AHA ACLS Written Test Version C | 50 Questions | 2026-2027 Verified Answers by Expert
AHA ACLS Written Test Version C 2026
Questions and Answers (Verified Answers by Expert)
50 Multiple-Choice Questions | Aligned with 2025-2026 AHA Guidelines
Section 1: High-Quality CPR and BLS Review (Q1-Q10)
Compression Depth, Rate, Recoil, Ventilation, and Compression Fraction
Q1: During high-quality CPR on an adult patient in cardiac arrest, what is the recommended compression depth?
A. At least 1 inch (2.5 cm)
B. At least 1.5 inches (3.8 cm)
C. At least 2 inches (5 cm) but not more than 2.4 inches (6 cm) [CORRECT]
D. At least 3 inches (7.5 cm) for adequate cardiac output
Correct Answer: C
Rationale: Per AHA 2025-2026 guidelines, adult chest compressions should be at least 2 inches (5 cm) but not exceed 2.4 inches (6 cm). Compressions deeper
than 2.4 inches increase the risk of chest injury without improving outcomes. Depth less than 2 inches is insufficient to generate adequate cardiac output and
coronary perfusion pressure.
Q2: What is the target compression rate during adult CPR?
A. 80-100 compressions per minute
B. 100-120 compressions per minute [CORRECT]
C. 120-140 compressions per minute
D. 60-80 compressions per minute
Correct Answer: B
Rationale: The AHA recommends a compression rate of 100-120 per minute. Rates below 100 compromise perfusion pressure, while rates above 120 reduce
compression depth and coronary perfusion. The rate should be maintained consistently throughout resuscitation.
Q3: A single rescuer is performing CPR on an adult cardiac arrest victim without an advanced airway in place. What is the correct
compression-to-ventilation ratio?
A. 15:2
B. 30:2 [CORRECT]
C. 50:2
D. Continuous compressions with 10 breaths per minute
Correct Answer: B
Rationale: For a single rescuer performing CPR without an advanced airway, the ratio is 30 compressions to 2 ventilations. The 30:2 ratio maximizes the
number of compressions delivered while still providing adequate ventilation. Continuous compressions with asynchronous breaths apply only when an
advanced airway (ETT or supraglottic) is in place.
Q4: Once an advanced airway is placed during cardiac arrest, how should ventilations be delivered?
A. Pause compressions to deliver 2 breaths every 30 compressions
B. Deliver 1 breath every 6 seconds (10 breaths/min) without pausing compressions [CORRECT]
C. Deliver 1 breath every 3 seconds (20 breaths/min) during chest compressions
D. Pause compressions every minute to deliver 4 breaths
Correct Answer: B
Rationale: With an advanced airway in place, the AHA recommends continuous chest compressions without pausing for ventilations. Ventilations are
delivered asynchronously at 1 breath every 6 seconds (approximately 10 breaths/min). Pausing compressions reduces the compression fraction and coronary
perfusion pressure.
Q5: What is the minimum target compression fraction (CCF) during resuscitation?
A. Greater than 50%
B. Greater than 60%
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, AHA ACLS Written Test Version C | 50 Questions | 2026-2027 Verified Answers by Expert
C. Greater than 80% [CORRECT]
D. Greater than 95%
Correct Answer: C
Rationale: The AHA recommends a compression fraction (the proportion of time during which compressions are performed) of at least 80%. High CCF is
associated with improved survival. Minimizing pre-shock pauses, rhythm checks, and other interruptions is essential to achieving this target. A CCF below 80%
significantly reduces the likelihood of ROSC.
Q6: Why is complete chest recoil between compressions critically important?
A. It allows the heart to rest between compressions
B. It allows ventricular filling and coronary perfusion; leaning reduces cardiac output [CORRECT]
C. It prevents rib fractures during resuscitation
D. It allows the rescuer to conserve energy during prolonged CPR
Correct Answer: B
Rationale: Full chest recoil allows the heart to refill with blood between compressions. Incomplete recoil (leaning on the chest) increases intrathoracic pressure,
decreasing venous return, coronary perfusion, and cardiac output. Rescuers must ensure the chest fully expands after each compression without lifting hands
off the sternum completely.
Q7: How often should rescuers switch compressor roles during CPR?
A. Every 1 minute
B. Every 2 minutes (after approximately 5 cycles of 30:2) [CORRECT]
C. Every 5 minutes
D. Only when the compressor reports fatigue
Correct Answer: B
Rationale: Rescuers should switch compressor roles every 2 minutes (approximately 5 cycles of 30:2) to prevent fatigue and maintain compression quality.
Compression quality degrades rapidly, often within 1-2 minutes, even if the rescuer does not feel fatigued. The switch should occur in less than 5 seconds to
minimize interruptions.
Q8: After delivering a defibrillation shock, what is the correct immediate action?
A. Check for a pulse before resuming compressions
B. Resume CPR immediately, beginning with compressions, without checking for pulse [CORRECT]
C. Wait 10 seconds to assess rhythm on the monitor
D. Administer epinephrine before resuming compressions
Correct Answer: B
Rationale: Per current AHA guidelines, CPR should be resumed immediately after defibrillation, starting with compressions. Pulse checks are performed only
after 2 minutes of CPR, unless the patient shows obvious signs of ROSC. Delaying compressions to check a pulse or rhythm wastes critical time and reduces the
chance of successful defibrillation.
Q9: During cardiac arrest, end-tidal CO2 (EtCO2) capnography shows a reading of 8 mmHg. What does this value suggest?
A. Adequate CPR quality and possible ROSC
B. Poor CPR quality; compressions should be optimized to improve cardiac output [CORRECT]
C. The patient has achieved ROSC and compressions should be stopped
D. The advanced airway is malpositioned and must be replaced
Correct Answer: B
Rationale: EtCO2 values below 10 mmHg during cardiac arrest suggest inadequate chest compressions and poor cardiac output. The AHA identifies
capnography as the most reliable indicator of CPR quality during arrest. A sudden increase to above 40 mmHg may indicate ROSC. Values of 10-20 mmHg
are associated with better outcomes. The response is to optimize compression quality, not replace the airway.
Q10: What is the maximum recommended pause between pausing compressions and delivering a shock?
A. Less than 10 seconds
B. Less than 5 seconds [CORRECT]
C. Less than 15 seconds
D. Less than 2 seconds
Correct Answer: B
Page 2
AHA ACLS Written Test Version C 2026
Questions and Answers (Verified Answers by Expert)
50 Multiple-Choice Questions | Aligned with 2025-2026 AHA Guidelines
Section 1: High-Quality CPR and BLS Review (Q1-Q10)
Compression Depth, Rate, Recoil, Ventilation, and Compression Fraction
Q1: During high-quality CPR on an adult patient in cardiac arrest, what is the recommended compression depth?
A. At least 1 inch (2.5 cm)
B. At least 1.5 inches (3.8 cm)
C. At least 2 inches (5 cm) but not more than 2.4 inches (6 cm) [CORRECT]
D. At least 3 inches (7.5 cm) for adequate cardiac output
Correct Answer: C
Rationale: Per AHA 2025-2026 guidelines, adult chest compressions should be at least 2 inches (5 cm) but not exceed 2.4 inches (6 cm). Compressions deeper
than 2.4 inches increase the risk of chest injury without improving outcomes. Depth less than 2 inches is insufficient to generate adequate cardiac output and
coronary perfusion pressure.
Q2: What is the target compression rate during adult CPR?
A. 80-100 compressions per minute
B. 100-120 compressions per minute [CORRECT]
C. 120-140 compressions per minute
D. 60-80 compressions per minute
Correct Answer: B
Rationale: The AHA recommends a compression rate of 100-120 per minute. Rates below 100 compromise perfusion pressure, while rates above 120 reduce
compression depth and coronary perfusion. The rate should be maintained consistently throughout resuscitation.
Q3: A single rescuer is performing CPR on an adult cardiac arrest victim without an advanced airway in place. What is the correct
compression-to-ventilation ratio?
A. 15:2
B. 30:2 [CORRECT]
C. 50:2
D. Continuous compressions with 10 breaths per minute
Correct Answer: B
Rationale: For a single rescuer performing CPR without an advanced airway, the ratio is 30 compressions to 2 ventilations. The 30:2 ratio maximizes the
number of compressions delivered while still providing adequate ventilation. Continuous compressions with asynchronous breaths apply only when an
advanced airway (ETT or supraglottic) is in place.
Q4: Once an advanced airway is placed during cardiac arrest, how should ventilations be delivered?
A. Pause compressions to deliver 2 breaths every 30 compressions
B. Deliver 1 breath every 6 seconds (10 breaths/min) without pausing compressions [CORRECT]
C. Deliver 1 breath every 3 seconds (20 breaths/min) during chest compressions
D. Pause compressions every minute to deliver 4 breaths
Correct Answer: B
Rationale: With an advanced airway in place, the AHA recommends continuous chest compressions without pausing for ventilations. Ventilations are
delivered asynchronously at 1 breath every 6 seconds (approximately 10 breaths/min). Pausing compressions reduces the compression fraction and coronary
perfusion pressure.
Q5: What is the minimum target compression fraction (CCF) during resuscitation?
A. Greater than 50%
B. Greater than 60%
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, AHA ACLS Written Test Version C | 50 Questions | 2026-2027 Verified Answers by Expert
C. Greater than 80% [CORRECT]
D. Greater than 95%
Correct Answer: C
Rationale: The AHA recommends a compression fraction (the proportion of time during which compressions are performed) of at least 80%. High CCF is
associated with improved survival. Minimizing pre-shock pauses, rhythm checks, and other interruptions is essential to achieving this target. A CCF below 80%
significantly reduces the likelihood of ROSC.
Q6: Why is complete chest recoil between compressions critically important?
A. It allows the heart to rest between compressions
B. It allows ventricular filling and coronary perfusion; leaning reduces cardiac output [CORRECT]
C. It prevents rib fractures during resuscitation
D. It allows the rescuer to conserve energy during prolonged CPR
Correct Answer: B
Rationale: Full chest recoil allows the heart to refill with blood between compressions. Incomplete recoil (leaning on the chest) increases intrathoracic pressure,
decreasing venous return, coronary perfusion, and cardiac output. Rescuers must ensure the chest fully expands after each compression without lifting hands
off the sternum completely.
Q7: How often should rescuers switch compressor roles during CPR?
A. Every 1 minute
B. Every 2 minutes (after approximately 5 cycles of 30:2) [CORRECT]
C. Every 5 minutes
D. Only when the compressor reports fatigue
Correct Answer: B
Rationale: Rescuers should switch compressor roles every 2 minutes (approximately 5 cycles of 30:2) to prevent fatigue and maintain compression quality.
Compression quality degrades rapidly, often within 1-2 minutes, even if the rescuer does not feel fatigued. The switch should occur in less than 5 seconds to
minimize interruptions.
Q8: After delivering a defibrillation shock, what is the correct immediate action?
A. Check for a pulse before resuming compressions
B. Resume CPR immediately, beginning with compressions, without checking for pulse [CORRECT]
C. Wait 10 seconds to assess rhythm on the monitor
D. Administer epinephrine before resuming compressions
Correct Answer: B
Rationale: Per current AHA guidelines, CPR should be resumed immediately after defibrillation, starting with compressions. Pulse checks are performed only
after 2 minutes of CPR, unless the patient shows obvious signs of ROSC. Delaying compressions to check a pulse or rhythm wastes critical time and reduces the
chance of successful defibrillation.
Q9: During cardiac arrest, end-tidal CO2 (EtCO2) capnography shows a reading of 8 mmHg. What does this value suggest?
A. Adequate CPR quality and possible ROSC
B. Poor CPR quality; compressions should be optimized to improve cardiac output [CORRECT]
C. The patient has achieved ROSC and compressions should be stopped
D. The advanced airway is malpositioned and must be replaced
Correct Answer: B
Rationale: EtCO2 values below 10 mmHg during cardiac arrest suggest inadequate chest compressions and poor cardiac output. The AHA identifies
capnography as the most reliable indicator of CPR quality during arrest. A sudden increase to above 40 mmHg may indicate ROSC. Values of 10-20 mmHg
are associated with better outcomes. The response is to optimize compression quality, not replace the airway.
Q10: What is the maximum recommended pause between pausing compressions and delivering a shock?
A. Less than 10 seconds
B. Less than 5 seconds [CORRECT]
C. Less than 15 seconds
D. Less than 2 seconds
Correct Answer: B
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