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ACLS Exam Practice Questions and Answers | Advanced Cardiovascular Life Support Certification Preparation 2026/2027

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ACLS Exam Practice Questions and Answers | Advanced Cardiovascular Life Support Certification Preparation 2026/2027

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Advanced Cardiovascular Life
Support Exam Version A (50
questions)

Please do not mark on this exam. Record the best answer on the
separate answer sheet.


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.


2. You are evaluating a 58-year-old man with chest pain.
The blood pressure is 92/50 mm Hg, the heart rate is
92/min, the nonlabored respiratory rate is 14
breaths/min, and the pulse oximetry reading is 97%.
What assessment step is most important now?
A. PETCO2
B. Chest x-ray
C. Laboratory testing
D. Obtaining a 12-lead ECG


3. What is the preferred method of access for
epinephrine administration during cardiac arrest
in most patients?
A. Intraosseous
B. Endotracheal
C. Central intravenous
D. Peripheral intravenous


4. An activated AED does not promptly analyze the rhythm.
What is your next action?

A. Begin chest compressions.
B. Discontinue the resuscitation attempt.
C. Check all AED connections and reanalyze.
D. Rotate AED electrodes to an alternate position.

, 5. You have completed 2 minutes of CPR. The ECG monitor
displays the lead II rhythm below, and the patient has no
pulse. Another member of your team resumes chest
compressions, and an IV is in place. What management step
is your next priority?




A. Give 0.5 mg of atropine.
B. Insert an advanced airway.
C. Administer 1 mg of epinephrine.
D. Administer a dopamine infusion.


6. During a pause in CPR, you see this lead II ECG
rhythm on the monitor. The patient has no pulse.
What is the next action?




A. Establish vascular access.
B. Obtain the patient’s history.
C. Resume chest compressions.
D. Terminate the resuscitative effort.


7. What is a common but sometimes fatal mistake in
cardiac arrest management?

A. Failure to obtain vascular access
B. Prolonged periods of no ventilations
C. Failure to perform endotracheal intubation
D. Prolonged interruptions in chest compressions


8. Which action is a component of high-quality chest
compressions?
A. Allowing complete chest recoil
B. Chest compressions without ventilation
C. 60 to 100 compressions per minute with a 15:2 ratio
D. Uninterrupted compressions at a depth of 1½ inches

, 9. Which action increases the chance of successfulconversion
of ventricular fibrillation?

A. Pausing chest compressions immediately after a defibrillation attempt
B. Administering 4 quick ventilations immediately before a defibrillation
attempt
C. Using manual defibrillator paddles with light pressure against the chest
D. Providing quality compressions immediately before a defibrillation
attempt


10. Which situation BEST describes pulseless electrical activity?

A. Asystole without a pulse
B. Sinus rhythm without a pulse
C. Torsades de pointes with a pulse
D. Ventricular tachycardia with a pulse


11. What is the BEST strategy for performing
high-quality CPR on a patient with an advanced
airway in place?

A. Provide compressions and ventilations with a 15:2 ratio.
B. Provide compressions and ventilations with a 30:2 ratio.
C. Provide a single ventilation every 6 seconds during the compression
pause.
D. Provide continuous chest compressions without pauses and 10
ventilations per minute.


12. Three minutes after witnessing a cardiac arrest,
one member of your team inserts an endotracheal tube
while another performs continuous chest
compressions. During subsequent ventilation, you
notice the presence of a waveform on the capnography
screen and a PETCO2 level of 8 mm Hg. What is the
significance of this finding?

A. Chest compressions may not be effective.
B. The endotracheal tube is no longer in the trachea.
C. The patient meets the criteria for termination of efforts.
D. The team is ventilating the patient too often (hyperventilation).


13. The use of quantitative capnography in intubated patients

A. allows for monitoring of CPR quality.
B. measures oxygen levels at the alveoli level.
C. determines inspired carbon dioxide relating to cardiac output.
D. detects electrolyte abnormalities early in code management.

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