. 

    During CPR, the rate of chest compressions should be approximately 100/minute

    • True

    • False

    Correct Answer
    A. True
  • 18. 

    The naso-pharyngeal airway (NPA) does not active the gag reflex so it does not cause vomiting. Is it more appropriately used in the conscious or unconscious patient?

    • Conscious or semi-conscious

    • Unconscious

    Correct Answer
    A. Conscious or semi-conscious
  • 19. 

    The oro-pharyngeal airway (OPA) does trigger the gag reflex.  Is it more appropriately using in conscious or unconscious patients.

    • Conscious and semi-conscious patients

    • Unconscious

    Correct Answer
    A. Unconscious
    Explanation
    The OPA sits in the posterior oropharynx, excites and gag reflex,
    and if used in an conscious patient will likely lead to vomiting and aspiration.

    Rate this question:

  • 20. 

    Bystander CPR has not been shown to change outcome.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    For every minute that passes between a witnessed VF arrest
    and defibrillation, the chance of survival decreased by 7-10%.
    With bystander CPR, the decline is more gradual and falls by 3-4% per minute.

    CPR saves lives.

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  • 21. 

    CPR should be begun while the AED is readied for use.

    • True

    • False

    Correct Answer
    A. True
  • 22. 

    In defibrillating VT/VF, in a biphasic defibrillator, the initial shock should be between 120 J and 200 J, each subsequent shock at the same or greater energy. In an monophasic defibrillator, the initial shock should be ______.

    • 100 J

    • 200 J

    • 300 J

    • 360 J

    Correct Answer
    A. 360 J
  • 23. 

    Which of the following does not appear in the algorithm for ventricular fibrillation?

    • Epinephrine 1 mg

    • Atropine 1 mg

    • Defibrillation

    • Vasopressin 40 units

    • All appear

    Correct Answer
    A. Atropine 1 mg
  • 24. 

    In which rhythm is escalating doses of epinephrine (1 mg, followed by 3 mg, followed but 5 mg q 5 minutes) indicated?

    • Pulseless VT

    • VF

    • Asystole

    • None of the above.

    Correct Answer
    A. None of the above.
    Explanation
    There is no indication of escalating or high dose epinephrine.

    Rate this question:

  • 25. 
    Identify this rhythm. - ProProfs

    Identify this rhythm.

    • First Degree Heart Block

    • Second Degree Heart Block, Mobitz 1 (Wenckebach)

    • Second Degree Heart Block, Mobitz 2

    • Third Degree Heart Block

    Correct Answer
    A. First Degree Heart Block
    Explanation
    This is first degree heart block.
    Conduction has been slowed through the AV node so the
    PR interval>0.2 seconds (one large box).

    Rate this question:

  • 26. 
    Identify this rhythm. - ProProfs

    Identify this rhythm.

    • First Degree Heart Block

    • Second Degree Heart Block, Mobitz 1 (Wenckebach)

    • Second Degree Heart Block, Mobitz 2

    • Third Degree Heart Block

    Correct Answer
    A. Second Degree Heart Block, Mobitz 1 (Wenckebach)
    Explanation
    This is Second Degree Heart Block, Type 1 (Wenckebach).
    Notice the PR interval lengthens with each subsequent beat
    until a P wave is not followed by a QRS. After this dropped beat,
    the PR interval shortens again.

    Rate this question:

  • 27. 
    Identify this rhythm. - ProProfs

    Identify this rhythm.

    • First Degree Heart Block

    • Second Degree Heart Block, Mobitz 1 (Wenckebach)

    • Second Degree Heart Block, Mobitz 2

    • Third Degree Heart Block

    Correct Answer
    A. Second Degree Heart Block, Mobitz 2
    Explanation
    This is Second Degree Heart Block, Mobitz 2.
    Notice that the PR interval is fixed, and that many
    P waves are not conducted so they are not followed
    by a QRS complex. In this example, every third P-wave
    is conducted

    Rate this question:

  • 28. 
    Identify this rhythm. - ProProfs

    Identify this rhythm.

    • First Degree Heart Block

    • Second Degree Heart Block, Mobitz 1 (Wenckebach)

    • Second Degree Heart Block, Mobitz 2

    • Third Degree Heart Block

    Correct Answer
    A. Third Degree Heart Block
    Explanation
    This is Third Degree Heart Block.
    Notice the complete dissociation between the
    P-waves and the QRS complexes.
    If you measure the distance between each
    P-wave it will be fixed.
    If you measure the distance between each QRS
    complex it will be fixed.
    Since there is no relationship between the P-Wave and
    the QRS complex, the PR interval will be entirely varied.

    Rate this question:

  • 29. 
    Identify this ryhthm. - ProProfs

    Identify this ryhthm.

    • Atrial Fibrillation

    • Atrial Flutter

    • SVT

    • Ventricular Tachycardia

    • Ventricular Fibrillation

    • Ventricular Tachycardia (Torsades de Points)

    Correct Answer
    A. Atrial Fibrillation
    Explanation
    This is Atrial Fibrillation.
    Notice that there are no discernible P-waves and that the interval
    between each QRS varies, beat-to-beat.

    Rate this question:

  • 30. 
    Identify this ryhthm. - ProProfs

    Identify this ryhthm.

    • Atrial Fibrillation

    • Atrial Flutter

    • SVT

    • Ventricular Tachycardia

    • Ventricular Fibrillation

    • Ventricular Tachycardia (Torsades de Points)

    Correct Answer
    A. Atrial Flutter
    Explanation
    This is Atrial Flutter.
    Notice the flutter give the telltale 'sawtooth' pattern.
    the rate of the flutter waves is 300 BPM, and in this example
    every 3rd or every 4th flutter wave is conducted.

    Rate this question:

  • 31. 
    Identify this ryhthm. - ProProfs

    Identify this ryhthm.

    • Atrial Fibrillation

    • Atrial Flutter

    • SVT

    • Ventricular Tachycardia

    • Ventricular Fibrillation

    • Ventricular Tachycardia (Torsades de Points)

    Correct Answer
    A. SVT
    Explanation
    This is SVT.
    Notice that this is a narrow-complex, rapid, regular rhythm.
    There are no discernible P-waves.

    Rate this question:

  • 32. 
    Identify this ryhthm. - ProProfs

    Identify this ryhthm.

    • Atrial Fibrillation

    • Atrial Flutter

    • SVT

    • Ventricular Tachycardia

    • Ventricular Fibrillation

    • Ventricular Tachycardia (Torsades de Points)

    Correct Answer
    A. Ventricular Tachycardia
    Explanation
    This is VT.
    Notice that this is a wide-complex, rapid, regular rhythm.
    There are no discernible P-waves.

    Rate this question:

  • 33. 
    Identify this ryhthm. - ProProfs

    Identify this ryhthm.

    • Atrial Fibrillation

    • Atrial Flutter

    • SVT

    • Ventricular Tachycardia

    • Ventricular Fibrillation

    • Ventricular Tachycardia (Torsades de Points)

    Correct Answer
    A. Ventricular Fibrillation
    Explanation
    This is Ventricular Fibrillation.
    Notice that this is wide-complex and irregular.
    This rhythm will not generate any mechanical systoles.

    Rate this question:

  • 34. 
    Identify this ryhthm. - ProProfs

    Identify this ryhthm.

    • Atrial Fibrillation

    • Atrial Flutter

    • SVT

    • Ventricular Tachycardia

    • Ventricular Fibrillation

    • Ventricular Tachycardia (Torsades de Points)

    Correct Answer
    A. Ventricular Tachycardia (Torsades de Points)
    Explanation
    This is VVentricular Tachycardia (Torsades de Points).
    Notice the sinusoidal nature of this rhythm. This is generated
    as the axis of depolarization revolves around a point.
    This rhythm needs to be recognized because treatment is
    Magnesium Sulfate.

    Rate this question:

  • 35. 
    Your patient is in the following rhythm but has no pulse. Which are possible causes for this Pulseless Electrical Activity? - ProProfs

    Your patient is in the following rhythm but has no pulse. Which are possible causes for this Pulseless Electrical Activity?

    • HyperKalemia

    • Hypoxia

    • Hypothermia

    • Hydrogen Ions (Acidosis)

    • Hypothermia

    • Hypoglycemia

    • Tamponade

    • Tension Pneumothorax

    • Thrombosis (PE)

    • Thrombosis (MI)

    • Toxins

    • Trauma

    Correct Answer(s)
    A. HyperKalemia
    A. Hypoxia
    A. Hypothermia
    A. Hydrogen Ions (Acidosis)
    A. Hypothermia
    A. Hypoglycemia
    A. Tamponade
    A. Tension Pneumothorax
    A. Thrombosis (PE)
    A. Thrombosis (MI)
    A. Toxins
    A. Trauma
    Explanation
    These are the H's and T's of PEA.
    Know them.

    Rate this question:

  • 36. 

    The recommended length of time for a Rhythm Check is <10 seconds.

    • True

    • False

    Correct Answer
    A. True
  • 37. 
    Your patient is very lightheaded.  Her Blood pressure = 62/40 mmHg.  HR=38 BPM Her rhythm is below: While awaiting cardiology to place a pacemaker, appropriate interventions include - ProProfs

    Your patient is very lightheaded.  Her Blood pressure = 62/40 mmHg.  HR=38 BPM Her rhythm is below: While awaiting cardiology to place a pacemaker, appropriate interventions include

    • Transcutaneous Pacing

    • Dopamine 2-10 mcg/kg/minute

    • Epinephrine 2-10 mcg/minute

    • Atropine 1 mg

    Correct Answer(s)
    A. Transcutaneous Pacing
    A. Dopamine 2-10 mcg/kg/minute
    A. Epinephrine 2-10 mcg/minute
    Explanation
    Atropine does not have a role in complete heart block.

    Rate this question:

  • 38. 

    In a patient with a suspected C-spine injury, the recommended technique for airway opening is the chin-lift/head-tilt

    • True

    • False

    Correct Answer
    A. False
    Explanation
    When a c-spine injury is suspected, open the airway
    with the jaw thrust maneuver

    Rate this question:

  • 39. 

    During a resuscitation, with an ET tube in place, chest compressions should be paused to give a breath?

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Chest compressions should not be withheld.
    The respiratory rate should be approximately
    one breath every 6-8 seconds.

    Rate this question:

  • 40. 

    A patient arrests near a pool and is partially submerged in water, the AED may be safely and effectively discharged with moving the patient.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    If a patient is in a puddle or in the snow, he does not need to
    be moved. If he is submerged, he should be moved to drier ground.

    Rate this question:

  • 41. 

    During CPR, chest compressions should NOT be interrupted for _____.

    • Ventilation

    • To intubate a patient who is being ventilated by BVM.

    • Rhythm checks in an unchanged rhythm.

    • Charging the defibrillator.

    • Defibrillation

    Correct Answer(s)
    A. Ventilation
    A. To intubate a patient who is being ventilated by BVM.
    A. Rhythm checks in an unchanged rhythm.
    A. Charging the defibrillator.
  • 42. 

    Following defibrillation, when should chest compressions resume?

    • Following a pulse check.

    • After a 10 second pulse check, and giving 2 breaths.

    • After evaluating the post-defibrillation rhythm.

    • Immediately.

    Correct Answer
    A. Immediately.
    Explanation
    A pulse check is appropriate after about 2 minutes of
    CPR following defibrillation.

    Rate this question:

Quiz Review Timeline (Updated): Jun 19, 2019 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Jun 19, 2019
    Quiz Edited by
    ProProfs Editorial Team
  • Sep 27, 2015
    Quiz Created by
    Haitham Zraigat

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