2026 Advanced Cardiovascular Life
Support (ACLS) Full-Length Practice
Examination Original Questions with
Answers and Rationales
1.
A 58-year-old patient suddenly collapses in the emergency
department. The patient is unresponsive, is not breathing
normally, and has no definite pulse. What is the most
appropriate immediate action?
A. Obtain a 12-lead ECG
B. Begin high-quality CPR
C. Administer amiodarone
D. Establish an advanced airway
Answer: B. Begin high-quality CPR
Rationale: An unresponsive adult with absent normal
breathing and no definite pulse should receive immediate
high-quality CPR while the resuscitation team obtains a
rhythm assessment and defibrillator.
2.
During adult CPR, which chest-compression rate is most
appropriate?
,A. 60–80 compressions/minute
B. 80–100 compressions/minute
C. 100–120 compressions/minute
D. 130–150 compressions/minute
Answer: C. 100–120 compressions/minute
Rationale: High-quality adult CPR requires a compression rate
of approximately 100–120 compressions per minute.
3.
Which finding most strongly indicates that chest
compressions are being performed effectively?
A. Compression depth of approximately 1 cm
B. Frequent interruptions for pulse checks
C. Adequate chest recoil after each compression
D. Hyperventilation between compressions
Answer: C. Adequate chest recoil after each compression
Rationale: Complete chest recoil allows the heart to refill
between compressions and is an essential component of
effective CPR.
4.
A patient in cardiac arrest is found to have ventricular
fibrillation. What is the priority treatment?
A. Immediate synchronized cardioversion
B. Immediate defibrillation
,C. Atropine administration
D. Adenosine administration
Answer: B. Immediate defibrillation
Rationale: Ventricular fibrillation is a shockable rhythm.
Prompt unsynchronized defibrillation, combined with high-
quality CPR, is central to treatment.
5.
A patient remains in ventricular fibrillation after an initial
defibrillation attempt. What should the team do next?
A. Immediately stop CPR and obtain a 12-lead ECG
B. Resume CPR immediately
C. Administer atropine
D. Perform synchronized cardioversion
Answer: B. Resume CPR immediately
Rationale: CPR should resume immediately after a shock
rather than pausing for a prolonged rhythm or pulse
assessment. The next rhythm assessment occurs after an
appropriate CPR interval.
6.
Which of the following is a reversible cause of cardiac arrest?
A. Hypertension
B. Hypovolemia
, C. Hyperlipidemia
D. Chronic anemia
Answer: B. Hypovolemia
Rationale: Hypovolemia is one of the reversible causes of
cardiac arrest and should be considered during evaluation of
a nonshockable or refractory arrest.
7.
Which group correctly identifies several reversible causes
commonly considered during cardiac arrest?
A. Hypovolemia, hypoxia, hydrogen ion excess, hypothermia
B. Hypertension, hyperlipidemia, fever, anemia
C. Bradycardia, hypertension, diabetes, obesity
D. Stroke, seizure, hypertension, hyperglycemia
Answer: A. Hypovolemia, hypoxia, hydrogen ion excess,
hypothermia
Rationale: The reversible causes include the commonly taught
Hs and Ts, including hypovolemia, hypoxia, acidosis, hypo-
/hyperkalemia, hypothermia, tension pneumothorax,
tamponade, toxins, pulmonary thrombosis, and coronary
thrombosis.
8.
Which rhythm is considered nonshockable?
Support (ACLS) Full-Length Practice
Examination Original Questions with
Answers and Rationales
1.
A 58-year-old patient suddenly collapses in the emergency
department. The patient is unresponsive, is not breathing
normally, and has no definite pulse. What is the most
appropriate immediate action?
A. Obtain a 12-lead ECG
B. Begin high-quality CPR
C. Administer amiodarone
D. Establish an advanced airway
Answer: B. Begin high-quality CPR
Rationale: An unresponsive adult with absent normal
breathing and no definite pulse should receive immediate
high-quality CPR while the resuscitation team obtains a
rhythm assessment and defibrillator.
2.
During adult CPR, which chest-compression rate is most
appropriate?
,A. 60–80 compressions/minute
B. 80–100 compressions/minute
C. 100–120 compressions/minute
D. 130–150 compressions/minute
Answer: C. 100–120 compressions/minute
Rationale: High-quality adult CPR requires a compression rate
of approximately 100–120 compressions per minute.
3.
Which finding most strongly indicates that chest
compressions are being performed effectively?
A. Compression depth of approximately 1 cm
B. Frequent interruptions for pulse checks
C. Adequate chest recoil after each compression
D. Hyperventilation between compressions
Answer: C. Adequate chest recoil after each compression
Rationale: Complete chest recoil allows the heart to refill
between compressions and is an essential component of
effective CPR.
4.
A patient in cardiac arrest is found to have ventricular
fibrillation. What is the priority treatment?
A. Immediate synchronized cardioversion
B. Immediate defibrillation
,C. Atropine administration
D. Adenosine administration
Answer: B. Immediate defibrillation
Rationale: Ventricular fibrillation is a shockable rhythm.
Prompt unsynchronized defibrillation, combined with high-
quality CPR, is central to treatment.
5.
A patient remains in ventricular fibrillation after an initial
defibrillation attempt. What should the team do next?
A. Immediately stop CPR and obtain a 12-lead ECG
B. Resume CPR immediately
C. Administer atropine
D. Perform synchronized cardioversion
Answer: B. Resume CPR immediately
Rationale: CPR should resume immediately after a shock
rather than pausing for a prolonged rhythm or pulse
assessment. The next rhythm assessment occurs after an
appropriate CPR interval.
6.
Which of the following is a reversible cause of cardiac arrest?
A. Hypertension
B. Hypovolemia
, C. Hyperlipidemia
D. Chronic anemia
Answer: B. Hypovolemia
Rationale: Hypovolemia is one of the reversible causes of
cardiac arrest and should be considered during evaluation of
a nonshockable or refractory arrest.
7.
Which group correctly identifies several reversible causes
commonly considered during cardiac arrest?
A. Hypovolemia, hypoxia, hydrogen ion excess, hypothermia
B. Hypertension, hyperlipidemia, fever, anemia
C. Bradycardia, hypertension, diabetes, obesity
D. Stroke, seizure, hypertension, hyperglycemia
Answer: A. Hypovolemia, hypoxia, hydrogen ion excess,
hypothermia
Rationale: The reversible causes include the commonly taught
Hs and Ts, including hypovolemia, hypoxia, acidosis, hypo-
/hyperkalemia, hypothermia, tension pneumothorax,
tamponade, toxins, pulmonary thrombosis, and coronary
thrombosis.
8.
Which rhythm is considered nonshockable?
