ACLS Basics 5 — Questions and Answers
Question 1: What is the correct hand placement for chest compressions in an adult during CPR?
- Upper half of the sternum
- Lower half of the sternum (Correct answer)
- Left side of the chest over the heart
- Xiphoid process
Correct answer: Lower half of the sternum
Compressions should be delivered on the lower half of the sternum to effectively compress the heart.
Question 2: During ACLS, what is the significance of a 'no-flow time' ratio?
- It measures time from arrest to hospital arrival
- It is the fraction of time without chest compressions during resuscitation (Correct answer)
- It tracks time between epinephrine doses
- It measures time without an advanced airway
Correct answer: It is the fraction of time without chest compressions during resuscitation
No-flow time refers to pauses in chest compressions; minimizing this ratio is critical to maintaining coronary perfusion pressure.
Question 3: Which of the following scenarios represents the appropriate use of a bag-mask device (BVM) during ACLS?
- One rescuer delivers ventilations while maintaining a mask seal with one hand
- Two rescuers — one holds the mask with two hands, one squeezes the bag (Correct answer)
- One rescuer delivers ventilations continuously without pausing compressions
- BVM is only used after advanced airway placement fails
Correct answer: Two rescuers — one holds the mask with two hands, one squeezes the bag
A two-rescuer BVM technique, with one maintaining a two-hand mask seal and the other squeezing the bag, provides better ventilation.
Question 4: In ACLS, vasopressin was previously listed as an alternative to epinephrine. What does current guidance recommend?
- Vasopressin 40 units replaces the first dose of epinephrine
- Vasopressin has been removed; epinephrine is the sole vasopressor (Correct answer)
- Vasopressin 20 units is added to every other epinephrine dose
- Vasopressin is only used in asystole
Correct answer: Vasopressin has been removed; epinephrine is the sole vasopressor
Current AHA ACLS guidelines have removed vasopressin from the algorithm; epinephrine 1 mg IV/IO every 3–5 minutes is the standard vasopressor.
Question 5: What is the recommended target SpO2 range during post-cardiac arrest care after ROSC?
- 88–92%
- 92–96%
- 94–99% (Correct answer)
- 100%
Correct answer: 94–99%
After ROSC, SpO2 should be maintained at 94–99% to avoid both hypoxia and hyperoxia, which can worsen neurological outcomes.
Question 6: Which ACLS role is responsible for recording medication times, CPR intervals, and rhythm changes during a resuscitation?
- Team leader
- Compressor
- Timekeeper/recorder (Correct answer)
- Airway manager
Correct answer: Timekeeper/recorder
The timekeeper/recorder tracks timing of interventions, medication doses, and rhythm changes to keep the team informed.
Question 7: A patient in cardiac arrest has a rhythm of asystole confirmed in two leads. What is the correct next step?
- Deliver 360 J monophasic shock immediately
- Continue CPR and investigate reversible causes (Correct answer)
- Administer amiodarone 300 mg IV
- Perform synchronized cardioversion
Correct answer: Continue CPR and investigate reversible causes
Asystole is a non-shockable rhythm; defibrillation is contraindicated and CPR with investigation of the H's and T's is the correct approach.
ACLS Basics 5
What is the correct hand placement for chest compressions in an adult during CPR?