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
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,Section 1: Basic Life Support (BLS) and CPR - Questions 1-25
1. During CPR, the compressor switches roles with the ventilator every 2 minutes. What is the
primary purpose of this rotation?
A) To allow the compressor to rest and maintain compression quality.
B) To ensure that the ventilator has practice with compressions.
C) To reduce the risk of rescuer fatigue and maintain effective compressions.
D) To distribute the workload evenly among team members.
Answer: C
Rationale: Compression quality deteriorates after about 2 minutes due to rescuer fatigue,
leading to inadequate depth and rate. Rotating compressors every 2 minutes helps maintain
high-quality compressions throughout resuscitation. While options A and D are related, the
primary evidence-based reason is to prevent fatigue-related decline in compression quality.
Option B is not a goal.
2. A patient with a suspected cervical spine injury is found unresponsive, not breathing, and
pulseless. Two rescuers are present. How should BLS be modified?
A) Use a jaw-thrust maneuver without head tilt to open the airway, and begin chest
compressions.
B) Use a head-tilt chin-lift to ensure adequate airway, as cervical spine injury is not a priority.
C) Perform chest compressions only, without rescue breaths, to avoid moving the neck.
D) Place a cervical collar before starting any BLS interventions.
Answer: A
Rationale: In suspected cervical spine injury, the airway should be opened using a jaw-thrust
maneuver without head tilt to minimize spine movement. Chest compressions are started
immediately. Rescue breaths are still given using the jaw-thrust. Option B is incorrect because
head-tilt may worsen injury; option C is wrong because ventilations are necessary; option D
delays critical interventions.
3. A patient in respiratory arrest has a pulse of 50 bpm and is receiving bag-mask ventilation
with a clear airway. The rescuer notices that the chest rises inadequately despite a good mask
seal. Which action should be prioritized to improve ventilation effectiveness?
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,A) Increase the ventilation rate to 12 breaths/min
B) Reopen the airway using the head-tilt, chin-lift maneuver and ensure a two-handed mask
hold
C) Insert an oropharyngeal airway and switch to a supraglottic airway device
D) Administer 100% oxygen via non-rebreather mask while maintaining current rate
Answer: B
Rationale: Inadequate chest rise despite good mask seal most often indicates airway
obstruction or improper head positioning. Reopening the airway with head-tilt, chin-lift and
using a two-handed mask hold improves seal and airway patency. Increasing ventilation rate (A)
does not address the underlying obstruction; inserting an airway (C) may be considered after
basic maneuvers fail; (D) is inappropriate for a patient in respiratory arrest requiring positive
pressure ventilation.
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.
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.
Page | 3
, 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?
A) It maximizes minute ventilation to prevent hypoxia during cardiac arrest.
B) It balances the need for coronary perfusion pressure with minimal interruptions in
compressions.
C) It ensures that the rescuer does not fatigue quickly by alternating tasks.
D) It is derived from animal studies showing optimal survival with 5 compressions per
ventilation.
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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
Page | 1
,Section 1: Basic Life Support (BLS) and CPR - Questions 1-25
1. During CPR, the compressor switches roles with the ventilator every 2 minutes. What is the
primary purpose of this rotation?
A) To allow the compressor to rest and maintain compression quality.
B) To ensure that the ventilator has practice with compressions.
C) To reduce the risk of rescuer fatigue and maintain effective compressions.
D) To distribute the workload evenly among team members.
Answer: C
Rationale: Compression quality deteriorates after about 2 minutes due to rescuer fatigue,
leading to inadequate depth and rate. Rotating compressors every 2 minutes helps maintain
high-quality compressions throughout resuscitation. While options A and D are related, the
primary evidence-based reason is to prevent fatigue-related decline in compression quality.
Option B is not a goal.
2. A patient with a suspected cervical spine injury is found unresponsive, not breathing, and
pulseless. Two rescuers are present. How should BLS be modified?
A) Use a jaw-thrust maneuver without head tilt to open the airway, and begin chest
compressions.
B) Use a head-tilt chin-lift to ensure adequate airway, as cervical spine injury is not a priority.
C) Perform chest compressions only, without rescue breaths, to avoid moving the neck.
D) Place a cervical collar before starting any BLS interventions.
Answer: A
Rationale: In suspected cervical spine injury, the airway should be opened using a jaw-thrust
maneuver without head tilt to minimize spine movement. Chest compressions are started
immediately. Rescue breaths are still given using the jaw-thrust. Option B is incorrect because
head-tilt may worsen injury; option C is wrong because ventilations are necessary; option D
delays critical interventions.
3. A patient in respiratory arrest has a pulse of 50 bpm and is receiving bag-mask ventilation
with a clear airway. The rescuer notices that the chest rises inadequately despite a good mask
seal. Which action should be prioritized to improve ventilation effectiveness?
Page | 2
,A) Increase the ventilation rate to 12 breaths/min
B) Reopen the airway using the head-tilt, chin-lift maneuver and ensure a two-handed mask
hold
C) Insert an oropharyngeal airway and switch to a supraglottic airway device
D) Administer 100% oxygen via non-rebreather mask while maintaining current rate
Answer: B
Rationale: Inadequate chest rise despite good mask seal most often indicates airway
obstruction or improper head positioning. Reopening the airway with head-tilt, chin-lift and
using a two-handed mask hold improves seal and airway patency. Increasing ventilation rate (A)
does not address the underlying obstruction; inserting an airway (C) may be considered after
basic maneuvers fail; (D) is inappropriate for a patient in respiratory arrest requiring positive
pressure ventilation.
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.
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.
Page | 3
, 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?
A) It maximizes minute ventilation to prevent hypoxia during cardiac arrest.
B) It balances the need for coronary perfusion pressure with minimal interruptions in
compressions.
C) It ensures that the rescuer does not fatigue quickly by alternating tasks.
D) It is derived from animal studies showing optimal survival with 5 compressions per
ventilation.
Page | 4
