ACLS Advanced Cardiovascular
Life Support Test 2026/2027:
Practice Exam, Quizzes, and Study
Manual
Question 1:
A hospital visitor collapses in the lobby. The patient is unresponsive, is not breathing
normally, and has no detectable carotid pulse. The emergency response system has
already been activated. Which action should the responder perform next?
A. Deliver two rescue breaths before beginning compressions
B. Obtain a 12-lead electrocardiogram
C. Begin high-quality chest compressions immediately
D. Wait for an automated external defibrillator to arrive
Correct Answer: C. Begin high-quality chest compressions immediately
Rationale: Once cardiac arrest is confirmed by unresponsiveness, abnormal or absent
breathing, and absence of a pulse, chest compressions must begin immediately.
Compressions provide limited but essential blood flow to the heart and brain. Rescue
breaths alone do not circulate blood, a 12-lead ECG is not the initial priority, and
waiting for an AED unnecessarily delays lifesaving CPR.
Question 2:
A rescuer finds an adult who is unresponsive and taking occasional gasping breaths.
After activating the emergency response system, which assessment should be
completed before determining whether chest compressions are required?
A. Check the carotid pulse for 5 to 10 seconds
B. Listen for breath sounds for 30 seconds
C. Measure the patient’s blood pressure
D. Apply a pulse oximeter and await a stable reading
Correct Answer: A. Check the carotid pulse for 5 to 10 seconds
Rationale: A pulse check should take no more than 5 to 10 seconds because prolonged
assessment delays chest compressions. Agonal gasps are not normal breathing and
may occur during early cardiac arrest. Blood pressure and pulse oximetry are
unreliable or unobtainable in arrest, while an extended respiratory assessment wastes
critical time without improving the decision to begin CPR.
,Question 3:
A 59-year-old man is found unresponsive on the kitchen floor. He makes slow,
irregular gasping sounds every 15 seconds. Which interpretation of this breathing
pattern is most appropriate?
A. The patient is breathing adequately but requires oxygen
B. The patient is experiencing agonal gasps associated with cardiac arrest
C. The patient is hyperventilating because of metabolic acidosis
D. The patient has an intact airway and should be placed in recovery position
Correct Answer: B. The patient is experiencing agonal gasps associated with
cardiac arrest
Rationale: Agonal gasps are abnormal, ineffective breaths that may occur during the
first minutes of sudden cardiac arrest. They must not be mistaken for normal
breathing. Supplemental oxygen without circulation is inadequate, hyperventilation
consists of rapid breathing rather than occasional gasps, and the recovery position is
inappropriate when cardiac arrest is suspected and a pulse must be assessed promptly.
Question 4:
Which combination best represents effective adult chest-compression technique
during cardiopulmonary resuscitation?
A. A rate of 60 to 80/min with a depth of approximately 1 inch
B. A rate of at least 100/min with a depth of at least 2 inches
C. A rate of 80 to 90/min with progressively increasing depth
D. A rate above 150/min with a depth limited to 1.5 inches
Correct Answer: B. A rate of at least 100/min with a depth of at least 2 inches
Rationale: Effective adult CPR requires rapid, sufficiently deep compressions to
generate forward blood flow. According to the supplied material, compressions
should be delivered at a rate of at least 100/min and a depth of at least 2 inches.
Slower or shallower compressions produce inadequate perfusion, while excessively
rapid compressions may prevent full recoil and reduce ventricular filling.
Question 5:
During a resuscitation, the team leader notices that the compressor keeps leaning on
the patient’s chest between compressions. Why should the team leader immediately
correct this technique?
A. Leaning increases the risk of gastric inflation
B. Leaning prevents adequate chest recoil and reduces venous return
,C. Leaning causes the defibrillator to misinterpret the rhythm
D. Leaning increases oxygen consumption by the myocardium
Correct Answer: B. Leaning prevents adequate chest recoil and reduces venous
return
Rationale: Complete chest recoil allows negative intrathoracic pressure to develop,
promoting venous return and refilling of the heart before the next compression.
Continuous pressure on the chest limits recoil and reduces cardiac output. Gastric
inflation is primarily associated with excessive ventilation, and leaning does not
directly interfere with rhythm interpretation or significantly increase myocardial
oxygen consumption.
Question 6:
A resuscitation has continued for several minutes, and the current compressor’s depth
is becoming inconsistent. Which team action is most appropriate?
A. Increase ventilation frequency to compensate
B. Switch compressors approximately every 2 minutes
C. Pause compressions until the provider recovers
D. Continue with the same compressor to maintain continuity
Correct Answer: B. Switch compressors approximately every 2 minutes
Rationale: Chest-compression quality decreases as rescuers become fatigued, often
without their awareness. Switching compressors approximately every 2 minutes,
ideally during a planned rhythm check, helps maintain adequate rate and depth.
Increasing ventilation does not compensate for poor perfusion, an extended pause is
harmful, and keeping a fatigued compressor in place reduces CPR effectiveness.
Question 7:
What is the maximum recommended duration for a planned interruption in chest
compressions during cardiac arrest management?
A. 5 seconds
B. 10 seconds
C. 20 seconds
D. 30 seconds
Correct Answer: B. 10 seconds
Rationale: Planned pauses for rhythm assessment, pulse checks, or shock delivery
should be limited to 10 seconds or less. Longer interruptions rapidly decrease
coronary and cerebral perfusion pressure and may reduce the likelihood of successful
defibrillation. Although even shorter pauses are desirable, 10 seconds is the stated
maximum. Pauses of 20 or 30 seconds are excessively prolonged.
, Question 8:
An automated external defibrillator is attached to a pulseless patient but fails to
analyze the rhythm promptly. What should the rescuers do while troubleshooting the
device?
A. Continue or immediately resume chest compressions
B. Perform repeated pulse checks
C. Provide rescue breaths without compressions
D. Remove the pads and wait for a manual defibrillator
Correct Answer: A. Continue or immediately resume chest compressions
Rationale: When an AED is delayed or unable to analyze, rescuers should minimize
the period without circulation by continuing chest compressions. Repeated pulse
checks create unnecessary pauses, ventilations alone do not produce blood flow, and
waiting for different equipment delays treatment. CPR should continue until the AED
is ready to analyze or deliver a shock.
Question 9:
Which advantage is associated with hands-free adhesive defibrillation pads compared
with handheld paddles?
A. They eliminate the need to confirm cardiac arrest
B. They allow faster shock delivery with less direct rescuer contact
C. They guarantee successful conversion of ventricular fibrillation
D. They permit shocks to be delivered during active chest compressions
Correct Answer: B. They allow faster shock delivery with less direct rescuer
contact
Rationale: Hands-free pads can be applied in advance and permit rhythm analysis and
shock delivery without a rescuer holding paddles against the chest. This may speed
defibrillation and improve safety. They do not eliminate assessment, guarantee
rhythm conversion, or allow compressions to continue during shock delivery; all
personnel must remain clear when the shock is administered.
Question 10:
A patient in ventricular fibrillation is ready for defibrillation. Oxygen is being
delivered by a bag-mask device. Which safety action is most important immediately
before shock delivery?
A. Increase oxygen flow to the maximum setting
B. Ensure oxygen is not blowing across the patient’s chest
Life Support Test 2026/2027:
Practice Exam, Quizzes, and Study
Manual
Question 1:
A hospital visitor collapses in the lobby. The patient is unresponsive, is not breathing
normally, and has no detectable carotid pulse. The emergency response system has
already been activated. Which action should the responder perform next?
A. Deliver two rescue breaths before beginning compressions
B. Obtain a 12-lead electrocardiogram
C. Begin high-quality chest compressions immediately
D. Wait for an automated external defibrillator to arrive
Correct Answer: C. Begin high-quality chest compressions immediately
Rationale: Once cardiac arrest is confirmed by unresponsiveness, abnormal or absent
breathing, and absence of a pulse, chest compressions must begin immediately.
Compressions provide limited but essential blood flow to the heart and brain. Rescue
breaths alone do not circulate blood, a 12-lead ECG is not the initial priority, and
waiting for an AED unnecessarily delays lifesaving CPR.
Question 2:
A rescuer finds an adult who is unresponsive and taking occasional gasping breaths.
After activating the emergency response system, which assessment should be
completed before determining whether chest compressions are required?
A. Check the carotid pulse for 5 to 10 seconds
B. Listen for breath sounds for 30 seconds
C. Measure the patient’s blood pressure
D. Apply a pulse oximeter and await a stable reading
Correct Answer: A. Check the carotid pulse for 5 to 10 seconds
Rationale: A pulse check should take no more than 5 to 10 seconds because prolonged
assessment delays chest compressions. Agonal gasps are not normal breathing and
may occur during early cardiac arrest. Blood pressure and pulse oximetry are
unreliable or unobtainable in arrest, while an extended respiratory assessment wastes
critical time without improving the decision to begin CPR.
,Question 3:
A 59-year-old man is found unresponsive on the kitchen floor. He makes slow,
irregular gasping sounds every 15 seconds. Which interpretation of this breathing
pattern is most appropriate?
A. The patient is breathing adequately but requires oxygen
B. The patient is experiencing agonal gasps associated with cardiac arrest
C. The patient is hyperventilating because of metabolic acidosis
D. The patient has an intact airway and should be placed in recovery position
Correct Answer: B. The patient is experiencing agonal gasps associated with
cardiac arrest
Rationale: Agonal gasps are abnormal, ineffective breaths that may occur during the
first minutes of sudden cardiac arrest. They must not be mistaken for normal
breathing. Supplemental oxygen without circulation is inadequate, hyperventilation
consists of rapid breathing rather than occasional gasps, and the recovery position is
inappropriate when cardiac arrest is suspected and a pulse must be assessed promptly.
Question 4:
Which combination best represents effective adult chest-compression technique
during cardiopulmonary resuscitation?
A. A rate of 60 to 80/min with a depth of approximately 1 inch
B. A rate of at least 100/min with a depth of at least 2 inches
C. A rate of 80 to 90/min with progressively increasing depth
D. A rate above 150/min with a depth limited to 1.5 inches
Correct Answer: B. A rate of at least 100/min with a depth of at least 2 inches
Rationale: Effective adult CPR requires rapid, sufficiently deep compressions to
generate forward blood flow. According to the supplied material, compressions
should be delivered at a rate of at least 100/min and a depth of at least 2 inches.
Slower or shallower compressions produce inadequate perfusion, while excessively
rapid compressions may prevent full recoil and reduce ventricular filling.
Question 5:
During a resuscitation, the team leader notices that the compressor keeps leaning on
the patient’s chest between compressions. Why should the team leader immediately
correct this technique?
A. Leaning increases the risk of gastric inflation
B. Leaning prevents adequate chest recoil and reduces venous return
,C. Leaning causes the defibrillator to misinterpret the rhythm
D. Leaning increases oxygen consumption by the myocardium
Correct Answer: B. Leaning prevents adequate chest recoil and reduces venous
return
Rationale: Complete chest recoil allows negative intrathoracic pressure to develop,
promoting venous return and refilling of the heart before the next compression.
Continuous pressure on the chest limits recoil and reduces cardiac output. Gastric
inflation is primarily associated with excessive ventilation, and leaning does not
directly interfere with rhythm interpretation or significantly increase myocardial
oxygen consumption.
Question 6:
A resuscitation has continued for several minutes, and the current compressor’s depth
is becoming inconsistent. Which team action is most appropriate?
A. Increase ventilation frequency to compensate
B. Switch compressors approximately every 2 minutes
C. Pause compressions until the provider recovers
D. Continue with the same compressor to maintain continuity
Correct Answer: B. Switch compressors approximately every 2 minutes
Rationale: Chest-compression quality decreases as rescuers become fatigued, often
without their awareness. Switching compressors approximately every 2 minutes,
ideally during a planned rhythm check, helps maintain adequate rate and depth.
Increasing ventilation does not compensate for poor perfusion, an extended pause is
harmful, and keeping a fatigued compressor in place reduces CPR effectiveness.
Question 7:
What is the maximum recommended duration for a planned interruption in chest
compressions during cardiac arrest management?
A. 5 seconds
B. 10 seconds
C. 20 seconds
D. 30 seconds
Correct Answer: B. 10 seconds
Rationale: Planned pauses for rhythm assessment, pulse checks, or shock delivery
should be limited to 10 seconds or less. Longer interruptions rapidly decrease
coronary and cerebral perfusion pressure and may reduce the likelihood of successful
defibrillation. Although even shorter pauses are desirable, 10 seconds is the stated
maximum. Pauses of 20 or 30 seconds are excessively prolonged.
, Question 8:
An automated external defibrillator is attached to a pulseless patient but fails to
analyze the rhythm promptly. What should the rescuers do while troubleshooting the
device?
A. Continue or immediately resume chest compressions
B. Perform repeated pulse checks
C. Provide rescue breaths without compressions
D. Remove the pads and wait for a manual defibrillator
Correct Answer: A. Continue or immediately resume chest compressions
Rationale: When an AED is delayed or unable to analyze, rescuers should minimize
the period without circulation by continuing chest compressions. Repeated pulse
checks create unnecessary pauses, ventilations alone do not produce blood flow, and
waiting for different equipment delays treatment. CPR should continue until the AED
is ready to analyze or deliver a shock.
Question 9:
Which advantage is associated with hands-free adhesive defibrillation pads compared
with handheld paddles?
A. They eliminate the need to confirm cardiac arrest
B. They allow faster shock delivery with less direct rescuer contact
C. They guarantee successful conversion of ventricular fibrillation
D. They permit shocks to be delivered during active chest compressions
Correct Answer: B. They allow faster shock delivery with less direct rescuer
contact
Rationale: Hands-free pads can be applied in advance and permit rhythm analysis and
shock delivery without a rescuer holding paddles against the chest. This may speed
defibrillation and improve safety. They do not eliminate assessment, guarantee
rhythm conversion, or allow compressions to continue during shock delivery; all
personnel must remain clear when the shock is administered.
Question 10:
A patient in ventricular fibrillation is ready for defibrillation. Oxygen is being
delivered by a bag-mask device. Which safety action is most important immediately
before shock delivery?
A. Increase oxygen flow to the maximum setting
B. Ensure oxygen is not blowing across the patient’s chest
