ACLS Pulseless 2

Question 1

A patient in pulseless VT fails to convert after the first defibrillation attempt and CPR is resumed. Which drug should be given next?

Accepted Answer

Epinephrine 1 mg IV

Answer

Epinephrine 1 mg IV is the first drug of choice in any pulseless arrest, given every 3–5 minutes.

Question 2

During CPR for a pulseless patient, you notice the waveform capnography reading is consistently below 10 mmHg after 20 minutes. What does this most likely indicate?

Accepted Answer

Unlikely to achieve ROSC; consider stopping resuscitation

Answer

PETCO2 persistently below 10 mmHg after 20 minutes of high-quality CPR suggests poor prognosis and may inform the decision to terminate resuscitation.

Question 3

What is the recommended energy for biphasic defibrillation of pulseless VT/VF when the manufacturer's recommendation is unknown?

Accepted Answer

150–200 J

Answer

When biphasic manufacturer settings are unknown, 150–200 J is recommended for the initial shock.

Question 4

A patient develops PEA after a witnessed cardiac arrest. The rate on the monitor is 40 bpm. Which reversible cause should be highest on your differential?

Accepted Answer

Tension pneumothorax

Answer

A slow PEA rate (bradycardic PEA) raises strong suspicion for tension pneumothorax, cardiac tamponade, or severe acidosis.

Question 5

After defibrillation, CPR is immediately resumed. What is the primary reason to avoid checking the pulse immediately after a shock?

Accepted Answer

Pulse checks interrupt compressions and reduce coronary perfusion

Answer

Immediate CPR after defibrillation maintains coronary and cerebral perfusion; even if ROSC occurred, compressions cause minimal harm.

ACLS Practice Test

ACLS Practice Test

ACLS Pulseless 2