ACLS Final Exam Actual Exam 2026/2027: Complete
Exam-Style Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Systematic Approach & High-Quality BLS | Q1 – Q10
Section 2 | Airway Management & Respiratory Arrest | Q11 – Q20
Section 3 | Bradycardia & Tachycardia Management | Q21 – Q30
Section 4 | Cardiac Arrest & Post-Cardiac Arrest Care | Q31 – Q40
Section 5 | Acute Coronary Syndrome & Stroke | Q41 – Q50
Instructions: Choose the single best answer. Pass: 84% in 90 minutes.
══════════════════════════════════════
SECTION 1: SYSTEMATIC APPROACH & HIGH-QUALITY BLS Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 68-year-old man collapses in the hospital cafeteria. A nurse finds him unresponsive,
not breathing, and without a pulse. The code team arrives with an AED within 90
seconds. What is the immediate priority after starting high-quality chest compressions?
A. Insert an advanced airway and begin positive pressure ventilation at 10 breaths per
minute
B. Establish IV access and administer 1 mg epinephrine immediately
C. Continue compressions and apply the AED pads to analyze the rhythm as soon as
possible ✓ CORRECT
D. Perform a 12-lead ECG to determine the precise arrhythmia before any further action
Correct Answer: C
Rationale: In witnessed adult cardiac arrest, the BLS sequence prioritizes immediate
high-quality CPR and rapid AED application for shockable rhythms; advanced airways
and medications come later in the algorithm. Choice A is incorrect because airway
,insertion should not interrupt compressions and is not the immediate priority over
defibrillation in the first minutes. Early defibrillation remains the single most effective
intervention for ventricular fibrillation.
Question 2 of 50
A 4-year-old child is eating a hot dog in the hospital playroom when she suddenly stands
up, grasps her throat with both hands, and cannot speak or cough. Her lips are turning
blue. What is your immediate intervention?
A. Perform abdominal thrusts until the object is expelled or the child becomes
unresponsive ✓ CORRECT
B. Deliver five back blows while the child is standing upright
C. Immediately lay the child supine and begin CPR compressions
D. Insert an oropharyngeal airway to bypass the obstruction
Correct Answer: A
Rationale: A child with severe airway obstruction who cannot speak, cough, or breathe
requires immediate abdominal thrusts according to the choking algorithm for
responsive victims. Choice B is incorrect because back blows are reserved for infants
under one year; for children and adults, abdominal thrusts are the primary intervention.
Time is critical here, and delaying thrusts to attempt other maneuvers increases the risk
of progression to cardiac arrest.
Question 3 of 50
During a resuscitation of a 45-year-old man in pulseless VT, the team leader asks the
recorder to announce the time every two minutes. The compressor states she is
fatigued. The airway provider says he is ready to intubate. What should the team leader
say next?
A. "Continue compressions and ignore the fatigue until the rhythm check"
B. "Stop compressions now so we can intubate immediately"
,C. "Switch compressors after the next shock, but not before"
D. "Switch compressors now and continue CPR while we prepare for intubation" ✓
CORRECT
Correct Answer: D
Rationale: High-quality CPR requires compressor rotation every two minutes or when
fatigue is reported, and intubation should be performed without interrupting
compressions whenever possible. Choice B is incorrect because stopping
compressions for intubation violates the principle of minimizing interruptions to less
than ten seconds. Effective team dynamics depend on closed-loop communication and
prioritizing uninterrupted compressions over procedural convenience.
Question 4 of 50
A 52-year-old woman suffers an out-of-hospital cardiac arrest. Bystanders begin CPR
before EMS arrives. The paramedics note the compressions appear shallow. What is the
correct compression depth for this adult patient?
A. At least 1 inch but no more than 1.5 inches
B. At least 2 inches but no more than 2.4 inches ✓ CORRECT
C. Exactly 3 inches to ensure adequate cardiac output
D. Approximately 1.5 inches to avoid rib fractures
Correct Answer: B
Rationale: AHA guidelines recommend compressing the adult chest at least 2 inches
but no more than 2.4 inches to generate adequate perfusion without increasing the risk
of injury excessively. Choice A describes infant compression depth, not adult. Achieving
adequate depth often requires significant force, and rescuers should recalibrate if they
are not reaching the minimum threshold.
Question 5 of 50
, You are performing CPR on a 70-year-old man when an AED arrives. The device advises
a shock. What is the correct sequence of actions?
A. Deliver the shock immediately while compressions continue
B. Wait for the team leader to verify the rhythm on the monitor before shocking
C. Clear the patient, deliver the shock, and immediately resume compressions ✓
CORRECT
D. Administer 1 mg epinephrine before delivering the shock
Correct Answer: C
Rationale: When an AED advises a shock, rescuers must clear the patient to ensure
safety, deliver the shock, and then resume compressions immediately without pausing
for a pulse check or rhythm analysis. Choice B is incorrect because the AED's advisory
is sufficient for BLS providers; waiting for manual rhythm verification wastes critical
time. Every second without compressions reduces coronary perfusion pressure and the
likelihood of ROSC.
Question 6 of 50
A 29-year-old man is found unresponsive in a parking lot with slow, gasping respirations
and pinpoint pupils. His friend says he may have taken opioids. His pulse is present but
weak. What is the immediate intervention?
A. Administer intranasal or intramuscular naloxone and support ventilation with a
bag-mask device ✓ CORRECT
B. Begin immediate chest compressions at 100 to 120 per minute
C. Insert an oropharyngeal airway and wait for spontaneous recovery
D. Administer flumazenil to reverse the suspected overdose
Correct Answer: A
Rationale: Opioid overdose with respiratory depression but present pulse requires
ventilation support and naloxone administration; CPR is not indicated unless the patient
becomes pulseless. Choice B is incorrect because chest compressions are reserved for
Exam-Style Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Systematic Approach & High-Quality BLS | Q1 – Q10
Section 2 | Airway Management & Respiratory Arrest | Q11 – Q20
Section 3 | Bradycardia & Tachycardia Management | Q21 – Q30
Section 4 | Cardiac Arrest & Post-Cardiac Arrest Care | Q31 – Q40
Section 5 | Acute Coronary Syndrome & Stroke | Q41 – Q50
Instructions: Choose the single best answer. Pass: 84% in 90 minutes.
══════════════════════════════════════
SECTION 1: SYSTEMATIC APPROACH & HIGH-QUALITY BLS Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 68-year-old man collapses in the hospital cafeteria. A nurse finds him unresponsive,
not breathing, and without a pulse. The code team arrives with an AED within 90
seconds. What is the immediate priority after starting high-quality chest compressions?
A. Insert an advanced airway and begin positive pressure ventilation at 10 breaths per
minute
B. Establish IV access and administer 1 mg epinephrine immediately
C. Continue compressions and apply the AED pads to analyze the rhythm as soon as
possible ✓ CORRECT
D. Perform a 12-lead ECG to determine the precise arrhythmia before any further action
Correct Answer: C
Rationale: In witnessed adult cardiac arrest, the BLS sequence prioritizes immediate
high-quality CPR and rapid AED application for shockable rhythms; advanced airways
and medications come later in the algorithm. Choice A is incorrect because airway
,insertion should not interrupt compressions and is not the immediate priority over
defibrillation in the first minutes. Early defibrillation remains the single most effective
intervention for ventricular fibrillation.
Question 2 of 50
A 4-year-old child is eating a hot dog in the hospital playroom when she suddenly stands
up, grasps her throat with both hands, and cannot speak or cough. Her lips are turning
blue. What is your immediate intervention?
A. Perform abdominal thrusts until the object is expelled or the child becomes
unresponsive ✓ CORRECT
B. Deliver five back blows while the child is standing upright
C. Immediately lay the child supine and begin CPR compressions
D. Insert an oropharyngeal airway to bypass the obstruction
Correct Answer: A
Rationale: A child with severe airway obstruction who cannot speak, cough, or breathe
requires immediate abdominal thrusts according to the choking algorithm for
responsive victims. Choice B is incorrect because back blows are reserved for infants
under one year; for children and adults, abdominal thrusts are the primary intervention.
Time is critical here, and delaying thrusts to attempt other maneuvers increases the risk
of progression to cardiac arrest.
Question 3 of 50
During a resuscitation of a 45-year-old man in pulseless VT, the team leader asks the
recorder to announce the time every two minutes. The compressor states she is
fatigued. The airway provider says he is ready to intubate. What should the team leader
say next?
A. "Continue compressions and ignore the fatigue until the rhythm check"
B. "Stop compressions now so we can intubate immediately"
,C. "Switch compressors after the next shock, but not before"
D. "Switch compressors now and continue CPR while we prepare for intubation" ✓
CORRECT
Correct Answer: D
Rationale: High-quality CPR requires compressor rotation every two minutes or when
fatigue is reported, and intubation should be performed without interrupting
compressions whenever possible. Choice B is incorrect because stopping
compressions for intubation violates the principle of minimizing interruptions to less
than ten seconds. Effective team dynamics depend on closed-loop communication and
prioritizing uninterrupted compressions over procedural convenience.
Question 4 of 50
A 52-year-old woman suffers an out-of-hospital cardiac arrest. Bystanders begin CPR
before EMS arrives. The paramedics note the compressions appear shallow. What is the
correct compression depth for this adult patient?
A. At least 1 inch but no more than 1.5 inches
B. At least 2 inches but no more than 2.4 inches ✓ CORRECT
C. Exactly 3 inches to ensure adequate cardiac output
D. Approximately 1.5 inches to avoid rib fractures
Correct Answer: B
Rationale: AHA guidelines recommend compressing the adult chest at least 2 inches
but no more than 2.4 inches to generate adequate perfusion without increasing the risk
of injury excessively. Choice A describes infant compression depth, not adult. Achieving
adequate depth often requires significant force, and rescuers should recalibrate if they
are not reaching the minimum threshold.
Question 5 of 50
, You are performing CPR on a 70-year-old man when an AED arrives. The device advises
a shock. What is the correct sequence of actions?
A. Deliver the shock immediately while compressions continue
B. Wait for the team leader to verify the rhythm on the monitor before shocking
C. Clear the patient, deliver the shock, and immediately resume compressions ✓
CORRECT
D. Administer 1 mg epinephrine before delivering the shock
Correct Answer: C
Rationale: When an AED advises a shock, rescuers must clear the patient to ensure
safety, deliver the shock, and then resume compressions immediately without pausing
for a pulse check or rhythm analysis. Choice B is incorrect because the AED's advisory
is sufficient for BLS providers; waiting for manual rhythm verification wastes critical
time. Every second without compressions reduces coronary perfusion pressure and the
likelihood of ROSC.
Question 6 of 50
A 29-year-old man is found unresponsive in a parking lot with slow, gasping respirations
and pinpoint pupils. His friend says he may have taken opioids. His pulse is present but
weak. What is the immediate intervention?
A. Administer intranasal or intramuscular naloxone and support ventilation with a
bag-mask device ✓ CORRECT
B. Begin immediate chest compressions at 100 to 120 per minute
C. Insert an oropharyngeal airway and wait for spontaneous recovery
D. Administer flumazenil to reverse the suspected overdose
Correct Answer: A
Rationale: Opioid overdose with respiratory depression but present pulse requires
ventilation support and naloxone administration; CPR is not indicated unless the patient
becomes pulseless. Choice B is incorrect because chest compressions are reserved for
