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. Regarding BLS in adults which one of the following statements is incorrect:

a) The correct location for cardiac compression is over the lower 1/2 of the sternum

b) Initially 5 breaths should be given

c) Expired air contains approximately 4% carbon dioxide

d) Head tilt is contraindicated in suspected cervical spine injury

2 breaths should be given initially. Old BLS guidelines advocated 5 initial breaths.

2 breaths should be given initially. Old BLS guidelines advocated 5 initial breaths.

2 / 15

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

a) Anterior posterior - with anterior being negative

b) Basal posterior

c) Apical basal

d) Anterior posterior

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.

3 / 15

3. In an adult patient with witnessed, monitored, in hospital cardiac arrest due to VF which one of the following strategies is most likely to obtain ROSC?

a) 2 minutes of CPR then defibrillation

b) 3 stacked shocks, 1mg adrenaline then 2 minutes of CPR if ineffective

c) Immediate single defibrillation, then 2 minutes of CPR if ineffective

d) CPR until defibrillator ready, 3 stacked shocks, then 2 minutes of CPR if ineffective

In an adult patient with witnessed, monitored, in hospital cardiac arrest due to VF, CPR until defibrillator ready, 3 stacked shocks, then 2 minutes of CPR if ineffective is the strategy most likely to obtain ROSC. According to ILCOR guidelines (as of 2025) this strategy should be considered, but evidence suggests it is superior to the out of hospital cardiac arrest algorithm.

In an adult patient with witnessed, monitored, in hospital cardiac arrest due to VF, CPR until defibrillator ready, 3 stacked shocks, then 2 minutes of CPR if ineffective is the strategy most likely to obtain ROSC. According to ILCOR guidelines (as of 2025) this strategy should be considered, but evidence suggests it is superior to the out of hospital cardiac arrest algorithm.

4 / 15

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

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

b) Compression should comprise 50% of the cycle

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

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

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.

5 / 15

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

a) Propofol

b) Ketamine

c) Midazolam

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.

6 / 15

6. Regarding cardiac arrest in severe hypothermia which one of the following is incorrect:

a) Active core rewarming techniques should be used until body temperature exceeds 31 C before defibrillation should be attempted

b) Oxygen consumption is much lower in the hypothermic patient and therefore may be able to survive a more prolonged arrest than a normothermic patient

c) The pulse should be felt for 30 seconds before deciding it is absent

d) Anti-arrhthymic drugs are usually ineffective in severe hypothermia

Initial defibrillation should be attempted at any temperature, but if unsuccessful, active core rewarming techniques should be used until body temperature exceeds 30 degrees then recommence defibrillation as required.

Initial defibrillation should be attempted at any temperature, but if unsuccessful, active core rewarming techniques should be used until body temperature exceeds 30 degrees then recommence defibrillation as required

7 / 15

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

a) 90/min

b) 80/min

c) 120/min

d) 140/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. 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) Commence CPR / obtain IV access / perform endotracheal intubation / administer atropine 1mg / administer adrenaline every 2 minutes

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

d) Obtain IV access / perform endotracheal intubation / commence CPR / administer adrenaline 1mg / 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.

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9. In adult cardiac arrest with a shockable rhythm adrenaline should first be given

a) 6 minutes after CPR has commenced

b) 4 minutes after CPR has commenced

c) Immediately on recognition of cardiac arrest

d) 2 minutes after CPR has commenced

In adult cardiac arrest with a shockable rhythm adrenaline should first be given 2 minutes after CPR has commenced.

In adult cardiac arrest with a shockable rhythm adrenaline should first be given 2 minutes after CPR has commenced.

10 / 15

10. 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.

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11. The estimated circulation time of drugs given in cardiac arrest with CPR in progress is

a) 90 seconds

b) 15 seconds

c) 60 seconds

d) 30 seconds

The estimated circulation time of drugs given in cardiac arrest is about 90 seconds with CPR in progress.

The estimated circulation time of drugs given in cardiac arrest is about 90 seconds with CPR in progress.

12 / 15

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

a) Very fine VF can be misinterpreted as asystole

b) Deep breathing may mimic complete heart block

c) Shivering may mimic ventricular fibrillation

d) Coarse Parkinsonian tremor can mimic atrial flutter

13 / 15

13. Regarding cardiac arrest in pregnancy which one of the following is correct

a) Displacement of the uterus to the left should occur during (and after) CPR

b) A postmortem Caesarean section may be considered if the fetus has a gestational age of > 20 weeks / the time from arrest is < 15 min / the cause of maternal death is not haemorrhagic shock or obstetric related

c) Chest compression should occur over the mid sternum to prevent damage to the fetus

d) The risk of pulmonary aspiration decreases with advancing gestational age

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

a) Naloxone is an antidote for clonidine toxicity

b) HCO3 therapy may be indicated

c) Diazepam and adrenaline are antidotes for chloroquine toxicity

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

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15. Which one of the following statements is incorrect

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

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

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

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

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