2026 Advanced Cardiovascular Life
Support (ACLS) Final Practice
Questions with Quality Answers and
Verified Rationales
1.
A hospitalized adult suddenly becomes unresponsive and is
not breathing normally. A healthcare professional checks for a
pulse but cannot confidently identify one within 10 seconds.
What should occur next?
A. Obtain a 12-lead ECG
B. Administer atropine
C. Begin CPR and attach the cardiac monitor/defibrillator
D. Establish an intravenous line before compressions
Rationale: If a pulse cannot be confidently identified within 10
seconds in an unresponsive adult with abnormal or absent
breathing, cardiac arrest should be assumed and
resuscitation should begin immediately.
2.
Which finding most strongly indicates that a patient is in
cardiac arrest?
A. Slow regular respirations
B. Palpable radial pulse
,C. Unresponsiveness with absent or abnormal breathing and
no definite pulse
D. Blood pressure of 80/50 mmHg
Rationale: Cardiac arrest is characterized by
unresponsiveness, absent or abnormal breathing, and
absence of a definite pulse in the healthcare professional
assessment.
3.
Which action has the greatest immediate priority during adult
cardiac arrest?
A. Obtain a complete medical history
B. Insert a urinary catheter
C. Provide high-quality chest compressions
D. Obtain a chest radiograph
Rationale: High-quality CPR is a fundamental intervention
during cardiac arrest and should not be unnecessarily delayed
for diagnostic procedures.
4.
What is the recommended chest-compression rate for an
adult in cardiac arrest?
A. 60–80/min
B. 80–90/min
C. 100–120/min
D. 130–150/min
Rationale: Adult chest compressions should generally be
delivered at 100–120 compressions per minute.
,5.
What is the recommended minimum chest-compression
depth for an average adult?
A. 1 cm
B. 3 cm
C. At least 5 cm
D. 8 cm
Rationale: Adult compressions should be at least 5 cm deep
while avoiding excessive depth greater than approximately 6
cm.
6.
Which intervention best promotes effective chest-
compression quality?
A. Allowing prolonged pauses for rhythm interpretation
B. Compressing only until a pulse is felt
C. Allowing complete chest recoil between compressions
D. Performing frequent pulse checks
Rationale: Complete chest recoil facilitates venous return and
contributes to effective CPR.
7.
A patient has no advanced airway during CPR. What
compression-to-ventilation ratio should generally be used by
healthcare professionals?
A. 15:1
B. 30:2
, C. 30:1
D. 50:2
Rationale: For adult CPR without an advanced airway, cycles
of 30 compressions followed by 2 breaths are used.
8.
An advanced airway has been placed during cardiac arrest.
What ventilation strategy is appropriate?
A. Stop compressions for every ventilation
B. Give 20 breaths/minute
C. Give 1 breath every 2 seconds
D. Give approximately 1 breath every 6 seconds with
continuous compressions
Rationale: Once an advanced airway is in place, continuous
chest compressions are performed while ventilation is
provided approximately every 6 seconds.
9.
Which finding is most concerning for excessive ventilation
during CPR?
A. Mild chest rise
B. Appropriate oxygenation
C. Frequent positive-pressure breaths causing
hyperventilation
D. Continuous compressions
Rationale: Excessive ventilation can increase intrathoracic
pressure, reduce venous return, and decrease cardiac output
during CPR.
Support (ACLS) Final Practice
Questions with Quality Answers and
Verified Rationales
1.
A hospitalized adult suddenly becomes unresponsive and is
not breathing normally. A healthcare professional checks for a
pulse but cannot confidently identify one within 10 seconds.
What should occur next?
A. Obtain a 12-lead ECG
B. Administer atropine
C. Begin CPR and attach the cardiac monitor/defibrillator
D. Establish an intravenous line before compressions
Rationale: If a pulse cannot be confidently identified within 10
seconds in an unresponsive adult with abnormal or absent
breathing, cardiac arrest should be assumed and
resuscitation should begin immediately.
2.
Which finding most strongly indicates that a patient is in
cardiac arrest?
A. Slow regular respirations
B. Palpable radial pulse
,C. Unresponsiveness with absent or abnormal breathing and
no definite pulse
D. Blood pressure of 80/50 mmHg
Rationale: Cardiac arrest is characterized by
unresponsiveness, absent or abnormal breathing, and
absence of a definite pulse in the healthcare professional
assessment.
3.
Which action has the greatest immediate priority during adult
cardiac arrest?
A. Obtain a complete medical history
B. Insert a urinary catheter
C. Provide high-quality chest compressions
D. Obtain a chest radiograph
Rationale: High-quality CPR is a fundamental intervention
during cardiac arrest and should not be unnecessarily delayed
for diagnostic procedures.
4.
What is the recommended chest-compression rate for an
adult in cardiac arrest?
A. 60–80/min
B. 80–90/min
C. 100–120/min
D. 130–150/min
Rationale: Adult chest compressions should generally be
delivered at 100–120 compressions per minute.
,5.
What is the recommended minimum chest-compression
depth for an average adult?
A. 1 cm
B. 3 cm
C. At least 5 cm
D. 8 cm
Rationale: Adult compressions should be at least 5 cm deep
while avoiding excessive depth greater than approximately 6
cm.
6.
Which intervention best promotes effective chest-
compression quality?
A. Allowing prolonged pauses for rhythm interpretation
B. Compressing only until a pulse is felt
C. Allowing complete chest recoil between compressions
D. Performing frequent pulse checks
Rationale: Complete chest recoil facilitates venous return and
contributes to effective CPR.
7.
A patient has no advanced airway during CPR. What
compression-to-ventilation ratio should generally be used by
healthcare professionals?
A. 15:1
B. 30:2
, C. 30:1
D. 50:2
Rationale: For adult CPR without an advanced airway, cycles
of 30 compressions followed by 2 breaths are used.
8.
An advanced airway has been placed during cardiac arrest.
What ventilation strategy is appropriate?
A. Stop compressions for every ventilation
B. Give 20 breaths/minute
C. Give 1 breath every 2 seconds
D. Give approximately 1 breath every 6 seconds with
continuous compressions
Rationale: Once an advanced airway is in place, continuous
chest compressions are performed while ventilation is
provided approximately every 6 seconds.
9.
Which finding is most concerning for excessive ventilation
during CPR?
A. Mild chest rise
B. Appropriate oxygenation
C. Frequent positive-pressure breaths causing
hyperventilation
D. Continuous compressions
Rationale: Excessive ventilation can increase intrathoracic
pressure, reduce venous return, and decrease cardiac output
during CPR.
