Advanced Cardiovascular Life Support (ACLS) Exams A & B
2026/2027 – Questions, Answers & Annotated Solutions
EXAM A
SECTION 1 — RECOGNITION & INITIAL MANAGEMENT
Question 1
An adult suddenly collapses in a hospital hallway. What should the rescuer do
first?
A. Obtain an ECG
B. Check responsiveness and assess breathing
C. Establish IV access
D. Administer oxygen
Answer: B
Rationale: Immediate assessment of responsiveness and breathing determines
whether the patient may be in cardiac arrest and whether resuscitation should
begin.
Question 2
An unresponsive adult is not breathing normally and has only occasional gasping.
How should the gasping be interpreted?
A. Normal breathing
B. Anxiety-related hyperventilation
C. Agonal breathing consistent with possible cardiac arrest
D. Obstructive sleep apnea
Answer: C
Rationale: Occasional gasps are not effective normal respirations. Agonal gasping
should prompt an arrest response when other findings support cardiac arrest.
,Question 3
A healthcare professional finds an adult unresponsive and without normal
breathing. What is the most important immediate action?
A. Begin chest compressions
B. Give atropine
C. Obtain a 12-lead ECG
D. Start a maintenance IV
Answer: A
Rationale: For a pulseless adult, high-quality CPR should begin immediately while
the resuscitation team and defibrillator are activated.
Question 4
Which finding most strongly supports cardiac arrest?
A. Slow respirations with a strong pulse
B. Unresponsiveness with abnormal breathing and no definite pulse
C. Chest discomfort with normal consciousness
D. Mild cyanosis with a palpable pulse
Answer: B
Rationale: Unresponsiveness, abnormal or absent breathing, and absence of a
definite pulse are the classic findings prompting cardiac arrest management.
Question 5
How long should a healthcare professional generally take to assess an adult pulse
during an arrest assessment?
A. No more than 10 seconds
B. 20 seconds
C. 30 seconds
D. 60 seconds
,Answer: A
Rationale: A prolonged pulse check delays CPR. If a definite pulse is not identified
promptly, resuscitation should proceed.
Question 6
A patient is unresponsive but has a definite pulse and is breathing inadequately.
What is the priority?
A. Defibrillation
B. Provide ventilatory support
C. Give amiodarone
D. Start chest compressions immediately
Answer: B
Rationale: A pulse is present, so the immediate problem is inadequate
ventilation. Support breathing and reassess continuously.
Question 7
A patient with severe respiratory distress has a pulse but is becoming fatigued.
Which intervention is most appropriate?
A. Ignore the respiratory effort because a pulse is present
B. Support ventilation and oxygenation while treating the cause
C. Administer a defibrillation shock
D. Begin post-arrest cooling
Answer: B
Rationale: Respiratory failure can rapidly progress to cardiac arrest. Ventilatory
and oxygenation support are priorities.
Question 8
, Which clinical situation most commonly requires activation of an emergency
response system?
A. Mild chronic headache
B. Sudden unresponsiveness
C. Stable hypertension
D. Controlled diabetes
Answer: B
Rationale: Sudden unresponsiveness may indicate cardiac arrest, stroke, severe
hypoglycemia, or another life-threatening condition.
Question 9
During an initial assessment, which finding requires immediate attention?
A. Chronic back pain
B. Mild nausea
C. Absent normal breathing
D. Stable heart rate of 80/min
Answer: C
Rationale: Absent or abnormal breathing can indicate cardiac arrest and requires
immediate assessment and intervention.
Question 10
A patient suddenly develops severe dyspnea, cyanosis, and altered mental status.
What is the priority?
A. Delay treatment until laboratory results return
B. Assess airway, breathing, and circulation while activating appropriate
emergency support
C. Give oral fluids
D. Obtain a routine outpatient appointment
Answer: B
2026/2027 – Questions, Answers & Annotated Solutions
EXAM A
SECTION 1 — RECOGNITION & INITIAL MANAGEMENT
Question 1
An adult suddenly collapses in a hospital hallway. What should the rescuer do
first?
A. Obtain an ECG
B. Check responsiveness and assess breathing
C. Establish IV access
D. Administer oxygen
Answer: B
Rationale: Immediate assessment of responsiveness and breathing determines
whether the patient may be in cardiac arrest and whether resuscitation should
begin.
Question 2
An unresponsive adult is not breathing normally and has only occasional gasping.
How should the gasping be interpreted?
A. Normal breathing
B. Anxiety-related hyperventilation
C. Agonal breathing consistent with possible cardiac arrest
D. Obstructive sleep apnea
Answer: C
Rationale: Occasional gasps are not effective normal respirations. Agonal gasping
should prompt an arrest response when other findings support cardiac arrest.
,Question 3
A healthcare professional finds an adult unresponsive and without normal
breathing. What is the most important immediate action?
A. Begin chest compressions
B. Give atropine
C. Obtain a 12-lead ECG
D. Start a maintenance IV
Answer: A
Rationale: For a pulseless adult, high-quality CPR should begin immediately while
the resuscitation team and defibrillator are activated.
Question 4
Which finding most strongly supports cardiac arrest?
A. Slow respirations with a strong pulse
B. Unresponsiveness with abnormal breathing and no definite pulse
C. Chest discomfort with normal consciousness
D. Mild cyanosis with a palpable pulse
Answer: B
Rationale: Unresponsiveness, abnormal or absent breathing, and absence of a
definite pulse are the classic findings prompting cardiac arrest management.
Question 5
How long should a healthcare professional generally take to assess an adult pulse
during an arrest assessment?
A. No more than 10 seconds
B. 20 seconds
C. 30 seconds
D. 60 seconds
,Answer: A
Rationale: A prolonged pulse check delays CPR. If a definite pulse is not identified
promptly, resuscitation should proceed.
Question 6
A patient is unresponsive but has a definite pulse and is breathing inadequately.
What is the priority?
A. Defibrillation
B. Provide ventilatory support
C. Give amiodarone
D. Start chest compressions immediately
Answer: B
Rationale: A pulse is present, so the immediate problem is inadequate
ventilation. Support breathing and reassess continuously.
Question 7
A patient with severe respiratory distress has a pulse but is becoming fatigued.
Which intervention is most appropriate?
A. Ignore the respiratory effort because a pulse is present
B. Support ventilation and oxygenation while treating the cause
C. Administer a defibrillation shock
D. Begin post-arrest cooling
Answer: B
Rationale: Respiratory failure can rapidly progress to cardiac arrest. Ventilatory
and oxygenation support are priorities.
Question 8
, Which clinical situation most commonly requires activation of an emergency
response system?
A. Mild chronic headache
B. Sudden unresponsiveness
C. Stable hypertension
D. Controlled diabetes
Answer: B
Rationale: Sudden unresponsiveness may indicate cardiac arrest, stroke, severe
hypoglycemia, or another life-threatening condition.
Question 9
During an initial assessment, which finding requires immediate attention?
A. Chronic back pain
B. Mild nausea
C. Absent normal breathing
D. Stable heart rate of 80/min
Answer: C
Rationale: Absent or abnormal breathing can indicate cardiac arrest and requires
immediate assessment and intervention.
Question 10
A patient suddenly develops severe dyspnea, cyanosis, and altered mental status.
What is the priority?
A. Delay treatment until laboratory results return
B. Assess airway, breathing, and circulation while activating appropriate
emergency support
C. Give oral fluids
D. Obtain a routine outpatient appointment
Answer: B
