ACLS EXAM VERSION A 2026 – 350
PRACTICE QUESTIONS WITH ANSWERS
& RATIONALES
Section 1: High Quality CPR & BLS Foundations (Questions 1–40)
1. What is the recommended compression rate during highquality CPR?
A. 80–90/min
B. 100–120/min
C. 120–140/min
D. 60–80/min
Correct Answer: B
Rationale: High quality CPR requires a compression rate of 100–120 per
minute to maintain adequate coronary and cerebral perfusion.
2. What is the FIRST action in a witnessed cardiac arrest in a hospital?
A. Intubate immediately
B. Start chest compressions
C. Check pulse for 2 minutes
D. Give epinephrine
,Correct Answer: B
Rationale: Immediate chest compressions improve survival and should be
started without delay.
3. What is the recommended compressiontoventilation ratio for an adult
WITHOUT an advanced airway?
A. 15:2
B. 30:2
C. 20:2
D. 10:1
Correct Answer: B
Rationale: ACLS recommends a 30:2 ratio for adults without an advanced
airway to ensure adequate perfusion and oxygenation.
4. Compression depth for an adult should be:
A. At least 1.5 inches
B. At least 2 inches (5 cm)
C. At least 2.4 inches (6 cm)
D. Between 1 and 1.5 inches
Correct Answer: B
Rationale: AHA guidelines recommend at least 2 inches (5 cm), but not exceed
2.4 inches (6 cm).
5. Chest compression fraction should be at least:
,A. 50%
B. 60%
C. 70%
D. 80%
Correct Answer: B
Rationale: AHA recommends ≥60% chest compression fraction, with ideal
>80% to maximize perfusion.
6. After placing an advanced airway (ET tube), compressions should be:
A. Paused for each breath
B. Continuous at 100120/min with breaths q6s (10 breaths/min)
C. 30:2 regardless
D. 15:2
Correct Answer: B
Rationale: Continuous compressions without pauses. Give 1 breath every 6
seconds (10/min).
7. What is the maximum interval for rhythm checks during CPR?
A. 1 minute
B. 2 minutes
C. 3 minutes
D. 4 minutes
Correct Answer: B
, Rationale: Check rhythm every 2 minutes (after 5 cycles of 30:2 or 2 minutes
of CPR).
8. Agonal gasping is:
A. A sign of effective breathing
B. Not considered normal breathing; treat as cardiac arrest
C. An indication to stop compressions
D. Always present in VF arrest
Correct Answer: B
Rationale: Agonal gasping is abnormal and common in early cardiac arrest. Do
not mistake for normal breathing.
9. Complete chest recoil allows:
A. Faster compression rate
B. Venous return and coronary perfusion
C. Less fatigue for rescuer
D. Higher tidal volume
Correct Answer: B
Rationale: Recoil creates negative intrathoracic pressure, enhancing venous
return and cardiac output.
10. What is the correct rate for bagmask ventilation during CPR when an
advanced airway is in place?
A. 5–6/min
PRACTICE QUESTIONS WITH ANSWERS
& RATIONALES
Section 1: High Quality CPR & BLS Foundations (Questions 1–40)
1. What is the recommended compression rate during highquality CPR?
A. 80–90/min
B. 100–120/min
C. 120–140/min
D. 60–80/min
Correct Answer: B
Rationale: High quality CPR requires a compression rate of 100–120 per
minute to maintain adequate coronary and cerebral perfusion.
2. What is the FIRST action in a witnessed cardiac arrest in a hospital?
A. Intubate immediately
B. Start chest compressions
C. Check pulse for 2 minutes
D. Give epinephrine
,Correct Answer: B
Rationale: Immediate chest compressions improve survival and should be
started without delay.
3. What is the recommended compressiontoventilation ratio for an adult
WITHOUT an advanced airway?
A. 15:2
B. 30:2
C. 20:2
D. 10:1
Correct Answer: B
Rationale: ACLS recommends a 30:2 ratio for adults without an advanced
airway to ensure adequate perfusion and oxygenation.
4. Compression depth for an adult should be:
A. At least 1.5 inches
B. At least 2 inches (5 cm)
C. At least 2.4 inches (6 cm)
D. Between 1 and 1.5 inches
Correct Answer: B
Rationale: AHA guidelines recommend at least 2 inches (5 cm), but not exceed
2.4 inches (6 cm).
5. Chest compression fraction should be at least:
,A. 50%
B. 60%
C. 70%
D. 80%
Correct Answer: B
Rationale: AHA recommends ≥60% chest compression fraction, with ideal
>80% to maximize perfusion.
6. After placing an advanced airway (ET tube), compressions should be:
A. Paused for each breath
B. Continuous at 100120/min with breaths q6s (10 breaths/min)
C. 30:2 regardless
D. 15:2
Correct Answer: B
Rationale: Continuous compressions without pauses. Give 1 breath every 6
seconds (10/min).
7. What is the maximum interval for rhythm checks during CPR?
A. 1 minute
B. 2 minutes
C. 3 minutes
D. 4 minutes
Correct Answer: B
, Rationale: Check rhythm every 2 minutes (after 5 cycles of 30:2 or 2 minutes
of CPR).
8. Agonal gasping is:
A. A sign of effective breathing
B. Not considered normal breathing; treat as cardiac arrest
C. An indication to stop compressions
D. Always present in VF arrest
Correct Answer: B
Rationale: Agonal gasping is abnormal and common in early cardiac arrest. Do
not mistake for normal breathing.
9. Complete chest recoil allows:
A. Faster compression rate
B. Venous return and coronary perfusion
C. Less fatigue for rescuer
D. Higher tidal volume
Correct Answer: B
Rationale: Recoil creates negative intrathoracic pressure, enhancing venous
return and cardiac output.
10. What is the correct rate for bagmask ventilation during CPR when an
advanced airway is in place?
A. 5–6/min
