ACLS - Advanced Cardiovascular Life Support Tachycardia and Bradycardia Algorithms Questions and Answers

Question 1

A 58-year-old male presents with dizziness and shortness of breath. His heart rate is 40 bpm, blood pressure is 80/50 mmHg, and he appears pale and diaphoretic. The monitor shows a third-degree AV block. According to the ACLS Bradycardia Algorithm, which intervention should be prioritized after initial stabilization (airway, oxygen)?

Accepted Answer

Preparing for immediate transcutaneous pacing.

Answer

In a patient with symptomatic bradycardia due to a high-degree AV block (like third-degree block) and signs of poor perfusion (hypotension, altered mental status), atropine is unlikely to be effective. The ACLS algorithm indicates immediate preparation for transcutaneous pacing as the next critical step to increase the heart rate and improve perfusion.

Question 2

A patient with a regular, narrow-complex tachycardia at a rate of 180 bpm is stable but symptomatic. Vagal maneuvers have been ineffective. What is the correct initial drug and dose according to the ACLS Tachycardia Algorithm?

Accepted Answer

Adenosine 6 mg rapid IV push.

Answer

For stable, regular, narrow-complex supraventricular tachycardia (SVT) that does not respond to vagal maneuvers, the first-line pharmacologic agent is adenosine. The correct initial dose is 6 mg administered as a rapid IV push, followed by a saline flush.

Question 3

Which of the following is a primary indication for immediate synchronized cardioversion in the Tachycardia Algorithm?

Accepted Answer

An unstable patient with persistent tachyarrhythmia causing hypotension.

Answer

The key decision point in the Tachycardia Algorithm is patient stability. Immediate synchronized cardioversion is indicated for patients who are unstable due to a persistent tachyarrhythmia. Signs of instability include hypotension, acutely altered mental status, signs of shock, ischemic chest discomfort, or acute heart failure.

Question 4

According to the most recent ACLS guidelines for adult symptomatic bradycardia, what is the correct first dose of atropine?

Accepted Answer

1 mg IV, repeat every 3-5 minutes.

Answer

The ACLS guidelines updated the single-dose administration of atropine for symptomatic bradycardia from 0.5 mg to 1 mg. The correct procedure is to give a 1 mg bolus IV and repeat every 3-5 minutes as needed, up to a maximum total dose of 3 mg.

Question 5

A 66-year-old female is in the emergency department with palpitations. The monitor shows a regular, wide-complex tachycardia (QRS > 0.12 sec) at a rate of 160 bpm. Her blood pressure is 118/76 mmHg and she is alert and oriented. Which of the following interventions can be considered for this stable patient?

Accepted Answer

Administration of adenosine.

Answer

For a stable patient with a regular, monomorphic wide-complex tachycardia, the ACLS algorithm allows for the consideration of adenosine. Antiarrhythmic infusions like procainamide or amiodarone are also options. Immediate shock is reserved for unstable patients, and pacing or atropine would be inappropriate for tachycardia.

ACLS Practice Test

ACLS Practice Test

ACLS - Advanced Cardiovascular Life Support Tachycardia and Bradycardia Algorithms Questions and Answers