Life support quiz – The Emergency Medicine Manual

This is a 15 question single best answer MCQ quiz on aspects of BLS and ALS.
Questions are taken from a bank so will be different each time the quiz is taken.

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Created on November 16, 2025 By Bob Dunn

Life support

BLS and ALS

1 / 15

1. The effectiveness of a single 200J biphasic defibrillation in an adult with VF when delivered within 30 seconds of VF onset is approximately

a) 30%

b) 70%

c) 95%

d) 50%

The effectiveness of a single 200J biphasic defibrillation in an adult with VF when delivered within 30 seconds of VF onset is approximately 95%.

The effectiveness of a single 200J biphasic defibrillation in an adult with VF when delivered within 30 seconds of VF onset is approximately 95%.

2 / 15

2. In adult cardiac arrest due to VF unresponsive to standard BLS/ALS treatment, which one of the following is most likely to be of benefit

a) Vector change defibrillation

b) High dose adrenaline

c) Empiric HCO3

d) Empiric K+

In adult cardiac arrest due to VF unresponsive to standard BLS/ALS treatment, vector change defibrillation is most likely to be of benefit - although limited. The other treatments are all associated with even worse outcomes than expected.

In adult cardiac arrest due to VF unresponsive to standard BLS/ALS treatment, vector change defibrillation is most likely to be of benefit - although limited. The other treatments are all associated with even worse outcomes than expected.

3 / 15

3. The appropriate compression : relaxation ratio for chest compressions in BLS in adults is

a) 1:1

b) 2:1

c) 1:2

d) 1.5:1

The appropriate compression : relaxation ratio for chest compressions in BLS in adults is 1:1.

The appropriate compression : relaxation ratio for chest compressions in BLS in adults is 1:1.

4 / 15

4. Common causes of spurious rhythms may include all of the following except:

a) Coarse Parkinsonian tremor can mimic atrial flutter

b) Very fine VF can be misinterpreted as asystole

c) Shivering may mimic ventricular fibrillation

d) Deep breathing may mimic complete heart block

5 / 15

5. Which one of the following is the most important in the treatment of cardiac arrest

a) Therapeutic hypothermia

b) Effective cardiac compression

c) Adequate ventilation

d) Delivery of supplemental oxygen

Effective cardiac compression to maintain coronary perfusion is the most important of the choices given. Oxygenation is important, however coronary perfusion of poorly oxygenated blood is still better than no coronary perfusion of highly oxygenated blood. Ventilation is usually only required to maintain oxygenation, whilst restoration of normal acid base status is probably of no benefit and possibly harmful. Hypothermia may have a role to play following ROSC from ventricular fibrillation, but is never an initial priority.

Effective cardiac compression to maintain coronary perfusion is the most important of the choices given. Oxygenation is important, however coronary perfusion of poorly oxygenated blood is still better than no coronary perfusion of highly oxygenated blood. Ventilation is usually only required to maintain oxygenation, whilst restoration of normal acid base status is probably of no benefit and possibly harmful. Hypothermia may have a role to play following ROSC from ventricular fibrillation, but is never an initial priority.

6 / 15

6. Regarding endotracheal drug delivery which one of the following statements is incorrect:

a) 5 - 10 forceful ventilations should be given following endotracheal drug delivery

b) Endotracheal drug delivery delivers a significant decrease & delay in peak serum levels compared with IV administration

c) Amiodarone may be delivered via the endotracheal tube

d) It should only be used if IV access is unable to be obtained after 5 minutes

Amiodarone cannot be given via ETT.

Amiodarone cannot be given via ETT.

7 / 15

7. In an adult patient with cardiac arrest, defibrillation pads should be placed

a) Basal posterior

b) Apical basal

c) Anterior posterior

d) Anterior posterior - with anterior being negative

In an adult patient with cardiac arrest, defibrillation pads should be placed apical basal. Anteroposterior placement would require interruption of CPR, which should be avoided.

In an adult patient with cardiac arrest, defibrillation pads should be placed apical basal. Anteroposterior placement would require interruption of CPR, which should be avoided.

8 / 15

8. During CPR, the effectiveness of the operator performing chest compression usually starts to reduce between

a) 1-2 min

b) 3-4 min

c) 0-1 min

d) 2-3 min

A 10-20% reduction in compression depth occurs by 90 sec., despite operators not necessarily feeling fatigued. This is the reason that changing operators at least every 2 minutes (usually at the time of rhythm check) is required.

A 10-20% reduction in compression depth occurs by 90 sec., despite operators not necessarily feeling fatigued. This is the reason that changing operators at least every 2 minutes (usually at the time of rhythm check) is required.

9 / 15

9. Which of the following statements about a precordial thump are correct

a) It is indicated in children

b) It is less effective in victims of high voltage electrocution

c) it delivers about 70 J of energy

d) It is indicated in monitored VF

Precordial thump is only indicated in monitored VF as if applied to pulseless VT it could precipitate VF (although pVT is only 2% of shockable rhythms). It delivers about 10-20J of energy and appears to be more effective in victims of high voltage electrocution, making it useful in mass arrests due to lightning strike.

Precordial thump is only indicated in monitored VF as if applied to pulseless VT it could precipitate VF (although pVT is only 2% of shockable rhythms). It delivers about 10-20J of energy and appears to be more effective in victims of high voltage electrocution, making it useful in mass arrests due to lightning strike.

10 / 15

10. The most appropriate sedation agent for a patient with VF about to be defibrillated but who is still aware during CPR is

a) Ketamine

b) Midazolam

c) Propofol

d) Nothing

The most appropriate sedation agent for a patient with VF who is still aware during CPR is nothing. Whilst this may seem harsh, the delay to administration of any agent (allowing for circulation time) will decrease the probability of survival too much to justify.

The most appropriate sedation agent for a patient with VF who is still aware during CPR is nothing. Whilst this may seem harsh, the delay to administration of any agent (allowing for circulation time) will decrease the probability of survival too much to justify.

11 / 15

11. The actual correct management sequence of BLS in cardiac arrest is as follows

a) SDRABC

b) DABRCS

c) DRSABC

d) DRSCAB

The actual correct sequence is Danger Response Send for help Compressions Airway Breathing. The ‘S’ was added in 2011 but unfortunately the ‘ABC’ sequence was not changed in the acronym did not change from DRSABC as this was thought to be potentially confusing for people already familiar with the ‘ABC’ sequence.

The actual correct sequence is Danger Response Send for help Compressions Airway Breathing. The ‘S’ was added in 2011 but unfortunately the ‘ABC’ sequence was not changed in the acronym did not change from DRSABC as this was thought to be potentially confusing for people already familiar with the ‘ABC’ sequence.

12 / 15

12. The preferred initial sequence of management of asystole is which one of the following:

a) Commence CPR / obtain IV access / administer adrenaline 1mg / repeat adrenaline every 2 minutes/perform endotracheal intubation

b) Obtain IV access / perform endotracheal intubation / commence CPR / administer adrenaline 1mg / repeat adrenaline every 2 minutes

c) Commence CPR / obtain IV access / perform endotracheal intubation / administer atropine 1mg / administer adrenaline every 2 minutes

d) Commence CPR / obtain IV access / administer adrenaline 2mg / perform endotracheal intubation /repeat adrenaline every 2 minutes

Early intubation is most likely harmful as some interruption of CPR is usually required. It is best deferred until the patient fails to respond to initial CPR and defibrillation attempts or demonstrates ROSC. Chest compressions should only be ceased at the time the intubator is about to insert the laryngoscope into the patient’s mouth and intubation should be achieved within 10 seconds. The initial dose of adrenaline is 1mg, repeated every 2 minutes.

Early intubation is most likely harmful as some interruption of CPR is usually required. It is best deferred until the patient fails to respond to initial CPR and defibrillation attempts or demonstrates ROSC. Chest compressions should only be ceased at the time the intubator is about to insert the laryngoscope into the patient’s mouth and intubation should be achieved within 10 seconds. The initial dose of adrenaline is 1mg, repeated every 2 minutes.

13 / 15

13. Regarding cardiac arrest following poisoning which one of the following statements is incorrect:

a) HCO3 therapy may be indicated

b) The prognosis for most patients with poisoning is worse than that of older patients with cardiogenic cardiac arrest

c) Diazepam and adrenaline are antidotes for chloroquine toxicity

d) Naloxone is an antidote for clonidine toxicity

14 / 15

14. Which one of the following statements is incorrect

a) An appropriate minute volume for a patient in cardiac arrest is 4 litres / min

b) An appropriate respiratory rate for a patient in cardiac arrest is 8/min

c) The resting O2 consumption in an adult is 250 mL/min

d) An appropriate tidal volume for a patient in cardiac arrest is 500mL

15 / 15

15. In relation to palpation of the pulse during cardiac arrest, which one of the following statements is incorrect:

a) It should be analysed for 10 seconds in normothermic patients

b) It does not need to be checked whilst performing CPR

c) It can be felt every minute during cardiac arrest

d) The femoral or brachial pulse should be palpated in infants

The pulse can be palpated as often as you like during CPR, however stopping CPR to perform a rhythm check should only occur 2 minutes after each intervention in ACLS, and not at all in BLS. The rhythm should be analysed for no longer than 10 seconds in normothermic patients, and 5 seconds is usually plenty.

The pulse can be palpated as often as you like during CPR, however stopping CPR to perform a rhythm check should only occur 2 minutes after each intervention in ACLS, and not at all in BLS. The rhythm should be analysed for no longer than 10 seconds in normothermic patients, and 5 seconds is usually plenty.

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