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ACLS 2025 – Complete Study Guide, Practice
Questions & Verified Answers 2026
Questions 1–250
SECTION 1: HIGH-QUALITY CPR & BASIC LIFE SUPPORT
QUESTION 1
You find an unresponsive adult patient who is not breathing. After activating the
emergency response system, you determine there is no pulse. What is your next action?
A. Open the airway with a head tilt-chin lift
B. Administer epinephrine 1 mg IV
C. Deliver 2 rescue breaths
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: In cardiac arrest, high-quality CPR should be started immediately after
confirming no pulse. Compressions should be delivered at a rate of 100-120/min, at a
depth of 2-2.4 inches (5-6 cm), with full chest recoil. The compressor should be rotated
every 2 minutes or sooner if fatigued .
QUESTION 2
What is a common but sometimes fatal mistake in cardiac arrest management?
A. Failure to obtain vascular access
B. Prolonged periods of no ventilations
Sure pass
,2
C. Failure to perform endotracheal intubation
D. Prolonged interruptions in chest compressions
Correct Answer: D. Prolonged interruptions in chest compressions
Rationale: Prolonged interruptions in chest compressions is a common and potentially
fatal mistake in cardiac arrest management. Minimizing interruptions maintains coronary
perfusion pressure and maximizes the chances of ROSC. Interruptions should be limited to
10 seconds or less for rhythm/pulse checks .
QUESTION 3
Which action is a component of high-quality chest compressions?
A. Allowing complete chest recoil
B. Chest compressions without ventilation
C. 60 to 100 compressions per minute
D. Compressing the upper third of the sternum
Correct Answer: A. Allowing complete chest recoil
Rationale: Components of high-quality CPR include: compression rate of 100-120/min,
depth of 2-2.4 inches (5-6 cm), allowing complete chest recoil, minimizing interruptions,
and avoiding excessive ventilation . Complete recoil allows for venous return and optimal
cardiac output.
QUESTION 4
Before placement of an advanced airway during CPR, the compression-to-ventilation
ratio is:
A. 30:1
B. 30:2
C. 15:1
D. 15:2
Correct Answer: B. 30:2
Sure pass
,3
Rationale: Without an advanced airway, the compression-to-ventilation ratio is 30:2 for
single rescuers and 2-rescuer adult CPR. Once an advanced airway is in place,
compressions are continuous with one ventilation every 6 seconds (10 breaths/min) .
QUESTION 5
What is the appropriate interval for interruptions in chest compressions?
A. 5 seconds or less
B. 10 seconds or less
C. 15 seconds or less
D. Interruptions are never acceptable
Correct Answer: B. 10 seconds or less
Rationale: Chest compressions should be interrupted for no more than 10 seconds for
rhythm or pulse checks. Minimizing interruptions maximizes coronary perfusion pressure
and patient survival .
QUESTION 6
What is a sign of effective CPR?
A. ETCO2 ≥ 10 mm Hg
B. Measured urine output of 1 mL/kg/hr
C. Patient temperature > 32°C
D. Diastolic intra-arterial pressure < 20 mm Hg
Correct Answer: A. ETCO2 ≥ 10 mm Hg
Rationale: End-tidal CO2 (ETCO2) ≥ 10 mm Hg during CPR indicates adequate perfusion
from chest compressions. An ETCO2 that remains < 10 mm Hg by the 20-minute mark
indicates an exceptionally low chance of survival .
Sure pass
, 4
QUESTION 7
When an advanced airway is in place during cardiac arrest, the recommended
ventilation rate is:
A. 1 breath every 3-5 seconds
B. 1 breath every 6 seconds
C. 2 breaths every 30 compressions
D. 1 breath every 10 seconds
Correct Answer: B. 1 breath every 6 seconds
Rationale: When an advanced airway is in place, compressions are delivered continuously
and ventilations are asynchronous. One ventilation should be delivered every 6 seconds
(10 breaths per minute) to avoid hyperventilation, which can decrease venous return and
cardiac output .
QUESTION 8
The proper hand position for chest compressions on an adult is:
A. The upper third of the sternum
B. The lower half of the sternum, between the nipples
C. Just above the xiphoid process
D. The middle third of the sternum
Correct Answer: B. The lower half of the sternum, between the nipples
Rationale: Chest compressions should be performed on the lower half of the sternum,
between the nipples. This location optimizes cardiac output during CPR. Compressions
should be at a rate of 100-120/min and a depth of 2-2.4 inches .
QUESTION 9
A patient is gasping for breath but does not appear to be breathing effectively. What
should you do?
A. Wait to see if breathing improves
B. Check for a pulse
Sure pass
ACLS 2025 – Complete Study Guide, Practice
Questions & Verified Answers 2026
Questions 1–250
SECTION 1: HIGH-QUALITY CPR & BASIC LIFE SUPPORT
QUESTION 1
You find an unresponsive adult patient who is not breathing. After activating the
emergency response system, you determine there is no pulse. What is your next action?
A. Open the airway with a head tilt-chin lift
B. Administer epinephrine 1 mg IV
C. Deliver 2 rescue breaths
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: In cardiac arrest, high-quality CPR should be started immediately after
confirming no pulse. Compressions should be delivered at a rate of 100-120/min, at a
depth of 2-2.4 inches (5-6 cm), with full chest recoil. The compressor should be rotated
every 2 minutes or sooner if fatigued .
QUESTION 2
What is a common but sometimes fatal mistake in cardiac arrest management?
A. Failure to obtain vascular access
B. Prolonged periods of no ventilations
Sure pass
,2
C. Failure to perform endotracheal intubation
D. Prolonged interruptions in chest compressions
Correct Answer: D. Prolonged interruptions in chest compressions
Rationale: Prolonged interruptions in chest compressions is a common and potentially
fatal mistake in cardiac arrest management. Minimizing interruptions maintains coronary
perfusion pressure and maximizes the chances of ROSC. Interruptions should be limited to
10 seconds or less for rhythm/pulse checks .
QUESTION 3
Which action is a component of high-quality chest compressions?
A. Allowing complete chest recoil
B. Chest compressions without ventilation
C. 60 to 100 compressions per minute
D. Compressing the upper third of the sternum
Correct Answer: A. Allowing complete chest recoil
Rationale: Components of high-quality CPR include: compression rate of 100-120/min,
depth of 2-2.4 inches (5-6 cm), allowing complete chest recoil, minimizing interruptions,
and avoiding excessive ventilation . Complete recoil allows for venous return and optimal
cardiac output.
QUESTION 4
Before placement of an advanced airway during CPR, the compression-to-ventilation
ratio is:
A. 30:1
B. 30:2
C. 15:1
D. 15:2
Correct Answer: B. 30:2
Sure pass
,3
Rationale: Without an advanced airway, the compression-to-ventilation ratio is 30:2 for
single rescuers and 2-rescuer adult CPR. Once an advanced airway is in place,
compressions are continuous with one ventilation every 6 seconds (10 breaths/min) .
QUESTION 5
What is the appropriate interval for interruptions in chest compressions?
A. 5 seconds or less
B. 10 seconds or less
C. 15 seconds or less
D. Interruptions are never acceptable
Correct Answer: B. 10 seconds or less
Rationale: Chest compressions should be interrupted for no more than 10 seconds for
rhythm or pulse checks. Minimizing interruptions maximizes coronary perfusion pressure
and patient survival .
QUESTION 6
What is a sign of effective CPR?
A. ETCO2 ≥ 10 mm Hg
B. Measured urine output of 1 mL/kg/hr
C. Patient temperature > 32°C
D. Diastolic intra-arterial pressure < 20 mm Hg
Correct Answer: A. ETCO2 ≥ 10 mm Hg
Rationale: End-tidal CO2 (ETCO2) ≥ 10 mm Hg during CPR indicates adequate perfusion
from chest compressions. An ETCO2 that remains < 10 mm Hg by the 20-minute mark
indicates an exceptionally low chance of survival .
Sure pass
, 4
QUESTION 7
When an advanced airway is in place during cardiac arrest, the recommended
ventilation rate is:
A. 1 breath every 3-5 seconds
B. 1 breath every 6 seconds
C. 2 breaths every 30 compressions
D. 1 breath every 10 seconds
Correct Answer: B. 1 breath every 6 seconds
Rationale: When an advanced airway is in place, compressions are delivered continuously
and ventilations are asynchronous. One ventilation should be delivered every 6 seconds
(10 breaths per minute) to avoid hyperventilation, which can decrease venous return and
cardiac output .
QUESTION 8
The proper hand position for chest compressions on an adult is:
A. The upper third of the sternum
B. The lower half of the sternum, between the nipples
C. Just above the xiphoid process
D. The middle third of the sternum
Correct Answer: B. The lower half of the sternum, between the nipples
Rationale: Chest compressions should be performed on the lower half of the sternum,
between the nipples. This location optimizes cardiac output during CPR. Compressions
should be at a rate of 100-120/min and a depth of 2-2.4 inches .
QUESTION 9
A patient is gasping for breath but does not appear to be breathing effectively. What
should you do?
A. Wait to see if breathing improves
B. Check for a pulse
Sure pass
