ACLS Final Exam | 2026/2027 Actual Exam
2026/2027 | Complete Exam-Style Questions with
Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
BLS & High-Quality CPR Foundations
Q1: During high-quality adult CPR, chest compressions should be delivered to which depth?
A. At least 1.5 inches (4 cm)
B. At least 2 inches (5 cm), while avoiding compressions deeper than 2.4 inches (6 cm)
[CORRECT]
C. At least 3 inches (7.5 cm) to guarantee adequate perfusion
D. Any depth that is comfortable for the rescuer
Correct Answer: B
Rationale: The best answer is B — push at least 2 inches (5 cm) and avoid going deeper than
about 2.4 inches (6 cm), since excessive depth increases injury risk without improving
outcomes. This matches the principle that compression quality is measured, not guessed.
Q2: You are running a code and notice the compressor's rate has drifted down to about
90/min during the second minute of the cycle. What rate should you coach the team back
to?
A. 60–80/min
B. 80–100/min
C. 100–120/min [CORRECT]
D. As fast as the compressor can push
Correct Answer: C
Rationale: The ACLS key here is the 100–120/min window — slower rates reduce coronary
and cerebral perfusion, and pushing faster than 120 doesn't allow the heart to fill between
compressions. Coach the team back into that range immediately.
Q3: A code review shows that rhythm and pulse checks routinely take 20–30 seconds. What
is the most important consequence of this practice?
A. It improves the accuracy of rhythm interpretation
B. It lowers the compression fraction below the recommended minimum; pauses should be
kept under 10 seconds [CORRECT]
C. It requires higher defibrillation energy on subsequent shocks
D. It reduces the risk of rescuer fatigue
Correct Answer: B
Rationale: This choice is correct because every second off the chest lowers your
compression fraction, and the guideline minimum is above 60% with 80% as the goal. Keep
any pause under 10 seconds — know your rhythm before you stop compressions.
, Q4: Two rescuers are performing CPR on an adult with no advanced airway in place. What
compression-to-ventilation ratio should they use?
A. 30:2 [CORRECT]
B. 15:2
C. 10:1
D. Continuous compressions with 1 breath every 6 seconds
Correct Answer: A
Rationale: The best answer is A — adult CPR at any rescuer count uses 30:2 until an
advanced airway is placed. The continuous 1-breath-every-6-seconds approach only applies
once an advanced airway is secured.
Q5: A witnessed adult collapse occurs in your unit. CPR is in progress, the pads are applied,
and the AED announces "shock advised." What should you do next?
A. Recheck the carotid pulse before shocking
B. Give two rescue breaths and then shock
C. Continue CPR for another 2 minutes before allowing the shock
D. Clear the patient, deliver the shock, and immediately resume compressions [CORRECT]
Correct Answer: D
Rationale: The ACLS key here is that a shockable rhythm gets shocked as soon as the
machine advises it, and compressions restart the instant the shock is delivered. Stopping to
recheck a pulse or squeeze in breaths only wastes perfusion time.
Q6: During a prolonged resuscitation, when should the compressor be switched?
A. Every 5 cycles or about every 2 minutes, ideally during a rhythm check, with the switch
taking less than 10 seconds [CORRECT]
B. Only when the compressor says his arms are tired
C. After each individual compression cycle of 30
D. Never — consistency is more important than fatigue
Correct Answer: A
Rationale: This aligns with the principle that compression quality degrades before the
rescuer feels fatigued, so planned switches about every 2 minutes keep depth and rate
consistent. Coordinate the swap during a rhythm check so the pause stays under 10
seconds.
Q7: A compressor is observed leaning on the patient's chest between compressions. Why
does your team leader correct this immediately?
A. Leaning causes the rhythm to convert on the monitor
B. Full chest recoil allows venous return and cardiac filling; leaning reduces preload and
coronary perfusion pressure [CORRECT]
C. Leaning interferes only with the AED pads
D. Leaning increases the risk of gastric inflation
Correct Answer: B
Rationale: This choice is correct because the recoil phase is when the heart refills — leaning
on the sternum effectively eliminates that refill and drops coronary perfusion pressure.
Remind the compressor to come completely off the chest between compressions.
2026/2027 | Complete Exam-Style Questions with
Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
BLS & High-Quality CPR Foundations
Q1: During high-quality adult CPR, chest compressions should be delivered to which depth?
A. At least 1.5 inches (4 cm)
B. At least 2 inches (5 cm), while avoiding compressions deeper than 2.4 inches (6 cm)
[CORRECT]
C. At least 3 inches (7.5 cm) to guarantee adequate perfusion
D. Any depth that is comfortable for the rescuer
Correct Answer: B
Rationale: The best answer is B — push at least 2 inches (5 cm) and avoid going deeper than
about 2.4 inches (6 cm), since excessive depth increases injury risk without improving
outcomes. This matches the principle that compression quality is measured, not guessed.
Q2: You are running a code and notice the compressor's rate has drifted down to about
90/min during the second minute of the cycle. What rate should you coach the team back
to?
A. 60–80/min
B. 80–100/min
C. 100–120/min [CORRECT]
D. As fast as the compressor can push
Correct Answer: C
Rationale: The ACLS key here is the 100–120/min window — slower rates reduce coronary
and cerebral perfusion, and pushing faster than 120 doesn't allow the heart to fill between
compressions. Coach the team back into that range immediately.
Q3: A code review shows that rhythm and pulse checks routinely take 20–30 seconds. What
is the most important consequence of this practice?
A. It improves the accuracy of rhythm interpretation
B. It lowers the compression fraction below the recommended minimum; pauses should be
kept under 10 seconds [CORRECT]
C. It requires higher defibrillation energy on subsequent shocks
D. It reduces the risk of rescuer fatigue
Correct Answer: B
Rationale: This choice is correct because every second off the chest lowers your
compression fraction, and the guideline minimum is above 60% with 80% as the goal. Keep
any pause under 10 seconds — know your rhythm before you stop compressions.
, Q4: Two rescuers are performing CPR on an adult with no advanced airway in place. What
compression-to-ventilation ratio should they use?
A. 30:2 [CORRECT]
B. 15:2
C. 10:1
D. Continuous compressions with 1 breath every 6 seconds
Correct Answer: A
Rationale: The best answer is A — adult CPR at any rescuer count uses 30:2 until an
advanced airway is placed. The continuous 1-breath-every-6-seconds approach only applies
once an advanced airway is secured.
Q5: A witnessed adult collapse occurs in your unit. CPR is in progress, the pads are applied,
and the AED announces "shock advised." What should you do next?
A. Recheck the carotid pulse before shocking
B. Give two rescue breaths and then shock
C. Continue CPR for another 2 minutes before allowing the shock
D. Clear the patient, deliver the shock, and immediately resume compressions [CORRECT]
Correct Answer: D
Rationale: The ACLS key here is that a shockable rhythm gets shocked as soon as the
machine advises it, and compressions restart the instant the shock is delivered. Stopping to
recheck a pulse or squeeze in breaths only wastes perfusion time.
Q6: During a prolonged resuscitation, when should the compressor be switched?
A. Every 5 cycles or about every 2 minutes, ideally during a rhythm check, with the switch
taking less than 10 seconds [CORRECT]
B. Only when the compressor says his arms are tired
C. After each individual compression cycle of 30
D. Never — consistency is more important than fatigue
Correct Answer: A
Rationale: This aligns with the principle that compression quality degrades before the
rescuer feels fatigued, so planned switches about every 2 minutes keep depth and rate
consistent. Coordinate the swap during a rhythm check so the pause stays under 10
seconds.
Q7: A compressor is observed leaning on the patient's chest between compressions. Why
does your team leader correct this immediately?
A. Leaning causes the rhythm to convert on the monitor
B. Full chest recoil allows venous return and cardiac filling; leaning reduces preload and
coronary perfusion pressure [CORRECT]
C. Leaning interferes only with the AED pads
D. Leaning increases the risk of gastric inflation
Correct Answer: B
Rationale: This choice is correct because the recoil phase is when the heart refills — leaning
on the sternum effectively eliminates that refill and drops coronary perfusion pressure.
Remind the compressor to come completely off the chest between compressions.
