ACLS Tachycardia and Bradycardia Algorithms 2

Question 1

A patient has a heart rate of 160 bpm with a narrow QRS complex and is hemodynamically stable. What is the first-line treatment?

Accepted Answer

Vagal maneuvers

Answer

Vagal maneuvers (e.g., Valsalva, carotid sinus massage) are the first-line treatment for stable narrow-complex tachycardia.

Question 2

During the bradycardia algorithm, atropine fails to increase the heart rate. What is the next intervention?

Accepted Answer

Transcutaneous pacing or dopamine/epinephrine infusion

Answer

If atropine is ineffective for symptomatic bradycardia, transcutaneous pacing or vasopressor infusion (dopamine or epinephrine) should be initiated.

Question 3

A 58-year-old patient has a heart rate of 190 bpm with a wide QRS complex and is pulseless. What is the correct action?

Accepted Answer

Defibrillation and CPR per VF/pVT algorithm

Answer

A pulseless wide-complex tachycardia is treated as ventricular fibrillation/pulseless VT — defibrillation and CPR per cardiac arrest algorithm.

Question 4

Which of the following is NOT a sign of hemodynamic instability requiring immediate intervention in tachycardia?

Accepted Answer

Heart rate of 110 bpm at rest

Answer

A heart rate of 110 bpm alone does not constitute instability; signs like hypotension, altered mentation, and pulmonary edema indicate instability.

Question 5

What is the maximum total dose of atropine recommended in the ACLS bradycardia algorithm?

Accepted Answer

3 mg

Answer

The maximum total dose of atropine in the ACLS bradycardia algorithm is 3 mg (given as 0.5 mg doses every 3–5 minutes).

ACLS Practice Test