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. How much does the effectiveness of defibrillation in terminating VF decrease by each minute of delay?

a) 15%

b) 1%

c) 5%

d) 10%

The effectiveness of defibrillation in terminating VF decreases by about 15% for each minute of delay.

The effectiveness of defibrillation in terminating VF decreases by about 15% for each minute of delay.

2 / 15

2. In out of hospital adult cardiac arrest with a shockable rhythm the third shock will be delivered at

a) 4 minutes after CPR has commenced

b) 6 minutes after CPR has commenced

c) 2 minutes after CPR has commenced

d) 8 minutes after CPR has commenced

In out of hospital adult cardiac arrest with a shockable rhythm the third shock will be delivered at 4 minutes after CPR has commenced.

In out of hospital adult cardiac arrest with a shockable rhythm the third shock will be delivered at 4 minutes after CPR has commenced.

3 / 15

3. The preferred initial sequence of management of pulseless electrical activity is which one of the following:

a) Obtain IV access / perform endotracheal intubation / commence CPR / administer adrenaline 1mg / repeat adrenaline every 4 minutes / check for treatable causes

b) Commence CPR / obtain IV access / administer adrenaline 1mg /check for treatable causes / repeat adrenaline every 4 minutes/ perform endotracheal intubation

c) Check for treatable causes / commence CPR / obtain IV access / perform endotracheal intubation / administer adrenaline 1mg / repeat adrenaline every 4 minutes

d) Commence CPR / obtain IV access / administer atropine 1mg / check for treatable causes / perform endotracheal intubation / administer adrenaline every 4 minutes

4 / 15

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

a) Shivering may mimic ventricular fibrillation

b) Coarse Parkinsonian tremor can mimic atrial flutter

c) Deep breathing may mimic complete heart block

d) Very fine VF can be misinterpreted as asystole

5 / 15

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

a) DRSABC

b) DABRCS

c) DRSCAB

d) SDRABC

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.

6 / 15

6. Which one of the following statements regarding drug therapy in ALS for shockable rhythms is correct

a) Lignocaine is superior to amiodarone

b) Amiodarone and lignocaine are similarly effective

c) Amiodarone and lignocaine are highly effective

d) Amiodarone is superior to lignocaine

In shockable rhythms that have failed defibrillation attempts and adrenaline, lignocaine and amiodarone are considered of equal (but low) effectiveness.

In shockable rhythms that have failed defibrillation attempts and adrenaline, lignocaine and amiodarone are considered of equal (but low) effectiveness.

7 / 15

7. The appropriate rate of chest compressions in BLS in adults is

a) 120/min

b) 90/min

c) 140/min

d) 80/min

The appropriate rate of chest compressions in BLS in adults is 100-120/min with most people preferring around 120/min.

The appropriate rate of chest compressions in BLS in adults is 100-120/min with most people preferring around 120/min.

8 / 15

8. Which one of the following statements is incorrect

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

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

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

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

9 / 15

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

a) Delivery of supplemental oxygen

b) Adequate ventilation

c) Therapeutic hypothermia

d) Effective cardiac compression

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.

10 / 15

10. In advanced prehospital systems such as Australia and New Zealand, the median time to defibrillation for shockable rhythms is approximately

a) 10 minutes

b) 7 minutes

c) 12 minutes

d) 4 minutes

In advanced prehospital systems such as Australia and New Zealand, the median time to defibrillation for shockable rhythms is approximately 7 minutes. This means there is significant organ hypoxia and acidosis that is not present in in hospital witnessed cardiac arrests.

In advanced prehospital systems such as Australia and New Zealand, the median time to defibrillation for shockable rhythms is approximately 7 minutes. This means there is significant organ hypoxia and acidosis that is not present in in hospital witnessed cardiac arrests.

11 / 15

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

a) 0-1 min

b) 3-4 min

c) 1-2 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.

12 / 15

12. Which one of the following statements is indicative of the correct CPR technique in an adult:

a) The ventilation : compression ratio should be 2:5

b) Compression should comprise 50% of the cycle

c) The depth of compression should be approximately 1/5 of the thoracic diameter

d) The rate of compression should be at least 80/min in adults

Depth of compression should be 5 – 6cm (>1/3 of the thoracic diameter). Ventilation compression ratio should be 2:30. The compression rate should be 100-120/min.

Depth of compression should be 5 – 6cm (>1/3 of the thoracic diameter). Ventilation compression ratio should be 2:30. The compression rate should be 100-120/min.

13 / 15

13. In cardiac arrest due to ventricular fibrillation in adults, which one of the following management sequences is preferred:

a) Commence CPR / apply monitor to determine rhythm / perform endotracheal intubation / defibrillate

b) Commence CPR / establish IV access / apply monitor to determine rhythm / defibrillate

c) Commence CPR / apply monitor to determine rhythm / defibrillate

d) Perform endotracheal intubation / commence CPR / apply monitor to determine rhythm / defibrillate

In cardiac arrest due to ventricular fibrillation in adults the following sequence is preferred: Commence external cardiac massage / apply monitor to determine rhythm / defibrillate.

In cardiac arrest due to ventricular fibrillation in adults the following sequence is preferred: Commence external cardiac massage / apply monitor to determine rhythm / defibrillate.

14 / 15

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

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

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

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

d) Amiodarone may be delivered via the endotracheal tube

Amiodarone cannot be given via ETT.

Amiodarone cannot be given via ETT.

15 / 15

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

a) It is indicated in children

b) It is indicated in monitored VF

c) it delivers about 70 J of energy

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

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.

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