1
AHA ACLS FINAL EXAM 2026/2027 | Most Comprehensive
Validation | Latest Guidelines | Pass Guaranteed - A+
Graded
Section 1: Cardiac Arrest Algorithms - Pulseless Arrest (Q1-12)
Q1. A 62-year-old male collapses in the hospital lobby. Bystanders initiate CPR. The
first arriving ACLS team member confirms unresponsiveness, absent breathing, and
no pulse. According to the 2025/2026 AHA ACLS Guidelines, what is the
recommended initial compression rate and depth for adult high-quality CPR?
A. Rate 80–100/min, depth at least 1.5 inches (4 cm)
B. Rate 100–120/min, depth at least 2 inches (5 cm) but not greater than 2.4 inches (6
cm)
C. Rate 120–140/min, depth at least 2.5 inches (6.5 cm)
D. Rate 100–120/min, depth at least 1.5 inches (4 cm) but not greater than 2 inches
(5 cm)
Correct Answer: B
Rationale: The 2025 AHA Guidelines reinforce compression rate of 100–120/min for
all age groups and specify adult compression depth of at least 2 inches (5 cm) with a
new emphasis on avoiding excessive depth (no greater than 2.4 inches/6 cm) to
reduce compression-related injuries. Option A has an inadequate rate and depth.
Option C exceeds the maximum recommended rate and depth. Option D has
inadequate depth.
Q2. A patient in monitored telemetry suddenly becomes unresponsive. The monitor
shows ventricular fibrillation (VF). The code team arrives with a biphasic defibrillator.
What is the most appropriate initial energy selection for the first shock?
,2
A. 50 J
B. 100 J
C. 120–200 J (or per manufacturer's recommendation)
D. 360 J
Correct Answer: C
Rationale: For biphasic defibrillators, the initial shock energy for VF/pVT is 120–200
J, or the manufacturer's recommended dose if known. If the optimal biphasic energy
is unknown, use the manufacturer's first-shock dose. Option A and B are too low for
effective VF termination. Option D (360 J) is the recommended dose for monophasic
defibrillators, not biphasic.
Q3. During a cardiac arrest with a shockable rhythm (VF), the team has delivered the
first shock and immediately resumed CPR. According to the 2025/2026 ACLS
Guidelines, when should epinephrine first be administered in this scenario?
A. Immediately after the first shock, before resuming CPR
B. After 2–3 failed defibrillation attempts while continuing high-quality CPR
C. After 5 minutes of CPR regardless of rhythm
D. Epinephrine is not indicated for shockable rhythms
Correct Answer: B
Rationale: The 2025 Guidelines specify that for shockable rhythms, epinephrine
should be administered AFTER initial defibrillation attempts have failed, prioritizing
rapid defibrillation over medication administration. This typically means after 2–3
failed shocks while continuing CPR. Option A incorrectly prioritizes medication over
defibrillation. Option C delays appropriate intervention. Option D is incorrect—
epinephrine is indicated after failed defibrillation.
Q4. A 58-year-old woman is found pulseless and apneic. The monitor shows asystole.
The team has initiated high-quality CPR and established IV access. What is the
correct epinephrine dosing and timing for this non-shockable rhythm?
, 3
A. 0.5 mg IV every 5–10 minutes
B. 1 mg IV every 3–5 minutes
C. 2 mg IV every 3–5 minutes
D. 1 mg IV every 1–2 minutes
Correct Answer: B
Rationale: For non-shockable rhythms (asystole/PEA), epinephrine 1 mg IV/IO
should be given as soon as feasible and then every 3–5 minutes. Option A uses an
incorrect dose. Option C uses an excessive dose (high-dose epinephrine is not
recommended). Option D uses an inappropriate frequency that could cause toxicity.
Q5. During CPR on a patient with PEA, the team leader calls for assessment of
reversible causes. Which of the following correctly lists the "Hs and Ts" of reversible
causes in cardiac arrest?
A. Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo-/Hyperkalemia,
Hypothermia; Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis
(pulmonary), Thrombosis (coronary)
B. Hypertension, Hypoglycemia, Hypocalcemia, Hypomagnesemia, Hyperthermia;
Trauma, Tachycardia, Tachypnea, Thrombocytopenia, Thyroid storm
C. Hypotension, Hypoxia, Hyperglycemia, Hypokalemia, Hypothermia; Tension
pneumothorax, Tamponade, Toxins, Thrombosis, Trauma
D. Hypovolemia, Hypoxia, Hypernatremia, Hypokalemia, Hypothermia; Tension
pneumothorax, Tamponade, Toxins, Thrombosis, Tachycardia
Correct Answer: A
Rationale: The classic H's and T's are: Hypovolemia, Hypoxia, Hydrogen ion
(acidosis), Hypo-/Hyperkalemia, Hypothermia; and Tension pneumothorax,
Tamponade (cardiac), Toxins, Thrombosis (pulmonary/PE), Thrombosis (coronary/MI).
Option B includes incorrect causes (hypertension, tachycardia, thrombocytopenia are
not reversible causes of arrest). Option C incorrectly includes hyperglycemia and
omits acidosis. Option D incorrectly includes hypernatremia and tachycardia.
AHA ACLS FINAL EXAM 2026/2027 | Most Comprehensive
Validation | Latest Guidelines | Pass Guaranteed - A+
Graded
Section 1: Cardiac Arrest Algorithms - Pulseless Arrest (Q1-12)
Q1. A 62-year-old male collapses in the hospital lobby. Bystanders initiate CPR. The
first arriving ACLS team member confirms unresponsiveness, absent breathing, and
no pulse. According to the 2025/2026 AHA ACLS Guidelines, what is the
recommended initial compression rate and depth for adult high-quality CPR?
A. Rate 80–100/min, depth at least 1.5 inches (4 cm)
B. Rate 100–120/min, depth at least 2 inches (5 cm) but not greater than 2.4 inches (6
cm)
C. Rate 120–140/min, depth at least 2.5 inches (6.5 cm)
D. Rate 100–120/min, depth at least 1.5 inches (4 cm) but not greater than 2 inches
(5 cm)
Correct Answer: B
Rationale: The 2025 AHA Guidelines reinforce compression rate of 100–120/min for
all age groups and specify adult compression depth of at least 2 inches (5 cm) with a
new emphasis on avoiding excessive depth (no greater than 2.4 inches/6 cm) to
reduce compression-related injuries. Option A has an inadequate rate and depth.
Option C exceeds the maximum recommended rate and depth. Option D has
inadequate depth.
Q2. A patient in monitored telemetry suddenly becomes unresponsive. The monitor
shows ventricular fibrillation (VF). The code team arrives with a biphasic defibrillator.
What is the most appropriate initial energy selection for the first shock?
,2
A. 50 J
B. 100 J
C. 120–200 J (or per manufacturer's recommendation)
D. 360 J
Correct Answer: C
Rationale: For biphasic defibrillators, the initial shock energy for VF/pVT is 120–200
J, or the manufacturer's recommended dose if known. If the optimal biphasic energy
is unknown, use the manufacturer's first-shock dose. Option A and B are too low for
effective VF termination. Option D (360 J) is the recommended dose for monophasic
defibrillators, not biphasic.
Q3. During a cardiac arrest with a shockable rhythm (VF), the team has delivered the
first shock and immediately resumed CPR. According to the 2025/2026 ACLS
Guidelines, when should epinephrine first be administered in this scenario?
A. Immediately after the first shock, before resuming CPR
B. After 2–3 failed defibrillation attempts while continuing high-quality CPR
C. After 5 minutes of CPR regardless of rhythm
D. Epinephrine is not indicated for shockable rhythms
Correct Answer: B
Rationale: The 2025 Guidelines specify that for shockable rhythms, epinephrine
should be administered AFTER initial defibrillation attempts have failed, prioritizing
rapid defibrillation over medication administration. This typically means after 2–3
failed shocks while continuing CPR. Option A incorrectly prioritizes medication over
defibrillation. Option C delays appropriate intervention. Option D is incorrect—
epinephrine is indicated after failed defibrillation.
Q4. A 58-year-old woman is found pulseless and apneic. The monitor shows asystole.
The team has initiated high-quality CPR and established IV access. What is the
correct epinephrine dosing and timing for this non-shockable rhythm?
, 3
A. 0.5 mg IV every 5–10 minutes
B. 1 mg IV every 3–5 minutes
C. 2 mg IV every 3–5 minutes
D. 1 mg IV every 1–2 minutes
Correct Answer: B
Rationale: For non-shockable rhythms (asystole/PEA), epinephrine 1 mg IV/IO
should be given as soon as feasible and then every 3–5 minutes. Option A uses an
incorrect dose. Option C uses an excessive dose (high-dose epinephrine is not
recommended). Option D uses an inappropriate frequency that could cause toxicity.
Q5. During CPR on a patient with PEA, the team leader calls for assessment of
reversible causes. Which of the following correctly lists the "Hs and Ts" of reversible
causes in cardiac arrest?
A. Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo-/Hyperkalemia,
Hypothermia; Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis
(pulmonary), Thrombosis (coronary)
B. Hypertension, Hypoglycemia, Hypocalcemia, Hypomagnesemia, Hyperthermia;
Trauma, Tachycardia, Tachypnea, Thrombocytopenia, Thyroid storm
C. Hypotension, Hypoxia, Hyperglycemia, Hypokalemia, Hypothermia; Tension
pneumothorax, Tamponade, Toxins, Thrombosis, Trauma
D. Hypovolemia, Hypoxia, Hypernatremia, Hypokalemia, Hypothermia; Tension
pneumothorax, Tamponade, Toxins, Thrombosis, Tachycardia
Correct Answer: A
Rationale: The classic H's and T's are: Hypovolemia, Hypoxia, Hydrogen ion
(acidosis), Hypo-/Hyperkalemia, Hypothermia; and Tension pneumothorax,
Tamponade (cardiac), Toxins, Thrombosis (pulmonary/PE), Thrombosis (coronary/MI).
Option B includes incorrect causes (hypertension, tachycardia, thrombocytopenia are
not reversible causes of arrest). Option C incorrectly includes hyperglycemia and
omits acidosis. Option D incorrectly includes hypernatremia and tachycardia.
