American Red Cross ACLS Final Exam
Practice Questions Latest Update 2026|2027|
A Comprehensive Review of 300 Practice
Questions with Answers and Rationales
|Pass Guaranteed
Introduction
The American Red Cross Advanced Life Support (ALS/ACLS) certification is
designed for healthcare professionals who participate in the assessment and
management of critical patients. The course emphasizes high-quality patient care
by integrating rhythm interpretation, electrical interventions, and pharmacologic
knowledge with critical thinking and team-based response.
The Red Cross ALS course combines online coursework with an in-person skills
session. After completing the online portion and passing the final written exam,
candidates must demonstrate their skills to a certified instructor to receive
certification. The certification is valid for two years.
This comprehensive practice set covers essential ACLS topics including:
• High-Quality CPR and BLS Integration: Compression rate, depth,
ventilation ratios, and minimizing interruptions
• Rhythm Recognition: Shockable rhythms (VF/pulseless VT) versus non-
shockable rhythms (asystole/PEA)
• Cardiac Arrest Algorithms: Defibrillation, medication administration, and
reversible causes (H's and Ts)
• Pharmacology: Epinephrine, Amiodarone, Adenosine, Atropine, and other
ACLS medications
• Airway Management: BVM ventilation, advanced airways, and
capnography
, • Post-Cardiac Arrest Care: Targeted temperature management, oxygenation
goals, and hemodynamic support
• Acute Coronary Syndromes and Stroke: Recognition, triage, and
reperfusion strategies
• Team Dynamics: Closed-loop communication and resuscitation team roles
MULTICHOICE QUESTIONS
1. You arrive at a patient in cardiac arrest. The monitor shows pulseless
ventricular tachycardia. What is the next step?
A) Start CPR, administer epinephrine
B) Defibrillate immediately and resume CPR
C) Give amiodarone only
D) Observe and monitor
Answer: B
Rationale: Pulseless VT is a shockable rhythm. Immediate defibrillation is critical
for survival, followed by immediate resumption of high-quality CPR.
2. During CPR, the recommended compression-to-ventilation ratio for a single
rescuer in an adult is:
A) 15:2
B) 30:2
C) 5:1
D) 100:2
Answer: B
Rationale: Current ACLS guidelines recommend 30 compressions followed by 2
ventilations for adult cardiac arrest.
3. A patient has ROSC (Return of Spontaneous Circulation). What is the first
step in post-cardiac arrest care?
,A) Administer amiodarone
B) Optimize ventilation and oxygenation
C) Start immediate defibrillation
D) Give aspirin
Answer: B
Rationale: Post-arrest care focuses on maintaining oxygenation, perfusion, and
identifying the cause of arrest.
4. Which medication is recommended for a patient in asystole?
A) Aspirin
B) Amiodarone
C) Epinephrine
D) Adenosine
Answer: C
Rationale: Asystole is non-shockable. Epinephrine every 3-5 minutes is
recommended during CPR.
5. Which of the following is a reversible cause of cardiac arrest (H's & T's)?
A) Hypertension
B) Hypoxia
C) Hypothermia only
D) Hyperglycemia
Answer: B
Rationale: H's and T's include hypoxia, hypovolemia, hydrogen ion (acidosis),
hypo/hyperkalemia, hypothermia, toxins, tamponade, tension pneumothorax, and
thrombosis.
6. What is the first step if you witness an adult suddenly collapse?
, A) Call a family member
B) Check responsiveness and activate emergency response
C) Give CPR immediately
D) Apply AED pads
Answer: B
Rationale: Always ensure safety, check responsiveness, and call for help first
before initiating CPR.
7. Which rhythm is shockable in ACLS?
A) Asystole
B) Pulseless electrical activity
C) Ventricular fibrillation
D) Sinus bradycardia
Answer: C
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are the two
shockable rhythms in ACLS.
8. What is the recommended rate for chest compressions during CPR?
A) 60-80 per minute
B) 80-100 per minute
C) 100-120 per minute
D) 120-140 per minute
Answer: C
Rationale: High-quality CPR requires a compression rate of 100-120 per minute.
9. What is the recommended depth for adult chest compressions?
A) At least 1 inch
B) At least 2 inches
Practice Questions Latest Update 2026|2027|
A Comprehensive Review of 300 Practice
Questions with Answers and Rationales
|Pass Guaranteed
Introduction
The American Red Cross Advanced Life Support (ALS/ACLS) certification is
designed for healthcare professionals who participate in the assessment and
management of critical patients. The course emphasizes high-quality patient care
by integrating rhythm interpretation, electrical interventions, and pharmacologic
knowledge with critical thinking and team-based response.
The Red Cross ALS course combines online coursework with an in-person skills
session. After completing the online portion and passing the final written exam,
candidates must demonstrate their skills to a certified instructor to receive
certification. The certification is valid for two years.
This comprehensive practice set covers essential ACLS topics including:
• High-Quality CPR and BLS Integration: Compression rate, depth,
ventilation ratios, and minimizing interruptions
• Rhythm Recognition: Shockable rhythms (VF/pulseless VT) versus non-
shockable rhythms (asystole/PEA)
• Cardiac Arrest Algorithms: Defibrillation, medication administration, and
reversible causes (H's and Ts)
• Pharmacology: Epinephrine, Amiodarone, Adenosine, Atropine, and other
ACLS medications
• Airway Management: BVM ventilation, advanced airways, and
capnography
, • Post-Cardiac Arrest Care: Targeted temperature management, oxygenation
goals, and hemodynamic support
• Acute Coronary Syndromes and Stroke: Recognition, triage, and
reperfusion strategies
• Team Dynamics: Closed-loop communication and resuscitation team roles
MULTICHOICE QUESTIONS
1. You arrive at a patient in cardiac arrest. The monitor shows pulseless
ventricular tachycardia. What is the next step?
A) Start CPR, administer epinephrine
B) Defibrillate immediately and resume CPR
C) Give amiodarone only
D) Observe and monitor
Answer: B
Rationale: Pulseless VT is a shockable rhythm. Immediate defibrillation is critical
for survival, followed by immediate resumption of high-quality CPR.
2. During CPR, the recommended compression-to-ventilation ratio for a single
rescuer in an adult is:
A) 15:2
B) 30:2
C) 5:1
D) 100:2
Answer: B
Rationale: Current ACLS guidelines recommend 30 compressions followed by 2
ventilations for adult cardiac arrest.
3. A patient has ROSC (Return of Spontaneous Circulation). What is the first
step in post-cardiac arrest care?
,A) Administer amiodarone
B) Optimize ventilation and oxygenation
C) Start immediate defibrillation
D) Give aspirin
Answer: B
Rationale: Post-arrest care focuses on maintaining oxygenation, perfusion, and
identifying the cause of arrest.
4. Which medication is recommended for a patient in asystole?
A) Aspirin
B) Amiodarone
C) Epinephrine
D) Adenosine
Answer: C
Rationale: Asystole is non-shockable. Epinephrine every 3-5 minutes is
recommended during CPR.
5. Which of the following is a reversible cause of cardiac arrest (H's & T's)?
A) Hypertension
B) Hypoxia
C) Hypothermia only
D) Hyperglycemia
Answer: B
Rationale: H's and T's include hypoxia, hypovolemia, hydrogen ion (acidosis),
hypo/hyperkalemia, hypothermia, toxins, tamponade, tension pneumothorax, and
thrombosis.
6. What is the first step if you witness an adult suddenly collapse?
, A) Call a family member
B) Check responsiveness and activate emergency response
C) Give CPR immediately
D) Apply AED pads
Answer: B
Rationale: Always ensure safety, check responsiveness, and call for help first
before initiating CPR.
7. Which rhythm is shockable in ACLS?
A) Asystole
B) Pulseless electrical activity
C) Ventricular fibrillation
D) Sinus bradycardia
Answer: C
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are the two
shockable rhythms in ACLS.
8. What is the recommended rate for chest compressions during CPR?
A) 60-80 per minute
B) 80-100 per minute
C) 100-120 per minute
D) 120-140 per minute
Answer: C
Rationale: High-quality CPR requires a compression rate of 100-120 per minute.
9. What is the recommended depth for adult chest compressions?
A) At least 1 inch
B) At least 2 inches
