1. Ten minutes after an 85-year-old woman collapses, paramedics arrive and start CPR for the first time. The monitor shows fine (low-amplitude) VF. Which of the following actions should they take next?
a. Perform at least 5 minutes of vigorous CPR before attempting defibrillation
b. Insert an endotracheal tube, administer 2 to 2.5 mg epinephrine in 10 mL NS through the tube and then defibrillate
c. Deliver up to 3 precordial thumps while observing the patient’s response on the monitor. Deliver about 2 minutes or 5 cycles of CPR, and deliver a 360-J monophasic or equivalentcurrent biphasic shock
2. A cardiac arrest patient arrives in the ED with PEA at 30 bpm. CPR continues, proper tube placement is confirmed, and IV access is established. Which of the following medications is most appropriate to give next?
a. Calcium chloride 5 mL of 10% solution IV
b. Epinephrine 1 mg IV
c. Synchronized cardioversion at 200 J
d. Sodium bicarbonate 1 mEq/kg IV
3. Which of the following actions helps deliver maximum current during defibrillation?
a. Place alcohol pads between the paddles and skin
b. Reduce the pressure used to push down on the defibrillator paddles
c. Apply conductive paste to the paddles
d. Decrease shock energy after the 2nd shock
4. Which of the following actions is NOT performed when you “clear” a patient just before defibrillator discharge?
a. Check the person managing the airway: body not touching bag mask or tracheal tube, oxygen not flowing directly onto chest
b. Check yourself: hands correctly placed on paddles, body not touching patient or bed
c. Check monitor leads: leads disconnected to prevent shock damage to monitor
d. Check others: no one touching patient, bed, or equipment connected to patient
5. A woman with a history of narrow-complex PSVT arrives in the ED. She is alert and oriented but pale. HR is 165 bpm, and the ECG documents SVT. BP is 105/70 mm Hg. Supplemental oxygen is provided, and IV access has been established. Which of the following drug-dose combinations is the most appropriate initial treatment?
a. Adenosine 6 mg rapid IV push
b. Epinephrine 1 mg IV push
c. Synchronized cardioversion with 25 to 50 J
d. Atropine 1 mg IV push
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ACLS Self Assessment Test
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