AHA ACLS Post Test 2026/2027 | American Heart Association –
Questions & Verified Answers with Detailed Rationales
Question 1
You find an unresponsive adult patient. You shout for help, check for breathing,
and find no normal breathing but a faint pulse. What is your next immediate
action?
A) Begin cycles of 30 chest compressions and 2 breaths.
B) Provide rescue breaths at a rate of 1 breath every 6 seconds.
C) Deliver a rapid shock using an Automated External Defibrillator (AED).
D) Establish immediate intraosseous (IO) access.
Correct Answer: B) Provide rescue breaths at a rate of 1 breath every 6 seconds.
Detailed Rationale: According to the latest AHA ACLS guidelines, if an
unresponsive patient has a pulse but is not breathing normally (respiratory
arrest), the provider must deliver rescue breathing. The proper adult rate is 1
breath every 6 seconds (approximately 10 breaths per minute). Chest
compressions are not indicated because a pulse is present, and an AED is only
used for cardiac arrest.
Question 2
During a resuscitation attempt, your team is performing chest compressions.
What is the correct compression rate and depth for an adult patient?
A) 80 to 100/min; depth of at least 1.5 inches
B) 100 to 120/min; depth of 2 to 2.4 inches (5 to 6 cm)
C) 120 to 140/min; depth of at least 3 inches
D) 100 to 120/min; depth allowing partial chest wall recoil
Correct Answer: B) 100 to 120/min; depth of 2 to 2.4 inches (5 to 6 cm)
,Detailed Rationale: High-quality CPR requirements dictate a compression rate of
100 to 120 compressions per minute. The depth must be at least 2 inches (5 cm)
but must not exceed 2.4 inches (6 cm) to avoid internal injury. Providers must also
allow for complete chest wall recoil between compressions to maximize venous
return to the heart.
Question 3
A patient in the emergency department goes into cardiac arrest. The monitor
shows Ventricular Fibrillation (VF). You deliver the first shock. What should your
team do immediately after the shock is delivered?
A) Check the monitor to see if the rhythm changed.
B) Check the patient for a carotid pulse.
C) Resume high-quality chest compressions immediately.
D) Administer a 1 mg dose of Epinephrine IV.
Correct Answer: C) Resume high-quality chest compressions immediately.
Detailed Rationale: Immediately following any defibrillation attempt, providers
must resume chest compressions without delay, starting with compressions
rather than rhythm or pulse checks. Minimizing interruptions in chest
compressions is vital to sustaining coronary perfusion pressure. A pulse or rhythm
check is only conducted after completing the 2-minute cycle of CPR.
Question 4
A patient remains in refractory Ventricular Fibrillation (VF) despite receiving two
shocks and 1 mg of Epinephrine. Which antiarrhythmic medication and first-
dose quantity are indicated next?
A) Amiodarone 150 mg IV push
B) Lidocaine 5 mg/kg IV push
C) Amiodarone 300 mg IV bolus
D) Magnesium Sulfate 2 g IV push
Correct Answer: C) Amiodarone 300 mg IV bolus
,Detailed Rationale: For persistent or refractory VF/pulseless VT after the second
shock, Amiodarone 300 mg IV/IO is the first-line antiarrhythmic choice. If VF
recurs later, a second follow-up dose of 150 mg can be given. Lidocaine is an
acceptable alternative, but its initial dose is 1 to 1.5 mg/kg.
Question 5
The monitor displays a sinus-like rhythm at a rate of 65 bpm, but the patient
does not have a detectable carotid pulse. What is this rhythm, and what is the
primary management strategy?
A) Sinus Bradycardia; administer Atropine 1 mg
B) Pulseless Electrical Activity (PEA); perform immediate defibrillation
C) Pulseless Electrical Activity (PEA); administer Epinephrine 1 mg and look for
reversible causes
D) Asystole; insert an advanced airway immediately
Correct Answer: C) Pulseless Electrical Activity (PEA); administer Epinephrine 1
mg and look for reversible causes
Detailed Rationale: Organised electrical activity on a monitor without a
corresponding palpable pulse is classified as Pulseless Electrical Activity (PEA).
PEA is a non-shockable rhythm, meaning defibrillation is contraindicated.
Management relies on continuous high-quality CPR, administering Epinephrine 1
mg every 3–5 minutes, and systematically assessing for reversible causes,
universally known as the H's and T's.
Question 6
A 67-year-old male presents with symptomatic bradycardia. His heart rate is 38
bpm, and his blood pressure is 82/44 mmHg. He appears confused and
diaphoretic. What is your first-line medical intervention?
A) Adenosine 6 mg rapid IV push
B) Atropine 1 mg IV push
C) Epinephrine 1 mg IV push
D) Synchronized Cardioversion at 100 Joules
, Correct Answer: B) Atropine 1 mg IV push
Detailed Rationale: For symptomatic or unstable bradycardia, the first-line drug
therapy is Atropine 1 mg IV push (updated to 1 mg from the older 0.5 mg dose). It
can be repeated every 3 to 5 minutes up to a maximum total dose of 3 mg. If
Atropine is ineffective, the provider should move to transcutaneous pacing or
initiate a Dopamine or Epinephrine infusion.
Question 7
A patient has a regular, narrow-complex tachycardia on the monitor with a rate
of 175 bpm. The patient is stable with a blood pressure of 122/80 mmHg. Vagal
maneuvers were unsuccessful. What is the next step?
A) Deliver an unsynchronized shock at 200 Joules
B) Administer Adenosine 6 mg rapid IV push followed by a saline flush
C) Administer Amiodarone 300 mg IV bolus
D) Perform immediate synchronized cardioversion
Correct Answer: B) Administer Adenosine 6 mg rapid IV push followed by a
saline flush
Detailed Rationale: For a stable patient experiencing regular narrow-complex
Supraventricular Tachycardia (SVT) that does not respond to vagal maneuvers, the
correct first pharmaceutical intervention is Adenosine 6 mg delivered as a rapid
IV push. This must be accompanied by an immediate 10–20 mL saline flush
because of the drug’s exceptionally short half-life. If the rhythm does not convert,
a second dose of 12 mg may follow.
Question 8
Following return of spontaneous circulation (ROSC), a patient remains comatose
and unresponsive to verbal commands. What is the target temperature
management range recommended by the AHA?
A) 30°C to 32°C for at least 12 hours
B) 32°C to 36°C maintained for at least 24 hours
C) 36.5°C to 37.5°C maintained for 48 hours
Questions & Verified Answers with Detailed Rationales
Question 1
You find an unresponsive adult patient. You shout for help, check for breathing,
and find no normal breathing but a faint pulse. What is your next immediate
action?
A) Begin cycles of 30 chest compressions and 2 breaths.
B) Provide rescue breaths at a rate of 1 breath every 6 seconds.
C) Deliver a rapid shock using an Automated External Defibrillator (AED).
D) Establish immediate intraosseous (IO) access.
Correct Answer: B) Provide rescue breaths at a rate of 1 breath every 6 seconds.
Detailed Rationale: According to the latest AHA ACLS guidelines, if an
unresponsive patient has a pulse but is not breathing normally (respiratory
arrest), the provider must deliver rescue breathing. The proper adult rate is 1
breath every 6 seconds (approximately 10 breaths per minute). Chest
compressions are not indicated because a pulse is present, and an AED is only
used for cardiac arrest.
Question 2
During a resuscitation attempt, your team is performing chest compressions.
What is the correct compression rate and depth for an adult patient?
A) 80 to 100/min; depth of at least 1.5 inches
B) 100 to 120/min; depth of 2 to 2.4 inches (5 to 6 cm)
C) 120 to 140/min; depth of at least 3 inches
D) 100 to 120/min; depth allowing partial chest wall recoil
Correct Answer: B) 100 to 120/min; depth of 2 to 2.4 inches (5 to 6 cm)
,Detailed Rationale: High-quality CPR requirements dictate a compression rate of
100 to 120 compressions per minute. The depth must be at least 2 inches (5 cm)
but must not exceed 2.4 inches (6 cm) to avoid internal injury. Providers must also
allow for complete chest wall recoil between compressions to maximize venous
return to the heart.
Question 3
A patient in the emergency department goes into cardiac arrest. The monitor
shows Ventricular Fibrillation (VF). You deliver the first shock. What should your
team do immediately after the shock is delivered?
A) Check the monitor to see if the rhythm changed.
B) Check the patient for a carotid pulse.
C) Resume high-quality chest compressions immediately.
D) Administer a 1 mg dose of Epinephrine IV.
Correct Answer: C) Resume high-quality chest compressions immediately.
Detailed Rationale: Immediately following any defibrillation attempt, providers
must resume chest compressions without delay, starting with compressions
rather than rhythm or pulse checks. Minimizing interruptions in chest
compressions is vital to sustaining coronary perfusion pressure. A pulse or rhythm
check is only conducted after completing the 2-minute cycle of CPR.
Question 4
A patient remains in refractory Ventricular Fibrillation (VF) despite receiving two
shocks and 1 mg of Epinephrine. Which antiarrhythmic medication and first-
dose quantity are indicated next?
A) Amiodarone 150 mg IV push
B) Lidocaine 5 mg/kg IV push
C) Amiodarone 300 mg IV bolus
D) Magnesium Sulfate 2 g IV push
Correct Answer: C) Amiodarone 300 mg IV bolus
,Detailed Rationale: For persistent or refractory VF/pulseless VT after the second
shock, Amiodarone 300 mg IV/IO is the first-line antiarrhythmic choice. If VF
recurs later, a second follow-up dose of 150 mg can be given. Lidocaine is an
acceptable alternative, but its initial dose is 1 to 1.5 mg/kg.
Question 5
The monitor displays a sinus-like rhythm at a rate of 65 bpm, but the patient
does not have a detectable carotid pulse. What is this rhythm, and what is the
primary management strategy?
A) Sinus Bradycardia; administer Atropine 1 mg
B) Pulseless Electrical Activity (PEA); perform immediate defibrillation
C) Pulseless Electrical Activity (PEA); administer Epinephrine 1 mg and look for
reversible causes
D) Asystole; insert an advanced airway immediately
Correct Answer: C) Pulseless Electrical Activity (PEA); administer Epinephrine 1
mg and look for reversible causes
Detailed Rationale: Organised electrical activity on a monitor without a
corresponding palpable pulse is classified as Pulseless Electrical Activity (PEA).
PEA is a non-shockable rhythm, meaning defibrillation is contraindicated.
Management relies on continuous high-quality CPR, administering Epinephrine 1
mg every 3–5 minutes, and systematically assessing for reversible causes,
universally known as the H's and T's.
Question 6
A 67-year-old male presents with symptomatic bradycardia. His heart rate is 38
bpm, and his blood pressure is 82/44 mmHg. He appears confused and
diaphoretic. What is your first-line medical intervention?
A) Adenosine 6 mg rapid IV push
B) Atropine 1 mg IV push
C) Epinephrine 1 mg IV push
D) Synchronized Cardioversion at 100 Joules
, Correct Answer: B) Atropine 1 mg IV push
Detailed Rationale: For symptomatic or unstable bradycardia, the first-line drug
therapy is Atropine 1 mg IV push (updated to 1 mg from the older 0.5 mg dose). It
can be repeated every 3 to 5 minutes up to a maximum total dose of 3 mg. If
Atropine is ineffective, the provider should move to transcutaneous pacing or
initiate a Dopamine or Epinephrine infusion.
Question 7
A patient has a regular, narrow-complex tachycardia on the monitor with a rate
of 175 bpm. The patient is stable with a blood pressure of 122/80 mmHg. Vagal
maneuvers were unsuccessful. What is the next step?
A) Deliver an unsynchronized shock at 200 Joules
B) Administer Adenosine 6 mg rapid IV push followed by a saline flush
C) Administer Amiodarone 300 mg IV bolus
D) Perform immediate synchronized cardioversion
Correct Answer: B) Administer Adenosine 6 mg rapid IV push followed by a
saline flush
Detailed Rationale: For a stable patient experiencing regular narrow-complex
Supraventricular Tachycardia (SVT) that does not respond to vagal maneuvers, the
correct first pharmaceutical intervention is Adenosine 6 mg delivered as a rapid
IV push. This must be accompanied by an immediate 10–20 mL saline flush
because of the drug’s exceptionally short half-life. If the rhythm does not convert,
a second dose of 12 mg may follow.
Question 8
Following return of spontaneous circulation (ROSC), a patient remains comatose
and unresponsive to verbal commands. What is the target temperature
management range recommended by the AHA?
A) 30°C to 32°C for at least 12 hours
B) 32°C to 36°C maintained for at least 24 hours
C) 36.5°C to 37.5°C maintained for 48 hours
