ACLS (ADVANCED CARDIOVASCULAR LIFE SUPPORT)
EXAM | QUESTIONS AND 100% CORRECT ANSWERS WITH
RATIONALES | LATEST UPDATE GRADED A+
1. Which of the following is the most appropriate first step for a patient in cardiac
arrest?
A. Administer epinephrine
B. Begin CPR immediately
C. Attach a cardiac monitor
D. Call for a cardiologist
Answer: B – Begin CPR immediately
Rationale: High-quality CPR should be initiated immediately in cardiac arrest to maintain
circulation until defibrillation or medications are available.
2. What is the recommended compression rate for adult CPR?
A. 60–70/min
B. 80–90/min
C. 100–120/min
D. 140–160/min
Answer: C – 100–120/min
Rationale: Current ACLS guidelines recommend a compression rate of 100–120 per minute
for effective perfusion.
3. What is the recommended depth for chest compressions in adults?
A. 1 inch
B. 2 inches
C. 3 inches
D. 4 inches
Answer: B – 2 inches
Rationale: Compressions should be at least 2 inches (5 cm) deep to create adequate blood
flow during CPR.
4. Which rhythm is considered shockable in ACLS?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Answer: C – Ventricular fibrillation
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are shockable
rhythms; asystole and PEA are not.
, 5. During ACLS, when is epinephrine indicated?
A. Only for bradycardia
B. For shockable and non-shockable cardiac arrest
C. Only after defibrillation fails
D. Only in patients with chest pain
Answer: B – For shockable and non-shockable cardiac arrest
Rationale: Epinephrine is administered every 3–5 minutes during cardiac arrest for both
shockable and non-shockable rhythms.
6. Which of the following is a correct dose of amiodarone for ventricular
fibrillation?
A. 150 mg IV push
B. 300 mg IV push
C. 500 mg IV push
D. 50 mg IV push
Answer: B – 300 mg IV push
Rationale: The first dose of amiodarone in VF/pulseless VT is 300 mg IV push; a second dose
may be 150 mg.
7. What is the next step if a patient is in asystole?
A. Defibrillate immediately
B. Begin CPR and administer epinephrine
C. Administer amiodarone
D. Observe and wait
Answer: B – Begin CPR and administer epinephrine
Rationale: Asystole is non-shockable; immediate CPR and epinephrine are indicated.
8. Which of the following is considered high-quality CPR?
A. Minimal interruptions in compressions
B. Allow full chest recoil
C. Correct depth and rate
D. All of the above
Answer: D – All of the above
Rationale: High-quality CPR requires proper depth, rate, minimal interruptions, and full
chest recoil.
9. For a witnessed sudden cardiac arrest, what is the preferred first action?
A. Start CPR
B. Call for help and get the AED
C. Administer epinephrine
D. Intubate
,Answer: B – Call for help and get the AED
Rationale: Early defibrillation significantly improves survival in witnessed sudden cardiac
arrest.
10. Which rhythm requires immediate defibrillation?
A. Sinus tachycardia
B. Pulseless VT
C. Asystole
D. Normal sinus rhythm
Answer: B – Pulseless VT
Rationale: Pulseless ventricular tachycardia is shockable and requires immediate
defibrillation.
11. Which of the following medications is used for bradycardia with a pulse?
A. Amiodarone
B. Adenosine
C. Atropine
D. Epinephrine
Answer: C – Atropine
Rationale: Atropine is first-line for symptomatic bradycardia with a pulse.
12. For a patient with pulseless VT, what is the immediate next step?
A. Administer amiodarone only
B. Begin CPR and prepare defibrillation
C. Give atropine
D. Observe
Answer: B – Begin CPR and prepare defibrillation
Rationale: Pulseless VT is a shockable rhythm; CPR should continue while preparing
defibrillation.
13. Which of the following is the recommended energy for the first shock with a
biphasic defibrillator?
A. 50 J
B. 120–200 J
C. 300 J
D. 360 J
Answer: B – 120–200 J
Rationale: Biphasic defibrillators typically use 120–200 J for the first shock according to
ACLS guidelines.
14. During a cardiac arrest, how often should you rotate the person performing
chest compressions?
A. Every 1 minute
B. Every 2 minutes
, C. Every 5 minutes
D. Only when fatigued
Answer: B – Every 2 minutes
Rationale: Rotating every 2 minutes helps maintain high-quality compressions and reduces
rescuer fatigue.
15. Which rhythm is characterized by a rapid, chaotic, and irregular QRS without a
pulse?
A. Ventricular fibrillation
B. Pulseless electrical activity
C. Asystole
D. Sinus tachycardia
Answer: A – Ventricular fibrillation
Rationale: VF is a disorganized, rapid ventricular rhythm without effective cardiac output.
16. For a patient with suspected STEMI, what is the immediate ACLS
recommendation?
A. Administer CPR
B. Obtain a 12-lead ECG
C. Defibrillate immediately
D. Give atropine
Answer: B – Obtain a 12-lead ECG
Rationale: Early ECG helps diagnose STEMI and guide reperfusion therapy.
17. Which drug is first-line for torsades de pointes?
A. Epinephrine
B. Magnesium sulfate
C. Adenosine
D. Atropine
Answer: B – Magnesium sulfate
Rationale: Magnesium stabilizes the cardiac membrane in torsades de pointes.
18. For adult tachyarrhythmias with a pulse, what is the first consideration?
A. Immediate defibrillation
B. Assess stability and symptoms
C. Give amiodarone immediately
D. Start CPR
Answer: B – Assess stability and symptoms
Rationale: Stable tachyarrhythmias are treated differently from unstable; patient stability
guides treatment.
19. Which of the following is a non-shockable rhythm?
A. Pulseless VT
EXAM | QUESTIONS AND 100% CORRECT ANSWERS WITH
RATIONALES | LATEST UPDATE GRADED A+
1. Which of the following is the most appropriate first step for a patient in cardiac
arrest?
A. Administer epinephrine
B. Begin CPR immediately
C. Attach a cardiac monitor
D. Call for a cardiologist
Answer: B – Begin CPR immediately
Rationale: High-quality CPR should be initiated immediately in cardiac arrest to maintain
circulation until defibrillation or medications are available.
2. What is the recommended compression rate for adult CPR?
A. 60–70/min
B. 80–90/min
C. 100–120/min
D. 140–160/min
Answer: C – 100–120/min
Rationale: Current ACLS guidelines recommend a compression rate of 100–120 per minute
for effective perfusion.
3. What is the recommended depth for chest compressions in adults?
A. 1 inch
B. 2 inches
C. 3 inches
D. 4 inches
Answer: B – 2 inches
Rationale: Compressions should be at least 2 inches (5 cm) deep to create adequate blood
flow during CPR.
4. Which rhythm is considered shockable in ACLS?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Answer: C – Ventricular fibrillation
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are shockable
rhythms; asystole and PEA are not.
, 5. During ACLS, when is epinephrine indicated?
A. Only for bradycardia
B. For shockable and non-shockable cardiac arrest
C. Only after defibrillation fails
D. Only in patients with chest pain
Answer: B – For shockable and non-shockable cardiac arrest
Rationale: Epinephrine is administered every 3–5 minutes during cardiac arrest for both
shockable and non-shockable rhythms.
6. Which of the following is a correct dose of amiodarone for ventricular
fibrillation?
A. 150 mg IV push
B. 300 mg IV push
C. 500 mg IV push
D. 50 mg IV push
Answer: B – 300 mg IV push
Rationale: The first dose of amiodarone in VF/pulseless VT is 300 mg IV push; a second dose
may be 150 mg.
7. What is the next step if a patient is in asystole?
A. Defibrillate immediately
B. Begin CPR and administer epinephrine
C. Administer amiodarone
D. Observe and wait
Answer: B – Begin CPR and administer epinephrine
Rationale: Asystole is non-shockable; immediate CPR and epinephrine are indicated.
8. Which of the following is considered high-quality CPR?
A. Minimal interruptions in compressions
B. Allow full chest recoil
C. Correct depth and rate
D. All of the above
Answer: D – All of the above
Rationale: High-quality CPR requires proper depth, rate, minimal interruptions, and full
chest recoil.
9. For a witnessed sudden cardiac arrest, what is the preferred first action?
A. Start CPR
B. Call for help and get the AED
C. Administer epinephrine
D. Intubate
,Answer: B – Call for help and get the AED
Rationale: Early defibrillation significantly improves survival in witnessed sudden cardiac
arrest.
10. Which rhythm requires immediate defibrillation?
A. Sinus tachycardia
B. Pulseless VT
C. Asystole
D. Normal sinus rhythm
Answer: B – Pulseless VT
Rationale: Pulseless ventricular tachycardia is shockable and requires immediate
defibrillation.
11. Which of the following medications is used for bradycardia with a pulse?
A. Amiodarone
B. Adenosine
C. Atropine
D. Epinephrine
Answer: C – Atropine
Rationale: Atropine is first-line for symptomatic bradycardia with a pulse.
12. For a patient with pulseless VT, what is the immediate next step?
A. Administer amiodarone only
B. Begin CPR and prepare defibrillation
C. Give atropine
D. Observe
Answer: B – Begin CPR and prepare defibrillation
Rationale: Pulseless VT is a shockable rhythm; CPR should continue while preparing
defibrillation.
13. Which of the following is the recommended energy for the first shock with a
biphasic defibrillator?
A. 50 J
B. 120–200 J
C. 300 J
D. 360 J
Answer: B – 120–200 J
Rationale: Biphasic defibrillators typically use 120–200 J for the first shock according to
ACLS guidelines.
14. During a cardiac arrest, how often should you rotate the person performing
chest compressions?
A. Every 1 minute
B. Every 2 minutes
, C. Every 5 minutes
D. Only when fatigued
Answer: B – Every 2 minutes
Rationale: Rotating every 2 minutes helps maintain high-quality compressions and reduces
rescuer fatigue.
15. Which rhythm is characterized by a rapid, chaotic, and irregular QRS without a
pulse?
A. Ventricular fibrillation
B. Pulseless electrical activity
C. Asystole
D. Sinus tachycardia
Answer: A – Ventricular fibrillation
Rationale: VF is a disorganized, rapid ventricular rhythm without effective cardiac output.
16. For a patient with suspected STEMI, what is the immediate ACLS
recommendation?
A. Administer CPR
B. Obtain a 12-lead ECG
C. Defibrillate immediately
D. Give atropine
Answer: B – Obtain a 12-lead ECG
Rationale: Early ECG helps diagnose STEMI and guide reperfusion therapy.
17. Which drug is first-line for torsades de pointes?
A. Epinephrine
B. Magnesium sulfate
C. Adenosine
D. Atropine
Answer: B – Magnesium sulfate
Rationale: Magnesium stabilizes the cardiac membrane in torsades de pointes.
18. For adult tachyarrhythmias with a pulse, what is the first consideration?
A. Immediate defibrillation
B. Assess stability and symptoms
C. Give amiodarone immediately
D. Start CPR
Answer: B – Assess stability and symptoms
Rationale: Stable tachyarrhythmias are treated differently from unstable; patient stability
guides treatment.
19. Which of the following is a non-shockable rhythm?
A. Pulseless VT
