OHIO ACLS INSTRUCTOR PRACTICE EXAM –
QUESTIONS WITH ANSWERS & RATIONALES
ABOUT THIS STUDY RESOURCE
This comprehensive practice exam is designed for candidates preparing for
the Ohio Advanced Cardiac Life Support (ACLS) Instructor Certification
Examination. The questions are aligned with the 2025–2026 AHA
Guidelines for CPR and Emergency Cardiovascular Care and cover all
core content areas:
• High-Quality CPR & BLS Fundamentals (Compression depth/rate,
recoil, ventilation, team CPR)
• ACLS Algorithms & Cardiac Arrest Management (VF/pVT, PEA,
asystole, tachycardia, bradycardia)
• Pharmacology & Medication Administration (Epinephrine,
amiodarone, lidocaine, atropine, adenosine)
• Airway Management & Ventilation (Bag-mask ventilation,
advanced airways, ETCO₂ monitoring)
• Defibrillation & Electrical Therapies (AED, manual defibrillation,
synchronized cardioversion, pacing)
• Reversible Causes & Special Circumstances (H's and T's, pregnancy,
opioid overdose, hypothermia)
• Team Dynamics, Communication & Instructor Responsibilities
SECTION 1: BLS & HIGH-QUALITY CPR
FUNDAMENTALS (Questions 1–35)
,Question 1: You find an unresponsive patient who is not breathing. After
activating the emergency response system, you determine there is no pulse.
What is your next action?
A) Give two rescue breaths
B) Attach the AED
C) Check for a pulse again
D) Start chest compressions of at least 100 per minute
Correct Answer: D) Start chest compressions of at least 100 per minute
Rationale: The BLS algorithm prioritizes immediate initiation of chest
compressions once unresponsiveness and absence of breathing/pulse are
confirmed. High-quality chest compressions are the foundation of
resuscitation.
Question 2: What is the recommended compression rate for adult CPR?
A) 60–80 compressions per minute
B) 80–100 compressions per minute
C) 100–120 compressions per minute
D) 120–140 compressions per minute
Correct Answer: C) 100–120 compressions per minute
Rationale: Chest compressions should be performed at a rate of 100–120 per
minute to optimize coronary perfusion pressure. This rate ensures adequate
blood flow during cardiac arrest.
,Question 3: What is the recommended compression depth for adult CPR?
A) 1.5 to 2 inches (4–5 cm)
B) 2 to 2.4 inches (5–6 cm)
C) 2.5 to 3 inches (6–7.5 cm)
D) 3 to 3.5 inches (7.5–9 cm)
Correct Answer: B) 2 to 2.4 inches (5–6 cm)
Rationale: The 2025 AHA guidelines recommend compression depth of at
least 2 inches (5 cm) but not exceeding 2.4 inches (6 cm) for adults. This
depth ensures adequate cardiac output while minimizing the risk of injury.
Question 4: Which characteristic BEST defines high-quality chest
compressions in adult CPR?
A) Compression depth of at least 2 inches (5 cm) with complete chest recoil
B) Compression rate of 80–100 per minute with 50% duty cycle
C) Compression depth of 1.5 inches with a compression-to-ventilation ratio
of 15:2
D) Continuous compressions without pauses for any reason
Correct Answer: A) Compression depth of at least 2 inches (5 cm) with
complete chest recoil
Rationale: High-quality CPR requires compression depth of at least 2 inches
(5 cm) but not exceeding 2.4 inches (6 cm), with a rate of 100–120/min,
allowing complete chest recoil between compressions, minimizing
interruptions, and avoiding excessive ventilation. Complete recoil enhances
venous return and cardiac filling.
, Question 5: During two-rescuer adult CPR, the compressor should switch
roles with the ventilator every:
A) 1 minute or after 4 cycles of CPR
B) 2 minutes or after 5 cycles of CPR
C) 3 minutes or after 6 cycles of CPR
D) Only when the rescuer becomes fatigued
Correct Answer: B) 2 minutes or after 5 cycles of CPR
Rationale: Rescuers should switch roles every 2 minutes (approximately 5
cycles of 30:2) or sooner if fatigued. This prevents compression quality
deterioration, maintains adequate depth and rate, and ensures consistent
perfusion. The switch should take less than 5 seconds.
Question 6: Which of the following is a sign of effective CPR?
A) PETCO₂ < 10 mmHg
B) PETCO₂ ≥ 20 mmHg
C) PETCO₂ < 15 mmHg
D) PETCO₂ ≥ 30 mmHg
Correct Answer: B) PETCO₂ ≥ 20 mmHg
Rationale: An ETCO₂ (end-tidal carbon dioxide) level of ≥20 mmHg during
CPR indicates effective chest compressions and adequate perfusion. Lower
values suggest poor-quality CPR or other causes of low cardiac output.
Question 7: What is the compression-to-ventilation ratio for adult CPR with
a single rescuer?
QUESTIONS WITH ANSWERS & RATIONALES
ABOUT THIS STUDY RESOURCE
This comprehensive practice exam is designed for candidates preparing for
the Ohio Advanced Cardiac Life Support (ACLS) Instructor Certification
Examination. The questions are aligned with the 2025–2026 AHA
Guidelines for CPR and Emergency Cardiovascular Care and cover all
core content areas:
• High-Quality CPR & BLS Fundamentals (Compression depth/rate,
recoil, ventilation, team CPR)
• ACLS Algorithms & Cardiac Arrest Management (VF/pVT, PEA,
asystole, tachycardia, bradycardia)
• Pharmacology & Medication Administration (Epinephrine,
amiodarone, lidocaine, atropine, adenosine)
• Airway Management & Ventilation (Bag-mask ventilation,
advanced airways, ETCO₂ monitoring)
• Defibrillation & Electrical Therapies (AED, manual defibrillation,
synchronized cardioversion, pacing)
• Reversible Causes & Special Circumstances (H's and T's, pregnancy,
opioid overdose, hypothermia)
• Team Dynamics, Communication & Instructor Responsibilities
SECTION 1: BLS & HIGH-QUALITY CPR
FUNDAMENTALS (Questions 1–35)
,Question 1: You find an unresponsive patient who is not breathing. After
activating the emergency response system, you determine there is no pulse.
What is your next action?
A) Give two rescue breaths
B) Attach the AED
C) Check for a pulse again
D) Start chest compressions of at least 100 per minute
Correct Answer: D) Start chest compressions of at least 100 per minute
Rationale: The BLS algorithm prioritizes immediate initiation of chest
compressions once unresponsiveness and absence of breathing/pulse are
confirmed. High-quality chest compressions are the foundation of
resuscitation.
Question 2: What is the recommended compression rate for adult CPR?
A) 60–80 compressions per minute
B) 80–100 compressions per minute
C) 100–120 compressions per minute
D) 120–140 compressions per minute
Correct Answer: C) 100–120 compressions per minute
Rationale: Chest compressions should be performed at a rate of 100–120 per
minute to optimize coronary perfusion pressure. This rate ensures adequate
blood flow during cardiac arrest.
,Question 3: What is the recommended compression depth for adult CPR?
A) 1.5 to 2 inches (4–5 cm)
B) 2 to 2.4 inches (5–6 cm)
C) 2.5 to 3 inches (6–7.5 cm)
D) 3 to 3.5 inches (7.5–9 cm)
Correct Answer: B) 2 to 2.4 inches (5–6 cm)
Rationale: The 2025 AHA guidelines recommend compression depth of at
least 2 inches (5 cm) but not exceeding 2.4 inches (6 cm) for adults. This
depth ensures adequate cardiac output while minimizing the risk of injury.
Question 4: Which characteristic BEST defines high-quality chest
compressions in adult CPR?
A) Compression depth of at least 2 inches (5 cm) with complete chest recoil
B) Compression rate of 80–100 per minute with 50% duty cycle
C) Compression depth of 1.5 inches with a compression-to-ventilation ratio
of 15:2
D) Continuous compressions without pauses for any reason
Correct Answer: A) Compression depth of at least 2 inches (5 cm) with
complete chest recoil
Rationale: High-quality CPR requires compression depth of at least 2 inches
(5 cm) but not exceeding 2.4 inches (6 cm), with a rate of 100–120/min,
allowing complete chest recoil between compressions, minimizing
interruptions, and avoiding excessive ventilation. Complete recoil enhances
venous return and cardiac filling.
, Question 5: During two-rescuer adult CPR, the compressor should switch
roles with the ventilator every:
A) 1 minute or after 4 cycles of CPR
B) 2 minutes or after 5 cycles of CPR
C) 3 minutes or after 6 cycles of CPR
D) Only when the rescuer becomes fatigued
Correct Answer: B) 2 minutes or after 5 cycles of CPR
Rationale: Rescuers should switch roles every 2 minutes (approximately 5
cycles of 30:2) or sooner if fatigued. This prevents compression quality
deterioration, maintains adequate depth and rate, and ensures consistent
perfusion. The switch should take less than 5 seconds.
Question 6: Which of the following is a sign of effective CPR?
A) PETCO₂ < 10 mmHg
B) PETCO₂ ≥ 20 mmHg
C) PETCO₂ < 15 mmHg
D) PETCO₂ ≥ 30 mmHg
Correct Answer: B) PETCO₂ ≥ 20 mmHg
Rationale: An ETCO₂ (end-tidal carbon dioxide) level of ≥20 mmHg during
CPR indicates effective chest compressions and adequate perfusion. Lower
values suggest poor-quality CPR or other causes of low cardiac output.
Question 7: What is the compression-to-ventilation ratio for adult CPR with
a single rescuer?
