American Heart Association
ACLS Final Exam
Questions & Answers with Explanation
Most Comprehensive to Pass the Exam · 100% Verified
Latest Edition
125 Comprehensive Questions & Verified Answers
Aligned with AHA Guidelines for CPR & ECC
Emergency Cardiovascular Care Education Series
,AHA ACLS Final Exam — Questions & Answers with Explanation · 100% Verified
Exam Overview
Purpose: This 125-item final examination is designed to evaluate mastery of the AHA Advanced Cardiovascular
Life Support (ACLS) Provider Manual content per the 2026/2027 AHA Guidelines for CPR and ECC. Items
comprehensively cover BLS foundations, ECG rhythm recognition, cardiac arrest algorithms,
bradycardia/tachycardia management, ACLS pharmacology, airway management, post-cardiac arrest care, acute
coronary syndromes, stroke, and special resuscitation situations with team dynamics.
Structure: The exam is organized into nine competency-labeled sections. Approximately 80% of items are
scenario-based, requiring sequential clinical decision-making mirroring the ACLS megacode testing format, and
20% are direct recall items reinforcing core algorithm, drug, and rhythm concepts. Each item includes a 3-5 sentence
rationale explaining why the correct answer is right AND why each distractor is wrong, with AHA guideline
references. Recommended administration time: 200 minutes. Pre-test readiness benchmark: 85% correct.
# Section Item Range Items
1 Section 1: BLS and High-Quality CPR Foundations Q1–Q13 13
2 Section 2: Rhythm Recognition and ECG Interpretation Q14–Q29 16
3 Section 3: Cardiac Arrest Algorithms Q30–Q47 18
4 Section 4: Bradycardia and Tachycardia Algorithms Q48–Q62 15
5 Section 5: ACLS Pharmacology Q63–Q78 16
6 Section 6: Airway Management and Ventilation Q79–Q91 13
7 Section 7: Post-Cardiac Arrest Care Q92–Q104 13
8 Section 8: Acute Coronary Syndromes and Stroke Q105–Q115 11
9 Section 9: Special Resuscitation Situations and Team Dynamics Q116–Q125 10
TOTAL 125
How to use this exam: Attempt each item without external references. Review every rationale — even for items
answered correctly — to confirm mastery. For missed items, identify the algorithm step, drug dose, or rhythm feature
that caused the error and re-study that section of the AHA ACLS Provider Manual before retaking a megacode-style
practice session.
Emergency Cardiovascular Care Education Series Page 2
,AHA ACLS Final Exam — Questions & Answers with Explanation · 100% Verified
SECTION 1
Section 1: BLS and High-Quality CPR Foundations
Compression Rate/Depth, Ventilation, Team Dynamics, and AED Use
Q1: A 60-year-old male collapses in the hospital lobby. A pulse check confirms no pulse. Which compression
rate and depth meet AHA 2026 high-quality CPR standards for an adult?
A. Rate 80-100/min, depth 1.5 inches
B. Rate 100-120/min, depth at least 2 inches (5 cm) but not exceeding 2.4 inches (6 cm) [CORRECT]
C. Rate 120-140/min, depth 3 inches
D. Rate 60-80/min, depth 1 inch
Correct Answer: B. Rate 100-120/min, depth at least 2 inches (5 cm) but not
exceeding 2.4 inches (6 cm)
Rationale: AHA 2026 guidelines specify a compression rate of 100-120/min and a depth of at least 2 inches (5 cm) without
exceeding 2.4 inches (6 cm) in adults. Rates of 80-100 or 120-140 are outside the recommended range, and depths of 1
inch or 3 inches are too shallow or excessive, risking injury and reducing cardiac output.
Q2: During two-rescuer CPR for an adult with an advanced airway in place, what is the recommended
ventilation rate?
A. 2 breaths every 30 compressions (30:2)
B. 1 breath every 6 seconds (10 breaths/min) asynchronous with compressions [CORRECT]
C. 1 breath every 3 seconds (20 breaths/min)
D. 2 breaths every 15 compressions (15:2)
Correct Answer: B. 1 breath every 6 seconds (10 breaths/min) asynchronous with
compressions
Rationale: Once an advanced airway is in place, compressions are continuous and ventilations are delivered at 1 breath
every 6 seconds (10 breaths/min). The 30:2 ratio applies to CPR without an advanced airway. The 15:2 ratio is for
two-rescuer CPR in infants and children without an advanced airway. Twenty breaths/min risks hyperventilation and
increased intrathoracic pressure, reducing cardiac output.
Q3: Which of the following is a key metric of high-quality CPR that directly affects survival?
A. Minimizing interruptions in compressions to achieve a compression fraction ≥ 60% (ideally > 80%)
[CORRECT]
B. Using the highest possible oxygen flow
C. Deferring pulse checks to avoid interrupting compressions
D. Increasing ventilation rate to compensate for acidosis
Correct Answer: A. Minimizing interruptions in compressions to achieve a
compression fraction ≥ 60% (ideally > 80%)
Rationale: High-quality CPR requires a compression fraction ≥ 60% (ideally >80%), meaning minimizing interruptions.
Higher oxygen flow does not compensate for poor compressions. Pulse checks should be brief (<10 seconds) and not
deferred. Hyperventilation increases intrathoracic pressure and decreases venous return, worsening outcomes.
Emergency Cardiovascular Care Education Series Page 3
, AHA ACLS Final Exam — Questions & Answers with Explanation · 100% Verified
Q4: An AED is applied to an unresponsive apneic adult. The AED announces "no shock advised." What is the
NEXT action?
A. Remove the AED pads and reposition them
B. Immediately resume CPR beginning with compressions [CORRECT]
C. Wait for the AED to reanalyze in 60 seconds
D. Perform a pulse check for 30 seconds before any action
Correct Answer: B. Immediately resume CPR beginning with compressions
Rationale: After a "no shock advised" message, resume CPR immediately beginning with compressions. Repositioning
pads is only indicated if the original placement was clearly incorrect. Waiting 60 seconds wastes precious no-flow time.
Pulse checks should be brief (<10 seconds) and are not routinely required if the patient is pulseless.
Q5: When placing AED pads on an adult, the recommended pad position is:
A. Anterior-posterior (front and back)
B. One pad to the right of the upper sternum below the clavicle and one to the left of the nipple in the
midaxillary line [CORRECT]
C. Both pads on the anterior chest side by side
D. Both pads on the back parallel to the spine
Correct Answer: B. One pad to the right of the upper sternum below the clavicle
and one to the left of the nipple in the midaxillary line
Rationale: The standard adult AED pad placement is one pad to the right of the upper sternum below the right clavicle and
one to the left of the nipple in the midaxillary line. Anterior-posterior placement is an acceptable alternative in some cases
but not the standard. Side-by-side on the chest or both on the back can cause inadequate current delivery.
Q6: Which action BEST demonstrates closed-loop communication during a code?
A. The team leader says, "Give epinephrine." The pharmacist says, "OK."
B. The team leader says, "Give 1 mg epinephrine IV push." The pharmacist repeats, "1 mg epinephrine
IV push given," and confirms administration [CORRECT]
C. The team leader says, "Give epi," and the pharmacist silently prepares the drug
D. The team leader says, "Increase the shock," without further direction
Correct Answer: B. The team leader says, "Give 1 mg epinephrine IV push." The
pharmacist repeats, "1 mg epinephrine IV push given," and confirms
administration
Rationale: Closed-loop communication involves a clear order, repetition back of the order by the receiver, and
confirmation of administration. "OK" is not confirmation. Silent preparation risks medication errors. Vague orders like
"increase the shock" without specifics can lead to errors.
Emergency Cardiovascular Care Education Series Page 4
ACLS Final Exam
Questions & Answers with Explanation
Most Comprehensive to Pass the Exam · 100% Verified
Latest Edition
125 Comprehensive Questions & Verified Answers
Aligned with AHA Guidelines for CPR & ECC
Emergency Cardiovascular Care Education Series
,AHA ACLS Final Exam — Questions & Answers with Explanation · 100% Verified
Exam Overview
Purpose: This 125-item final examination is designed to evaluate mastery of the AHA Advanced Cardiovascular
Life Support (ACLS) Provider Manual content per the 2026/2027 AHA Guidelines for CPR and ECC. Items
comprehensively cover BLS foundations, ECG rhythm recognition, cardiac arrest algorithms,
bradycardia/tachycardia management, ACLS pharmacology, airway management, post-cardiac arrest care, acute
coronary syndromes, stroke, and special resuscitation situations with team dynamics.
Structure: The exam is organized into nine competency-labeled sections. Approximately 80% of items are
scenario-based, requiring sequential clinical decision-making mirroring the ACLS megacode testing format, and
20% are direct recall items reinforcing core algorithm, drug, and rhythm concepts. Each item includes a 3-5 sentence
rationale explaining why the correct answer is right AND why each distractor is wrong, with AHA guideline
references. Recommended administration time: 200 minutes. Pre-test readiness benchmark: 85% correct.
# Section Item Range Items
1 Section 1: BLS and High-Quality CPR Foundations Q1–Q13 13
2 Section 2: Rhythm Recognition and ECG Interpretation Q14–Q29 16
3 Section 3: Cardiac Arrest Algorithms Q30–Q47 18
4 Section 4: Bradycardia and Tachycardia Algorithms Q48–Q62 15
5 Section 5: ACLS Pharmacology Q63–Q78 16
6 Section 6: Airway Management and Ventilation Q79–Q91 13
7 Section 7: Post-Cardiac Arrest Care Q92–Q104 13
8 Section 8: Acute Coronary Syndromes and Stroke Q105–Q115 11
9 Section 9: Special Resuscitation Situations and Team Dynamics Q116–Q125 10
TOTAL 125
How to use this exam: Attempt each item without external references. Review every rationale — even for items
answered correctly — to confirm mastery. For missed items, identify the algorithm step, drug dose, or rhythm feature
that caused the error and re-study that section of the AHA ACLS Provider Manual before retaking a megacode-style
practice session.
Emergency Cardiovascular Care Education Series Page 2
,AHA ACLS Final Exam — Questions & Answers with Explanation · 100% Verified
SECTION 1
Section 1: BLS and High-Quality CPR Foundations
Compression Rate/Depth, Ventilation, Team Dynamics, and AED Use
Q1: A 60-year-old male collapses in the hospital lobby. A pulse check confirms no pulse. Which compression
rate and depth meet AHA 2026 high-quality CPR standards for an adult?
A. Rate 80-100/min, depth 1.5 inches
B. Rate 100-120/min, depth at least 2 inches (5 cm) but not exceeding 2.4 inches (6 cm) [CORRECT]
C. Rate 120-140/min, depth 3 inches
D. Rate 60-80/min, depth 1 inch
Correct Answer: B. Rate 100-120/min, depth at least 2 inches (5 cm) but not
exceeding 2.4 inches (6 cm)
Rationale: AHA 2026 guidelines specify a compression rate of 100-120/min and a depth of at least 2 inches (5 cm) without
exceeding 2.4 inches (6 cm) in adults. Rates of 80-100 or 120-140 are outside the recommended range, and depths of 1
inch or 3 inches are too shallow or excessive, risking injury and reducing cardiac output.
Q2: During two-rescuer CPR for an adult with an advanced airway in place, what is the recommended
ventilation rate?
A. 2 breaths every 30 compressions (30:2)
B. 1 breath every 6 seconds (10 breaths/min) asynchronous with compressions [CORRECT]
C. 1 breath every 3 seconds (20 breaths/min)
D. 2 breaths every 15 compressions (15:2)
Correct Answer: B. 1 breath every 6 seconds (10 breaths/min) asynchronous with
compressions
Rationale: Once an advanced airway is in place, compressions are continuous and ventilations are delivered at 1 breath
every 6 seconds (10 breaths/min). The 30:2 ratio applies to CPR without an advanced airway. The 15:2 ratio is for
two-rescuer CPR in infants and children without an advanced airway. Twenty breaths/min risks hyperventilation and
increased intrathoracic pressure, reducing cardiac output.
Q3: Which of the following is a key metric of high-quality CPR that directly affects survival?
A. Minimizing interruptions in compressions to achieve a compression fraction ≥ 60% (ideally > 80%)
[CORRECT]
B. Using the highest possible oxygen flow
C. Deferring pulse checks to avoid interrupting compressions
D. Increasing ventilation rate to compensate for acidosis
Correct Answer: A. Minimizing interruptions in compressions to achieve a
compression fraction ≥ 60% (ideally > 80%)
Rationale: High-quality CPR requires a compression fraction ≥ 60% (ideally >80%), meaning minimizing interruptions.
Higher oxygen flow does not compensate for poor compressions. Pulse checks should be brief (<10 seconds) and not
deferred. Hyperventilation increases intrathoracic pressure and decreases venous return, worsening outcomes.
Emergency Cardiovascular Care Education Series Page 3
, AHA ACLS Final Exam — Questions & Answers with Explanation · 100% Verified
Q4: An AED is applied to an unresponsive apneic adult. The AED announces "no shock advised." What is the
NEXT action?
A. Remove the AED pads and reposition them
B. Immediately resume CPR beginning with compressions [CORRECT]
C. Wait for the AED to reanalyze in 60 seconds
D. Perform a pulse check for 30 seconds before any action
Correct Answer: B. Immediately resume CPR beginning with compressions
Rationale: After a "no shock advised" message, resume CPR immediately beginning with compressions. Repositioning
pads is only indicated if the original placement was clearly incorrect. Waiting 60 seconds wastes precious no-flow time.
Pulse checks should be brief (<10 seconds) and are not routinely required if the patient is pulseless.
Q5: When placing AED pads on an adult, the recommended pad position is:
A. Anterior-posterior (front and back)
B. One pad to the right of the upper sternum below the clavicle and one to the left of the nipple in the
midaxillary line [CORRECT]
C. Both pads on the anterior chest side by side
D. Both pads on the back parallel to the spine
Correct Answer: B. One pad to the right of the upper sternum below the clavicle
and one to the left of the nipple in the midaxillary line
Rationale: The standard adult AED pad placement is one pad to the right of the upper sternum below the right clavicle and
one to the left of the nipple in the midaxillary line. Anterior-posterior placement is an acceptable alternative in some cases
but not the standard. Side-by-side on the chest or both on the back can cause inadequate current delivery.
Q6: Which action BEST demonstrates closed-loop communication during a code?
A. The team leader says, "Give epinephrine." The pharmacist says, "OK."
B. The team leader says, "Give 1 mg epinephrine IV push." The pharmacist repeats, "1 mg epinephrine
IV push given," and confirms administration [CORRECT]
C. The team leader says, "Give epi," and the pharmacist silently prepares the drug
D. The team leader says, "Increase the shock," without further direction
Correct Answer: B. The team leader says, "Give 1 mg epinephrine IV push." The
pharmacist repeats, "1 mg epinephrine IV push given," and confirms
administration
Rationale: Closed-loop communication involves a clear order, repetition back of the order by the receiver, and
confirmation of administration. "OK" is not confirmation. Silent preparation risks medication errors. Vague orders like
"increase the shock" without specifics can lead to errors.
Emergency Cardiovascular Care Education Series Page 4
