ACLS Exam Version A Practice Test Questions and Verified
Answers 2026-2027
1. You are evaluating a patient with a cardiac arrest rhythm showing persistent Ventricular
Fibrillation despite two shocks and high-quality CPR. What is the next drug and dose to
administer?
A) Epinephrine 1 mg IV/IO push
B) Atropine 1 mg IV push
C) Amiodarone 150 mg IV push
D) Sodium Bicarbonate 50 mEq IV
Correct Answer: A) Epinephrine 1 mg IV/IO push
Explanation: In the ACLS cardiac arrest algorithm for shockable rhythms (VF/pVT), Epinephrine 1 mg IV/IO is
administered as soon as vascular access is available and repeated every 3 to 5 minutes. Antiarrhythmics
(Amiodarone/Lidocaine) are introduced after the second/third shock.
2. A patient in refractory VF receives a third shock and Epinephrine. The rhythm check shows
persistent VF. You prepare to administer Amiodarone. What is the correct initial bolus dose?
A) 150 mg IV/IO
B) 300 mg IV/IO
C) 1 mg/kg IV/IO
D) 400 mg IV/IO
Correct Answer: B) 300 mg IV/IO
Explanation: The initial bolus of Amiodarone for refractory VF/pVT is 300 mg IV/IO push. A second dose of 150
mg IV/IO can be given if VF/pVT persists.
3. What is the recommended target chest compression rate for an adult in cardiac arrest?
A) 80 to 100 per minute
B) 100 to 120 per minute
C) 120 to 140 per minute
D) At least 130 per minute
Correct Answer: B) 100 to 120 per minute
Explanation: High-quality CPR requires a chest compression rate between 100 and 120 compressions per minute
, to optimize coronary and cerebral perfusion.
4. What is the correct chest compression depth for adult CPR?
A) At least 1.5 inches (4 cm)
B) At least 2 inches (5 cm) but no more than 2.4 inches (6 cm)
C) At least 3 inches (7.5 cm)
D) Exactly 1 inch (2.5 cm)
Correct Answer: B) At least 2 inches (5 cm) but no more than 2.4 inches (6 cm)
Explanation: Chest compressions in adult resuscitation should be at least 2 inches (5 cm) deep, avoiding
excessive depth greater than 2.4 inches (6 cm) to reduce chest trauma risks.
5. A patient with a pulse presents with regular, narrow-complex tachycardia at a rate of 190 bpm.
He is conscious and denying chest pain or shortness of breath. What is the initial intervention?
A) Synchronized cardioversion at 50 Joules
B) Perform vagal maneuvers
C) Administer Adenosine 12 mg rapid IV push
D) Administer Amiodarone 150 mg IV over 10 minutes
Correct Answer: B) Perform vagal maneuvers
Explanation: In a stable patient with regular narrow-complex SVT, vagal maneuvers (such as a modified Valsalva
maneuver) should be attempted first before initiating pharmacological therapy with Adenosine.
6. Vagal maneuvers fail to convert the regular narrow-complex SVT in the stable patient above.
What is the first drug and dose to administer?
A) Adenosine 6 mg rapid IV push
B) Adenosine 12 mg slow IV infusion
C) Diltiazem 20 mg IV push over 2 minutes
D) Metoprolol 5 mg IV push
Correct Answer: A) Adenosine 6 mg rapid IV push
Explanation: The primary drug for stable regular narrow-complex SVT is Adenosine 6 mg rapid IV push, followed
immediately by a 20 mL saline flush.
, 7. A patient with unstable narrow-complex SVT presents with a blood pressure of 74/40 mmHg and
severe lethargy. What is the primary intervention?
A) Adenosine 6 mg rapid IV push
B) Synchronized cardioversion starting at 50 to 100 Joules
C) Unsynchronized defibrillation at 200 Joules
D) Transcutaneous pacing at 60 bpm
Correct Answer: B) Synchronized cardioversion starting at 50 to 100 Joules
Explanation: Unstable tachycardia with serious signs of hypoperfusion (hypotension, altered mental status)
requires immediate synchronized cardioversion. Initial energy for narrow regular SVT is 50-100 J.
8. An adult patient presents with symptomatic bradycardia (heart rate 34 bpm), blood pressure
82/50 mmHg, and dizziness. What is the first-line medication?
A) Epinephrine 1 mg IV push
B) Atropine 1 mg IV bolus
C) Dopamine 20 mcg/kg/min IV infusion
D) Isoproterenol 10 mg IV push
Correct Answer: B) Atropine 1 mg IV bolus
Explanation: Atropine 1 mg IV bolus is the first-line treatment for unstable or symptomatic bradycardia. It can be
repeated every 3 to 5 minutes up to a maximum total dose of 3 mg.
9. What is the maximum total dose of Atropine for symptomatic bradycardia?
A) 1 mg
B) 2 mg
C) 3 mg
D) 6 mg
Correct Answer: C) 3 mg
Explanation: The maximum cumulative dose of Atropine for bradycardia is 3 mg (3 doses of 1 mg each),
achieving full vagal blockade.
10. Atropine 3 mg has been administered to a patient with symptomatic 2nd-degree Type II AV
block without heart rate improvement. What is the next immediate intervention?
A) Repeat Atropine 1 mg IV
Answers 2026-2027
1. You are evaluating a patient with a cardiac arrest rhythm showing persistent Ventricular
Fibrillation despite two shocks and high-quality CPR. What is the next drug and dose to
administer?
A) Epinephrine 1 mg IV/IO push
B) Atropine 1 mg IV push
C) Amiodarone 150 mg IV push
D) Sodium Bicarbonate 50 mEq IV
Correct Answer: A) Epinephrine 1 mg IV/IO push
Explanation: In the ACLS cardiac arrest algorithm for shockable rhythms (VF/pVT), Epinephrine 1 mg IV/IO is
administered as soon as vascular access is available and repeated every 3 to 5 minutes. Antiarrhythmics
(Amiodarone/Lidocaine) are introduced after the second/third shock.
2. A patient in refractory VF receives a third shock and Epinephrine. The rhythm check shows
persistent VF. You prepare to administer Amiodarone. What is the correct initial bolus dose?
A) 150 mg IV/IO
B) 300 mg IV/IO
C) 1 mg/kg IV/IO
D) 400 mg IV/IO
Correct Answer: B) 300 mg IV/IO
Explanation: The initial bolus of Amiodarone for refractory VF/pVT is 300 mg IV/IO push. A second dose of 150
mg IV/IO can be given if VF/pVT persists.
3. What is the recommended target chest compression rate for an adult in cardiac arrest?
A) 80 to 100 per minute
B) 100 to 120 per minute
C) 120 to 140 per minute
D) At least 130 per minute
Correct Answer: B) 100 to 120 per minute
Explanation: High-quality CPR requires a chest compression rate between 100 and 120 compressions per minute
, to optimize coronary and cerebral perfusion.
4. What is the correct chest compression depth for adult CPR?
A) At least 1.5 inches (4 cm)
B) At least 2 inches (5 cm) but no more than 2.4 inches (6 cm)
C) At least 3 inches (7.5 cm)
D) Exactly 1 inch (2.5 cm)
Correct Answer: B) At least 2 inches (5 cm) but no more than 2.4 inches (6 cm)
Explanation: Chest compressions in adult resuscitation should be at least 2 inches (5 cm) deep, avoiding
excessive depth greater than 2.4 inches (6 cm) to reduce chest trauma risks.
5. A patient with a pulse presents with regular, narrow-complex tachycardia at a rate of 190 bpm.
He is conscious and denying chest pain or shortness of breath. What is the initial intervention?
A) Synchronized cardioversion at 50 Joules
B) Perform vagal maneuvers
C) Administer Adenosine 12 mg rapid IV push
D) Administer Amiodarone 150 mg IV over 10 minutes
Correct Answer: B) Perform vagal maneuvers
Explanation: In a stable patient with regular narrow-complex SVT, vagal maneuvers (such as a modified Valsalva
maneuver) should be attempted first before initiating pharmacological therapy with Adenosine.
6. Vagal maneuvers fail to convert the regular narrow-complex SVT in the stable patient above.
What is the first drug and dose to administer?
A) Adenosine 6 mg rapid IV push
B) Adenosine 12 mg slow IV infusion
C) Diltiazem 20 mg IV push over 2 minutes
D) Metoprolol 5 mg IV push
Correct Answer: A) Adenosine 6 mg rapid IV push
Explanation: The primary drug for stable regular narrow-complex SVT is Adenosine 6 mg rapid IV push, followed
immediately by a 20 mL saline flush.
, 7. A patient with unstable narrow-complex SVT presents with a blood pressure of 74/40 mmHg and
severe lethargy. What is the primary intervention?
A) Adenosine 6 mg rapid IV push
B) Synchronized cardioversion starting at 50 to 100 Joules
C) Unsynchronized defibrillation at 200 Joules
D) Transcutaneous pacing at 60 bpm
Correct Answer: B) Synchronized cardioversion starting at 50 to 100 Joules
Explanation: Unstable tachycardia with serious signs of hypoperfusion (hypotension, altered mental status)
requires immediate synchronized cardioversion. Initial energy for narrow regular SVT is 50-100 J.
8. An adult patient presents with symptomatic bradycardia (heart rate 34 bpm), blood pressure
82/50 mmHg, and dizziness. What is the first-line medication?
A) Epinephrine 1 mg IV push
B) Atropine 1 mg IV bolus
C) Dopamine 20 mcg/kg/min IV infusion
D) Isoproterenol 10 mg IV push
Correct Answer: B) Atropine 1 mg IV bolus
Explanation: Atropine 1 mg IV bolus is the first-line treatment for unstable or symptomatic bradycardia. It can be
repeated every 3 to 5 minutes up to a maximum total dose of 3 mg.
9. What is the maximum total dose of Atropine for symptomatic bradycardia?
A) 1 mg
B) 2 mg
C) 3 mg
D) 6 mg
Correct Answer: C) 3 mg
Explanation: The maximum cumulative dose of Atropine for bradycardia is 3 mg (3 doses of 1 mg each),
achieving full vagal blockade.
10. Atropine 3 mg has been administered to a patient with symptomatic 2nd-degree Type II AV
block without heart rate improvement. What is the next immediate intervention?
A) Repeat Atropine 1 mg IV
