1
ACLS FINAL EXAM ACTUAL
QUESTIONS AND CORRECT
ANSWERS 2026
A patient with suspected stroke arrives at the emergency department. The
patient is diagnosed with acute ischemic stroke and is a candidate for fibrinolytic
therapy. To achieve the best outcomes, this therapy should be initiated within
what time frame?
Within 30 minutes of the patient's arrival
Within 1 hour of the patient's arrival
Within 2 hours of the patient's arrival
Within 3 hours of the patient's arrival - correct-answer - Within 1 hour of the
patient's arrival
For patients with ischemic stroke who meet the eligibility criteria, fibrinolytic
therapy is the first-line treatment. Administration of IV recombinant tissue
plasminogen activator (rtPA) within 1 hour of the patient's arrival and within 3
hours of the onset of signs and symptoms is optimal.
Which statement accurately reflects the management of cardiac arrest in a
pregnancy of 26 weeks' gestation?
Fetal monitoring should be immediately initiated after pulselessness is
determined.
Resuscitative cesarean delivery (RCD) should be performed within 5 minutes from
the time of arrest.
, 2
Targeted temperature management (TTM) is contraindicated in the post-cardiac
arrest pregnant patient.
Intravenous access should be placed below the level of the diaphragm. - correct-
answer - Resuscitative cesarean delivery (RCD) should be performed within 5
minutes from the time of arrest.
Resuscitative cesarean delivery (RCD) should be performed within 5 minutes from
the time of arrest in a pregnant patient if the gestational age is known to be equal
to or greater than 20 weeks or if the fundus is at or above the umbilicus. In a
pregnant patient, intravenous access should be obtained above, not below, the
level of the diaphragm. To keep the focus on the pregnant patient, during arrest
fetal monitoring should be removed. Targeted temperature management (TTM) is
a viable consideration for post-cardiac arrest care in a pregnant patient.
A 28-year-old pregnant patient who resides in transitional housing presents to the
emergency department with complaints of feeling feverish and very faint. The
patient tells the emergency nurse that she does not know when she became
pregnant. Upon palpation, the fundus is not at or above the umbilicus. The
patient's condition quickly deteriorates and she goes into cardiac arrest. If
available and able to be used without impeding or delaying the resuscitation
effort, what diagnostic tool could be used to guide decision-making in the care of
this patient?
Fetal echocardiogram
Abdominal radiograph
Point-of-care ultrasound
Fetal monitoring - correct-answer - Point-of-care ultrasound
Gestational age is an important consideration when determining the approach to
a pregnant patient in cardiac arrest. If the gestational age is not known and point-
of-care ultrasound is available and able to be performed without impeding or
delaying the resuscitation effort, it can be used to quickly estimate gestational
age and guide decision-making.
, 3
What is the priority intervention for a patient with a narrow-complex tachycardia
(160 bpm) and a blood pressure of 72/48 mmHg?
Perform immediate synchronized cardioversion
Administer amiodarone, 150 mg IV over 10 minutes
Administer adenosine, 6 mg via rapid IV push
Perform carotid massage - correct-answer - Perform immediate synchronized
cardioversion
Immediate synchronized cardioversion is recommended for a patient with signs of
hemodynamic compromise and a supraventricular tachycardia. A vagal maneuver,
such as carotid massage, is recommended for a patient with a narrow-complex
tachycardia if the rhythm is regular and there are no signs of hemodynamic
compromise. Adenosine may be considered for this patient, but immediate
cardioversion should be performed without delay. Amiodarone may be
considered if this patient's rhythm is refractory.
Cardiac monitoring reveals a tachyarrhythmia. The patient is hemodynamically
stable and has a regular heart rate ranging from 120 to 135 beats per minute.
Which statements by the patient could the team interpret as contributing to the
tachyarrhythmia?
"I've had a terrible cold with a horrible cough for the past week and today I
developed a fever."
"I've been so anxious lately because I just lost my job."
"I had the first shot of the COVID-19 vaccine over a week ago."
"I've been vomiting for the past 2 days from a gastrointestinal bug." - correct-
answer - "I've had a terrible cold with a horrible cough for the past week and
today I developed a fever."
"I've been so anxious lately because I just lost my job."
"I've been vomiting for the past 2 days from a gastrointestinal bug."
ACLS FINAL EXAM ACTUAL
QUESTIONS AND CORRECT
ANSWERS 2026
A patient with suspected stroke arrives at the emergency department. The
patient is diagnosed with acute ischemic stroke and is a candidate for fibrinolytic
therapy. To achieve the best outcomes, this therapy should be initiated within
what time frame?
Within 30 minutes of the patient's arrival
Within 1 hour of the patient's arrival
Within 2 hours of the patient's arrival
Within 3 hours of the patient's arrival - correct-answer - Within 1 hour of the
patient's arrival
For patients with ischemic stroke who meet the eligibility criteria, fibrinolytic
therapy is the first-line treatment. Administration of IV recombinant tissue
plasminogen activator (rtPA) within 1 hour of the patient's arrival and within 3
hours of the onset of signs and symptoms is optimal.
Which statement accurately reflects the management of cardiac arrest in a
pregnancy of 26 weeks' gestation?
Fetal monitoring should be immediately initiated after pulselessness is
determined.
Resuscitative cesarean delivery (RCD) should be performed within 5 minutes from
the time of arrest.
, 2
Targeted temperature management (TTM) is contraindicated in the post-cardiac
arrest pregnant patient.
Intravenous access should be placed below the level of the diaphragm. - correct-
answer - Resuscitative cesarean delivery (RCD) should be performed within 5
minutes from the time of arrest.
Resuscitative cesarean delivery (RCD) should be performed within 5 minutes from
the time of arrest in a pregnant patient if the gestational age is known to be equal
to or greater than 20 weeks or if the fundus is at or above the umbilicus. In a
pregnant patient, intravenous access should be obtained above, not below, the
level of the diaphragm. To keep the focus on the pregnant patient, during arrest
fetal monitoring should be removed. Targeted temperature management (TTM) is
a viable consideration for post-cardiac arrest care in a pregnant patient.
A 28-year-old pregnant patient who resides in transitional housing presents to the
emergency department with complaints of feeling feverish and very faint. The
patient tells the emergency nurse that she does not know when she became
pregnant. Upon palpation, the fundus is not at or above the umbilicus. The
patient's condition quickly deteriorates and she goes into cardiac arrest. If
available and able to be used without impeding or delaying the resuscitation
effort, what diagnostic tool could be used to guide decision-making in the care of
this patient?
Fetal echocardiogram
Abdominal radiograph
Point-of-care ultrasound
Fetal monitoring - correct-answer - Point-of-care ultrasound
Gestational age is an important consideration when determining the approach to
a pregnant patient in cardiac arrest. If the gestational age is not known and point-
of-care ultrasound is available and able to be performed without impeding or
delaying the resuscitation effort, it can be used to quickly estimate gestational
age and guide decision-making.
, 3
What is the priority intervention for a patient with a narrow-complex tachycardia
(160 bpm) and a blood pressure of 72/48 mmHg?
Perform immediate synchronized cardioversion
Administer amiodarone, 150 mg IV over 10 minutes
Administer adenosine, 6 mg via rapid IV push
Perform carotid massage - correct-answer - Perform immediate synchronized
cardioversion
Immediate synchronized cardioversion is recommended for a patient with signs of
hemodynamic compromise and a supraventricular tachycardia. A vagal maneuver,
such as carotid massage, is recommended for a patient with a narrow-complex
tachycardia if the rhythm is regular and there are no signs of hemodynamic
compromise. Adenosine may be considered for this patient, but immediate
cardioversion should be performed without delay. Amiodarone may be
considered if this patient's rhythm is refractory.
Cardiac monitoring reveals a tachyarrhythmia. The patient is hemodynamically
stable and has a regular heart rate ranging from 120 to 135 beats per minute.
Which statements by the patient could the team interpret as contributing to the
tachyarrhythmia?
"I've had a terrible cold with a horrible cough for the past week and today I
developed a fever."
"I've been so anxious lately because I just lost my job."
"I had the first shot of the COVID-19 vaccine over a week ago."
"I've been vomiting for the past 2 days from a gastrointestinal bug." - correct-
answer - "I've had a terrible cold with a horrible cough for the past week and
today I developed a fever."
"I've been so anxious lately because I just lost my job."
"I've been vomiting for the past 2 days from a gastrointestinal bug."
