2026/2027
ACLS Advanced Cardiovascular
Life Support Test 2026/2027:
Complete Exam Prep and Test Bank
Review
Question 1
A hospital visitor suddenly collapses and is found unresponsive. The patient is not
breathing normally, and no carotid pulse is detected within 10 seconds. The
emergency response system has already been activated. Which action should the
responder perform next?
A. Deliver two rescue breaths before beginning compressions
B. Begin chest compressions immediately
C. Obtain a 12-lead ECG
D. Insert an advanced airway
Correct Answer: B. Begin chest compressions immediately
Rationale: Once cardiac arrest is confirmed by unresponsiveness, abnormal or absent
breathing, and lack of a pulse, chest compressions should begin immediately.
Delaying compressions for ventilation, ECG acquisition, or advanced-airway
placement reduces coronary and cerebral perfusion. Ventilation and rhythm
assessment remain important, but they should be integrated into resuscitation without
postponing high-quality CPR.
Question 2
A patient suddenly becomes unconscious during an examination. The patient is not
breathing normally. After checking the carotid artery for several seconds, the clinician
remains uncertain whether a pulse is present. What is the most appropriate action?
A. Continue checking the pulse for another 20 seconds
B. Provide rescue breathing without chest compressions
C. Begin chest compressions
D. Wait for an ECG rhythm to appear
Correct Answer: C. Begin chest compressions
Rationale: A pulse check should take no more than 5 to 10 seconds. When a pulse
cannot be confidently detected within that period, the responder should assume
cardiac arrest and begin compressions. Prolonged pulse checks delay circulation.
,2026/2027
Rescue breathing alone is appropriate only when a definite pulse is present, while
waiting for ECG confirmation unnecessarily postpones lifesaving treatment.
Question 3
A rescue team finds a 59-year-old man unresponsive on the kitchen floor. He makes
occasional irregular gasping sounds but does not respond to verbal or painful
stimulation. What should the team do next?
A. Place him in the recovery position
B. Check for a pulse for 5 to 10 seconds
C. Assume the gasps represent effective breathing
D. Administer sublingual nitroglycerin
Correct Answer: B. Check for a pulse for 5 to 10 seconds
Rationale: Agonal gasps are abnormal breaths commonly occurring during the first
minutes of cardiac arrest and should not be mistaken for normal breathing. The next
assessment is a rapid pulse check. Recovery positioning is inappropriate in a
potentially pulseless patient. Nitroglycerin has no role in the immediate evaluation,
and assuming that gasping represents adequate ventilation could delay CPR.
Question 4
During an adult cardiac arrest, a team leader observes that the compressor is
delivering approximately 80 compressions per minute. Which instruction is most
appropriate?
A. Increase the rate to at least 100 compressions per minute
B. Maintain the current rate to improve chest recoil
C. Reduce the rate to 60 compressions per minute
D. Pause after every five compressions to reassess the pulse
Correct Answer: A. Increase the rate to at least 100 compressions per minute
Rationale: Effective adult CPR requires a compression rate of at least 100 per minute
according to the supplied material. A rate of 80 per minute is unlikely to generate
adequate coronary and cerebral perfusion. Complete recoil remains important but
should occur between appropriately paced compressions. Frequent pauses and slower
rates reduce blood flow and decrease the likelihood of successful resuscitation.
Question 5
A quality-improvement observer notes that an adult patient’s sternum is being
compressed only about 2.5 cm during CPR. Which correction should be made?
,2026/2027
A. Increase compression depth to at least 5 cm
B. Maintain the depth to reduce rib fractures
C. Compress only during exhalation
D. Replace compressions with abdominal thrusts
Correct Answer: A. Increase compression depth to at least 5 cm
Rationale: Adult chest compressions should reach a minimum depth of approximately
2 inches, or 5 cm, to produce meaningful forward blood flow. Shallow compressions
are frequently ineffective. Concern about possible rib injury should not lead to
inadequate compression depth. Abdominal thrusts do not replace CPR, and
compressions should be continuous rather than coordinated with the patient’s
exhalation.
Question 6
During resuscitation, the compressor maintains pressure on the sternum between
compressions instead of allowing the chest to return to its normal position. Why
should the team leader correct this technique?
A. Incomplete recoil increases ventilation volume
B. Incomplete recoil limits venous return to the heart
C. Complete recoil causes excessive intracranial pressure
D. Complete recoil prevents defibrillator analysis
Correct Answer: B. Incomplete recoil limits venous return to the heart
Rationale: Complete chest recoil allows negative intrathoracic pressure to develop,
promoting venous return and refilling of the heart. Leaning on the chest between
compressions reduces preload and lowers cardiac output during CPR. Recoil does not
interfere with rhythm analysis or cause excessive intracranial pressure. High-quality
CPR therefore requires both adequate compression and complete release.
Question 7
A resuscitation team pauses chest compressions for 18 seconds while attempting
intubation. Which statement best explains why this practice is harmful?
A. Interruptions longer than 10 seconds reduce perfusion pressure
B. Intubation is never permitted during cardiac arrest
C. Pauses increase the effectiveness of subsequent compressions
D. Ventilation must always take priority over circulation
Correct Answer: A. Interruptions longer than 10 seconds reduce perfusion
pressure
Rationale: Interruptions in chest compressions should generally be limited to 10
seconds or less. Coronary perfusion pressure falls rapidly whenever compressions
, 2026/2027
stop and requires several subsequent compressions to rebuild. Intubation may be
performed during resuscitation, but it should not cause a prolonged pause. Circulation
and ventilation must be coordinated rather than allowing airway procedures to
interrupt CPR unnecessarily.
Question 8
After two minutes of continuous compressions, a rescuer’s compression depth begins
to decrease because of fatigue. What should the team leader do?
A. Continue with the same rescuer until a rhythm change occurs
B. Switch compressors while minimizing the pause
C. Stop CPR for one minute to allow recovery
D. Reduce compression depth until the rescuer recovers
Correct Answer: B. Switch compressors while minimizing the pause
Rationale: Compressor fatigue commonly develops within approximately two minutes
and may reduce depth, rate, and recoil even when the rescuer does not recognize it.
Compressors should therefore be switched about every two minutes or five cycles.
The exchange should be rapid and coordinated. Continuing ineffective compressions,
deliberately reducing depth, or pausing for an extended rest compromises circulation.
Question 9
A patient with pulseless ventricular fibrillation receives a defibrillation shock. What
should the team do immediately afterward?
A. Check the pulse for 30 seconds
B. Resume CPR beginning with chest compressions
C. Obtain a 12-lead ECG
D. Administer amiodarone before restarting compressions
Correct Answer: B. Resume CPR beginning with chest compressions
Rationale: After a shock, CPR should resume immediately, beginning with chest
compressions. Even when defibrillation successfully terminates ventricular fibrillation,
the heart may not initially produce effective circulation. An immediate pulse check or
ECG delays perfusion. Antiarrhythmic medication may be indicated later for
refractory rhythms, but it should not postpone the next two-minute cycle of CPR.
Question 10
A defibrillator is being charged while CPR is in progress for ventricular fibrillation.
Which action best minimizes the interruption in chest compressions?
ACLS Advanced Cardiovascular
Life Support Test 2026/2027:
Complete Exam Prep and Test Bank
Review
Question 1
A hospital visitor suddenly collapses and is found unresponsive. The patient is not
breathing normally, and no carotid pulse is detected within 10 seconds. The
emergency response system has already been activated. Which action should the
responder perform next?
A. Deliver two rescue breaths before beginning compressions
B. Begin chest compressions immediately
C. Obtain a 12-lead ECG
D. Insert an advanced airway
Correct Answer: B. Begin chest compressions immediately
Rationale: Once cardiac arrest is confirmed by unresponsiveness, abnormal or absent
breathing, and lack of a pulse, chest compressions should begin immediately.
Delaying compressions for ventilation, ECG acquisition, or advanced-airway
placement reduces coronary and cerebral perfusion. Ventilation and rhythm
assessment remain important, but they should be integrated into resuscitation without
postponing high-quality CPR.
Question 2
A patient suddenly becomes unconscious during an examination. The patient is not
breathing normally. After checking the carotid artery for several seconds, the clinician
remains uncertain whether a pulse is present. What is the most appropriate action?
A. Continue checking the pulse for another 20 seconds
B. Provide rescue breathing without chest compressions
C. Begin chest compressions
D. Wait for an ECG rhythm to appear
Correct Answer: C. Begin chest compressions
Rationale: A pulse check should take no more than 5 to 10 seconds. When a pulse
cannot be confidently detected within that period, the responder should assume
cardiac arrest and begin compressions. Prolonged pulse checks delay circulation.
,2026/2027
Rescue breathing alone is appropriate only when a definite pulse is present, while
waiting for ECG confirmation unnecessarily postpones lifesaving treatment.
Question 3
A rescue team finds a 59-year-old man unresponsive on the kitchen floor. He makes
occasional irregular gasping sounds but does not respond to verbal or painful
stimulation. What should the team do next?
A. Place him in the recovery position
B. Check for a pulse for 5 to 10 seconds
C. Assume the gasps represent effective breathing
D. Administer sublingual nitroglycerin
Correct Answer: B. Check for a pulse for 5 to 10 seconds
Rationale: Agonal gasps are abnormal breaths commonly occurring during the first
minutes of cardiac arrest and should not be mistaken for normal breathing. The next
assessment is a rapid pulse check. Recovery positioning is inappropriate in a
potentially pulseless patient. Nitroglycerin has no role in the immediate evaluation,
and assuming that gasping represents adequate ventilation could delay CPR.
Question 4
During an adult cardiac arrest, a team leader observes that the compressor is
delivering approximately 80 compressions per minute. Which instruction is most
appropriate?
A. Increase the rate to at least 100 compressions per minute
B. Maintain the current rate to improve chest recoil
C. Reduce the rate to 60 compressions per minute
D. Pause after every five compressions to reassess the pulse
Correct Answer: A. Increase the rate to at least 100 compressions per minute
Rationale: Effective adult CPR requires a compression rate of at least 100 per minute
according to the supplied material. A rate of 80 per minute is unlikely to generate
adequate coronary and cerebral perfusion. Complete recoil remains important but
should occur between appropriately paced compressions. Frequent pauses and slower
rates reduce blood flow and decrease the likelihood of successful resuscitation.
Question 5
A quality-improvement observer notes that an adult patient’s sternum is being
compressed only about 2.5 cm during CPR. Which correction should be made?
,2026/2027
A. Increase compression depth to at least 5 cm
B. Maintain the depth to reduce rib fractures
C. Compress only during exhalation
D. Replace compressions with abdominal thrusts
Correct Answer: A. Increase compression depth to at least 5 cm
Rationale: Adult chest compressions should reach a minimum depth of approximately
2 inches, or 5 cm, to produce meaningful forward blood flow. Shallow compressions
are frequently ineffective. Concern about possible rib injury should not lead to
inadequate compression depth. Abdominal thrusts do not replace CPR, and
compressions should be continuous rather than coordinated with the patient’s
exhalation.
Question 6
During resuscitation, the compressor maintains pressure on the sternum between
compressions instead of allowing the chest to return to its normal position. Why
should the team leader correct this technique?
A. Incomplete recoil increases ventilation volume
B. Incomplete recoil limits venous return to the heart
C. Complete recoil causes excessive intracranial pressure
D. Complete recoil prevents defibrillator analysis
Correct Answer: B. Incomplete recoil limits venous return to the heart
Rationale: Complete chest recoil allows negative intrathoracic pressure to develop,
promoting venous return and refilling of the heart. Leaning on the chest between
compressions reduces preload and lowers cardiac output during CPR. Recoil does not
interfere with rhythm analysis or cause excessive intracranial pressure. High-quality
CPR therefore requires both adequate compression and complete release.
Question 7
A resuscitation team pauses chest compressions for 18 seconds while attempting
intubation. Which statement best explains why this practice is harmful?
A. Interruptions longer than 10 seconds reduce perfusion pressure
B. Intubation is never permitted during cardiac arrest
C. Pauses increase the effectiveness of subsequent compressions
D. Ventilation must always take priority over circulation
Correct Answer: A. Interruptions longer than 10 seconds reduce perfusion
pressure
Rationale: Interruptions in chest compressions should generally be limited to 10
seconds or less. Coronary perfusion pressure falls rapidly whenever compressions
, 2026/2027
stop and requires several subsequent compressions to rebuild. Intubation may be
performed during resuscitation, but it should not cause a prolonged pause. Circulation
and ventilation must be coordinated rather than allowing airway procedures to
interrupt CPR unnecessarily.
Question 8
After two minutes of continuous compressions, a rescuer’s compression depth begins
to decrease because of fatigue. What should the team leader do?
A. Continue with the same rescuer until a rhythm change occurs
B. Switch compressors while minimizing the pause
C. Stop CPR for one minute to allow recovery
D. Reduce compression depth until the rescuer recovers
Correct Answer: B. Switch compressors while minimizing the pause
Rationale: Compressor fatigue commonly develops within approximately two minutes
and may reduce depth, rate, and recoil even when the rescuer does not recognize it.
Compressors should therefore be switched about every two minutes or five cycles.
The exchange should be rapid and coordinated. Continuing ineffective compressions,
deliberately reducing depth, or pausing for an extended rest compromises circulation.
Question 9
A patient with pulseless ventricular fibrillation receives a defibrillation shock. What
should the team do immediately afterward?
A. Check the pulse for 30 seconds
B. Resume CPR beginning with chest compressions
C. Obtain a 12-lead ECG
D. Administer amiodarone before restarting compressions
Correct Answer: B. Resume CPR beginning with chest compressions
Rationale: After a shock, CPR should resume immediately, beginning with chest
compressions. Even when defibrillation successfully terminates ventricular fibrillation,
the heart may not initially produce effective circulation. An immediate pulse check or
ECG delays perfusion. Antiarrhythmic medication may be indicated later for
refractory rhythms, but it should not postpone the next two-minute cycle of CPR.
Question 10
A defibrillator is being charged while CPR is in progress for ventricular fibrillation.
Which action best minimizes the interruption in chest compressions?
