ACLS Medical Training 5 — Questions and Answers
Question 1: A patient has complete heart block with a heart rate of 30 bpm and is severely hypotensive. IV atropine fails to improve the rate. What is the next ACLS intervention?
- Double the atropine dose and repeat
- Transcutaneous pacing (Correct answer)
- Immediate implantable pacemaker
- Adenosine 6 mg IV push
Correct answer: Transcutaneous pacing
Transcutaneous pacing is the definitive bridge intervention for symptomatic bradycardia unresponsive to atropine.
Question 2: What does the 'T' for 'Toxins' in the H's and T's of cardiac arrest management prompt the ACLS provider to consider?
- Administering activated charcoal to all cardiac arrest patients
- Identifying and reversing drug overdose or poisoning as a cause of arrest (Correct answer)
- Testing blood toxicology before initiating CPR
- Using higher defibrillation energy for toxin-related arrests
Correct answer: Identifying and reversing drug overdose or poisoning as a cause of arrest
Toxins as a reversible cause prompts providers to consider drug overdose or poisoning and administer specific antidotes if available.
Question 3: In the ACLS systematic approach, what does the term 'primary survey' refer to?
- A detailed neurological assessment
- Airway, breathing, circulation, and defibrillation assessment (ABCDs) (Correct answer)
- Laboratory and imaging evaluation
- Patient history and medication reconciliation
Correct answer: Airway, breathing, circulation, and defibrillation assessment (ABCDs)
The primary survey in ACLS focuses on ABCDs — Airway, Breathing, Circulation, and Defibrillation — to identify and treat life threats rapidly.
Question 4: How often should epinephrine be administered during cardiac arrest according to current ACLS guidelines?
- Every 1–2 minutes
- Every 3–5 minutes (Correct answer)
- Once per resuscitation attempt
- Every 10 minutes
Correct answer: Every 3–5 minutes
Epinephrine 1 mg IV/IO is administered every 3–5 minutes throughout a cardiac arrest resuscitation.
Question 5: A post-cardiac arrest patient is being prepared for targeted temperature management. Which complication should be closely monitored?
- Hyperthermia rebound
- Coagulopathy and shivering (Correct answer)
- Hypertension and bradycardia only
- Respiratory alkalosis
Correct answer: Coagulopathy and shivering
TTM can cause coagulopathy, shivering (which raises temperature and metabolic demand), bradycardia, and electrolyte shifts requiring monitoring.
Question 6: During ACLS debriefing, which type of feedback is most effective for improving team performance in future codes?
- Immediate public criticism of individual errors
- Structured, objective debriefing focused on systems and behaviors (Correct answer)
- Only positive reinforcement with no discussion of errors
- Written feedback submitted anonymously after the event
Correct answer: Structured, objective debriefing focused on systems and behaviors
Structured debriefing that reviews both successes and areas for improvement in a blame-free environment is most effective for team learning.
Question 7: Which finding on a post-ROSC 12-lead ECG would prompt immediate transfer to the cardiac catheterization lab?
- Sinus tachycardia at 110 bpm
- ST-segment elevation in two contiguous leads (Correct answer)
- Presence of U waves
- PR interval of 220 ms
Correct answer: ST-segment elevation in two contiguous leads
ST-elevation on a post-ROSC ECG suggests STEMI, which requires emergency coronary angiography and intervention.
ACLS Medical Training 5
A patient has complete heart block with a heart rate of 30 bpm and is severely hypotensive.
IV atropine fails to improve the rate.
What is the next ACLS intervention?