AMC MCQ Resuscitation Questions: 10 Free Practice MCQs

Ten AMC MCQ-style resuscitation questions with the answer and the reasoning behind it. They come from the AU.med bank, which has 22 resuscitation questions and many more across every topic.

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1. 1 / 10

   A 70-year-old man becomes pulseless in the intensive care unit 6 hours after coronary artery bypass grafting. The cardiothoracic team is on site and the unit follows the cardiothoracic advanced life support algorithm.

   What is the recommended timeframe for emergency re-sternotomy in this situation?

   • A. Within 5 minutes of the onset of the cardiac arrest, by a trained team.
   • B. Within 30 minutes, after a full round of drug therapy.
   • C. Only if return of spontaneous circulation fails after 10 minutes of compressions.
   • D. After transfer to the operating theatre, however long that takes.
   Show answer

   Answer: A. Within 5 minutes of the onset of the cardiac arrest, by a trained team.

   Why: Cardiopulmonary arrest after cardiac surgery is usually caused by a small number of reversible problems such as tamponade, bleeding, tension pneumothorax, pacing failure or graft problems, and emergency re-sternotomy addresses most of them. The trained team should complete re-sternotomy within 5 minutes of the onset of the arrest, and chest compressions should not be withheld while this is prepared. Waiting for drugs to work, for compressions to fail, or for transfer to an operating theatre all waste that critical window.

   • B. This delay is far too long; reversible causes after cardiac surgery are addressed by re-sternotomy rather than by prolonged drug therapy.
   • C. Waiting for compressions to fail before opening the chest wastes the time in which re-sternotomy is most likely to succeed.
   • D. Re-sternotomy is performed where the patient arrests rather than after transfer, which would add harmful delay.

   Sources: ANZCOR Guideline 11.10 Resuscitation in Special Circumstances (2026)

2. 2 / 10

   During prolonged resuscitation of a 4-year-old boy weighing 16 kg in asystole, the team reviews the medications available while chest compressions continue and the rhythm is rechecked.

   Which drug and dose is correct?

   • A. Adrenaline 1:1000 given as 1 mg intravenously, as for adults
   • B. Adrenaline 1:10,000 at 10 microg/kg (0.1 mL/kg) intravenously or intraosseously, to a maximum of 1 mg
   • C. Amiodarone 5 mg/kg as a slow infusion over 20 minutes
   • D. Calcium chloride 10% at 0.2 mL/kg as a routine first drug in asystole, before adrenaline
   Show answer

   Answer: B. Adrenaline 1:10,000 at 10 microg/kg (0.1 mL/kg) intravenously or intraosseously, to a maximum of 1 mg

   Why: Primary resuscitation drugs are adrenaline 1:10,000 at 10 microg/kg (0.1 mL/kg) intravenously, intramuscularly or intraosseously with a maximum of 1 mg, and amiodarone 5 mg/kg as a rapid bolus with 5% glucose to a maximum of 300 mg. Undiluted 1:1000 adrenaline is not used, a slow amiodarone infusion is incorrect, and calcium, atropine, lidocaine and sodium bicarbonate are not given routinely. Hypovolaemia is corrected with a crystalloid bolus of 10 to 20 mL/kg and hypoglycaemia with 10% glucose 2 mL/kg.

   • A. The resuscitation strength is 1:10,000, and 1:1000 adrenaline is not given undiluted during cardiac arrest.
   • C. Amiodarone is given as a rapid bolus with 5% glucose rather than as a slow infusion.
   • D. Calcium, atropine, lidocaine and sodium bicarbonate are not used routinely and are considered only in specific situations.

   Sources: RCH Clinical Practice Guideline: Resuscitation - hospital management of cardiopulmonary arrest (The Royal Children's Hospital Melbourne, last updated December 2025)

3. 3 / 10

   A 67-year-old man with advanced kidney disease is in cardiac arrest. The rhythm is a bradyarrhythmia progressing to asystole, and a blood gas analyser confirms severe hyperkalaemia.

   Which treatment should be given first to protect the heart?

   • A. Insulin and glucose infusion alone
   • B. Sodium bicarbonate 50 mmol by rapid injection
   • C. Urgent haemodialysis as the initial step
   • D. 10 mL of 10% calcium chloride by rapid bolus
   Show answer

   Answer: D. 10 mL of 10% calcium chloride by rapid bolus

   Why: Hyperkalaemia is a reversible cause of arrest, and the first priority is to protect the myocardium from its arrhythmic effect with a rapid bolus of 10 mL of 10% calcium chloride, which may be repeated if the arrest is prolonged. Insulin with glucose and bicarbonate shift or redistribute potassium, and dialysis removes it, but none of these acts quickly enough to stabilise the heart at the moment of arrest. Insulin and glucose are then used to move potassium into cells, with dialysis considered for refractory cases.

   • A. Glucose with insulin shifts potassium into cells but does not immediately protect the myocardium from the arrhythmic effect of hyperkalaemia.
   • B. Bicarbonate is used when there is severe acidosis or renal failure and is not the first measure to stabilise the heart.
   • C. Dialysis removes potassium but cannot be arranged quickly enough to protect the heart during the arrest.

   Sources: ANZCOR Guideline 11.10 Resuscitation in Special Circumstances (2026)

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5. 4 / 10

   A 62-year-old man collapses in a shopping centre and bystander cardiopulmonary resuscitation is commenced. A manual defibrillator is attached and the rhythm shows ventricular fibrillation. The defibrillator is a biphasic device.

   What initial energy should be selected for the first shock?

   • A. 200 J
   • B. 360 J
   • C. 120 J
   • D. 150 J
   Show answer

   Answer: A. 200 J

   Why: The guideline for adult advanced life support states that for biphasic waveforms the default initial energy level for adults should be set at 200 J, because that is the level with supporting clinical data for modern defibrillators. Monophasic devices, in contrast, are set to maximum, usually 360 J, and an energy below the default is chosen only where device specific data show greater than 90% shock success. The chance of successful defibrillation falls with time, so an unsupported initial energy level reduces the likelihood of an effective first shock.

   • B. Monophasic defibrillators are set to maximum, usually 360 J, so this energy relates to older monophasic equipment rather than the biphasic device used here.
   • C. Energy below the recommended default is not supported by clinical data for this device, so an initial shock at this setting risks an unsuccessful first attempt.
   • D. This intermediate setting may be used only where specific clinical data show greater than 90% shock success for the particular defibrillator, which is not the scenario described.

   Sources: ANZCOR Guideline 11.2 Protocols for Adult Advanced Life Support (2026)

6. 5 / 10

   A 6-year-old girl weighing 20 kg collapses in the emergency department. After two minutes of cardiopulmonary resuscitation the rhythm is reported as pulseless ventricular tachycardia while compressions continue.

   What is the most appropriate next step?

   • A. Deliver a synchronised shock at 2 J/kg
   • B. Withhold defibrillation and give amiodarone 5 mg/kg while continuing compressions for another 2 minutes
   • C. Deliver an unsynchronised shock at 4 J/kg, giving 80 J, then resume compressions immediately for 2 minutes
   • D. Deliver a synchronised shock at 200 J
   Show answer

   Answer: C. Deliver an unsynchronised shock at 4 J/kg, giving 80 J, then resume compressions immediately for 2 minutes

   Why: Pulseless ventricular tachycardia is a shockable rhythm and is treated with an unsynchronised shock at 4 J/kg, rounding up, so a 20 kg child receives 80 J, with compressions resumed immediately for 2 minutes before the next rhythm check. Synchronised shocks are used for perfusing tachyarrhythmias, 200 J is an adult setting, and giving amiodarone instead of shocking would delay the only intervention that can restore circulation. Reversible causes such as hypoxaemia and hypovolaemia should also be addressed.

   • A. Shocks for ventricular fibrillation and pulseless ventricular tachycardia are unsynchronised, and the dose is 4 J/kg.
   • B. Defibrillation is the priority for a shockable rhythm, and any delay reduces the chance of return of spontaneous circulation.
   • D. A synchronised shock is used for a perfusing tachyarrhythmia, and 200 J is an adult setting rather than a weight based paediatric dose.

   Sources: RCH Clinical Practice Guideline: Resuscitation - hospital management of cardiopulmonary arrest (The Royal Children's Hospital Melbourne, last updated December 2025)

7. 6 / 10

   A 32-year-old woman at 34 weeks gestation is in cardiac arrest in the emergency department. She is supine on a trolley and resuscitation has begun.

   What modification to positioning should be made to relieve aortocaval compression?

   • A. Tilt the whole trolley into a steep 45 degree head-down position to improve venous return.
   • B. Place her fully on her left side before compressions are started.
   • C. Add a pillow under the head and keep her flat on her back.
   • D. Manually displace the uterus to the left, adding a tilt of only 15 to 30 degrees if needed.
   Show answer

   Answer: D. Manually displace the uterus to the left, adding a tilt of only 15 to 30 degrees if needed.

   Why: After 20 weeks, or whenever the uterus is palpable above the umbilicus, the pregnant woman in cardiac arrest should have the uterus manually displaced to the left and, if tilt is added, it should be limited to about 15 to 30 degrees so that high quality compressions remain possible. Leaving the uterus to compress the inferior vena cava and aorta reduces venous return, and rolling the patient fully lateral or tipping her head down would make effective compressions impossible.

   • A. Head-down positioning does not relieve aortocaval compression and would impede effective chest compressions.
   • B. A full lateral position makes high quality chest compressions impossible and is not the recommended modification.
   • C. Remaining flat on the back with the uterus palpable above the umbilicus allows the gravid uterus to compress the great vessels.

   Sources: ANZCOR Guideline 11.10 Resuscitation in Special Circumstances (2026)

8. 7 / 10

   A 24-year-old man is pulled from a surf beach and, after resuscitation, achieves return of spontaneous circulation. He is breathing spontaneously and his oxygen saturation is being monitored.

   What oxygen strategy should be used now?

   • A. Give 100% oxygen via a non-rebreather mask indefinitely to protect the brain.
   • B. Titrate the inspired oxygen concentration to keep the oxygen saturation between 94% and 98%.
   • C. Withhold supplemental oxygen while the saturation remains above 80%.
   • D. Give oxygen only if the chest radiograph shows an abnormality.
   Show answer

   Answer: B. Titrate the inspired oxygen concentration to keep the oxygen saturation between 94% and 98%.

   Why: Most people who arrest in water do so because of hypoxia, but once spontaneous circulation returns excessive oxygen is unhelpful. In non-fatal drowning the inspired oxygen concentration is titrated to achieve an oxygen saturation of 94% to 98%, with arterial blood gases used to confirm adequate oxygenation and ventilation once they are available. Continuing 100% oxygen unnecessarily, accepting saturations as low as 80%, or withholding oxygen until a radiograph changes all expose the patient to avoidable harm.

   • A. Once spontaneous circulation has returned the aim is to avoid unnecessary hyperoxia, so prolonged high concentration oxygen is not appropriate.
   • C. Allowing saturation to fall as low as 80% risks hypoxaemia in a patient who has just been resuscitated from a hypoxic arrest.
   • D. Oxygen is titrated to saturation guidance rather than being withheld until radiological changes appear.

   Sources: ANZCOR Guideline 11.10 Resuscitation in Special Circumstances (2026)

9. 8 / 10

   A 41-year-old hiker is found in cardiac arrest after a night exposed to cold and wet conditions. Oesophageal temperature is 27 degrees Celsius and the rhythm is ventricular fibrillation.

   How should adrenaline be managed during the resuscitation?

   • A. Withhold adrenaline until the core temperature is above 30 degrees Celsius.
   • B. Give adrenaline at the usual four-minute intervals throughout.
   • C. Give double the standard dose with each loop.
   • D. Give adrenaline only after three defibrillation attempts have failed.
   Show answer

   Answer: A. Withhold adrenaline until the core temperature is above 30 degrees Celsius.

   Why: The hypothermic heart responds poorly to cardioactive drugs, attempted pacing and defibrillation. Adrenaline is withheld when the core temperature is below 30 degrees Celsius, and the interval is lengthened to 6 to 10 minutes when the temperature is between 30 and 34 degrees Celsius. Resuscitation continues with active rewarming and transfer to a centre able to provide extracorporeal life support, and further defibrillation attempts are delayed until the core temperature is above 30 degrees Celsius if ventricular fibrillation persists after three shocks.

   • B. Standard dosing intervals do not apply at this temperature; drug effects are unpredictable and the interval is lengthened when the temperature is between 30 and 34 degrees Celsius.
   • C. Increasing the dose does not overcome the poor myocardial response to drugs at this temperature and is not advised.
   • D. Timing adrenaline against shocks is not the recommended modification; it is the falling core temperature that dictates whether the drug is given.

   Sources: ANZCOR Guideline 11.10 Resuscitation in Special Circumstances (2026)

10. 9 / 10

    A 34-year-old man is in cardiac arrest after blunt chest trauma. Ventilation is becoming progressively more difficult, the right hemithorax is hyperexpanded with absent breath sounds, and tension pneumothorax is suspected.

    Where should needle decompression be performed?

    • A. Second intercostal space in the mid-axillary line, just above the second rib.
    • B. Second intercostal space in the mid-clavicular line, just above the third rib.
    • C. Sixth intercostal space in the mid-clavicular line, just above the seventh rib.
    • D. Any intercostal space in the anterior axillary line, without regard to rib position.
    Show answer

    Answer: B. Second intercostal space in the mid-clavicular line, just above the third rib.

    Why: In cardiac arrest with a suspected tension pneumothorax the chest is decompressed immediately, using a needle-cannula at the second intercostal space just above the third rib in the mid-clavicular line or at the fourth or fifth intercostal space in the mid-axillary line, followed by insertion of a chest drain. An open thoracostomy is an alternative for those trained to perform it. Siting the needle too low, in the wrong line, or without reference to rib position risks injuring the intercostal vessels and nerve.

    • A. The mid-axillary site is used at the fourth or fifth intercostal space, not at the second space described here.
    • C. This site is too low and does not correspond to either of the recommended decompression points.
    • D. Decompression is sited above a rib to avoid the intercostal vessels and nerve, so rib position must be observed.

    Sources: ANZCOR Guideline 11.10 Resuscitation in Special Circumstances (2026)

11. 10 / 10

    A 9-year-old girl weighing 30 kg has a suspected pelvic fracture after a high speed vehicle collision. She is tachycardic with prolonged capillary refill and evidence of ongoing concealed bleeding. Her blood pressure is falling despite a pelvic binder and oxygen.

    Which early resuscitation step is most appropriate?

    • A. Give tranexamic acid 100 mg/kg intravenously
    • B. Give a 10 mL/kg bolus of sodium chloride 0.9% and tranexamic acid 15 mg/kg
    • C. Withhold tranexamic acid until surgical control of bleeding has been achieved
    • D. Give a 1 litre bolus of 4% albumin
    Show answer

    Answer: B. Give a 10 mL/kg bolus of sodium chloride 0.9% and tranexamic acid 15 mg/kg

    Why: Early resuscitation in paediatric trauma uses a 10 mL/kg bolus of sodium chloride 0.9% when the circulation is inadequate, followed by packed red blood cells at 10 mL/kg if bleeding is ongoing or occult. Tranexamic acid 15 mg/kg is given when there is haemodynamic compromise from suspected haemorrhage. A 100 mg/kg dose is far too high, waiting for surgery delays a time critical drug, and albumin is not the recommended initial fluid. Blood should be sent for cross match, full blood examination, venous blood gas, electrolytes and coagulation studies.

    • A. The recommended dose of tranexamic acid is 15 mg/kg when there is haemodynamic compromise from suspected haemorrhage.
    • C. Tranexamic acid is given early rather than after surgery, because it is most useful during active bleeding.
    • D. Isotonic crystalloid is the recommended initial fluid in paediatric trauma, and albumin is not part of the protocol.

    Sources: RCH Clinical Practice Guideline: Trauma - primary survey (The Royal Children's Hospital Melbourne, last updated January 2022)

Exam-style questions written by MedHub for practice. They are not official exam questions.