AHA ACLS EXAM PREPARATION: 200 HIGH-YIELD QUESTIONS
WITH VERIFIED ANSWERS AND RATIONALES
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. Open the airway with a head-tilt/chin-lift
B. Start chest compressions of at least 100 per minute
C. Give two rescue breaths
D. Attach the AED pads
Answer: B
Rationale: In cardiac arrest, high-quality chest compressions are the
priority immediately after pulse check. Compressions should be
initiated without delay to maintain perfusion to vital organs.
2. You are evaluating a 58-year-old man with chest pain. His blood
pressure is 92/50 mm Hg, heart rate is 92/min, non-labored
respiratory rate is 14/min, and pulse oximetry is 97%. What
assessment step is most important now?
A. Administer sublingual nitroglycerin
B. Obtain a 12-lead ECG
C. Start an IV line
D. Give aspirin 324 mg chewable
Answer: B
Rationale: Obtaining a 12-lead ECG is critical to identify ST-segment
elevation or other ischemic changes that guide reperfusion therapy in
acute coronary syndrome.
,3. What is the preferred method of access for epinephrine
administration during cardiac arrest in most patients?
A. Central venous line
B. Endotracheal tube
C. Intraosseous (IO) line
D. Peripheral IV
Answer: D
Rationale: A peripheral IV is the preferred and fastest route for
medication administration in cardiac arrest, with epinephrine 1 mg
given every 3–5 minutes.
4. An AED does not promptly analyze a rhythm. What is your next
step?
A. Check the electrode pads and connections
B. Begin chest compressions
C. Power cycle the AED
D. Attempt defibrillation with a manual defibrillator
Answer: B
Rationale: If the AED fails to analyze, resuming chest compressions
minimizes interruptions and maintains perfusion while troubleshooting
the device.
5. You have completed 2 minutes of CPR. The ECG monitor displays
PEA, and the patient has no pulse. Your partner resumes chest
compressions, and an IV is in place. What management step is your
next priority?
A. Administer atropine 1 mg
B. Administer 1 mg of epinephrine
C. Perform synchronized cardioversion
D. Give amiodarone 300 mg bolus
,Answer: B
Rationale: Epinephrine is the primary vasopressor for PEA, given as 1
mg IV/IO every 3–5 minutes to increase coronary perfusion pressure.
6. During a pause in CPR, you see a narrow-complex rhythm on the
monitor. The patient has no pulse. What is the next action?
A. Administer adenosine 6 mg rapid IV
B. Perform synchronized cardioversion
C. Resume chest compressions
D. Give a fluid bolus
Answer: C
Rationale: Pulseless electrical activity (PEA) requires immediate
resumption of high-quality CPR, as the rhythm is not shockable.
7. What is a common but sometimes fatal mistake in cardiac arrest
management?
A. Delivering too many rescue breaths
B. Prolonged interruptions in chest compressions
C. Using adult pads on a child
D. Administering epinephrine too frequently
Answer: B
Rationale: Interruptions reduce coronary perfusion pressure and
decrease the likelihood of return of spontaneous circulation (ROSC).
8. Which action is a component of high-quality chest compressions?
A. Compressing at a depth of at least 3 inches
B. Allowing complete chest recoil
C. Compressing at a rate of 80 per minute
D. Leaning on the chest between compressions
Answer: B
, Rationale: Complete chest recoil allows maximal venous return to the
heart, improving cardiac output during CPR.
9. Which action increases the chance of successful conversion of
ventricular fibrillation?
A. Administering amiodarone before defibrillation
B. Providing quality compressions immediately before a defibrillation
attempt
C. Delivering a single shock followed by 5 minutes of CPR
D. Applying oxygen at 15 L/min via non-rebreather
Answer: B
Rationale: High-quality compressions immediately before shock delivery
improve myocardial oxygen delivery and increase the likelihood of
successful defibrillation.
10. Which situation BEST describes PEA?
A. Ventricular tachycardia without a pulse
B. Sinus rhythm without a pulse
C. Atrial fibrillation with a rapid ventricular response
D. Asystole with occasional escape beats
Answer: B
Rationale: PEA is defined as any organized rhythm (including sinus) on
the monitor in the absence of a palpable pulse.
11. What is the best strategy for performing high-quality CPR on a
patient with an advanced airway in place?
A. Provide continuous chest compressions without pauses and 10
ventilations per minute
B. Interrupt compressions for each breath delivered
C. Provide 30 compressions to 2 ventilations
WITH VERIFIED ANSWERS AND RATIONALES
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. Open the airway with a head-tilt/chin-lift
B. Start chest compressions of at least 100 per minute
C. Give two rescue breaths
D. Attach the AED pads
Answer: B
Rationale: In cardiac arrest, high-quality chest compressions are the
priority immediately after pulse check. Compressions should be
initiated without delay to maintain perfusion to vital organs.
2. You are evaluating a 58-year-old man with chest pain. His blood
pressure is 92/50 mm Hg, heart rate is 92/min, non-labored
respiratory rate is 14/min, and pulse oximetry is 97%. What
assessment step is most important now?
A. Administer sublingual nitroglycerin
B. Obtain a 12-lead ECG
C. Start an IV line
D. Give aspirin 324 mg chewable
Answer: B
Rationale: Obtaining a 12-lead ECG is critical to identify ST-segment
elevation or other ischemic changes that guide reperfusion therapy in
acute coronary syndrome.
,3. What is the preferred method of access for epinephrine
administration during cardiac arrest in most patients?
A. Central venous line
B. Endotracheal tube
C. Intraosseous (IO) line
D. Peripheral IV
Answer: D
Rationale: A peripheral IV is the preferred and fastest route for
medication administration in cardiac arrest, with epinephrine 1 mg
given every 3–5 minutes.
4. An AED does not promptly analyze a rhythm. What is your next
step?
A. Check the electrode pads and connections
B. Begin chest compressions
C. Power cycle the AED
D. Attempt defibrillation with a manual defibrillator
Answer: B
Rationale: If the AED fails to analyze, resuming chest compressions
minimizes interruptions and maintains perfusion while troubleshooting
the device.
5. You have completed 2 minutes of CPR. The ECG monitor displays
PEA, and the patient has no pulse. Your partner resumes chest
compressions, and an IV is in place. What management step is your
next priority?
A. Administer atropine 1 mg
B. Administer 1 mg of epinephrine
C. Perform synchronized cardioversion
D. Give amiodarone 300 mg bolus
,Answer: B
Rationale: Epinephrine is the primary vasopressor for PEA, given as 1
mg IV/IO every 3–5 minutes to increase coronary perfusion pressure.
6. During a pause in CPR, you see a narrow-complex rhythm on the
monitor. The patient has no pulse. What is the next action?
A. Administer adenosine 6 mg rapid IV
B. Perform synchronized cardioversion
C. Resume chest compressions
D. Give a fluid bolus
Answer: C
Rationale: Pulseless electrical activity (PEA) requires immediate
resumption of high-quality CPR, as the rhythm is not shockable.
7. What is a common but sometimes fatal mistake in cardiac arrest
management?
A. Delivering too many rescue breaths
B. Prolonged interruptions in chest compressions
C. Using adult pads on a child
D. Administering epinephrine too frequently
Answer: B
Rationale: Interruptions reduce coronary perfusion pressure and
decrease the likelihood of return of spontaneous circulation (ROSC).
8. Which action is a component of high-quality chest compressions?
A. Compressing at a depth of at least 3 inches
B. Allowing complete chest recoil
C. Compressing at a rate of 80 per minute
D. Leaning on the chest between compressions
Answer: B
, Rationale: Complete chest recoil allows maximal venous return to the
heart, improving cardiac output during CPR.
9. Which action increases the chance of successful conversion of
ventricular fibrillation?
A. Administering amiodarone before defibrillation
B. Providing quality compressions immediately before a defibrillation
attempt
C. Delivering a single shock followed by 5 minutes of CPR
D. Applying oxygen at 15 L/min via non-rebreather
Answer: B
Rationale: High-quality compressions immediately before shock delivery
improve myocardial oxygen delivery and increase the likelihood of
successful defibrillation.
10. Which situation BEST describes PEA?
A. Ventricular tachycardia without a pulse
B. Sinus rhythm without a pulse
C. Atrial fibrillation with a rapid ventricular response
D. Asystole with occasional escape beats
Answer: B
Rationale: PEA is defined as any organized rhythm (including sinus) on
the monitor in the absence of a palpable pulse.
11. What is the best strategy for performing high-quality CPR on a
patient with an advanced airway in place?
A. Provide continuous chest compressions without pauses and 10
ventilations per minute
B. Interrupt compressions for each breath delivered
C. Provide 30 compressions to 2 ventilations
