ACLS 2026-2027 Test Bank Questions and Verified Answers
with Explanations
1. What is the recommended compression rate for adult high-quality CPR?
A) 80 to 100 compressions per minute
B) 100 to 120 compressions per minute
C) 120 to 140 compressions per minute
D) At least 140 compressions per minute
Correct Answer: B) 100 to 120 compressions per minute
Explanation: High-quality CPR requires a chest compression rate of 100 to 120 compressions per minute. Rates
slower than 100 reduce coronary perfusion, while rates faster than 120 decrease compression depth and cardiac
filling time.
2. What is the proper chest compression depth for an adult cardiac arrest victim?
A) At least 1 inch (2.5 cm) but no more than 1.5 inches (4 cm)
B) At least 2 inches (5 cm) but no more than 2.4 inches (6 cm)
C) At least 3 inches (7.5 cm)
D) Exactly 1.5 inches (4 cm)
Correct Answer: B) At least 2 inches (5 cm) but no more than 2.4 inches (6 cm)
Explanation: High-quality CPR guidelines recommend compressing the adult chest to a depth of at least 2 inches
(5 cm), avoiding excessive depths greater than 2.4 inches (6 cm) to prevent internal organ injury.
3. During adult resuscitation, how often should rescuers switch CPR compressor roles?
A) Every 1 minute or after 3 cycles of CPR
B) Every 2 minutes or after 5 cycles of CPR
C) Every 5 minutes or when the compressor feels dizzy
D) Only when the defibrillator recharges
Correct Answer: B) Every 2 minutes or after 5 cycles of CPR
Explanation: Rescuers should switch compressor roles every 2 minutes (or every 5 cycles of 30:2) to prevent
provider fatigue, which significantly degrades chest compression depth and quality.
,4. Which rhythm is considered shockable in the ACLS Cardiac Arrest Algorithm?
A) Asystole
B) Pulseless Electrical Activity (PEA)
C) Pulseless Ventricular Tachycardia (pVT)
D) Sinus Bradycardia
Correct Answer: C) Pulseless Ventricular Tachycardia (pVT)
Explanation: The two shockable rhythms in cardiac arrest are Ventricular Fibrillation (VF) and Pulseless
Ventricular Tachycardia (pVT). Asystole and PEA are non-shockable rhythms requiring immediate CPR and
epinephrine.
5. What is the initial recommended dose of Epinephrine administered during adult cardiac arrest?
A) 0.5 mg IV/IO every 10 minutes
B) 1 mg IV/IO every 3 to 5 minutes
C) 2 mg IV/IO every 2 minutes
D) 0.1 mg IV/IO rapid push
Correct Answer: B) 1 mg IV/IO every 3 to 5 minutes
Explanation: Epinephrine is administered as 1 mg IV/IO every 3 to 5 minutes during adult cardiac arrest. It acts
via alpha-1 adrenergic stimulation to increase coronary and cerebral perfusion pressure.
6. What is the first-line antiarrhythmic drug dose for refractory Ventricular Fibrillation or Pulseless
Ventricular Tachycardia?
A) Amiodarone 150 mg IV/IO bolus
B) Amiodarone 300 mg IV/IO bolus
C) Lidocaine 3 mg/kg IV/IO bolus
D) Atropine 1 mg IV/IO bolus
Correct Answer: B) Amiodarone 300 mg IV/IO bolus
Explanation: The initial IV/IO dose of Amiodarone for VF/pVT unresponsive to CPR and shocks is a 300 mg
bolus. A second dose of 150 mg IV/IO may be given if the shockable rhythm persists.
, 7. If Amiodarone is unavailable during a cardiac arrest with VF/pVT, what alternative
antiarrhythmic agent can be administered?
A) Adenosine
B) Lidocaine
C) Atropine
D) Metoprolol
Correct Answer: B) Lidocaine
Explanation: Lidocaine is an acceptable alternative to Amiodarone in VF/pVT cardiac arrest. Initial dose is 1 to 1.5
mg/kg IV/IO, followed by 0.5 to 0.75 mg/kg IV/IO for repeat doses.
8. What is the second dose of Amiodarone in refractory VF or pulseless VT?
A) 300 mg IV/IO
B) 150 mg IV/IO
C) 100 mg IV/IO
D) 75 mg IV/IO
Correct Answer: B) 150 mg IV/IO
Explanation: Following an initial 300 mg IV/IO bolus for refractory VF/pVT, the second dose of Amiodarone is 150
mg IV/IO bolus.
9. What is the main priority during CPR when an advanced airway (e.g., endotracheal tube) is in
place?
A) Pause compressions for 2 breaths every 30 compressions
B) Give 1 breath every 6 seconds (10 breaths/min) with continuous chest compressions
C) Give 1 breath every 3 seconds while pausing chest compressions
D) Give 20 breaths per minute to prevent hypercapnia
Correct Answer: B) Give 1 breath every 6 seconds (10 breaths/min) with continuous chest
compressions
Explanation: Once an advanced airway is secured, chest compressions are delivered continuously without
pauses, and ventilations are given at 1 breath every 6 seconds (10 breaths/min).
10. Continuous quantitative waveform capnography measures end-tidal CO2 (PETCO2). A
PETCO2 value consistently below what level during CPR indicates low quality chest
compressions?
with Explanations
1. What is the recommended compression rate for adult high-quality CPR?
A) 80 to 100 compressions per minute
B) 100 to 120 compressions per minute
C) 120 to 140 compressions per minute
D) At least 140 compressions per minute
Correct Answer: B) 100 to 120 compressions per minute
Explanation: High-quality CPR requires a chest compression rate of 100 to 120 compressions per minute. Rates
slower than 100 reduce coronary perfusion, while rates faster than 120 decrease compression depth and cardiac
filling time.
2. What is the proper chest compression depth for an adult cardiac arrest victim?
A) At least 1 inch (2.5 cm) but no more than 1.5 inches (4 cm)
B) At least 2 inches (5 cm) but no more than 2.4 inches (6 cm)
C) At least 3 inches (7.5 cm)
D) Exactly 1.5 inches (4 cm)
Correct Answer: B) At least 2 inches (5 cm) but no more than 2.4 inches (6 cm)
Explanation: High-quality CPR guidelines recommend compressing the adult chest to a depth of at least 2 inches
(5 cm), avoiding excessive depths greater than 2.4 inches (6 cm) to prevent internal organ injury.
3. During adult resuscitation, how often should rescuers switch CPR compressor roles?
A) Every 1 minute or after 3 cycles of CPR
B) Every 2 minutes or after 5 cycles of CPR
C) Every 5 minutes or when the compressor feels dizzy
D) Only when the defibrillator recharges
Correct Answer: B) Every 2 minutes or after 5 cycles of CPR
Explanation: Rescuers should switch compressor roles every 2 minutes (or every 5 cycles of 30:2) to prevent
provider fatigue, which significantly degrades chest compression depth and quality.
,4. Which rhythm is considered shockable in the ACLS Cardiac Arrest Algorithm?
A) Asystole
B) Pulseless Electrical Activity (PEA)
C) Pulseless Ventricular Tachycardia (pVT)
D) Sinus Bradycardia
Correct Answer: C) Pulseless Ventricular Tachycardia (pVT)
Explanation: The two shockable rhythms in cardiac arrest are Ventricular Fibrillation (VF) and Pulseless
Ventricular Tachycardia (pVT). Asystole and PEA are non-shockable rhythms requiring immediate CPR and
epinephrine.
5. What is the initial recommended dose of Epinephrine administered during adult cardiac arrest?
A) 0.5 mg IV/IO every 10 minutes
B) 1 mg IV/IO every 3 to 5 minutes
C) 2 mg IV/IO every 2 minutes
D) 0.1 mg IV/IO rapid push
Correct Answer: B) 1 mg IV/IO every 3 to 5 minutes
Explanation: Epinephrine is administered as 1 mg IV/IO every 3 to 5 minutes during adult cardiac arrest. It acts
via alpha-1 adrenergic stimulation to increase coronary and cerebral perfusion pressure.
6. What is the first-line antiarrhythmic drug dose for refractory Ventricular Fibrillation or Pulseless
Ventricular Tachycardia?
A) Amiodarone 150 mg IV/IO bolus
B) Amiodarone 300 mg IV/IO bolus
C) Lidocaine 3 mg/kg IV/IO bolus
D) Atropine 1 mg IV/IO bolus
Correct Answer: B) Amiodarone 300 mg IV/IO bolus
Explanation: The initial IV/IO dose of Amiodarone for VF/pVT unresponsive to CPR and shocks is a 300 mg
bolus. A second dose of 150 mg IV/IO may be given if the shockable rhythm persists.
, 7. If Amiodarone is unavailable during a cardiac arrest with VF/pVT, what alternative
antiarrhythmic agent can be administered?
A) Adenosine
B) Lidocaine
C) Atropine
D) Metoprolol
Correct Answer: B) Lidocaine
Explanation: Lidocaine is an acceptable alternative to Amiodarone in VF/pVT cardiac arrest. Initial dose is 1 to 1.5
mg/kg IV/IO, followed by 0.5 to 0.75 mg/kg IV/IO for repeat doses.
8. What is the second dose of Amiodarone in refractory VF or pulseless VT?
A) 300 mg IV/IO
B) 150 mg IV/IO
C) 100 mg IV/IO
D) 75 mg IV/IO
Correct Answer: B) 150 mg IV/IO
Explanation: Following an initial 300 mg IV/IO bolus for refractory VF/pVT, the second dose of Amiodarone is 150
mg IV/IO bolus.
9. What is the main priority during CPR when an advanced airway (e.g., endotracheal tube) is in
place?
A) Pause compressions for 2 breaths every 30 compressions
B) Give 1 breath every 6 seconds (10 breaths/min) with continuous chest compressions
C) Give 1 breath every 3 seconds while pausing chest compressions
D) Give 20 breaths per minute to prevent hypercapnia
Correct Answer: B) Give 1 breath every 6 seconds (10 breaths/min) with continuous chest
compressions
Explanation: Once an advanced airway is secured, chest compressions are delivered continuously without
pauses, and ventilations are given at 1 breath every 6 seconds (10 breaths/min).
10. Continuous quantitative waveform capnography measures end-tidal CO2 (PETCO2). A
PETCO2 value consistently below what level during CPR indicates low quality chest
compressions?
