ACLS Mirror Exam PDF | Advanced
Cardiovascular Life Support Practice Test
| 2026 Certification Prep
Question 1: An activated AED does not promptly analyze the rhythm. What is
your next action?
A. Begin chest compressions.
B. Discontinue the resuscitation attempt.
C. Check all AED connections and reanalyze.
D. Rotate AED electrodes to an alternate position.
Correct Answer: C. Check all AED connections and reanalyze.
Rationale: If an AED does not analyze promptly, check the electrode pad
connections, ensure good skin contact, and then prompt the AED to reanalyze.
Starting compressions is important but it is best to correct mechanical or
connection issues first to allow analysis.
Question 2: You have completed 2 minutes of CPR. The ECG monitor displays a
rhythm, and the patient has no pulse. Another member of your team resumes chest
compressions, and an IV is in place. What management step is your next priority?
A. Give atropine 0.5 mg IV.
B. Insert an advanced airway.
C. Administer epinephrine 1 mg IV.
D. Start a dopamine infusion.
,Correct Answer: C. Administer epinephrine 1 mg IV.
Rationale: For refractory ventricular fibrillation after initial defibrillation and
CPR, administer epinephrine 1 mg IV/IO every 3-5 minutes. Atropine is no longer
recommended in ventricular fibrillation or pulseless ventricular tachycardia.
Insertion of an advanced airway can be performed but does not take priority over
epinephrine administration. Dopamine infusion is not indicated during cardiac
arrest.
Question 3: What is the preferred method of access for epinephrine administration
during cardiac arrest in most patients?
A. Intraosseous
B. Endotracheal
C. Central intravenous
D. Peripheral intravenous
Correct Answer: D. Peripheral intravenous
Rationale: The preferred vascular access during cardiac arrest is peripheral
intravenous (IV) access due to its availability and rapid establishment in most
patients. If peripheral IV access is difficult or delayed, intraosseous (IO) access
provides an excellent alternative that quickly allows administration of medications.
Endotracheal administration is no longer preferred due to variable absorption and
efficacy.
,Question 4: You find an unresponsive patient who is not breathing. After
activating the emergency response system, you determine that there is no pulse.
What is your next action?
A. Open the airway with a head tilt-chin lift.
B. Administer epinephrine at a dose of 1 mg/kg.
C. Deliver 2 rescue breaths each over 1 second.
D. Start chest compressions at a rate of at least 100/min.
Correct Answer: D. Start chest compressions at a rate of at least 100/min.
Rationale: For a patient who is unresponsive, not breathing, and pulseless, the
immediate next step after activating the emergency response system is to start
high-quality chest compressions immediately. Chest compressions maintain
circulation to vital organs and are key to successful resuscitation. Opening the
airway and rescue breaths are provided during the CPR cycle, but compressions
take priority to maintain blood flow.
Question 5: You are evaluating a 58-year-old man with chest pain. The blood
pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate
is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is
most important now?
A. PETCO₂
B. Chest x-ray
C. Laboratory testing
D. Obtaining a 12-lead ECG
Correct Answer: D. Obtaining a 12-lead ECG
, Rationale: In a patient presenting with chest pain and signs of possible
hemodynamic compromise (low-normal blood pressure), obtaining a 12-lead ECG
should be prioritized. The ECG identifies ischemic changes, acute coronary
syndromes, or arrhythmias and guides urgent treatment decisions. While other tests
are important, they are secondary to early ECG acquisition in chest pain
evaluation.
Question 6: During a pause in CPR, you see asystole on the monitor. The patient
has no pulse. What is the next action?
A. Establish vascular access.
B. Obtain the patient's history.
C. Resume chest compressions.
D. Terminate the resuscitative effort.
Correct Answer: C. Resume chest compressions.
Rationale: Asystole is a nonshockable rhythm, and immediate resumption of high-
quality chest compressions is essential to maintain circulation and attempt return of
spontaneous circulation (ROSC). Vascular access is important but does not
supersede the need for uninterrupted compressions. Terminating resuscitation is
considered only after a prolonged code with no response.
Question 7: What is a common but sometimes fatal mistake in cardiac arrest
management?
A. Failure to obtain vascular access
B. Prolonged periods of no ventilations
Cardiovascular Life Support Practice Test
| 2026 Certification Prep
Question 1: An activated AED does not promptly analyze the rhythm. What is
your next action?
A. Begin chest compressions.
B. Discontinue the resuscitation attempt.
C. Check all AED connections and reanalyze.
D. Rotate AED electrodes to an alternate position.
Correct Answer: C. Check all AED connections and reanalyze.
Rationale: If an AED does not analyze promptly, check the electrode pad
connections, ensure good skin contact, and then prompt the AED to reanalyze.
Starting compressions is important but it is best to correct mechanical or
connection issues first to allow analysis.
Question 2: You have completed 2 minutes of CPR. The ECG monitor displays a
rhythm, and the patient has no pulse. Another member of your team resumes chest
compressions, and an IV is in place. What management step is your next priority?
A. Give atropine 0.5 mg IV.
B. Insert an advanced airway.
C. Administer epinephrine 1 mg IV.
D. Start a dopamine infusion.
,Correct Answer: C. Administer epinephrine 1 mg IV.
Rationale: For refractory ventricular fibrillation after initial defibrillation and
CPR, administer epinephrine 1 mg IV/IO every 3-5 minutes. Atropine is no longer
recommended in ventricular fibrillation or pulseless ventricular tachycardia.
Insertion of an advanced airway can be performed but does not take priority over
epinephrine administration. Dopamine infusion is not indicated during cardiac
arrest.
Question 3: What is the preferred method of access for epinephrine administration
during cardiac arrest in most patients?
A. Intraosseous
B. Endotracheal
C. Central intravenous
D. Peripheral intravenous
Correct Answer: D. Peripheral intravenous
Rationale: The preferred vascular access during cardiac arrest is peripheral
intravenous (IV) access due to its availability and rapid establishment in most
patients. If peripheral IV access is difficult or delayed, intraosseous (IO) access
provides an excellent alternative that quickly allows administration of medications.
Endotracheal administration is no longer preferred due to variable absorption and
efficacy.
,Question 4: You find an unresponsive patient who is not breathing. After
activating the emergency response system, you determine that there is no pulse.
What is your next action?
A. Open the airway with a head tilt-chin lift.
B. Administer epinephrine at a dose of 1 mg/kg.
C. Deliver 2 rescue breaths each over 1 second.
D. Start chest compressions at a rate of at least 100/min.
Correct Answer: D. Start chest compressions at a rate of at least 100/min.
Rationale: For a patient who is unresponsive, not breathing, and pulseless, the
immediate next step after activating the emergency response system is to start
high-quality chest compressions immediately. Chest compressions maintain
circulation to vital organs and are key to successful resuscitation. Opening the
airway and rescue breaths are provided during the CPR cycle, but compressions
take priority to maintain blood flow.
Question 5: You are evaluating a 58-year-old man with chest pain. The blood
pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate
is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is
most important now?
A. PETCO₂
B. Chest x-ray
C. Laboratory testing
D. Obtaining a 12-lead ECG
Correct Answer: D. Obtaining a 12-lead ECG
, Rationale: In a patient presenting with chest pain and signs of possible
hemodynamic compromise (low-normal blood pressure), obtaining a 12-lead ECG
should be prioritized. The ECG identifies ischemic changes, acute coronary
syndromes, or arrhythmias and guides urgent treatment decisions. While other tests
are important, they are secondary to early ECG acquisition in chest pain
evaluation.
Question 6: During a pause in CPR, you see asystole on the monitor. The patient
has no pulse. What is the next action?
A. Establish vascular access.
B. Obtain the patient's history.
C. Resume chest compressions.
D. Terminate the resuscitative effort.
Correct Answer: C. Resume chest compressions.
Rationale: Asystole is a nonshockable rhythm, and immediate resumption of high-
quality chest compressions is essential to maintain circulation and attempt return of
spontaneous circulation (ROSC). Vascular access is important but does not
supersede the need for uninterrupted compressions. Terminating resuscitation is
considered only after a prolonged code with no response.
Question 7: What is a common but sometimes fatal mistake in cardiac arrest
management?
A. Failure to obtain vascular access
B. Prolonged periods of no ventilations
