Congratulations on completing FirstAidWeb’s ACLS Provider Certification Course! You’ve invested the time, effort, and commitment—now it’s time to secure your certification.
This exam isn’t meant to trick you. It’s designed to confirm your understanding of the material. Take a breath, get focused, and review the key details below before you begin.
What is the preferred alternative route if IV access is not available?
Incorrect. IO access provides a reliable alternative for rapid drug delivery during resuscitation when IV access cannot be obtained.
Correct. IO access provides a reliable alternative for rapid drug delivery during resuscitation when IV access cannot be obtained.
How should you confirm the placement of an endotracheal tube?
Incorrect. Waveform capnography ensures proper ET tube placement by continuously monitoring exhaled CO? levels.
Correct. Waveform capnography ensures proper ET tube placement by continuously monitoring exhaled CO? levels.
Adenosine is contraindicated in unstable patients with narrow-complex SVT.
Incorrect. Adenosine is contraindicated in unstable patients; synchronized cardioversion is the treatment of choice in such cases.
Correct. Adenosine is contraindicated in unstable patients; synchronized cardioversion is the treatment of choice in such cases.
Which rhythm is not shockable?
Incorrect. Asystole is a non-shockable rhythm requiring high-quality CPR and epinephrine administration.
Correct. Asystole is a non-shockable rhythm requiring high-quality CPR and epinephrine administration.
Which drug is used for torsades de pointes?
Incorrect. Magnesium sulfate stabilizes the cardiac membrane and is the drug of choice for torsades de pointes.
Correct. Magnesium sulfate stabilizes the cardiac membrane and is the drug of choice for torsades de pointes.
Ventricular fibrillation is a non-shockable rhythm.
Incorrect. Ventricular fibrillation (VF) is a shockable rhythm and requires immediate defibrillation to restore an organized rhythm.
Correct. Ventricular fibrillation (VF) is a shockable rhythm and requires immediate defibrillation to restore an organized rhythm.
What is the primary focus during the first few minutes of ROSC?
Incorrect. Adequate oxygenation and ventilation are critical to preventing hypoxia or hyperoxia after ROSC.
Correct. Adequate oxygenation and ventilation are critical to preventing hypoxia or hyperoxia after ROSC.
The correct dose of epinephrine for pediatric cardiac arrest is 1 mg/kg IV/IO.
Incorrect. The correct dose of epinephrine for pediatric cardiac arrest is 0.01 mg/kg IV/IO, not 1 mg/kg.
Correct. The correct dose of epinephrine for pediatric cardiac arrest is 0.01 mg/kg IV/IO, not 1 mg/kg.
What is the maximum pause allowed for chest compressions during CPR?
Incorrect. Interruptions in chest compressions should be minimized to less than 10 seconds to maintain adequate perfusion.
Correct. Interruptions in chest compressions should be minimized to less than 10 seconds to maintain adequate perfusion.
What is the appropriate treatment for severe bradycardia in pediatric patients unresponsive to atropine?
Incorrect. Epinephrine is given as a continuous infusion to maintain adequate heart rate and perfusion when atropine is ineffective.
Correct. Epinephrine is given as a continuous infusion to maintain adequate heart rate and perfusion when atropine is ineffective.
What is the initial treatment for symptomatic bradycardia?
Incorrect. Atropine is the first-line drug for symptomatic bradycardia, increasing heart rate by blocking vagal stimulation.
Correct. Atropine is the first-line drug for symptomatic bradycardia, increasing heart rate by blocking vagal stimulation.
What is the maximum dose of atropine for bradycardia?
Incorrect. Atropine doses should not exceed 3 mg during bradycardia management to avoid adverse effects.
Correct. Atropine doses should not exceed 3 mg during bradycardia management to avoid adverse effects.
What is the correct dose of epinephrine for pediatric cardiac arrest?
Incorrect. Epinephrine is administered every 3-5 minutes during pediatric cardiac arrest to enhance coronary and cerebral perfusion.
Correct. Epinephrine is administered every 3-5 minutes during pediatric cardiac arrest to enhance coronary and cerebral perfusion.
How should compressions be performed for an infant during CPR?
Incorrect. The two-thumb encircling technique provides high-quality compressions for infants during CPR.
Correct. The two-thumb encircling technique provides high-quality compressions for infants during CPR.
The initial dose of amiodarone for refractory VF is 300 mg IV/IO.
Incorrect. Amiodarone 300 mg IV/IO is administered after defibrillation and epinephrine to treat refractory VF or pulseless VT.
Correct. Amiodarone 300 mg IV/IO is administered after defibrillation and epinephrine to treat refractory VF or pulseless VT.
What is the correct ventilation rate for CPR with an advanced airway?
Incorrect. Providing 6-8 breaths per minute ensures adequate oxygenation and ventilation without interfering with chest compressions.
Correct. Providing 6-8 breaths per minute ensures adequate oxygenation and ventilation without interfering with chest compressions.
Lidocaine is the first-line drug for ventricular fibrillation.
Incorrect. Epinephrine is the first-line drug for VF, with amiodarone as the preferred antiarrhythmic for refractory cases.
Correct. Epinephrine is the first-line drug for VF, with amiodarone as the preferred antiarrhythmic for refractory cases.
What is the correct energy setting for synchronized cardioversion in unstable VT?
Incorrect. Synchronized cardioversion at 100 J is effective for restoring a stable rhythm in unstable ventricular tachycardia.
Correct. Synchronized cardioversion at 100 J is effective for restoring a stable rhythm in unstable ventricular tachycardia.
Synchronized cardioversion is indicated for unstable ventricular tachycardia with a pulse.
Incorrect. Synchronized cardioversion restores organized cardiac activity in unstable VT with a pulse, preventing progression to VF.
Correct. Synchronized cardioversion restores organized cardiac activity in unstable VT with a pulse, preventing progression to VF.
What is the treatment for unstable atrial fibrillation?
Incorrect. Synchronized cardioversion is used to restore a normal rhythm in unstable atrial fibrillation.
Correct. Synchronized cardioversion is used to restore a normal rhythm in unstable atrial fibrillation.
What is the first-line drug for narrow-complex SVT?
Incorrect. Adenosine is used to terminate reentrant arrhythmias in narrow-complex SVT by slowing conduction through the AV node.
Correct. Adenosine is used to terminate reentrant arrhythmias in narrow-complex SVT by slowing conduction through the AV node.
What is the initial dose of amiodarone for pulseless ventricular tachycardia?
Incorrect. Stabilizes the myocardium and suppresses arrhythmias during refractory VF or pulseless VT.
Correct. Stabilizes the myocardium and suppresses arrhythmias during refractory VF or pulseless VT.
What is the recommended first action for an unresponsive infant?
Incorrect. Calling for help ensures timely assistance and access to advanced resuscitation equipment.
Correct. Calling for help ensures timely assistance and access to advanced resuscitation equipment.
Chest compressions should be started immediately for a patient in asystole.
Incorrect. Asystole is a non-shockable rhythm requiring immediate high-quality CPR and epinephrine to optimize perfusion.
Correct. Asystole is a non-shockable rhythm requiring immediate high-quality CPR and epinephrine to optimize perfusion.
What is the recommended dose of adenosine for treating stable SVT in adults?
Incorrect. Adenosine is administered as a rapid IV push at an initial dose of 6 mg to terminate stable SVT.
Correct. Adenosine is administered as a rapid IV push at an initial dose of 6 mg to terminate stable SVT.
What is the first drug given for stable narrow-complex tachycardia?
Incorrect. Adenosine is used to terminate stable narrow-complex tachycardia by slowing AV node conduction.
Correct. Adenosine is used to terminate stable narrow-complex tachycardia by slowing AV node conduction.
Magnesium sulfate is the first-line drug for ventricular fibrillation.
Incorrect. Magnesium sulfate is used to treat torsades de pointes but is not the first-line drug for VF, where epinephrine is prioritized.
Correct. Magnesium sulfate is used to treat torsades de pointes but is not the first-line drug for VF, where epinephrine is prioritized.
What is the shockable rhythm in cardiac arrest?
Incorrect. Requires immediate defibrillation to restore organized cardiac activity.
Correct. Requires immediate defibrillation to restore organized cardiac activity.
How often should you deliver breaths during CPR with an advanced airway?
Incorrect. Ventilations are delivered every 6-8 seconds to provide oxygenation without interrupting chest compressions.
Correct. Ventilations are delivered every 6-8 seconds to provide oxygenation without interrupting chest compressions.
ROSC should be followed by immediate reassessment of the patient’s rhythm and ventilation.
Incorrect. Following ROSC, immediate reassessment ensures stability of the patient’s rhythm, oxygenation, and ventilation.
Correct. Following ROSC, immediate reassessment ensures stability of the patient’s rhythm, oxygenation, and ventilation.
ROSC stands for Return of Circulation Success.
Incorrect. ROSC stands for "Return of Spontaneous Circulation," indicating the resumption of a perfusing rhythm.
Correct. ROSC stands for "Return of Spontaneous Circulation," indicating the resumption of a perfusing rhythm.
Amiodarone and lidocaine are both used for refractory VF during cardiac arrest.
Incorrect. Amiodarone is preferred, but lidocaine is an alternative antiarrhythmic for refractory VF or pulseless VT.
Correct. Amiodarone is preferred, but lidocaine is an alternative antiarrhythmic for refractory VF or pulseless VT.
How should an unconscious patient with a suspected spinal injury be positioned?
Incorrect. The jaw thrust maneuver opens the airway without moving the cervical spine, reducing the risk of spinal injury.
Correct. The jaw thrust maneuver opens the airway without moving the cervical spine, reducing the risk of spinal injury.
Targeted temperature management (TTM) aims to reduce the risk of brain injury post-ROSC.
Incorrect. TTM helps reduce neurological injury by maintaining a core temperature of 32-36°C after the return of spontaneous circulation.
Correct. TTM helps reduce neurological injury by maintaining a core temperature of 32-36°C after the return of spontaneous circulation.
What is the correct defibrillation dose for adults in VF?
Incorrect. For biphasic defibrillators, 120-200 J is the recommended energy range for VF.
Correct. For biphasic defibrillators, 120-200 J is the recommended energy range for VF.
The correct defibrillation dose for pediatric cardiac arrest starts at 4 J/kg.
Incorrect. Pediatric defibrillation starts at 2 J/kg, increasing to 4 J/kg for subsequent shocks if needed.
Correct. Pediatric defibrillation starts at 2 J/kg, increasing to 4 J/kg for subsequent shocks if needed.
What is the initial treatment for pulseless electrical activity (PEA)?
Incorrect. CPR is the primary treatment for PEA, along with epinephrine and addressing reversible causes to restore circulation.
Correct. CPR is the primary treatment for PEA, along with epinephrine and addressing reversible causes to restore circulation.
How often should a rhythm check occur during CPR?
Incorrect. Rhythm checks should be performed every 2 minutes during CPR, coinciding with compressor role switches.
Correct. Rhythm checks should be performed every 2 minutes during CPR, coinciding with compressor role switches.
What is the recommended maximum interval for chest compression interruptions?
Incorrect. Minimizing interruptions to less than 10 seconds preserves perfusion and improves resuscitation outcomes.
Correct. Minimizing interruptions to less than 10 seconds preserves perfusion and improves resuscitation outcomes.
What is the recommended initial dose of adenosine for adults?
Incorrect. Adenosine is administered as a 6 mg rapid IV push, followed by a saline flush, to terminate reentrant arrhythmias.
Correct. Adenosine is administered as a 6 mg rapid IV push, followed by a saline flush, to terminate reentrant arrhythmias.
Pulseless electrical activity (PEA) is treated with defibrillation.
Incorrect. PEA is not a shockable rhythm; it is managed with high-quality CPR and addressing the underlying reversible causes.
Correct. PEA is not a shockable rhythm; it is managed with high-quality CPR and addressing the underlying reversible causes.
What is the ideal chest compression fraction for high-quality CPR?
Incorrect. A compression fraction greater than 80% ensures that most of the resuscitation time is spent performing chest compressions.
Correct. A compression fraction greater than 80% ensures that most of the resuscitation time is spent performing chest compressions.
What is the most common cause of PEA?
Incorrect. Hypoxia is a reversible cause of PEA; it must be treated immediately with oxygenation and ventilation.
Correct. Hypoxia is a reversible cause of PEA; it must be treated immediately with oxygenation and ventilation.
What is the drug of choice for stable wide-complex tachycardia?
Incorrect. Amiodarone is used to stabilize wide-complex tachycardias in stable patients to prevent deterioration into cardiac arrest.
Correct. Amiodarone is used to stabilize wide-complex tachycardias in stable patients to prevent deterioration into cardiac arrest.
What is the target oxygen saturation during CPR?
Incorrect. Maintaining oxygen saturation within this range ensures adequate oxygenation without the risk of hyperoxia.
Correct. Maintaining oxygen saturation within this range ensures adequate oxygenation without the risk of hyperoxia.
What drug is used for torsades de pointes during ACLS?
Incorrect. Stabilizes the myocardial membrane and prevents arrhythmias.
Correct. Stabilizes the myocardial membrane and prevents arrhythmias.
What is the recommended oxygen saturation target during ROSC?
Incorrect. Reduces the risk of oxidative stress and worsened outcomes by preventing hyperoxia.
Correct. Reduces the risk of oxidative stress and worsened outcomes by preventing hyperoxia.
What is the correct response if a shockable rhythm persists after the first shock?
Incorrect. High-quality CPR should be resumed immediately after a shock to maintain perfusion and increase the likelihood of ROSC.
Correct. High-quality CPR should be resumed immediately after a shock to maintain perfusion and increase the likelihood of ROSC.
What is the recommended compression depth for pediatric CPR?
Incorrect. Compressing to one-third the depth of the chest ensures adequate perfusion while minimizing the risk of injury.
Correct. Compressing to one-third the depth of the chest ensures adequate perfusion while minimizing the risk of injury.
What is the recommended ventilation rate during CPR without an advanced airway?
Incorrect. Delivering 10 breaths per minute ensures adequate oxygenation without causing hyperventilation.
Correct. Delivering 10 breaths per minute ensures adequate oxygenation without causing hyperventilation.
How should you position a pregnant patient during resuscitation?
Incorrect. A left lateral tilt prevents aortocaval compression, improving venous return and cardiac output during resuscitation.
Correct. A left lateral tilt prevents aortocaval compression, improving venous return and cardiac output during resuscitation.
Which condition is included in the "T's" of reversible cardiac arrest causes?
Incorrect. Thrombosis (pulmonary or coronary) is a reversible cause of cardiac arrest and should be addressed immediately.
Correct. Thrombosis (pulmonary or coronary) is a reversible cause of cardiac arrest and should be addressed immediately.
What is the preferred treatment for unstable SVT?
Incorrect. Synchronized cardioversion is used to terminate unstable SVT by restoring normal electrical activity in the heart.
Correct. Synchronized cardioversion is used to terminate unstable SVT by restoring normal electrical activity in the heart.
What is the recommended treatment for unstable tachycardia?
Incorrect. Prevents progression to cardiac arrest by restoring a normal rhythm.
Correct. Prevents progression to cardiac arrest by restoring a normal rhythm.
How should you treat VF if it persists after 3 shocks?
Incorrect. Epinephrine is given to improve perfusion pressure and increase the chance of ROSC in persistent VF.
Correct. Epinephrine is given to improve perfusion pressure and increase the chance of ROSC in persistent VF.
Epinephrine is administered every 3-5 minutes during cardiac arrest.
Incorrect. Epinephrine is given every 3-5 minutes to enhance coronary and cerebral perfusion during cardiac arrest.
Correct. Epinephrine is given every 3-5 minutes to enhance coronary and cerebral perfusion during cardiac arrest.
How should you position a patient for defibrillation?
Incorrect. A supine position ensures proper electrode placement and effective delivery of defibrillation shocks.
Correct. A supine position ensures proper electrode placement and effective delivery of defibrillation shocks.
What is the best indicator of effective ventilation during CPR?
Incorrect. PETCO2 monitoring provides real-time feedback on ventilation and the effectiveness of chest compressions.
Correct. PETCO2 monitoring provides real-time feedback on ventilation and the effectiveness of chest compressions.
What is the maximum pause duration between chest compressions?
Incorrect. Pausing compressions for more than 10 seconds interrupts perfusion and reduces the chances of ROSC.
Correct. Pausing compressions for more than 10 seconds interrupts perfusion and reduces the chances of ROSC.
What is the recommended action after ROSC is achieved?
Incorrect. Oxygenation and ventilation should be optimized to avoid hypoxia or hyperoxia during post-cardiac arrest care.
Correct. Oxygenation and ventilation should be optimized to avoid hypoxia or hyperoxia during post-cardiac arrest care.
What is the preferred drug for refractory ventricular fibrillation?
Incorrect. Amiodarone is used after defibrillation and epinephrine for refractory VF to stabilize the myocardium.
Correct. Amiodarone is used after defibrillation and epinephrine for refractory VF to stabilize the myocardium.
Defibrillation is contraindicated in patients with ventricular fibrillation.
Incorrect. VF is a shockable rhythm, and defibrillation is the primary treatment to restore an organized rhythm.
Correct. VF is a shockable rhythm, and defibrillation is the primary treatment to restore an organized rhythm.
The recommended chest compression depth for infants is at least 2 inches.
Incorrect. Chest compressions for infants should be about 1/3 the depth of the chest, approximately 1.5 inches (4 cm).
Correct. Chest compressions for infants should be about 1/3 the depth of the chest, approximately 1.5 inches (4 cm).
What is the recommended compression-to-ventilation ratio for infants with two rescuers?
Incorrect. The 15:2 ratio improves oxygenation and circulation during high-quality infant CPR performed by two rescuers.
Correct. The 15:2 ratio improves oxygenation and circulation during high-quality infant CPR performed by two rescuers.
The initial dose of adenosine for narrow-complex SVT in adults is 6 mg IV.
Incorrect. Adenosine 6 mg is given as a rapid IV push for terminating narrow-complex SVT caused by reentrant pathways.
Correct. Adenosine 6 mg is given as a rapid IV push for terminating narrow-complex SVT caused by reentrant pathways.