ACLS CERTIFICATION PRACTICE TEST: HIGH-YIELD
QUESTIONS BASED ON EMERGENCY CARDIAC
CARE GUIDELINES Q&A WITH DETAILED
RATIONALES.
1. A 58-year-old patient suddenly collapses and is unresponsive. After
confirming the scene is safe, what is your first action?
A. Check for a carotid pulse for 30 seconds
B. Begin chest compressions immediately without assessment
C. Activate the emergency response system after 5 minutes
D. Assess responsiveness, breathing, and pulse simultaneously within 10
seconds
Answer: D
Rationale: The initial ACLS approach is to rapidly assess responsiveness, breathing,
and pulse simultaneously, taking no more than 10 seconds before deciding
whether CPR is required.
2. During high-quality CPR, the recommended chest compression rate for
adults is:
A. 80–100 compressions per minute
B. 100–120 compressions per minute
C. 130–150 compressions per minute
D. Exactly 100 compressions per minute
Answer: B
Rationale: High-quality CPR requires a compression rate of 100–120 compressions
per minute to optimize blood flow while allowing adequate chest recoil.
3. The recommended compression depth for an average adult is:
A. At least 1 inch (2.5 cm)
B. Exactly 3 inches (7.5 cm)
,C. At least 2 inches (5 cm) but not more than 2.4 inches (6 cm)
D. As deep as possible
Answer: C
Rationale: Adult compressions should be at least 5 cm deep but generally not
exceed 6 cm to maximize effectiveness while minimizing injury.
4. Which rhythm is considered shockable?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Answer: C
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are
shockable rhythms requiring prompt defibrillation.
5. Following delivery of a shock, the next action is:
A. Check the pulse immediately
B. Analyze the rhythm again
C. Ventilate for one minute
D. Resume CPR immediately for 2 minutes
Answer: D
Rationale: Immediately resuming CPR after a shock improves coronary and
cerebral perfusion before the next rhythm check.
6. Which medication is recommended after the first dose of epinephrine
during refractory ventricular fibrillation or pulseless ventricular tachycardia?
A. Lidocaine only
B. Adenosine
C. Atropine
D. Amiodarone
,Answer: D
Rationale: Amiodarone is recommended for shock-refractory VF/pulseless VT after
appropriate CPR, defibrillation, and epinephrine.
7. The recommended adult epinephrine dose during cardiac arrest is:
A. 0.1 mg IV every minute
B. 5 mg IV once
C. 1 mg IV/IO every 3–5 minutes
D. 10 mg IV every 10 minutes
Answer: C
Rationale: Epinephrine is administered at 1 mg IV/IO every 3–5 minutes during
adult cardiac arrest.
8. Which rhythm should NOT be defibrillated?
A. Ventricular fibrillation
B. Pulseless ventricular tachycardia
C. Pulseless electrical activity
D. Coarse ventricular fibrillation
Answer: C
Rationale: Pulseless electrical activity is treated with CPR, epinephrine, and
correction of reversible causes rather than defibrillation.
9. An advanced airway has been placed during CPR. Ventilations should be
delivered:
A. 30 breaths per minute
B. 10 breaths per minute without pausing compressions
C. 20 breaths per minute
D. One breath after every compression
Answer: B
, Rationale: After advanced airway placement, continuous compressions are
provided with one breath every 6 seconds.
10.Which reversible causes are commonly remembered as the Hs and Ts?
A. Potential causes of cardiac arrest that should be identified and treated
B. Types of tachycardia
C. CPR quality indicators
D. Defibrillator settings
Answer: A
Rationale: Identifying and correcting reversible causes can improve the likelihood
of successful resuscitation.
11.Which rhythm requires synchronized cardioversion if the patient is
unstable?
A. Asystole
B. Ventricular fibrillation
C. Supraventricular tachycardia with a pulse
D. Pulseless ventricular tachycardia
Answer: C
Rationale: Unstable tachycardia with a pulse is treated with synchronized
cardioversion.
12.Which medication is recommended first for symptomatic bradycardia?
A. Dopamine
B. Epinephrine infusion
C. Adenosine
D. Atropine
Answer: D
Rationale: Atropine is the initial medication for symptomatic bradycardia unless
contraindicated or unlikely to be effective.
QUESTIONS BASED ON EMERGENCY CARDIAC
CARE GUIDELINES Q&A WITH DETAILED
RATIONALES.
1. A 58-year-old patient suddenly collapses and is unresponsive. After
confirming the scene is safe, what is your first action?
A. Check for a carotid pulse for 30 seconds
B. Begin chest compressions immediately without assessment
C. Activate the emergency response system after 5 minutes
D. Assess responsiveness, breathing, and pulse simultaneously within 10
seconds
Answer: D
Rationale: The initial ACLS approach is to rapidly assess responsiveness, breathing,
and pulse simultaneously, taking no more than 10 seconds before deciding
whether CPR is required.
2. During high-quality CPR, the recommended chest compression rate for
adults is:
A. 80–100 compressions per minute
B. 100–120 compressions per minute
C. 130–150 compressions per minute
D. Exactly 100 compressions per minute
Answer: B
Rationale: High-quality CPR requires a compression rate of 100–120 compressions
per minute to optimize blood flow while allowing adequate chest recoil.
3. The recommended compression depth for an average adult is:
A. At least 1 inch (2.5 cm)
B. Exactly 3 inches (7.5 cm)
,C. At least 2 inches (5 cm) but not more than 2.4 inches (6 cm)
D. As deep as possible
Answer: C
Rationale: Adult compressions should be at least 5 cm deep but generally not
exceed 6 cm to maximize effectiveness while minimizing injury.
4. Which rhythm is considered shockable?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Answer: C
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are
shockable rhythms requiring prompt defibrillation.
5. Following delivery of a shock, the next action is:
A. Check the pulse immediately
B. Analyze the rhythm again
C. Ventilate for one minute
D. Resume CPR immediately for 2 minutes
Answer: D
Rationale: Immediately resuming CPR after a shock improves coronary and
cerebral perfusion before the next rhythm check.
6. Which medication is recommended after the first dose of epinephrine
during refractory ventricular fibrillation or pulseless ventricular tachycardia?
A. Lidocaine only
B. Adenosine
C. Atropine
D. Amiodarone
,Answer: D
Rationale: Amiodarone is recommended for shock-refractory VF/pulseless VT after
appropriate CPR, defibrillation, and epinephrine.
7. The recommended adult epinephrine dose during cardiac arrest is:
A. 0.1 mg IV every minute
B. 5 mg IV once
C. 1 mg IV/IO every 3–5 minutes
D. 10 mg IV every 10 minutes
Answer: C
Rationale: Epinephrine is administered at 1 mg IV/IO every 3–5 minutes during
adult cardiac arrest.
8. Which rhythm should NOT be defibrillated?
A. Ventricular fibrillation
B. Pulseless ventricular tachycardia
C. Pulseless electrical activity
D. Coarse ventricular fibrillation
Answer: C
Rationale: Pulseless electrical activity is treated with CPR, epinephrine, and
correction of reversible causes rather than defibrillation.
9. An advanced airway has been placed during CPR. Ventilations should be
delivered:
A. 30 breaths per minute
B. 10 breaths per minute without pausing compressions
C. 20 breaths per minute
D. One breath after every compression
Answer: B
, Rationale: After advanced airway placement, continuous compressions are
provided with one breath every 6 seconds.
10.Which reversible causes are commonly remembered as the Hs and Ts?
A. Potential causes of cardiac arrest that should be identified and treated
B. Types of tachycardia
C. CPR quality indicators
D. Defibrillator settings
Answer: A
Rationale: Identifying and correcting reversible causes can improve the likelihood
of successful resuscitation.
11.Which rhythm requires synchronized cardioversion if the patient is
unstable?
A. Asystole
B. Ventricular fibrillation
C. Supraventricular tachycardia with a pulse
D. Pulseless ventricular tachycardia
Answer: C
Rationale: Unstable tachycardia with a pulse is treated with synchronized
cardioversion.
12.Which medication is recommended first for symptomatic bradycardia?
A. Dopamine
B. Epinephrine infusion
C. Adenosine
D. Atropine
Answer: D
Rationale: Atropine is the initial medication for symptomatic bradycardia unless
contraindicated or unlikely to be effective.
