A H A A D VA N C E D C A R D I O VA S C U L A R L I F E
S U P P O R T
ACLS Final
Exam Q&A
155 Practice Questions with Detailed Answers & Explanations
Most Comprehensive to Pass the Exam, 100% Verified
LATEST EDITION
A complete, exam-aligned study guide for the AHA ACLS Final
Examination, covering BLS foundations, ECG rhythm interpretation, ACLS
pharmacology, airway management, cardiac arrest algorithms, peri-arrest
arrhythmias, acute coronary syndromes, and acute stroke — with detailed
explanations for every question.
155
VERIFIED QUESTIONS
8
C O R E TO P I C S
100%
R AT I O N A L E S I N C L U D E D
Z.ai Medical Education
Comprehensive AHA ACLS Provider Exam review VOL. 5 | ACLS EDITION
,AHA ACLS Final Exam: 155 Practice Questions with Answers & Explanations | Latest 2026/2027 Edition
BLS & CPR Foundations
Questions 1 through 20 cover the foundation of resuscitation: high-quality CPR parameters, basic life support
algorithms, AED use, and the integration of BLS skills into the ACLS framework.
Question 1.
A nurse finds an unresponsive adult client in a hospital room. After ensuring scene safety and checking for
responsiveness, what is the nurse's next action?
Open the airway and check for breathing
Call for help and activate the emergency response system
Check for a pulse for no more than 10 seconds
Begin chest compressions immediately
Correct Answer: B
Explanation
The BLS Healthcare Provider algorithm sequence is: (1) Verify scene safety, (2) Check responsiveness (shout and
shake), (3) If unresponsive, activate the emergency response system (call for help/code blue) and get an
AED/defibrillator, (4) Check for pulse and breathing simultaneously for no more than 10 seconds, (5) If no pulse,
begin chest compressions. Activating the response system FIRST ensures that additional help and equipment are
on the way while resuscitation begins. For a single rescuer in the community, the sequence is Call-First (call 911
before CPR) for adults and Care-First (CPR for 2 minutes before calling) for unresponsive infants/children when
alone.
Question 2.
When performing high-quality CPR on an adult, the nurse should ensure chest compressions are delivered at a
depth of:
At least 2 inches (5 cm)
1 to 1.5 inches (2.5 to 4 cm)
1.5 to 2 inches (4 to 5 cm)
At least 2.4 inches (6 cm)
Correct Answer: A
Explanation
High-quality adult CPR requires compression depth of at least 2 inches (5 cm) but no more than 2.4 inches (6 cm).
Compressions should be at a rate of 100-120 per minute, allowing full chest recoil between compressions,
minimizing interruptions to less than 10 seconds, and avoiding excessive ventilation. Excessive depth (>2.4 inches)
may cause injury without improving outcomes. Inadequate depth reduces coronary and cerebral perfusion. The
AHA 2020 guidelines reaffirmed these targets. Quality improvement feedback devices are recommended to ensure
proper depth and rate.
Z.ai Medical Education 2 ACLS Edition
,AHA ACLS Final Exam: 155 Practice Questions with Answers & Explanations | Latest 2026/2027 Edition
Question 3.
During two-rescuer CPR on an adult client with an advanced airway in place, what is the recommended ventilation
rate?
1 breath every 3-5 seconds (12-20 breaths/min)
1 breath every 6 seconds (10 breaths/min)
2 breaths every 30 compressions
2 breaths every 15 compressions
Correct Answer: B
Explanation
Once an advanced airway (endotracheal tube or supraglottic airway) is in place, chest compressions are delivered
continuously WITHOUT pausing for ventilations. The ventilator delivers 1 breath every 6 seconds (10
breaths/min) for adults. This contrasts with no advanced airway, where the ratio is 30 compressions to 2 breaths,
pausing compressions for ventilations. Continuous compressions maintain coronary perfusion pressure. Each
breath should be delivered over 1 second with just enough volume to produce visible chest rise; excessive
ventilation increases intrathoracic pressure, decreases venous return, and reduces cardiac output.
Question 4.
A nurse is performing chest compressions and feels fatigued. The nurse should:
Slow the rate to maintain effective compressions
Reduce depth to conserve energy
Switch with another rescuer within 5 seconds, ideally every 2 minutes
Continue until EMS arrives regardless of fatigue
Correct Answer: C
Explanation
Fatigue causes ineffective compressions within 1-2 minutes even when the rescuer feels able to continue. The AHA
recommends switching compressors every 2 minutes (or after 5 cycles of 30:2) to prevent fatigue, with the switch
taking less than 5 seconds to minimize no-flow time. Switching should ideally be timed with rhythm checks to avoid
extra interruptions. Slowing the rate or reducing depth produces ineffective compressions and decreases survival.
If no second rescuer is available, perform CPR until exhausted and then activate help if possible.
Z.ai Medical Education 3 ACLS Edition
, AHA ACLS Final Exam: 155 Practice Questions with Answers & Explanations | Latest 2026/2027 Edition
Question 5.
During CPR, the team leader notes that chest compressions are being paused for 15 seconds each time the AED
analyzes the rhythm. What is the most appropriate action?
Document the finding and continue as is
Minimize interruptions to less than 10 seconds
Increase the analysis time to ensure accuracy
Stop CPR during rhythm checks to avoid artifact
Correct Answer: B
Explanation
Interruptions in chest compressions reduce coronary perfusion pressure, myocardial blood flow, and survival. The
AHA emphasizes 'minimize interruptions' as a key component of high-quality CPR. All pauses (rhythm check, pulse
check, defibrillation, intubation) should be less than 10 seconds. Strategies include: charging the defibrillator
during the last compression before the rhythm check, then delivering the shock within 5 seconds; pre-positioning
intubation equipment; and rotating compressors during the rhythm analysis to avoid extra delay. The team leader
should monitor pause duration and provide feedback.
Question 6.
A client in cardiac arrest has return of spontaneous circulation (ROSC) after defibrillation and 4 minutes of CPR.
The first post-ROSC action the team should take is to:
Transport the client immediately to the ICU
Assess airway, breathing, and circulation; provide 12-lead ECG; and consider targeted temperature
management
Administer amiodarone prophylactically
Place the client in Trendelenburg position
Correct Answer: B
Explanation
Post-cardiac arrest care begins immediately after ROSC. Priorities include: (1) optimize oxygenation and
ventilation (avoid hyperoxia, target SpO2 94-99%, EtCO2 35-40 mmHg); (2) obtain 12-lead ECG to identify
STEMI requiring emergent reperfusion; (3) assess for and treat hypotension (target SBP ≥90, MAP ≥65) with
fluids and vasopressors; (4) initiate targeted temperature management (TTM) at 32-36°C for 24 hours for
comatose patients; (5) consider seizure prophylaxis and continuous EEG; (6) transport to critical care unit.
Trendelenburg is not recommended. Routine antiarrhythmics are not given post-ROSC unless indicated for
ongoing arrhythmia.
Z.ai Medical Education 4 ACLS Edition
S U P P O R T
ACLS Final
Exam Q&A
155 Practice Questions with Detailed Answers & Explanations
Most Comprehensive to Pass the Exam, 100% Verified
LATEST EDITION
A complete, exam-aligned study guide for the AHA ACLS Final
Examination, covering BLS foundations, ECG rhythm interpretation, ACLS
pharmacology, airway management, cardiac arrest algorithms, peri-arrest
arrhythmias, acute coronary syndromes, and acute stroke — with detailed
explanations for every question.
155
VERIFIED QUESTIONS
8
C O R E TO P I C S
100%
R AT I O N A L E S I N C L U D E D
Z.ai Medical Education
Comprehensive AHA ACLS Provider Exam review VOL. 5 | ACLS EDITION
,AHA ACLS Final Exam: 155 Practice Questions with Answers & Explanations | Latest 2026/2027 Edition
BLS & CPR Foundations
Questions 1 through 20 cover the foundation of resuscitation: high-quality CPR parameters, basic life support
algorithms, AED use, and the integration of BLS skills into the ACLS framework.
Question 1.
A nurse finds an unresponsive adult client in a hospital room. After ensuring scene safety and checking for
responsiveness, what is the nurse's next action?
Open the airway and check for breathing
Call for help and activate the emergency response system
Check for a pulse for no more than 10 seconds
Begin chest compressions immediately
Correct Answer: B
Explanation
The BLS Healthcare Provider algorithm sequence is: (1) Verify scene safety, (2) Check responsiveness (shout and
shake), (3) If unresponsive, activate the emergency response system (call for help/code blue) and get an
AED/defibrillator, (4) Check for pulse and breathing simultaneously for no more than 10 seconds, (5) If no pulse,
begin chest compressions. Activating the response system FIRST ensures that additional help and equipment are
on the way while resuscitation begins. For a single rescuer in the community, the sequence is Call-First (call 911
before CPR) for adults and Care-First (CPR for 2 minutes before calling) for unresponsive infants/children when
alone.
Question 2.
When performing high-quality CPR on an adult, the nurse should ensure chest compressions are delivered at a
depth of:
At least 2 inches (5 cm)
1 to 1.5 inches (2.5 to 4 cm)
1.5 to 2 inches (4 to 5 cm)
At least 2.4 inches (6 cm)
Correct Answer: A
Explanation
High-quality adult CPR requires compression depth of at least 2 inches (5 cm) but no more than 2.4 inches (6 cm).
Compressions should be at a rate of 100-120 per minute, allowing full chest recoil between compressions,
minimizing interruptions to less than 10 seconds, and avoiding excessive ventilation. Excessive depth (>2.4 inches)
may cause injury without improving outcomes. Inadequate depth reduces coronary and cerebral perfusion. The
AHA 2020 guidelines reaffirmed these targets. Quality improvement feedback devices are recommended to ensure
proper depth and rate.
Z.ai Medical Education 2 ACLS Edition
,AHA ACLS Final Exam: 155 Practice Questions with Answers & Explanations | Latest 2026/2027 Edition
Question 3.
During two-rescuer CPR on an adult client with an advanced airway in place, what is the recommended ventilation
rate?
1 breath every 3-5 seconds (12-20 breaths/min)
1 breath every 6 seconds (10 breaths/min)
2 breaths every 30 compressions
2 breaths every 15 compressions
Correct Answer: B
Explanation
Once an advanced airway (endotracheal tube or supraglottic airway) is in place, chest compressions are delivered
continuously WITHOUT pausing for ventilations. The ventilator delivers 1 breath every 6 seconds (10
breaths/min) for adults. This contrasts with no advanced airway, where the ratio is 30 compressions to 2 breaths,
pausing compressions for ventilations. Continuous compressions maintain coronary perfusion pressure. Each
breath should be delivered over 1 second with just enough volume to produce visible chest rise; excessive
ventilation increases intrathoracic pressure, decreases venous return, and reduces cardiac output.
Question 4.
A nurse is performing chest compressions and feels fatigued. The nurse should:
Slow the rate to maintain effective compressions
Reduce depth to conserve energy
Switch with another rescuer within 5 seconds, ideally every 2 minutes
Continue until EMS arrives regardless of fatigue
Correct Answer: C
Explanation
Fatigue causes ineffective compressions within 1-2 minutes even when the rescuer feels able to continue. The AHA
recommends switching compressors every 2 minutes (or after 5 cycles of 30:2) to prevent fatigue, with the switch
taking less than 5 seconds to minimize no-flow time. Switching should ideally be timed with rhythm checks to avoid
extra interruptions. Slowing the rate or reducing depth produces ineffective compressions and decreases survival.
If no second rescuer is available, perform CPR until exhausted and then activate help if possible.
Z.ai Medical Education 3 ACLS Edition
, AHA ACLS Final Exam: 155 Practice Questions with Answers & Explanations | Latest 2026/2027 Edition
Question 5.
During CPR, the team leader notes that chest compressions are being paused for 15 seconds each time the AED
analyzes the rhythm. What is the most appropriate action?
Document the finding and continue as is
Minimize interruptions to less than 10 seconds
Increase the analysis time to ensure accuracy
Stop CPR during rhythm checks to avoid artifact
Correct Answer: B
Explanation
Interruptions in chest compressions reduce coronary perfusion pressure, myocardial blood flow, and survival. The
AHA emphasizes 'minimize interruptions' as a key component of high-quality CPR. All pauses (rhythm check, pulse
check, defibrillation, intubation) should be less than 10 seconds. Strategies include: charging the defibrillator
during the last compression before the rhythm check, then delivering the shock within 5 seconds; pre-positioning
intubation equipment; and rotating compressors during the rhythm analysis to avoid extra delay. The team leader
should monitor pause duration and provide feedback.
Question 6.
A client in cardiac arrest has return of spontaneous circulation (ROSC) after defibrillation and 4 minutes of CPR.
The first post-ROSC action the team should take is to:
Transport the client immediately to the ICU
Assess airway, breathing, and circulation; provide 12-lead ECG; and consider targeted temperature
management
Administer amiodarone prophylactically
Place the client in Trendelenburg position
Correct Answer: B
Explanation
Post-cardiac arrest care begins immediately after ROSC. Priorities include: (1) optimize oxygenation and
ventilation (avoid hyperoxia, target SpO2 94-99%, EtCO2 35-40 mmHg); (2) obtain 12-lead ECG to identify
STEMI requiring emergent reperfusion; (3) assess for and treat hypotension (target SBP ≥90, MAP ≥65) with
fluids and vasopressors; (4) initiate targeted temperature management (TTM) at 32-36°C for 24 hours for
comatose patients; (5) consider seizure prophylaxis and continuous EEG; (6) transport to critical care unit.
Trendelenburg is not recommended. Routine antiarrhythmics are not given post-ROSC unless indicated for
ongoing arrhythmia.
Z.ai Medical Education 4 ACLS Edition
