ACLS Megacode Scenario 2

By Mark Dzwonkiewicz, FP-C, LI | Medically reviewed by Lisa Wright, MHA, RRT-NPS on October 20, 2024

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Question 1 of 13

1. Question

You are the lifeguard on duty at a local pool. You are trained in Basic Life Support for Healthcare Providers. You observe a group of teens pushing and shoving each other on the pool deck.

You are about to intervene when one of the teens is pushed into the pool. He strikes his head on the side of the pool. He falls in and sinks to the bottom. One of his friends dives in and pulls the injured teen to the surface. Another friend helps pull the injured teen out of the water. The boys lay the injured teenager at the edge of the pool.

You instruct one of the boys to go call 911, and you tell another boy to get the AED from the office. You rapidly evaluate the injured teen for responsiveness. He does not respond when you shake his shoulder and loudly ask if he is okay. You scan his chest for breathing. There are no visible respirations.

1. What is the next intervention?

a. Check for a carotid pulse

b. Open the airway and give two rescue breaths

c. Start high-quality chest compressions

d. Push on the chest and stomach to expel water

Correct

Incorrect

Question 2 of 13

2. Question

You do not feel a pulse within 10 seconds. The teenager is still not breathing.

2. What is your next intervention?

a. Attempt to listen for a heartbeat by placing your ear over the chest

b. Begin high-quality chest compressions

c. Open the airway and give two rescue breaths

d. Wait for the AED

Correct

Incorrect

Question 3 of 13

3. Question

3. How fast should compressions be given in the adult patient?

a. 100–120 compressions per minute

b. 80–100 compressions per minute

c. 60–80 compressions per minute

d. As quickly as possible

Correct

Incorrect

Question 4 of 13

4. Question

4. How deeply should the chest be compressed in the adult patient?

a. The chest should be compressed to a depth of 1–1.5 inches

b. The chest should be compressed to a depth of 1–2 inches

c. The chest should be compressed to a depth of 2–2.4 inches

d. The chest should be compressed to a depth of 1–1.4 inches

Correct

Incorrect

Question 5 of 13

5. Question

You provide 30 compressions at the rate and depth described above.

5. What is the next best intervention?

a. Give two rescue breaths

b. Continue compressions

c. Stop and wait for the AED

d. Check for a pulse

Correct

Incorrect

Question 6 of 13

6. Question

6. What maneuver should be used to open the patient’s airway prior to giving rescue breaths in this scenario?

a. Head tilt-chin lift

b. Jaw-thrust

c. The head should not be moved

d. Chin-thrust

Correct

Incorrect

Question 7 of 13

7. Question

You are completing a round of high-quality CPR when another lifeguard arrives with the AED.

He quickly sets the AED beside you. He tells you that he will continue CPR while you operate the AED.

7. What is the next intervention?

a. Turn on the AED

b. Attach the pads and connect to the AED

c. Wait until the other lifeguard finishes a round of chest compressions

d. Dry the chest

Correct

Incorrect

Question 8 of 13

8. Question

You lift the lid of the AED. The AED’s voice prompt instructs you to apply pads to the patient.

You quickly dry the patient’s chest with a towel. You attach the adult pads to the patient’s chest, placing one pad to the left of the nipple on the left side about two inches below the left axilla and one pad to the right of the sternum just below the clavicle. You attach the AED connecting cables to the AED machine.

The automated AED voice announces, “Stand clear, analyzing heart rhythm.” You instruct the other lifeguard to hold compressions. The AED analyzes the patient’s rhythm and announces “Shock Advised.”

8. What is the next intervention?

a. Complete a cycle of chest compressions and then push the shock button

b. Ensure no one is touching the patient and push the shock button

c. Immediately push the shock button

d. Give two quick rescue breaths and push the shock button

Correct

Incorrect

Question 9 of 13

9. Question

You announce, “I am going to shock on three. One, two, three, shocking!”

You push the SHOCK button. The patient’s muscles jerk, then relax.

9. What is the next intervention?

a. Immediately resume high-quality CPR, starting with compressions

b. Check for breathing

c. Clear the patient and shock again

d. Check for a pulse

Correct

Incorrect

Question 10 of 13

10. Question

You and the other lifeguard continue providing high-quality CPR. The AED automatically announces when it is time to pause and analyze the rhythm.

The AED advises you to deliver a shock after the next two rhythm checks. You and the other lifeguard switch roles during every rhythm analysis to prevent fatigue, which can lead to inadequate compressions. After the fourth rhythm analysis, the AED states, “No Shock Advised.”

10. What does “No Shock Advised” signify?

a. The AED detected a pulse

b. The AED requires troubleshooting

c. The patient is moving

d. The patient has a non shockable rhythm

Correct

Incorrect

Question 11 of 13

11. Question

11. What should you do in response to the AED alert stating, “No Shock Advised.”

a. Check for a pulse

b. Check for breathing

c. Resume high-quality CPR

d. Wait for the AED to give further directions

Correct

Incorrect

Question 12 of 13

12. Question

The ambulance arrives, and the crew takes over. They quickly establish IV access and administer epinephrine 1 mg.

After an additional shock, the EMS crew detects a weak and slow carotid pulse of 45 bpm. Compressions are discontinued, and rescue breathing continues to be provided.

12. At what rate should ventilations be provided during rescue breathing?

a. One breath every 6 seconds

b. Two breaths every 10 seconds

c. 12 breaths per minute

d. One breath every 5 seconds

Correct

Incorrect

Question 13 of 13

13. Question

The patient remains unresponsive and apneic; his pulse is 45 bpm.

The paramedic takes vital signs: 45 bpm; systolic BP 80 mmHg; SpO² 95%. Ventilation is being provided with a bag-mask device connected to 100% oxygen.

13. What medication may be indicated at this time?

a. Lidocaine

b. Atropine

c. Epinephrine

d. Dopamine

Correct

Incorrect

ACLS Megacode Scenario 2 Video

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Editorial Note

ACLS Certification Association (ACA) uses only high-quality medical resources and peer-reviewed studies to support the facts within our articles. Explore our editorial process to learn how our content reflects clinical accuracy and the latest best practices in medicine. As an ACA Authorized Training Center, all content is reviewed for medical accuracy by the ACA Medical Review Board.

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