ACLS EXAM VERSION A & B (2026 UPDATE) | ACTUAL
QUESTIONS & VERIFIED ANSWERS | 100% GUARANTEE PASS
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CORE DOMAINS
High-Quality CPR and Basic Life Support Integration
Cardiac Arrest Recognition and Defibrillation Strategies
ACLS Algorithms: VF/pVT, Asystole/PEA, Bradycardia,
Tachycardia
Airway Management and Ventilation
Emergency Pharmacology and Vascular Access
Peri-Arrest Conditions: ACS, Stroke, and Post-Cardiac Arrest
Care
Special Circumstances of Resuscitation (Opioid, Pregnancy,
Toxicology)
Team Dynamics, Systems of Care, and Termination of
Resuscitation
This comprehensive examination assesses the knowledge and
competency required for ACLS certification aligned with the 2025
American Heart Association Guidelines for Cardiopulmonary
Resuscitation and Emergency Cardiovascular Care, the document
from which ACLS providers are working in 2026. The examination
evaluates high-quality CPR, defibrillation strategy, airway
management, emergency pharmacology, and post-cardiac arrest
care. Through multiple-choice and scenario-based questions,
candidates demonstrate critical thinking, rapid decision-making,
and application of evidence-based resuscitation science. Emphasis is
placed on the first comprehensive guideline revision since 2020,
including updated defibrillation energy levels, persistent ventricular
,fibrillation management, and refined termination of resuscitation
rules.
SECTION ONE: QUESTIONS 1–300
1. What is the recommended compression depth for an adult
during CPR?
A. At least 1 inch (2.5 cm)
B. At least 2 inches (5 cm)
C. At least 3 inches (7.5 cm)
D. At least 4 inches (10 cm)
B. At least 2 inches (5 cm)
RATIONALE: High-quality CPR for adults requires chest
compressions of at least 2 inches (5 cm) in depth while avoiding
excessive depth greater than 2.4 inches (6 cm). This depth ensures
adequate cardiac output during resuscitation.
2. 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
C. Check all AED connections and reanalyze
,RATIONALE: If an AED does not analyze promptly, check the
electrode pad connections, ensure good skin contact, and then
prompt the AED to reanalyze. Starting compressions is important
but it is best to correct mechanical or connection issues first to
allow rhythm analysis. Discontinuing is inappropriate unless the
patient is obviously dead, and rotating electrodes is not standard
procedure.
3. You have completed 2 minutes of CPR. The ECG monitor
displays ventricular fibrillation, and the patient has no pulse.
Another member of the team has resumed chest compressions
and an IV is in place. What management step is your next
priority?
A. Administer 1 mg epinephrine IV
B. Establish vascular access
C. Obtain the patient's history
D. Terminate the resuscitative effort
A. Administer 1 mg epinephrine IV
RATIONALE: For VF/pVT, the next priority after confirming the
rhythm and resuming compressions is to deliver a shock and
administer epinephrine. Epinephrine 1 mg IV/IO is given every 3
to 5 minutes during cardiac arrest to improve coronary and
cerebral perfusion pressure.
4. What is a common but sometimes fatal mistake in cardiac
arrest management?
A. Failure to obtain a 12-lead ECG
B. Interrupting chest compressions for prolonged periods
, C. Administering too much oxygen
D. Using an AED instead of a manual defibrillator
B. Interrupting chest compressions for prolonged periods
RATIONALE: Minimizing interruptions in chest compressions is
critical. Prolonged interruptions reduce coronary perfusion
pressure and decrease the likelihood of return of spontaneous
circulation (ROSC). Compressions should be paused only briefly
for rhythm analysis and shock delivery.
5. What is the recommended initial energy level for
cardioversion of unstable atrial fibrillation?
A. 50 joules
B. 100 joules
C. 120 joules
D. 200 joules or more
D. 200 joules or more
RATIONALE: The 2025 guidelines recommend higher initial energy
levels (200 joules or more, rather than 120 joules) for
cardioversion of atrial fibrillation and flutter because lower initial
shocks were associated with lower success rates and a higher risk
of degeneration into ventricular fibrillation.
6. After verifying the absence of a pulse, you initiate CPR with
adequate bag-mask ventilation. The patient's lead II ECG shows
asystole. What is your next action?
A. IV or IO access
QUESTIONS & VERIFIED ANSWERS | 100% GUARANTEE PASS
CORE DOMAINS
High-Quality CPR and Basic Life Support Integration
Cardiac Arrest Recognition and Defibrillation Strategies
ACLS Algorithms: VF/pVT, Asystole/PEA, Bradycardia,
Tachycardia
Airway Management and Ventilation
Emergency Pharmacology and Vascular Access
Peri-Arrest Conditions: ACS, Stroke, and Post-Cardiac Arrest
Care
Special Circumstances of Resuscitation (Opioid, Pregnancy,
Toxicology)
Team Dynamics, Systems of Care, and Termination of
Resuscitation
This comprehensive examination assesses the knowledge and
competency required for ACLS certification aligned with the 2025
American Heart Association Guidelines for Cardiopulmonary
Resuscitation and Emergency Cardiovascular Care, the document
from which ACLS providers are working in 2026. The examination
evaluates high-quality CPR, defibrillation strategy, airway
management, emergency pharmacology, and post-cardiac arrest
care. Through multiple-choice and scenario-based questions,
candidates demonstrate critical thinking, rapid decision-making,
and application of evidence-based resuscitation science. Emphasis is
placed on the first comprehensive guideline revision since 2020,
including updated defibrillation energy levels, persistent ventricular
,fibrillation management, and refined termination of resuscitation
rules.
SECTION ONE: QUESTIONS 1–300
1. What is the recommended compression depth for an adult
during CPR?
A. At least 1 inch (2.5 cm)
B. At least 2 inches (5 cm)
C. At least 3 inches (7.5 cm)
D. At least 4 inches (10 cm)
B. At least 2 inches (5 cm)
RATIONALE: High-quality CPR for adults requires chest
compressions of at least 2 inches (5 cm) in depth while avoiding
excessive depth greater than 2.4 inches (6 cm). This depth ensures
adequate cardiac output during resuscitation.
2. 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
C. Check all AED connections and reanalyze
,RATIONALE: If an AED does not analyze promptly, check the
electrode pad connections, ensure good skin contact, and then
prompt the AED to reanalyze. Starting compressions is important
but it is best to correct mechanical or connection issues first to
allow rhythm analysis. Discontinuing is inappropriate unless the
patient is obviously dead, and rotating electrodes is not standard
procedure.
3. You have completed 2 minutes of CPR. The ECG monitor
displays ventricular fibrillation, and the patient has no pulse.
Another member of the team has resumed chest compressions
and an IV is in place. What management step is your next
priority?
A. Administer 1 mg epinephrine IV
B. Establish vascular access
C. Obtain the patient's history
D. Terminate the resuscitative effort
A. Administer 1 mg epinephrine IV
RATIONALE: For VF/pVT, the next priority after confirming the
rhythm and resuming compressions is to deliver a shock and
administer epinephrine. Epinephrine 1 mg IV/IO is given every 3
to 5 minutes during cardiac arrest to improve coronary and
cerebral perfusion pressure.
4. What is a common but sometimes fatal mistake in cardiac
arrest management?
A. Failure to obtain a 12-lead ECG
B. Interrupting chest compressions for prolonged periods
, C. Administering too much oxygen
D. Using an AED instead of a manual defibrillator
B. Interrupting chest compressions for prolonged periods
RATIONALE: Minimizing interruptions in chest compressions is
critical. Prolonged interruptions reduce coronary perfusion
pressure and decrease the likelihood of return of spontaneous
circulation (ROSC). Compressions should be paused only briefly
for rhythm analysis and shock delivery.
5. What is the recommended initial energy level for
cardioversion of unstable atrial fibrillation?
A. 50 joules
B. 100 joules
C. 120 joules
D. 200 joules or more
D. 200 joules or more
RATIONALE: The 2025 guidelines recommend higher initial energy
levels (200 joules or more, rather than 120 joules) for
cardioversion of atrial fibrillation and flutter because lower initial
shocks were associated with lower success rates and a higher risk
of degeneration into ventricular fibrillation.
6. After verifying the absence of a pulse, you initiate CPR with
adequate bag-mask ventilation. The patient's lead II ECG shows
asystole. What is your next action?
A. IV or IO access
