2026 Advanced Cardiovascular Life
Support (ACLS) Mock Certification
Examination Original Questions
Practice Answers with Quality
Rationales
1.
A 58-year-old man suddenly collapses in the hospital. He is
unresponsive and not breathing normally. A healthcare
professional checks for a pulse but cannot definitely detect
one within 10 seconds. What should the team do next?
A. Obtain a 12-lead ECG
B. Begin high-quality CPR
C. Administer atropine
D. Give oxygen by nasal cannula
Correct Answer: B. Begin high-quality CPR
Rationale: When an adult is unresponsive, not breathing
normally, and a definite pulse cannot be identified promptly,
cardiac arrest should be presumed and CPR should begin
immediately.
2.
,Which characteristic best describes high-quality adult chest
compressions?
A. Rate of 60–80/minute and depth of 2 cm
B. Rate of 80–100/minute and depth of 3 cm
C. Rate of 100–120/minute and depth of at least 5 cm
D. Rate of 130–150/minute and depth of 7 cm
Correct Answer: C. Rate of 100–120/minute and depth of at
least 5 cm
Rationale: Effective adult CPR requires compressions at 100–
120/minute with a depth of at least 5 cm while allowing
complete chest recoil.
3.
During CPR, which action is most important for maintaining
effective coronary and cerebral perfusion?
A. Frequent pauses for pulse checks
B. Minimizing interruptions in chest compressions
C. Providing rapid intravenous fluids to every patient
D. Hyperventilating the patient
Correct Answer: B. Minimizing interruptions in chest
compressions
Rationale: Interruptions reduce coronary perfusion pressure
and decrease the effectiveness of CPR.
4.
,A patient is receiving CPR without an advanced airway. What
compression-to-ventilation ratio should be used?
A. 15:1
B. 15:2
C. 30:1
D. 30:2
Correct Answer: D. 30:2
Rationale: In an adult without an advanced airway, CPR is
performed with 30 compressions followed by 2 breaths.
5.
An advanced airway has been successfully placed during
cardiac arrest. Which ventilation strategy is appropriate?
A. Two breaths after every 30 compressions
B. One breath every 6 seconds with continuous compressions
C. One breath every 2 seconds
D. Ten breaths after every rhythm check
Correct Answer: B. One breath every 6 seconds with
continuous compressions
Rationale: Once an advanced airway is in place, continuous
chest compressions are performed while providing
approximately 10 breaths per minute.
6.
, Which finding during CPR may suggest return of spontaneous
circulation (ROSC)?
A. Persistently low end-tidal CO₂
B. Abrupt sustained increase in end-tidal CO₂
C. Fixed dilated pupils alone
D. Decreasing oxygen saturation alone
Correct Answer: B. Abrupt sustained increase in end-tidal
CO₂
Rationale: A sudden sustained increase in ETCO₂ can be an
important indicator of ROSC during ongoing resuscitation.
7.
A cardiac arrest patient has ventricular fibrillation. Which
intervention is the highest priority?
A. Immediate synchronized cardioversion
B. Immediate defibrillation
C. Atropine administration
D. Adenosine administration
Correct Answer: B. Immediate defibrillation
Rationale: VF is a shockable rhythm. Prompt defibrillation
combined with high-quality CPR is central to treatment.
8.
Which rhythm is considered nonshockable?
Support (ACLS) Mock Certification
Examination Original Questions
Practice Answers with Quality
Rationales
1.
A 58-year-old man suddenly collapses in the hospital. He is
unresponsive and not breathing normally. A healthcare
professional checks for a pulse but cannot definitely detect
one within 10 seconds. What should the team do next?
A. Obtain a 12-lead ECG
B. Begin high-quality CPR
C. Administer atropine
D. Give oxygen by nasal cannula
Correct Answer: B. Begin high-quality CPR
Rationale: When an adult is unresponsive, not breathing
normally, and a definite pulse cannot be identified promptly,
cardiac arrest should be presumed and CPR should begin
immediately.
2.
,Which characteristic best describes high-quality adult chest
compressions?
A. Rate of 60–80/minute and depth of 2 cm
B. Rate of 80–100/minute and depth of 3 cm
C. Rate of 100–120/minute and depth of at least 5 cm
D. Rate of 130–150/minute and depth of 7 cm
Correct Answer: C. Rate of 100–120/minute and depth of at
least 5 cm
Rationale: Effective adult CPR requires compressions at 100–
120/minute with a depth of at least 5 cm while allowing
complete chest recoil.
3.
During CPR, which action is most important for maintaining
effective coronary and cerebral perfusion?
A. Frequent pauses for pulse checks
B. Minimizing interruptions in chest compressions
C. Providing rapid intravenous fluids to every patient
D. Hyperventilating the patient
Correct Answer: B. Minimizing interruptions in chest
compressions
Rationale: Interruptions reduce coronary perfusion pressure
and decrease the effectiveness of CPR.
4.
,A patient is receiving CPR without an advanced airway. What
compression-to-ventilation ratio should be used?
A. 15:1
B. 15:2
C. 30:1
D. 30:2
Correct Answer: D. 30:2
Rationale: In an adult without an advanced airway, CPR is
performed with 30 compressions followed by 2 breaths.
5.
An advanced airway has been successfully placed during
cardiac arrest. Which ventilation strategy is appropriate?
A. Two breaths after every 30 compressions
B. One breath every 6 seconds with continuous compressions
C. One breath every 2 seconds
D. Ten breaths after every rhythm check
Correct Answer: B. One breath every 6 seconds with
continuous compressions
Rationale: Once an advanced airway is in place, continuous
chest compressions are performed while providing
approximately 10 breaths per minute.
6.
, Which finding during CPR may suggest return of spontaneous
circulation (ROSC)?
A. Persistently low end-tidal CO₂
B. Abrupt sustained increase in end-tidal CO₂
C. Fixed dilated pupils alone
D. Decreasing oxygen saturation alone
Correct Answer: B. Abrupt sustained increase in end-tidal
CO₂
Rationale: A sudden sustained increase in ETCO₂ can be an
important indicator of ROSC during ongoing resuscitation.
7.
A cardiac arrest patient has ventricular fibrillation. Which
intervention is the highest priority?
A. Immediate synchronized cardioversion
B. Immediate defibrillation
C. Atropine administration
D. Adenosine administration
Correct Answer: B. Immediate defibrillation
Rationale: VF is a shockable rhythm. Prompt defibrillation
combined with high-quality CPR is central to treatment.
8.
Which rhythm is considered nonshockable?
