Advanced Cardiovascular Life Support Exam
Version A EXAM with Questions and Answers/Plus
a Rationale Updated 2026 A+/Instant Download
PDF
EXAM COVERAGE
1. High-Quality CPR and Basic Life Support
2. Advanced Airway Management and Ventilation
3. Acute Coronary Syndromes (ACS) Assessment and Management
4. Bradycardia and Tachycardia Algorithms
5. Cardiac Arrest Rhythms: VF, Pulseless VT, PEA, and Asystole
6. Post-Cardiac Arrest Care and Targeted Temperature Management
7. Stroke Recognition and Early Intervention
1. An adult patient in the emergency department suddenly collapses and is unresponsive. You
determine there is no pulse and no breathing. After activating the emergency response team,
what is the priority action?
A. Administer 100% oxygen via non-rebreather mask
B. Initiate high-quality chest compressions at a rate of 100–120/min
C. Attempt to obtain intravenous access
D. Use a bag-valve mask to provide hyperventilation
Answer: B
, Rationale: High-quality chest compressions are the most critical component of survival in
cardiac arrest. Options A and D do not address the lack of perfusion, and C is secondary to
restoring circulation.
CORRECT ANSWER : B
2. A patient in cardiac arrest is being monitored with an AED. The device indicates "Shock
Advised." What is the immediate next step after the shock is delivered?
A. Check for a pulse
B. Immediately resume chest compressions
C. Reanalyze the rhythm
D. Administer a dose of epinephrine
Answer: B
Rationale: Interruptions to chest compressions must be minimized to maintain coronary
perfusion pressure. Resuming compressions immediately after a shock is the current guideline
standard to optimize outcomes.
CORRECT ANSWER : B
3. A patient presents with symptomatic bradycardia (HR 38/min) and is showing signs of
hypoperfusion (confusion and systolic BP 80 mmHg). What is the first-line medication?
A. Epinephrine infusion
B. Atropine 1 mg
C. Dopamine infusion
D. Transcutaneous pacing
Answer: B
Rationale: Atropine is the first-line drug for symptomatic bradycardia. If ineffective,
transcutaneous pacing or catecholamine infusions are considered as secondary options.
CORRECT ANSWER : B
4. You are managing a patient with stable wide-complex tachycardia. The patient is alert but
reports palpitations. Which intervention is most appropriate?
, A. Immediate synchronized cardioversion
B. Administration of Adenosine 6 mg
C. Immediate unsynchronized defibrillation
D. Administration of Atropine
Answer: B
Rationale: For stable, regular, monomorphic wide-complex tachycardia, adenosine can be used
for both diagnosis and potential treatment. Synchronized cardioversion is reserved for unstable
patients.
CORRECT ANSWER : B
5. During the management of a patient in VF, the team has administered two shocks and one dose
of epinephrine. What is the next most appropriate antiarrhythmic agent to consider?
A. Procainamide
B. Amiodarone 300 mg
C. Atropine
D. Adenosine
Answer: B
Rationale: In the VF/pulseless VT algorithm, amiodarone (or lidocaine) is recommended after
the second shock/epinephrine cycle for refractory ventricular fibrillation.
CORRECT ANSWER : B
6. A patient is in PEA (Pulseless Electrical Activity). The team is performing high-quality CPR.
Which intervention is the highest priority to address potential reversible causes?
A. Administering sodium bicarbonate
B. Identifying and treating H's and T's
C. Rapid fluid bolus of 2 Liters
D. Performing an emergency tracheostomy
Answer: B
, Rationale: PEA is generally caused by underlying conditions (e.g., Hypovolemia, Hypoxia,
Tension pneumothorax). Addressing these reversible causes is essential, as the rhythm itself does
not respond to electrical therapy.
CORRECT ANSWER : B
7. What is the target capnography ($PETCO_2$) value that indicates high-quality CPR and
potential return of spontaneous circulation (ROSC)?
A. Less than 10 mmHg
B. 35–40 mmHg
C. Greater than 50 mmHg
D. Fluctuating between 20 and 60 mmHg
Answer: B
Rationale: A $PETCO_2$ value of 35–40 mmHg indicates effective ventilation and perfusion. A
sudden, sustained increase to this range often signals ROSC.
CORRECT ANSWER : B
8. During post-cardiac arrest care, what is the recommended target oxygen saturation ($SpO_2$)?
A. 85–89%
B. 92–98%
C. 100% at all times
D. Greater than 99%
Answer: B
Rationale: Avoiding both hypoxia and hyperoxia is essential. A range of 92–98% ensures
adequate tissue oxygenation while preventing the oxidative stress associated with excessive
hyperoxia.
CORRECT ANSWER : B
9. A patient is experiencing an acute ischemic stroke. Within what time frame from symptom onset
should IV fibrinolytic therapy be administered for eligible patients?
A. Within 60 minutes
Version A EXAM with Questions and Answers/Plus
a Rationale Updated 2026 A+/Instant Download
EXAM COVERAGE
1. High-Quality CPR and Basic Life Support
2. Advanced Airway Management and Ventilation
3. Acute Coronary Syndromes (ACS) Assessment and Management
4. Bradycardia and Tachycardia Algorithms
5. Cardiac Arrest Rhythms: VF, Pulseless VT, PEA, and Asystole
6. Post-Cardiac Arrest Care and Targeted Temperature Management
7. Stroke Recognition and Early Intervention
1. An adult patient in the emergency department suddenly collapses and is unresponsive. You
determine there is no pulse and no breathing. After activating the emergency response team,
what is the priority action?
A. Administer 100% oxygen via non-rebreather mask
B. Initiate high-quality chest compressions at a rate of 100–120/min
C. Attempt to obtain intravenous access
D. Use a bag-valve mask to provide hyperventilation
Answer: B
, Rationale: High-quality chest compressions are the most critical component of survival in
cardiac arrest. Options A and D do not address the lack of perfusion, and C is secondary to
restoring circulation.
CORRECT ANSWER : B
2. A patient in cardiac arrest is being monitored with an AED. The device indicates "Shock
Advised." What is the immediate next step after the shock is delivered?
A. Check for a pulse
B. Immediately resume chest compressions
C. Reanalyze the rhythm
D. Administer a dose of epinephrine
Answer: B
Rationale: Interruptions to chest compressions must be minimized to maintain coronary
perfusion pressure. Resuming compressions immediately after a shock is the current guideline
standard to optimize outcomes.
CORRECT ANSWER : B
3. A patient presents with symptomatic bradycardia (HR 38/min) and is showing signs of
hypoperfusion (confusion and systolic BP 80 mmHg). What is the first-line medication?
A. Epinephrine infusion
B. Atropine 1 mg
C. Dopamine infusion
D. Transcutaneous pacing
Answer: B
Rationale: Atropine is the first-line drug for symptomatic bradycardia. If ineffective,
transcutaneous pacing or catecholamine infusions are considered as secondary options.
CORRECT ANSWER : B
4. You are managing a patient with stable wide-complex tachycardia. The patient is alert but
reports palpitations. Which intervention is most appropriate?
, A. Immediate synchronized cardioversion
B. Administration of Adenosine 6 mg
C. Immediate unsynchronized defibrillation
D. Administration of Atropine
Answer: B
Rationale: For stable, regular, monomorphic wide-complex tachycardia, adenosine can be used
for both diagnosis and potential treatment. Synchronized cardioversion is reserved for unstable
patients.
CORRECT ANSWER : B
5. During the management of a patient in VF, the team has administered two shocks and one dose
of epinephrine. What is the next most appropriate antiarrhythmic agent to consider?
A. Procainamide
B. Amiodarone 300 mg
C. Atropine
D. Adenosine
Answer: B
Rationale: In the VF/pulseless VT algorithm, amiodarone (or lidocaine) is recommended after
the second shock/epinephrine cycle for refractory ventricular fibrillation.
CORRECT ANSWER : B
6. A patient is in PEA (Pulseless Electrical Activity). The team is performing high-quality CPR.
Which intervention is the highest priority to address potential reversible causes?
A. Administering sodium bicarbonate
B. Identifying and treating H's and T's
C. Rapid fluid bolus of 2 Liters
D. Performing an emergency tracheostomy
Answer: B
, Rationale: PEA is generally caused by underlying conditions (e.g., Hypovolemia, Hypoxia,
Tension pneumothorax). Addressing these reversible causes is essential, as the rhythm itself does
not respond to electrical therapy.
CORRECT ANSWER : B
7. What is the target capnography ($PETCO_2$) value that indicates high-quality CPR and
potential return of spontaneous circulation (ROSC)?
A. Less than 10 mmHg
B. 35–40 mmHg
C. Greater than 50 mmHg
D. Fluctuating between 20 and 60 mmHg
Answer: B
Rationale: A $PETCO_2$ value of 35–40 mmHg indicates effective ventilation and perfusion. A
sudden, sustained increase to this range often signals ROSC.
CORRECT ANSWER : B
8. During post-cardiac arrest care, what is the recommended target oxygen saturation ($SpO_2$)?
A. 85–89%
B. 92–98%
C. 100% at all times
D. Greater than 99%
Answer: B
Rationale: Avoiding both hypoxia and hyperoxia is essential. A range of 92–98% ensures
adequate tissue oxygenation while preventing the oxidative stress associated with excessive
hyperoxia.
CORRECT ANSWER : B
9. A patient is experiencing an acute ischemic stroke. Within what time frame from symptom onset
should IV fibrinolytic therapy be administered for eligible patients?
A. Within 60 minutes
