TABLE OF CONTENTS
SECTION 1: BASIC LIFE SUPPORT (BLS) AND CPR ...................... Questions 1-25
SECTION 2: ADVANCED CARDIAC LIFE SUPPORT (ACLS) ................. Questions 26-50
SECTION 3: PHARMACOLOGY AND MEDICATIONS ........................ Questions 51-75
SECTION 4: ECG INTERPRETATION AND ARRHYTHMIAS .................. Questions 76-100
SECTION 5: ACUTE CORONARY SYNDROMES (ACS) AND MI ............... Questions 101-125
SECTION 6: STROKE AND NEUROLOGICAL EMERGENCIES ............... Questions 126-150
SECTION 7: RESPIRATORY EMERGENCIES ............................ Questions 151-175
SECTION 8: CARDIAC DYSRHYTHMIAS AND MANAGEMENT ................ Questions 176-200
SECTION 9: SHOCK AND HEMODYNAMIC MONITORING ................... Questions 201-225
SECTION 10: SPECIAL RESUSCITATION SITUATIONS ................... Questions 226-250
1
,Section 1: Basic Life Support (BLS) and CPR - Questions 1-25
1. During a witnessed cardiac arrest in a monitored unit, the rhythm is initially ventricular
tachycardia (pulseless). A defibrillator is immediately available. According to the 2026/2027
AHA guidelines, what is the optimal sequence of actions for a single rescuer until additional
help arrives?
A) Immediately start chest compressions, then analyze rhythm, then defibrillate, then resume
compressions.
B) Check pulse for up to 10 seconds, then defibrillate immediately, then start chest
compressions.
C) Verify unresponsiveness, activate emergency response, get defibrillator, then analyze rhythm
and defibrillate if shockable.
D) Start chest compressions at a rate of 100-120/min, then after 2 minutes analyze rhythm,
then defibrillate.
Answer: C
Rationale: The correct sequence for a witnessed arrest with immediate defibrillator access is:
verify unresponsiveness, activate emergency response, retrieve defibrillator, then analyze
rhythm and deliver shock if indicated. Starting compressions before rhythm analysis delays
defibrillation, which is critical for shockable rhythms. Options A and D delay defibrillation;
option B suggests pulse check first, which is not recommended in witnessed arrest with
immediate defibrillator.
2. A team is performing CPR on a patient with suspected opioid overdose. The patient has a
pulse but is not breathing adequately. What is the most appropriate BLS intervention according
to the 2026/2027 guidelines?
A) Immediately begin chest compressions at a rate of 100-120/min until naloxone is
administered.
B) Provide rescue breaths at a rate of 1 breath every 5-6 seconds, reassess pulse frequently.
C) Administer naloxone intramuscularly and then reassess breathing before starting CPR.
D) Deliver two initial rescue breaths, then begin chest compressions if breathing does not
improve.
Answer: B
2
,Rationale: For a patient with a pulse but inadequate breathing (respiratory arrest), the
appropriate BLS intervention is rescue breathing. The recommended rate is 1 breath every 5-6
seconds (10-12 breaths per minute), with frequent pulse checks. Chest compressions are not
indicated when a pulse is present. Naloxone may be given but should not delay ventilation.
Options A and D include unnecessary compressions; option C delays ventilation.
3. In a cardiac arrest situation with an advanced airway in place, you are providing continuous
chest compressions at a rate of 110/min. What ventilation rate should be delivered to optimize
coronary perfusion pressure while avoiding hyperventilation?
A) 6 breaths per minute (1 breath every 10 seconds)
B) 8-10 breaths per minute (1 breath every 6-8 seconds)
C) 12-15 breaths per minute (1 breath every 4-5 seconds)
D) 20 breaths per minute (1 breath every 3 seconds)
Answer: B
Rationale: With an advanced airway, continuous compressions are performed at 100-120/min,
and ventilations are delivered at 8-10 breaths per minute (1 breath every 6-8 seconds). This
rate prevents hyperventilation, which can increase intrathoracic pressure and decrease venous
return, reducing coronary perfusion pressure. Option A (6/min) may be too low; options C and
D risk hyperventilation.
4. During CPR, a team member notes that the end-tidal CO2 (ETCO2) reading is persistently
below 10 mmHg despite high-quality compressions. What is the most likely implication for BLS
quality?
A) Compression rate is too fast, causing inadequate filling time.
B) Compression depth is insufficient, leading to poor cardiac output.
C) Ventilation rate is too high, causing respiratory alkalosis.
D) Chest recoil is incomplete, reducing venous return and cardiac output.
Answer: D
Rationale: Low ETCO2 (<10 mmHg) during CPR indicates low cardiac output, often due to
incomplete chest recoil. Incomplete recoil prevents negative intrathoracic pressure during
decompression, reducing venous return and subsequent cardiac output. While compression
depth and rate are important, persistent low ETCO2 despite adequate depth and rate should
prompt evaluation of recoil. Ventilation rate affects ETCO2 but is less likely to cause such a low
value if compressions are effective.
3
, 5. A team of two rescuers is performing CPR on an adult in cardiac arrest. The compressor is
delivering compressions at a depth of 2.2 inches and a rate of 110/min. The ventilations are
given as 2 breaths after every 30 compressions. What is the most critical adjustment needed to
improve CPR quality according to the 2026/2027 guidelines?
A) Increase compression rate to 120/min to maximize blood flow.
B) Switch to continuous compressions with asynchronous ventilations if an advanced airway is
placed.
C) Reduce compression depth to 2 inches to avoid injury.
D) Change compression-to-ventilation ratio to 15:2 to increase ventilation frequency.
Answer: B
Rationale: The scenario describes two-rescuer CPR without an advanced airway; the ratio is
30:2. However, the critical adjustment is to consider placing an advanced airway to allow
continuous compressions without pauses for ventilations. Continuous compressions improve
coronary perfusion pressure. Increasing rate beyond 110 is not recommended; depth of 2.2
inches is within the 2-2.4 inch range. Changing to 15:2 is not standard for adults and would
increase interruptions.
6. In a witnessed cardiac arrest with a shockable rhythm, the first shock is delivered.
Immediately after the shock, the rescuer should:
A) Check the rhythm and pulse for 10 seconds to assess ROSC.
B) Resume chest compressions immediately for 2 minutes before rhythm check.
C) Deliver a second shock if the rhythm remains shockable.
D) Administer epinephrine 1 mg IV/IO immediately after the shock.
Answer: B
Rationale: After defibrillation, the immediate priority is to resume chest compressions without
delay. Rhythm and pulse checks should be deferred for 2 minutes (5 cycles of 30:2) to minimize
interruptions in compressions. Delivering a second shock immediately or checking
rhythm/pulse prematurely interrupts compressions. Epinephrine is given after the second shock
(if rhythm remains shockable) or during the 2-minute cycle.
7. Which of the following best describes the physiological rationale for using a compression-to-
ventilation ratio of 30:2 in single-rescuer adult CPR?
4
SECTION 1: BASIC LIFE SUPPORT (BLS) AND CPR ...................... Questions 1-25
SECTION 2: ADVANCED CARDIAC LIFE SUPPORT (ACLS) ................. Questions 26-50
SECTION 3: PHARMACOLOGY AND MEDICATIONS ........................ Questions 51-75
SECTION 4: ECG INTERPRETATION AND ARRHYTHMIAS .................. Questions 76-100
SECTION 5: ACUTE CORONARY SYNDROMES (ACS) AND MI ............... Questions 101-125
SECTION 6: STROKE AND NEUROLOGICAL EMERGENCIES ............... Questions 126-150
SECTION 7: RESPIRATORY EMERGENCIES ............................ Questions 151-175
SECTION 8: CARDIAC DYSRHYTHMIAS AND MANAGEMENT ................ Questions 176-200
SECTION 9: SHOCK AND HEMODYNAMIC MONITORING ................... Questions 201-225
SECTION 10: SPECIAL RESUSCITATION SITUATIONS ................... Questions 226-250
1
,Section 1: Basic Life Support (BLS) and CPR - Questions 1-25
1. During a witnessed cardiac arrest in a monitored unit, the rhythm is initially ventricular
tachycardia (pulseless). A defibrillator is immediately available. According to the 2026/2027
AHA guidelines, what is the optimal sequence of actions for a single rescuer until additional
help arrives?
A) Immediately start chest compressions, then analyze rhythm, then defibrillate, then resume
compressions.
B) Check pulse for up to 10 seconds, then defibrillate immediately, then start chest
compressions.
C) Verify unresponsiveness, activate emergency response, get defibrillator, then analyze rhythm
and defibrillate if shockable.
D) Start chest compressions at a rate of 100-120/min, then after 2 minutes analyze rhythm,
then defibrillate.
Answer: C
Rationale: The correct sequence for a witnessed arrest with immediate defibrillator access is:
verify unresponsiveness, activate emergency response, retrieve defibrillator, then analyze
rhythm and deliver shock if indicated. Starting compressions before rhythm analysis delays
defibrillation, which is critical for shockable rhythms. Options A and D delay defibrillation;
option B suggests pulse check first, which is not recommended in witnessed arrest with
immediate defibrillator.
2. A team is performing CPR on a patient with suspected opioid overdose. The patient has a
pulse but is not breathing adequately. What is the most appropriate BLS intervention according
to the 2026/2027 guidelines?
A) Immediately begin chest compressions at a rate of 100-120/min until naloxone is
administered.
B) Provide rescue breaths at a rate of 1 breath every 5-6 seconds, reassess pulse frequently.
C) Administer naloxone intramuscularly and then reassess breathing before starting CPR.
D) Deliver two initial rescue breaths, then begin chest compressions if breathing does not
improve.
Answer: B
2
,Rationale: For a patient with a pulse but inadequate breathing (respiratory arrest), the
appropriate BLS intervention is rescue breathing. The recommended rate is 1 breath every 5-6
seconds (10-12 breaths per minute), with frequent pulse checks. Chest compressions are not
indicated when a pulse is present. Naloxone may be given but should not delay ventilation.
Options A and D include unnecessary compressions; option C delays ventilation.
3. In a cardiac arrest situation with an advanced airway in place, you are providing continuous
chest compressions at a rate of 110/min. What ventilation rate should be delivered to optimize
coronary perfusion pressure while avoiding hyperventilation?
A) 6 breaths per minute (1 breath every 10 seconds)
B) 8-10 breaths per minute (1 breath every 6-8 seconds)
C) 12-15 breaths per minute (1 breath every 4-5 seconds)
D) 20 breaths per minute (1 breath every 3 seconds)
Answer: B
Rationale: With an advanced airway, continuous compressions are performed at 100-120/min,
and ventilations are delivered at 8-10 breaths per minute (1 breath every 6-8 seconds). This
rate prevents hyperventilation, which can increase intrathoracic pressure and decrease venous
return, reducing coronary perfusion pressure. Option A (6/min) may be too low; options C and
D risk hyperventilation.
4. During CPR, a team member notes that the end-tidal CO2 (ETCO2) reading is persistently
below 10 mmHg despite high-quality compressions. What is the most likely implication for BLS
quality?
A) Compression rate is too fast, causing inadequate filling time.
B) Compression depth is insufficient, leading to poor cardiac output.
C) Ventilation rate is too high, causing respiratory alkalosis.
D) Chest recoil is incomplete, reducing venous return and cardiac output.
Answer: D
Rationale: Low ETCO2 (<10 mmHg) during CPR indicates low cardiac output, often due to
incomplete chest recoil. Incomplete recoil prevents negative intrathoracic pressure during
decompression, reducing venous return and subsequent cardiac output. While compression
depth and rate are important, persistent low ETCO2 despite adequate depth and rate should
prompt evaluation of recoil. Ventilation rate affects ETCO2 but is less likely to cause such a low
value if compressions are effective.
3
, 5. A team of two rescuers is performing CPR on an adult in cardiac arrest. The compressor is
delivering compressions at a depth of 2.2 inches and a rate of 110/min. The ventilations are
given as 2 breaths after every 30 compressions. What is the most critical adjustment needed to
improve CPR quality according to the 2026/2027 guidelines?
A) Increase compression rate to 120/min to maximize blood flow.
B) Switch to continuous compressions with asynchronous ventilations if an advanced airway is
placed.
C) Reduce compression depth to 2 inches to avoid injury.
D) Change compression-to-ventilation ratio to 15:2 to increase ventilation frequency.
Answer: B
Rationale: The scenario describes two-rescuer CPR without an advanced airway; the ratio is
30:2. However, the critical adjustment is to consider placing an advanced airway to allow
continuous compressions without pauses for ventilations. Continuous compressions improve
coronary perfusion pressure. Increasing rate beyond 110 is not recommended; depth of 2.2
inches is within the 2-2.4 inch range. Changing to 15:2 is not standard for adults and would
increase interruptions.
6. In a witnessed cardiac arrest with a shockable rhythm, the first shock is delivered.
Immediately after the shock, the rescuer should:
A) Check the rhythm and pulse for 10 seconds to assess ROSC.
B) Resume chest compressions immediately for 2 minutes before rhythm check.
C) Deliver a second shock if the rhythm remains shockable.
D) Administer epinephrine 1 mg IV/IO immediately after the shock.
Answer: B
Rationale: After defibrillation, the immediate priority is to resume chest compressions without
delay. Rhythm and pulse checks should be deferred for 2 minutes (5 cycles of 30:2) to minimize
interruptions in compressions. Delivering a second shock immediately or checking
rhythm/pulse prematurely interrupts compressions. Epinephrine is given after the second shock
(if rhythm remains shockable) or during the 2-minute cycle.
7. Which of the following best describes the physiological rationale for using a compression-to-
ventilation ratio of 30:2 in single-rescuer adult CPR?
4
