ACLS Medical Training 4 — Questions and Answers
Question 1: A patient develops torsades de pointes. Which treatment is specifically indicated for this arrhythmia?
- Amiodarone 300 mg IV
- Magnesium sulfate 1–2 g IV (Correct answer)
- Adenosine 6 mg IV push
- Atropine 0.5 mg IV
Correct answer: Magnesium sulfate 1–2 g IV
Magnesium sulfate is the treatment of choice for torsades de pointes, which is often associated with hypomagnesemia or QT prolongation.
Question 2: During an ACLS scenario, the team leader calls for a 'pulse check.' How long should this check last?
- Up to 30 seconds
- No more than 10 seconds (Correct answer)
- Exactly 5 seconds
- 15–20 seconds
Correct answer: No more than 10 seconds
Pulse checks should be no longer than 10 seconds to minimize interruptions to chest compressions.
Question 3: Which IV/IO access site is preferred for medication administration during cardiac arrest when peripheral IV is not available?
- Central venous catheter via subclavian vein
- Intraosseous (IO) access (Correct answer)
- Femoral vein catheter
- Umbilical vein catheter
Correct answer: Intraosseous (IO) access
IO access is preferred when IV access cannot be rapidly established, as it provides reliable vascular access during CPR.
Question 4: What is the energy setting recommended for the first biphasic defibrillation shock in an adult with VF?
- 100 J
- 120–200 J (per manufacturer) (Correct answer)
- 360 J
- 50 J
Correct answer: 120–200 J (per manufacturer)
For biphasic defibrillators, the recommended energy is 120–200 J based on manufacturer specifications for the first shock.
Question 5: A patient has narrow-complex tachycardia at 170 bpm and is hemodynamically stable. Vagal maneuvers fail. What is the next ACLS step?
- Adenosine 6 mg rapid IV push (Correct answer)
- Metoprolol 5 mg IV slow push
- Synchronized cardioversion at 50 J
- Amiodarone 150 mg IV over 10 minutes
Correct answer: Adenosine 6 mg rapid IV push
Adenosine 6 mg rapid IV push is the first pharmacologic intervention for stable narrow-complex SVT after failed vagal maneuvers.
Question 6: Which of the following best describes the role of high-quality CPR in ACLS?
- It is secondary to early defibrillation and medication administration
- It maintains perfusion pressure and improves likelihood of defibrillation success (Correct answer)
- It is only important in the first 2 minutes of cardiac arrest
- It primarily benefits the airway management team
Correct answer: It maintains perfusion pressure and improves likelihood of defibrillation success
High-quality CPR maintains coronary and cerebral perfusion, which increases the likelihood that defibrillation will restore a perfusing rhythm.
Question 7: During ACLS training, a learner is unable to identify a shockable rhythm within the 2-minute cycle. What should the team leader do?
- Stop CPR until the rhythm is correctly identified
- Provide closed-loop communication and redirect the team (Correct answer)
- Administer epinephrine immediately regardless of rhythm
- Call for rhythm identification from the IV nurse only
Correct answer: Provide closed-loop communication and redirect the team
Closed-loop communication and clear redirection are key ACLS team leader skills to keep resuscitation on track.
ACLS Medical Training 4
A patient develops torsades de pointes.
Which treatment is specifically indicated for this arrhythmia?