ACLS Final Exam | 2025/2026 Exam – 50
Questions and Correct Answers
SECTION I: BLS & High-Quality CPR Fundamentals
1. A 68-year-old man collapses in the emergency department waiting room. You
are the first responder. After ensuring scene safety and confirming
unresponsiveness, what is your immediate next action?
A. Begin chest compressions immediately
B. Check for a carotid pulse for no more than 10 seconds
C. Activate the emergency response system and request a defibrillator
D. Deliver two rescue breaths
Correct Answer: C
Rationale: After confirming unresponsiveness, the first step is to activate the
emergency response system and request a defibrillator. This ensures additional
resources are en route before initiating CPR. The 2025 AHA guidelines emphasize
that early activation and defibrillator retrieval are critical components of the BLS
chain of survival. Pulse checks follow activation, not precede it.
2. During high-quality CPR on an adult, what is the recommended compression
rate?
A. 60–80 compressions per minute
B. 80–100 compressions per minute
C. 100–120 compressions per minute
D. 120–140 compressions per minute
Correct Answer: C
Rationale: High-quality CPR requires a compression rate of 100–120
compressions per minute. This rate optimizes coronary perfusion pressure and
,cardiac output. Rates below 100 reduce cardiac output; rates above 120 reduce
venous return and coronary perfusion.
3. What is the recommended compression depth for adult CPR according to the
2025 AHA guidelines?
A. At least 1 inch (2.5 cm)
B. At least 1.5 inches (4 cm)
C. At least 2 inches (5 cm), not exceeding 2.4 inches (6 cm)
D. At least 3 inches (7.5 cm)
Correct Answer: C
Rationale: The AHA recommends a compression depth of at least 2 inches (5
cm) but no more than 2.4 inches (6 cm) for adult CPR. Adequate depth ensures
sufficient blood flow to vital organs, while excessive depth increases the risk of rib
fractures and internal organ injury. Current guidelines specify a depth of at least 5
cm for adults.
4. A resuscitation team is performing CPR on an adult patient in cardiac arrest.
Which of the following represents the maximum allowable interruption in chest
compressions?
A. 5 seconds
B. 10 seconds
C. 15 seconds
D. 20 seconds
Correct Answer: B
Rationale: Interruptions in chest compressions should be limited to no longer
than 10 seconds. When chest compressions stop, blood flow to the brain and
heart ceases, leading to rapid depletion of oxygen and metabolic substrates.
,Minimizing interruptions preserves coronary perfusion pressure and improves the
likelihood of ROSC.
5. Which of the following are components of high-quality CPR? (Select all that
apply.)
A. Compression rate of 100–120/min
B. Compression depth of at least 2 inches (5 cm)
C. Full chest recoil between compressions
D. Interruptions limited to less than 10 seconds
E. Hyperventilation to maximize oxygenation
F. Avoiding excessive ventilation
Correct Answers: A, B, C, D, F
Rationale: High-quality CPR includes: rate of 100–120/min, depth of at least 2
inches (5 cm) but not exceeding 2.4 inches, full chest recoil to allow venous
return, minimizing interruptions to less than 10 seconds, and avoiding excessive
ventilation. Hyperventilation increases intrathoracic pressure, decreases venous
return, and reduces coronary perfusion pressure—it is detrimental and should be
avoided.
6. A patient in cardiac arrest has an advanced airway in place. How often should
ventilations be delivered?
A. Every 3 seconds (20 breaths per minute)
B. Every 6 seconds (10 breaths per minute)
C. Every 10 seconds (6 breaths per minute)
D. Every 12 seconds (5 breaths per minute)
Correct Answer: B
Rationale: Once an advanced airway is placed during cardiac arrest,
ventilations should be delivered at a rate of 1 breath every 6 seconds (10 breaths
, per minute). Chest compressions continue continuously without pauses for
ventilation. This rate avoids hyperventilation while maintaining adequate
oxygenation.
7. What is the recommended compression-to-ventilation ratio for a single
rescuer performing CPR on an adult without an advanced airway?
A. 15:2
B. 30:2
C. 30:1
D. 100:2
Correct Answer: B
Rationale: The compression-to-ventilation ratio for a single rescuer
performing adult CPR is 30:2. This ratio maximizes the number of compressions
while providing adequate ventilation. For two-rescuer adult CPR, the ratio remains
30:2 until an advanced airway is placed.
8. During CPR, which of the following best describes “chest compression
fraction” (CCF)?
A. The number of compressions delivered per minute
B. The proportion of time spent performing compressions during cardiac arrest
C. The depth of each compression measured in centimeters
D. The force required to achieve adequate chest recoil
Correct Answer: B
Rationale: Chest compression fraction (CCF) is the proportion of resuscitation
time during which chest compressions are performed. The 2025 AHA guidelines
emphasize measuring and reporting CCF as a quality metric. A CCF of at least 60%
is recommended, with higher values associated with improved outcomes. CCF is
calculated as compression time divided by total resuscitation time.
Questions and Correct Answers
SECTION I: BLS & High-Quality CPR Fundamentals
1. A 68-year-old man collapses in the emergency department waiting room. You
are the first responder. After ensuring scene safety and confirming
unresponsiveness, what is your immediate next action?
A. Begin chest compressions immediately
B. Check for a carotid pulse for no more than 10 seconds
C. Activate the emergency response system and request a defibrillator
D. Deliver two rescue breaths
Correct Answer: C
Rationale: After confirming unresponsiveness, the first step is to activate the
emergency response system and request a defibrillator. This ensures additional
resources are en route before initiating CPR. The 2025 AHA guidelines emphasize
that early activation and defibrillator retrieval are critical components of the BLS
chain of survival. Pulse checks follow activation, not precede it.
2. During high-quality CPR on an adult, what is the recommended compression
rate?
A. 60–80 compressions per minute
B. 80–100 compressions per minute
C. 100–120 compressions per minute
D. 120–140 compressions per minute
Correct Answer: C
Rationale: High-quality CPR requires a compression rate of 100–120
compressions per minute. This rate optimizes coronary perfusion pressure and
,cardiac output. Rates below 100 reduce cardiac output; rates above 120 reduce
venous return and coronary perfusion.
3. What is the recommended compression depth for adult CPR according to the
2025 AHA guidelines?
A. At least 1 inch (2.5 cm)
B. At least 1.5 inches (4 cm)
C. At least 2 inches (5 cm), not exceeding 2.4 inches (6 cm)
D. At least 3 inches (7.5 cm)
Correct Answer: C
Rationale: The AHA recommends a compression depth of at least 2 inches (5
cm) but no more than 2.4 inches (6 cm) for adult CPR. Adequate depth ensures
sufficient blood flow to vital organs, while excessive depth increases the risk of rib
fractures and internal organ injury. Current guidelines specify a depth of at least 5
cm for adults.
4. A resuscitation team is performing CPR on an adult patient in cardiac arrest.
Which of the following represents the maximum allowable interruption in chest
compressions?
A. 5 seconds
B. 10 seconds
C. 15 seconds
D. 20 seconds
Correct Answer: B
Rationale: Interruptions in chest compressions should be limited to no longer
than 10 seconds. When chest compressions stop, blood flow to the brain and
heart ceases, leading to rapid depletion of oxygen and metabolic substrates.
,Minimizing interruptions preserves coronary perfusion pressure and improves the
likelihood of ROSC.
5. Which of the following are components of high-quality CPR? (Select all that
apply.)
A. Compression rate of 100–120/min
B. Compression depth of at least 2 inches (5 cm)
C. Full chest recoil between compressions
D. Interruptions limited to less than 10 seconds
E. Hyperventilation to maximize oxygenation
F. Avoiding excessive ventilation
Correct Answers: A, B, C, D, F
Rationale: High-quality CPR includes: rate of 100–120/min, depth of at least 2
inches (5 cm) but not exceeding 2.4 inches, full chest recoil to allow venous
return, minimizing interruptions to less than 10 seconds, and avoiding excessive
ventilation. Hyperventilation increases intrathoracic pressure, decreases venous
return, and reduces coronary perfusion pressure—it is detrimental and should be
avoided.
6. A patient in cardiac arrest has an advanced airway in place. How often should
ventilations be delivered?
A. Every 3 seconds (20 breaths per minute)
B. Every 6 seconds (10 breaths per minute)
C. Every 10 seconds (6 breaths per minute)
D. Every 12 seconds (5 breaths per minute)
Correct Answer: B
Rationale: Once an advanced airway is placed during cardiac arrest,
ventilations should be delivered at a rate of 1 breath every 6 seconds (10 breaths
, per minute). Chest compressions continue continuously without pauses for
ventilation. This rate avoids hyperventilation while maintaining adequate
oxygenation.
7. What is the recommended compression-to-ventilation ratio for a single
rescuer performing CPR on an adult without an advanced airway?
A. 15:2
B. 30:2
C. 30:1
D. 100:2
Correct Answer: B
Rationale: The compression-to-ventilation ratio for a single rescuer
performing adult CPR is 30:2. This ratio maximizes the number of compressions
while providing adequate ventilation. For two-rescuer adult CPR, the ratio remains
30:2 until an advanced airway is placed.
8. During CPR, which of the following best describes “chest compression
fraction” (CCF)?
A. The number of compressions delivered per minute
B. The proportion of time spent performing compressions during cardiac arrest
C. The depth of each compression measured in centimeters
D. The force required to achieve adequate chest recoil
Correct Answer: B
Rationale: Chest compression fraction (CCF) is the proportion of resuscitation
time during which chest compressions are performed. The 2025 AHA guidelines
emphasize measuring and reporting CCF as a quality metric. A CCF of at least 60%
is recommended, with higher values associated with improved outcomes. CCF is
calculated as compression time divided by total resuscitation time.
