ACLS Provider Exam Version A 2026/2027 – American
Heart Association | Detailed Questions & Verified
Answers with Rationales
SECTION 1 — INITIAL ASSESSMENT & HIGH-QUALITY CPR
1. A healthcare professional finds an adult who is unresponsive and not
breathing normally. What is the most appropriate immediate action?
A. Obtain a 12-lead ECG
B. Activate the emergency response system and assess for cardiac arrest
C. Establish IV access
D. Administer oxygen for 5 minutes
Answer: B
Rationale: An unresponsive adult who is not breathing normally should be
presumed to be in cardiac arrest until proven otherwise. Rapid activation of the
emergency response system and initiation of resuscitation are priorities.
2. Which finding is most consistent with cardiac arrest?
A. Unresponsiveness with absent or abnormal breathing
B. Respiratory rate of 18/min
C. Blood pressure of 100/70 mm Hg
D. Heart rate of 58/min
Answer: A
Rationale: Cardiac arrest should be recognized rapidly when a person is
unresponsive and has absent or abnormal breathing, including agonal gasping.
,3. What is the recommended adult chest-compression rate?
A. 60–80/min
B. 80–90/min
C. 100–120/min
D. 130–150/min
Answer: C
Rationale: High-quality adult CPR requires a compression rate of 100–120/min.
Rates that are too slow or too fast can reduce effective perfusion.
4. Approximately how deep should adult chest compressions be?
A. 1 inch
B. 1.5 inches
C. 2 inches, while avoiding excessive depth
D. 3.5 inches
Answer: C
Rationale: Adult compressions should be approximately 5 cm (2 inches) deep
while avoiding excessive compression depth.
5. Why is complete chest recoil important?
A. It reduces oxygen consumption
B. It permits cardiac filling between compressions
C. It prevents defibrillation
D. It increases airway resistance
Answer: B
Rationale: Complete recoil permits venous return and cardiac filling. Leaning on
the chest between compressions can reduce coronary and cerebral perfusion.
,6. What is the compression-to-ventilation ratio for adult CPR without an
advanced airway?
A. 15:2
B. 20:2
C. 30:2
D. 50:2
Answer: C
Rationale: Adult CPR without an advanced airway uses 30 compressions followed
by 2 breaths.
7. Which action best demonstrates high-quality CPR?
A. Frequent prolonged pauses
B. Compression rate of 70/min
C. Complete recoil and minimal interruptions
D. Hyperventilation
Answer: C
Rationale: High-quality CPR requires an appropriate compression rate and depth,
full recoil, effective ventilation, and minimal interruptions.
8. During prolonged CPR, when should the compressor generally be switched?
A. Every 30 seconds
B. About every 2 minutes
C. Every 10 minutes
D. Only after ROSC
Answer: B
Rationale: Compressors should generally rotate about every 2 minutes, or sooner
if fatigue affects compression quality.
, 9. A patient is making occasional gasping sounds but is unresponsive. How
should the gasping be interpreted?
A. Normal breathing
B. Sleep-related breathing
C. Abnormal/agonal breathing
D. Effective ventilation
Answer: C
Rationale: Agonal gasps are abnormal and can occur during cardiac arrest. They
should not delay CPR.
10. What should occur while the defibrillator is being prepared?
A. Stop CPR
B. Continue high-quality CPR
C. Perform a complete physical examination
D. Obtain a chest x-ray
Answer: B
Rationale: CPR should continue while the defibrillator is prepared, with
interruptions limited to necessary rhythm analysis and shock delivery.
11. What should rescuers do during AED rhythm analysis?
A. Continue compressions
B. Touch the patient
C. Ensure everyone is clear of the patient
D. Begin IV medication
Answer: C
Rationale: Movement can interfere with rhythm analysis and creates a safety
hazard. Everyone should be clear during analysis.
Heart Association | Detailed Questions & Verified
Answers with Rationales
SECTION 1 — INITIAL ASSESSMENT & HIGH-QUALITY CPR
1. A healthcare professional finds an adult who is unresponsive and not
breathing normally. What is the most appropriate immediate action?
A. Obtain a 12-lead ECG
B. Activate the emergency response system and assess for cardiac arrest
C. Establish IV access
D. Administer oxygen for 5 minutes
Answer: B
Rationale: An unresponsive adult who is not breathing normally should be
presumed to be in cardiac arrest until proven otherwise. Rapid activation of the
emergency response system and initiation of resuscitation are priorities.
2. Which finding is most consistent with cardiac arrest?
A. Unresponsiveness with absent or abnormal breathing
B. Respiratory rate of 18/min
C. Blood pressure of 100/70 mm Hg
D. Heart rate of 58/min
Answer: A
Rationale: Cardiac arrest should be recognized rapidly when a person is
unresponsive and has absent or abnormal breathing, including agonal gasping.
,3. What is the recommended adult chest-compression rate?
A. 60–80/min
B. 80–90/min
C. 100–120/min
D. 130–150/min
Answer: C
Rationale: High-quality adult CPR requires a compression rate of 100–120/min.
Rates that are too slow or too fast can reduce effective perfusion.
4. Approximately how deep should adult chest compressions be?
A. 1 inch
B. 1.5 inches
C. 2 inches, while avoiding excessive depth
D. 3.5 inches
Answer: C
Rationale: Adult compressions should be approximately 5 cm (2 inches) deep
while avoiding excessive compression depth.
5. Why is complete chest recoil important?
A. It reduces oxygen consumption
B. It permits cardiac filling between compressions
C. It prevents defibrillation
D. It increases airway resistance
Answer: B
Rationale: Complete recoil permits venous return and cardiac filling. Leaning on
the chest between compressions can reduce coronary and cerebral perfusion.
,6. What is the compression-to-ventilation ratio for adult CPR without an
advanced airway?
A. 15:2
B. 20:2
C. 30:2
D. 50:2
Answer: C
Rationale: Adult CPR without an advanced airway uses 30 compressions followed
by 2 breaths.
7. Which action best demonstrates high-quality CPR?
A. Frequent prolonged pauses
B. Compression rate of 70/min
C. Complete recoil and minimal interruptions
D. Hyperventilation
Answer: C
Rationale: High-quality CPR requires an appropriate compression rate and depth,
full recoil, effective ventilation, and minimal interruptions.
8. During prolonged CPR, when should the compressor generally be switched?
A. Every 30 seconds
B. About every 2 minutes
C. Every 10 minutes
D. Only after ROSC
Answer: B
Rationale: Compressors should generally rotate about every 2 minutes, or sooner
if fatigue affects compression quality.
, 9. A patient is making occasional gasping sounds but is unresponsive. How
should the gasping be interpreted?
A. Normal breathing
B. Sleep-related breathing
C. Abnormal/agonal breathing
D. Effective ventilation
Answer: C
Rationale: Agonal gasps are abnormal and can occur during cardiac arrest. They
should not delay CPR.
10. What should occur while the defibrillator is being prepared?
A. Stop CPR
B. Continue high-quality CPR
C. Perform a complete physical examination
D. Obtain a chest x-ray
Answer: B
Rationale: CPR should continue while the defibrillator is prepared, with
interruptions limited to necessary rhythm analysis and shock delivery.
11. What should rescuers do during AED rhythm analysis?
A. Continue compressions
B. Touch the patient
C. Ensure everyone is clear of the patient
D. Begin IV medication
Answer: C
Rationale: Movement can interfere with rhythm analysis and creates a safety
hazard. Everyone should be clear during analysis.
