ACLS Basics 3 — Questions and Answers
Question 1: In ACLS, what is the correct action immediately after delivering a defibrillation shock?
- Check pulse for 10 seconds
- Resume CPR immediately starting with chest compressions (Correct answer)
- Administer epinephrine 1 mg IV
- Check rhythm on the monitor
Correct answer: Resume CPR immediately starting with chest compressions
CPR should resume immediately after a shock without pausing to check pulse or rhythm, then a rhythm check occurs after 2 minutes.
Question 2: Which IV/IO access site is preferred for medication administration during cardiac arrest?
- Femoral vein
- Antecubital or external jugular vein (Correct answer)
- Subclavian vein
- Internal jugular vein
Correct answer: Antecubital or external jugular vein
Peripheral IV access at the antecubital or external jugular site is preferred due to speed and safety during arrest situations.
Question 3: What is the recommended energy level for the first biphasic defibrillation shock in adults?
- 100–150 J
- 120–200 J (Correct answer)
- 200–300 J
- 360 J
Correct answer: 120–200 J
The initial biphasic shock dose is 120–200 J based on the manufacturer's recommendation, or 200 J if unknown.
Question 4: Which of the following is an indication for intraosseous (IO) access during cardiac arrest?
- Successful peripheral IV on first attempt
- Failed or delayed IV access (Correct answer)
- Patient is a pediatric patient only
- Hypotension with peripheral IV access
Correct answer: Failed or delayed IV access
IO access is indicated when peripheral IV access is not rapidly achievable during cardiac arrest.
Question 5: What is the purpose of end-tidal CO2 (ETCO2) monitoring during cardiac arrest?
- To measure oxygen saturation
- To confirm correct endotracheal tube placement and assess CPR quality (Correct answer)
- To guide epinephrine dosing
- To determine when to terminate resuscitation only
Correct answer: To confirm correct endotracheal tube placement and assess CPR quality
ETCO2 confirms ETT placement and reflects cardiac output during CPR — values above 10 mmHg suggest effective compressions.
Question 6: A patient in cardiac arrest has an ETCO2 value that suddenly rises to 40 mmHg. What does this most likely indicate?
- Hyperventilation by the rescuer
- Worsening CPR quality
- Return of spontaneous circulation (ROSC) (Correct answer)
- Correct ETT placement was just confirmed
Correct answer: Return of spontaneous circulation (ROSC)
A sudden rise in ETCO2 to near-normal levels during CPR is a strong indicator of ROSC.
Question 7: According to ACLS guidelines, how should the team leader minimize interruptions to chest compressions?
- Pause compressions during rhythm checks and medication administration
- Limit pulse checks to 2–3 seconds and minimize pause duration (Correct answer)
- Check for a pulse after every 10 compressions
- Stop CPR while preparing the defibrillator
Correct answer: Limit pulse checks to 2–3 seconds and minimize pause duration
Pulse and rhythm checks should be brief (under 10 seconds) to minimize CPR interruptions and maintain coronary perfusion pressure.
ACLS Basics 3
In ACLS, what is the correct action immediately after delivering a defibrillation shock?