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AHA ACLS Final Exam — Comprehensive Practice Questions (2026–2027) Graded A+ | Original
Questions & Answers with Detailed Rationales | Aligned with 2025 | 2026 AHA Guidelines
This comprehensive final exam covers all core ACLS content areas: BLS
Assessment & High-Quality CPR, ACLS Cardiac Arrest Algorithms (VF/pVT,
Asystole/PEA), Bradycardia & Tachycardia Management, Pharmacology, ECG
Rhythm Recognition, Post-Cardiac Arrest Care, Acute Coronary Syndromes &
Stroke, Airway Management, and Team Dynamics. Each question includes a
correct answer and a detailed rationale based on the most current AHA
guidelines.
SECTION A: BLS ASSESSMENT & HIGH-QUALITY CPR
(Questions)
Question 1
You find an unresponsive patient who is not breathing. After
activating the emergency response system, you determine that
there is no pulse. What is your next action?
A. Open the airway with a head tilt-chin lift
B. Administer epinephrine at a dose of 1 mg/kg
C. Deliver 2 rescue breaths each over 1 second
D. Start chest compressions at a rate of at least 100/min
Correct Answer: D
Rationale: Once cardiac arrest is recognized (unresponsive, no
normal breathing, no pulse), you must immediately begin chest
compressions (C-A-B sequence). Minimizing the delay to
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compressions is critical for sustaining coronary and cerebral
perfusion.
Question 2
What is the first step in the systematic approach to patient
assessment?
A. Primary assessment
B. Secondary assessment
C. Initial impression
D. BLS assessment
Correct Answer: C
Rationale: The first step is forming an initial impression — a
visual survey to ensure safety, form an initial impression about
the patient's condition, and determine the need for additional
resources.
Question 3
What is the maximum amount of time you should
simultaneously perform the pulse and breathing checks?
A. 15 seconds
B. 20 seconds
C. 10 seconds
D. 5 seconds
Correct Answer: C
Rationale: The pulse and breathing checks should be performed
simultaneously for no more than 10 seconds to minimize
interruptions in chest compressions.
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Question 4
A resuscitation team is debriefing following a recent event. A
patient experienced cardiac arrest, and advanced life support
was initiated. The patient required the placement of an
advanced airway to maintain airway patency. Which statement
indicates that the team performed high-quality CPR?
A. "We initiated chest compressions at a rate of 100 to 110 per
minute to a depth of 2.4 inches and then gave 1 ventilation
every 10 seconds."
B. "We provided chest compressions at a rate of 100 to 120
compressions per minute while giving 1 ventilation every 6
seconds without pausing compressions."
C. "We provided chest compressions at a rate of 80 to 120 per
minute to a depth of at least 2 inches and gave 1 ventilation
every 6 seconds without pausing compressions."
D. "We kept the rate of chest compressions at 100 per minute
and paused after each compression to give a ventilation."
Correct Answer: B
Rationale: When an advanced airway has been placed in a
patient who is in cardiac arrest, compressions should be
delivered continuously (100 to 120 per minute) with no pauses
for ventilations. One ventilation should be given every 6 seconds
(10 breaths/min).
Question 5
During CPR, chest compression fraction (CCF) should be at least
___% and ideally greater than ___%.
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A. 50, 70
B. 60, 80
C. 70, 90
D. 40, 60
Correct Answer: B
Rationale: Chest compression fraction should be at least 60%
and ideally greater than 80% to maximize coronary perfusion
pressure and improve survival outcomes.
Question 6
What is the recommended compression depth for adult CPR?
A. At least 1 inch
B. At least 2 inches (5 cm)
C. At least 3 inches
D. At least 4 inches
Correct Answer: B
Rationale: Adult chest compressions should be delivered at a
depth of at least 2 inches (5 cm) but not greater than 2.4 inches
(6 cm) to ensure adequate cardiac output.
Question 7
Which of the following is a likely indicator of cardiac arrest in an
unresponsive patient?
A. Cyanosis
B. Agonal gasps
C. Warm skin
D. Bradycardia
AHA ACLS Final Exam — Comprehensive Practice Questions (2026–2027) Graded A+ | Original
Questions & Answers with Detailed Rationales | Aligned with 2025 | 2026 AHA Guidelines
This comprehensive final exam covers all core ACLS content areas: BLS
Assessment & High-Quality CPR, ACLS Cardiac Arrest Algorithms (VF/pVT,
Asystole/PEA), Bradycardia & Tachycardia Management, Pharmacology, ECG
Rhythm Recognition, Post-Cardiac Arrest Care, Acute Coronary Syndromes &
Stroke, Airway Management, and Team Dynamics. Each question includes a
correct answer and a detailed rationale based on the most current AHA
guidelines.
SECTION A: BLS ASSESSMENT & HIGH-QUALITY CPR
(Questions)
Question 1
You find an unresponsive patient who is not breathing. After
activating the emergency response system, you determine that
there is no pulse. What is your next action?
A. Open the airway with a head tilt-chin lift
B. Administer epinephrine at a dose of 1 mg/kg
C. Deliver 2 rescue breaths each over 1 second
D. Start chest compressions at a rate of at least 100/min
Correct Answer: D
Rationale: Once cardiac arrest is recognized (unresponsive, no
normal breathing, no pulse), you must immediately begin chest
compressions (C-A-B sequence). Minimizing the delay to
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compressions is critical for sustaining coronary and cerebral
perfusion.
Question 2
What is the first step in the systematic approach to patient
assessment?
A. Primary assessment
B. Secondary assessment
C. Initial impression
D. BLS assessment
Correct Answer: C
Rationale: The first step is forming an initial impression — a
visual survey to ensure safety, form an initial impression about
the patient's condition, and determine the need for additional
resources.
Question 3
What is the maximum amount of time you should
simultaneously perform the pulse and breathing checks?
A. 15 seconds
B. 20 seconds
C. 10 seconds
D. 5 seconds
Correct Answer: C
Rationale: The pulse and breathing checks should be performed
simultaneously for no more than 10 seconds to minimize
interruptions in chest compressions.
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Question 4
A resuscitation team is debriefing following a recent event. A
patient experienced cardiac arrest, and advanced life support
was initiated. The patient required the placement of an
advanced airway to maintain airway patency. Which statement
indicates that the team performed high-quality CPR?
A. "We initiated chest compressions at a rate of 100 to 110 per
minute to a depth of 2.4 inches and then gave 1 ventilation
every 10 seconds."
B. "We provided chest compressions at a rate of 100 to 120
compressions per minute while giving 1 ventilation every 6
seconds without pausing compressions."
C. "We provided chest compressions at a rate of 80 to 120 per
minute to a depth of at least 2 inches and gave 1 ventilation
every 6 seconds without pausing compressions."
D. "We kept the rate of chest compressions at 100 per minute
and paused after each compression to give a ventilation."
Correct Answer: B
Rationale: When an advanced airway has been placed in a
patient who is in cardiac arrest, compressions should be
delivered continuously (100 to 120 per minute) with no pauses
for ventilations. One ventilation should be given every 6 seconds
(10 breaths/min).
Question 5
During CPR, chest compression fraction (CCF) should be at least
___% and ideally greater than ___%.
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A. 50, 70
B. 60, 80
C. 70, 90
D. 40, 60
Correct Answer: B
Rationale: Chest compression fraction should be at least 60%
and ideally greater than 80% to maximize coronary perfusion
pressure and improve survival outcomes.
Question 6
What is the recommended compression depth for adult CPR?
A. At least 1 inch
B. At least 2 inches (5 cm)
C. At least 3 inches
D. At least 4 inches
Correct Answer: B
Rationale: Adult chest compressions should be delivered at a
depth of at least 2 inches (5 cm) but not greater than 2.4 inches
(6 cm) to ensure adequate cardiac output.
Question 7
Which of the following is a likely indicator of cardiac arrest in an
unresponsive patient?
A. Cyanosis
B. Agonal gasps
C. Warm skin
D. Bradycardia
