ACLS WRITTEN EXAM ACTUAL EXAM 2026 | ADVANCED CARDIOVASCULAR LIFE
SUPPORT EXAM | ALL QUESTIONS AND CORRECT ANSWERS | VERIFIED
ANSWERS | BRAND NEW VERSION!
Question 1
You find an unresponsive patient who is not breathing. After activating the emergency response
system, you determine there is no pulse. What is your next action?
A) Open the airway and provide two rescue breaths.
B) Deliver a synchronized shock.
C) Start chest compressions of at least 100 per minute.
D) Perform a needle decompression.
E) Check for a pulse for 20 seconds.
Correct Answer: C) Start chest compressions of at least 100 per min.
Rationale: Per the BLS and ACLS guidelines, once unresponsiveness and pulselessness are
confirmed, high-quality chest compressions should begin immediately to maintain
perfusion.
Question 2
You are evaluating a 58-year-old man with chest pain. The BP is 92/50, heart rate is 92/min,
respiratory rate is 14 breaths/min, and the pulse O2 is 97%. What assessment step is most
important now?
A) Administering high-flow oxygen.
B) Obtaining a 12-lead ECG.
C) Administering a 2-liter fluid bolus.
D) Performing a rectal exam to check for GI bleed.
E) Immediate synchronized cardioversion.
Correct Answer: B) Obtaining a 12 lead ECG.
Rationale: In a patient with chest pain, a 12-lead ECG is the gold standard for identifying
ST-segment elevation myocardial infarction (STEMI) and determining the course of
treatment.
Question 3
What is the preferred method of access for epinephrine administration during cardiac arrest in
most patients?
A) Central venous line.
B) Intraosseous (IO) access.
C) Endotracheal tube (ET) administration.
D) Peripheral IV.
E) Intracardiac injection.
Correct Answer: D) Peripheral IV
Rationale: Peripheral IV access is the preferred route for drug administration during
, 2
resuscitation due to ease of access and safety, followed by IO access if IV cannot be
established.
Question 4
An AED is attached to a patient but does not promptly analyze a rhythm. What is your next step?
A) Wait for the AED to provide instructions.
B) Replace the battery in the AED.
C) Begin chest compressions.
D) Perform a pulse check for 10 seconds.
E) Disconnect the AED and find a manual monitor.
Correct Answer: C) Begin chest compressions.
Rationale: Minimize interruptions in chest compressions. If there is any delay in rhythm
analysis or equipment operation, compressions should be resumed immediately.
Question 5
You have completed 2 minutes of CPR. The ECG monitor displays a narrow complex rhythm
(PEA) and the patient has no pulse. Your partner resumes chest compressions and an IV is in
place. What management step is your next priority?
A) Deliver an unsynchronized shock.
B) Administer 1mg of epinephrine.
C) Administer 300mg of amiodarone.
D) Perform synchronized cardioversion.
E) Stop compressions and check for breath sounds.
Correct Answer: B) Administer 1mg of epinepherine
Rationale: For non-shockable rhythms (PEA/Asystole), epinephrine should be administered
as soon as possible after access is established.
Question 6
During a pause in CPR, you see a narrow complex rhythm on the monitor. The patient has no
pulse. What is the next action?
A) Check the blood pressure.
B) Administer 0.5mg of Atropine.
C) Resume compressions.
D) Prepare for synchronized cardioversion.
E) Insert a central line.
Correct Answer: C) Resume compressions
Rationale: A rhythm without a pulse is Pulseless Electrical Activity (PEA). The treatment
for PEA is high-quality CPR and Epinephrine; shocks are not indicated.
Question 7
What is a common but sometimes fatal mistake in cardiac arrest management?
, 3
A) Giving too much IV fluid.
B) Using a mechanical chest compression device.
C) Prolonged interruptions in chest compressions.
D) Using a bag-mask device instead of an ET tube.
E) Administering epinephrine every 5 minutes instead of every 3.
Correct Answer: C) Prolonged interruptions in chest compressions.
Rationale: Coronary perfusion pressure drops significantly every second compressions are
stopped. Minimizing pauses is critical for survival.
Question 8
Which action is a component of high-quality chest compressions?
A) Compressing the chest at a rate of 60-80 per minute.
B) Allowing complete chest recoil.
C) Pausing every 15 compressions to check the rhythm.
D) Compressing the chest to a depth of at least 4 inches.
E) Providing breaths with a 15:2 ratio for adults.
Correct Answer: B) Allowing complete chest recoil
Rationale: Full recoil allows the heart to refill with blood (venous return), which is essential
for the effectiveness of the next compression.
Question 9
Which action increases the chance of successful conversion of ventricular fibrillation?
A) Providing a "precordial thump."
B) Hyperventilating the patient with 100% oxygen.
C) Providing quality compressions immediately before a defibrillation attempt.
D) Pausing compressions for 30 seconds while the monitor charges.
E) Giving 3 doses of amiodarone before the first shock.
Correct Answer: C) Providing quality compressions immediately before a defibrillation
attempt.
Rationale: Maintaining high perfusion pressure immediately before the shock significantly
increases the likelihood that the shock will terminate VF.
Question 10
Which situation BEST describes Pulseless Electrical Activity (PEA)?
A) Ventricular fibrillation with a faint pulse.
B) Sinus rhythm without a pulse.
C) Asystole on the monitor.
D) Torsades de pointes with a rapid pulse.
E) A heart rate of 30 bpm with a strong pulse.
Correct Answer: B) Sinus rythm without a pulse
SUPPORT EXAM | ALL QUESTIONS AND CORRECT ANSWERS | VERIFIED
ANSWERS | BRAND NEW VERSION!
Question 1
You find an unresponsive patient who is not breathing. After activating the emergency response
system, you determine there is no pulse. What is your next action?
A) Open the airway and provide two rescue breaths.
B) Deliver a synchronized shock.
C) Start chest compressions of at least 100 per minute.
D) Perform a needle decompression.
E) Check for a pulse for 20 seconds.
Correct Answer: C) Start chest compressions of at least 100 per min.
Rationale: Per the BLS and ACLS guidelines, once unresponsiveness and pulselessness are
confirmed, high-quality chest compressions should begin immediately to maintain
perfusion.
Question 2
You are evaluating a 58-year-old man with chest pain. The BP is 92/50, heart rate is 92/min,
respiratory rate is 14 breaths/min, and the pulse O2 is 97%. What assessment step is most
important now?
A) Administering high-flow oxygen.
B) Obtaining a 12-lead ECG.
C) Administering a 2-liter fluid bolus.
D) Performing a rectal exam to check for GI bleed.
E) Immediate synchronized cardioversion.
Correct Answer: B) Obtaining a 12 lead ECG.
Rationale: In a patient with chest pain, a 12-lead ECG is the gold standard for identifying
ST-segment elevation myocardial infarction (STEMI) and determining the course of
treatment.
Question 3
What is the preferred method of access for epinephrine administration during cardiac arrest in
most patients?
A) Central venous line.
B) Intraosseous (IO) access.
C) Endotracheal tube (ET) administration.
D) Peripheral IV.
E) Intracardiac injection.
Correct Answer: D) Peripheral IV
Rationale: Peripheral IV access is the preferred route for drug administration during
, 2
resuscitation due to ease of access and safety, followed by IO access if IV cannot be
established.
Question 4
An AED is attached to a patient but does not promptly analyze a rhythm. What is your next step?
A) Wait for the AED to provide instructions.
B) Replace the battery in the AED.
C) Begin chest compressions.
D) Perform a pulse check for 10 seconds.
E) Disconnect the AED and find a manual monitor.
Correct Answer: C) Begin chest compressions.
Rationale: Minimize interruptions in chest compressions. If there is any delay in rhythm
analysis or equipment operation, compressions should be resumed immediately.
Question 5
You have completed 2 minutes of CPR. The ECG monitor displays a narrow complex rhythm
(PEA) and the patient has no pulse. Your partner resumes chest compressions and an IV is in
place. What management step is your next priority?
A) Deliver an unsynchronized shock.
B) Administer 1mg of epinephrine.
C) Administer 300mg of amiodarone.
D) Perform synchronized cardioversion.
E) Stop compressions and check for breath sounds.
Correct Answer: B) Administer 1mg of epinepherine
Rationale: For non-shockable rhythms (PEA/Asystole), epinephrine should be administered
as soon as possible after access is established.
Question 6
During a pause in CPR, you see a narrow complex rhythm on the monitor. The patient has no
pulse. What is the next action?
A) Check the blood pressure.
B) Administer 0.5mg of Atropine.
C) Resume compressions.
D) Prepare for synchronized cardioversion.
E) Insert a central line.
Correct Answer: C) Resume compressions
Rationale: A rhythm without a pulse is Pulseless Electrical Activity (PEA). The treatment
for PEA is high-quality CPR and Epinephrine; shocks are not indicated.
Question 7
What is a common but sometimes fatal mistake in cardiac arrest management?
, 3
A) Giving too much IV fluid.
B) Using a mechanical chest compression device.
C) Prolonged interruptions in chest compressions.
D) Using a bag-mask device instead of an ET tube.
E) Administering epinephrine every 5 minutes instead of every 3.
Correct Answer: C) Prolonged interruptions in chest compressions.
Rationale: Coronary perfusion pressure drops significantly every second compressions are
stopped. Minimizing pauses is critical for survival.
Question 8
Which action is a component of high-quality chest compressions?
A) Compressing the chest at a rate of 60-80 per minute.
B) Allowing complete chest recoil.
C) Pausing every 15 compressions to check the rhythm.
D) Compressing the chest to a depth of at least 4 inches.
E) Providing breaths with a 15:2 ratio for adults.
Correct Answer: B) Allowing complete chest recoil
Rationale: Full recoil allows the heart to refill with blood (venous return), which is essential
for the effectiveness of the next compression.
Question 9
Which action increases the chance of successful conversion of ventricular fibrillation?
A) Providing a "precordial thump."
B) Hyperventilating the patient with 100% oxygen.
C) Providing quality compressions immediately before a defibrillation attempt.
D) Pausing compressions for 30 seconds while the monitor charges.
E) Giving 3 doses of amiodarone before the first shock.
Correct Answer: C) Providing quality compressions immediately before a defibrillation
attempt.
Rationale: Maintaining high perfusion pressure immediately before the shock significantly
increases the likelihood that the shock will terminate VF.
Question 10
Which situation BEST describes Pulseless Electrical Activity (PEA)?
A) Ventricular fibrillation with a faint pulse.
B) Sinus rhythm without a pulse.
C) Asystole on the monitor.
D) Torsades de pointes with a rapid pulse.
E) A heart rate of 30 bpm with a strong pulse.
Correct Answer: B) Sinus rythm without a pulse
