AHA ACLS Exam 2025 | American Heart Association Advanced
Cardiovascular Life Support Exam Study Guide, 2025 ACLS Provider
Course Exam Prep, 2025 AHA CPR & ECC Guidelines, High-Quality
CPR, Cardiac Arrest Algorithms, Airway Management, ECG Rhythm
Recognition, Defibrillation, Cardioversion, Transcutaneous Pacing,
Pharmacology, Stroke, Acute Coronary Syndromes, Post-Cardiac
Arrest Care, Practice Questions, Answers & Rationales
Question 1: A 68-year-old patient in the emergency department suddenly
collapses. The monitor shows ventricular fibrillation. According to the 2025 AHA
guidelines, what is the most appropriate first intervention?
A. Administer epinephrine 1 mg IV push
B. Perform synchronized cardioversion at 100 J
C. Begin high-quality CPR and prepare for immediate defibrillation
D. Administer amiodarone 300 mg IV push
CORRECT ANSWER: C. Begin high-quality CPR and prepare for immediate
defibrillation
Rationale: For VF/pulseless VT, the 2025 AHA guidelines emphasize high-quality
CPR and early defibrillation as the most critical interventions. Defibrillation should
be performed as soon as the device is available, with minimal interruptions in
chest compressions .
Question 2: During resuscitation of a patient in cardiac arrest, the team leader
notes the patient has an advanced airway in place. What is the correct
ventilation rate for this patient?
A. 1 breath every 3 seconds
B. 1 breath every 6 seconds
C. 2 breaths every 10 seconds
D. 1 breath every 10 seconds
CORRECT ANSWER: B. 1 breath every 6 seconds
Rationale: Once an advanced airway is placed during cardiac arrest, ventilations
should be delivered at 1 breath every 6 seconds (10 breaths per minute) without
pausing chest compressions .
,Question 3: A patient experiencing bradycardia has a heart rate of 42 bpm and
is symptomatic with hypotension and altered mental status. According to the
2025 ACLS guidelines, what is the recommended initial dose of atropine?
A. 0.5 mg IV
B. 1 mg IV
C. 2 mg IV
D. 3 mg IV
CORRECT ANSWER: B. 1 mg IV
Rationale: The 2025 AHA guidelines updated the atropine dose for symptomatic
bradycardia from 0.5 mg to 1 mg IV. The maximum total dose remains 3 mg .
Question 4: After return of spontaneous circulation (ROSC) in an adult patient,
what is the recommended minimum mean arterial pressure (MAP) to maintain?
A. 50 mm Hg
B. 55 mm Hg
C. 65 mm Hg
D. 75 mm Hg
CORRECT ANSWER: C. 65 mm Hg
Rationale: The 2025 AHA guidelines recommend avoiding hypotension after ROSC
by maintaining a minimum mean arterial pressure of at least 65 mm Hg .
Question 5: A patient in cardiac arrest is receiving CPR. The team leader wants
to confirm adequate compression depth. According to the 2025 guidelines, what
is the recommended compression depth for an average adult?
A. At least 1 inch
B. At least 1.5 inches
C. At least 2 inches
D. At least 3 inches
CORRECT ANSWER: C. At least 2 inches
Rationale: High-quality CPR for adults requires chest compressions to a depth of
at least 2 inches (5 cm) while avoiding excessive depth greater than 2.4 inches .
,Question 6: During ACLS, a patient with pulseless electrical activity (PEA) has
received one dose of epinephrine. What is the recommended interval for
repeating epinephrine during cardiac arrest?
A. Every 1 to 2 minutes
B. Every 3 to 5 minutes
C. Every 6 to 8 minutes
D. Every 10 minutes
CORRECT ANSWER: B. Every 3 to 5 minutes
Rationale: Epinephrine 1 mg IV/IO is administered every 3 to 5 minutes during
cardiac arrest according to the 2025 AHA ACLS guidelines .
Question 7: A patient presents with a narrow-complex tachycardia at a rate of
180 bpm and is hemodynamically stable. What is the recommended initial dose
of adenosine?
A. 3 mg IV push
B. 6 mg IV push
C. 12 mg IV push
D. 18 mg IV push
CORRECT ANSWER: B. 6 mg IV push
Rationale: For stable narrow-complex regular tachycardia (SVT), the initial dose of
adenosine is 6 mg IV push, followed by 12 mg if the first dose is ineffective .
Question 8: During a resuscitation attempt, the team is preparing to administer
medications. According to the 2025 AHA guidelines, which vascular access route
is preferred for drug administration in adult cardiac arrest?
A. Intraosseous (IO) access
B. Endotracheal tube (ETT) administration
C. Intravenous (IV) access
D. Intramuscular (IM) injection
CORRECT ANSWER: C. Intravenous (IV) access
, Rationale: The 2025 AHA guidelines recommend that healthcare professionals
first attempt establishing IV access for drug administration during adult cardiac
arrest. IO access is reasonable if IV attempts are unsuccessful or not feasible .
Question 9: A patient with acute coronary syndrome is being evaluated in the
emergency department. Which medication should be administered as soon as
possible if there are no contraindications?
A. Aspirin 162-325 mg chewed
B. Morphine 4 mg IV
C. Nitroglycerin sublingual
D. Heparin bolus
CORRECT ANSWER: A. Aspirin 162-325 mg chewed
Rationale: For acute coronary syndrome, the 2025 ACLS guidelines recommend
aspirin 162-325 mg chewed as soon as possible unless contraindicated, as it
reduces platelet aggregation and improves outcomes .
Question 10: A patient has a heart rate of 36 bpm with a blood pressure of
78/45 mm Hg and is confused. Atropine is administered but fails to improve the
heart rate. What is the next recommended intervention according to the 2025
bradycardia algorithm?
A. Administer a second dose of atropine 1 mg
B. Initiate transcutaneous pacing or dopamine infusion
C. Administer epinephrine 1 mg IV push
D. Perform synchronized cardioversion at 50 J
CORRECT ANSWER: B. Initiate transcutaneous pacing or dopamine infusion
Rationale: If atropine fails to improve symptomatic bradycardia, the next
interventions include transcutaneous pacing or a dopamine infusion (5-20 mcg/kg
per minute) or epinephrine infusion (2-10 mcg/min) .
Question 11: During post-cardiac arrest care, what is the recommended target
oxygen saturation range according to the 2025 AHA guidelines?
A. 85% to 90%
B. 90% to 98%
Cardiovascular Life Support Exam Study Guide, 2025 ACLS Provider
Course Exam Prep, 2025 AHA CPR & ECC Guidelines, High-Quality
CPR, Cardiac Arrest Algorithms, Airway Management, ECG Rhythm
Recognition, Defibrillation, Cardioversion, Transcutaneous Pacing,
Pharmacology, Stroke, Acute Coronary Syndromes, Post-Cardiac
Arrest Care, Practice Questions, Answers & Rationales
Question 1: A 68-year-old patient in the emergency department suddenly
collapses. The monitor shows ventricular fibrillation. According to the 2025 AHA
guidelines, what is the most appropriate first intervention?
A. Administer epinephrine 1 mg IV push
B. Perform synchronized cardioversion at 100 J
C. Begin high-quality CPR and prepare for immediate defibrillation
D. Administer amiodarone 300 mg IV push
CORRECT ANSWER: C. Begin high-quality CPR and prepare for immediate
defibrillation
Rationale: For VF/pulseless VT, the 2025 AHA guidelines emphasize high-quality
CPR and early defibrillation as the most critical interventions. Defibrillation should
be performed as soon as the device is available, with minimal interruptions in
chest compressions .
Question 2: During resuscitation of a patient in cardiac arrest, the team leader
notes the patient has an advanced airway in place. What is the correct
ventilation rate for this patient?
A. 1 breath every 3 seconds
B. 1 breath every 6 seconds
C. 2 breaths every 10 seconds
D. 1 breath every 10 seconds
CORRECT ANSWER: B. 1 breath every 6 seconds
Rationale: Once an advanced airway is placed during cardiac arrest, ventilations
should be delivered at 1 breath every 6 seconds (10 breaths per minute) without
pausing chest compressions .
,Question 3: A patient experiencing bradycardia has a heart rate of 42 bpm and
is symptomatic with hypotension and altered mental status. According to the
2025 ACLS guidelines, what is the recommended initial dose of atropine?
A. 0.5 mg IV
B. 1 mg IV
C. 2 mg IV
D. 3 mg IV
CORRECT ANSWER: B. 1 mg IV
Rationale: The 2025 AHA guidelines updated the atropine dose for symptomatic
bradycardia from 0.5 mg to 1 mg IV. The maximum total dose remains 3 mg .
Question 4: After return of spontaneous circulation (ROSC) in an adult patient,
what is the recommended minimum mean arterial pressure (MAP) to maintain?
A. 50 mm Hg
B. 55 mm Hg
C. 65 mm Hg
D. 75 mm Hg
CORRECT ANSWER: C. 65 mm Hg
Rationale: The 2025 AHA guidelines recommend avoiding hypotension after ROSC
by maintaining a minimum mean arterial pressure of at least 65 mm Hg .
Question 5: A patient in cardiac arrest is receiving CPR. The team leader wants
to confirm adequate compression depth. According to the 2025 guidelines, what
is the recommended compression depth for an average adult?
A. At least 1 inch
B. At least 1.5 inches
C. At least 2 inches
D. At least 3 inches
CORRECT ANSWER: C. At least 2 inches
Rationale: High-quality CPR for adults requires chest compressions to a depth of
at least 2 inches (5 cm) while avoiding excessive depth greater than 2.4 inches .
,Question 6: During ACLS, a patient with pulseless electrical activity (PEA) has
received one dose of epinephrine. What is the recommended interval for
repeating epinephrine during cardiac arrest?
A. Every 1 to 2 minutes
B. Every 3 to 5 minutes
C. Every 6 to 8 minutes
D. Every 10 minutes
CORRECT ANSWER: B. Every 3 to 5 minutes
Rationale: Epinephrine 1 mg IV/IO is administered every 3 to 5 minutes during
cardiac arrest according to the 2025 AHA ACLS guidelines .
Question 7: A patient presents with a narrow-complex tachycardia at a rate of
180 bpm and is hemodynamically stable. What is the recommended initial dose
of adenosine?
A. 3 mg IV push
B. 6 mg IV push
C. 12 mg IV push
D. 18 mg IV push
CORRECT ANSWER: B. 6 mg IV push
Rationale: For stable narrow-complex regular tachycardia (SVT), the initial dose of
adenosine is 6 mg IV push, followed by 12 mg if the first dose is ineffective .
Question 8: During a resuscitation attempt, the team is preparing to administer
medications. According to the 2025 AHA guidelines, which vascular access route
is preferred for drug administration in adult cardiac arrest?
A. Intraosseous (IO) access
B. Endotracheal tube (ETT) administration
C. Intravenous (IV) access
D. Intramuscular (IM) injection
CORRECT ANSWER: C. Intravenous (IV) access
, Rationale: The 2025 AHA guidelines recommend that healthcare professionals
first attempt establishing IV access for drug administration during adult cardiac
arrest. IO access is reasonable if IV attempts are unsuccessful or not feasible .
Question 9: A patient with acute coronary syndrome is being evaluated in the
emergency department. Which medication should be administered as soon as
possible if there are no contraindications?
A. Aspirin 162-325 mg chewed
B. Morphine 4 mg IV
C. Nitroglycerin sublingual
D. Heparin bolus
CORRECT ANSWER: A. Aspirin 162-325 mg chewed
Rationale: For acute coronary syndrome, the 2025 ACLS guidelines recommend
aspirin 162-325 mg chewed as soon as possible unless contraindicated, as it
reduces platelet aggregation and improves outcomes .
Question 10: A patient has a heart rate of 36 bpm with a blood pressure of
78/45 mm Hg and is confused. Atropine is administered but fails to improve the
heart rate. What is the next recommended intervention according to the 2025
bradycardia algorithm?
A. Administer a second dose of atropine 1 mg
B. Initiate transcutaneous pacing or dopamine infusion
C. Administer epinephrine 1 mg IV push
D. Perform synchronized cardioversion at 50 J
CORRECT ANSWER: B. Initiate transcutaneous pacing or dopamine infusion
Rationale: If atropine fails to improve symptomatic bradycardia, the next
interventions include transcutaneous pacing or a dopamine infusion (5-20 mcg/kg
per minute) or epinephrine infusion (2-10 mcg/min) .
Question 11: During post-cardiac arrest care, what is the recommended target
oxygen saturation range according to the 2025 AHA guidelines?
A. 85% to 90%
B. 90% to 98%
