2025\2026 ACLS Exams A and B questions and answers with
Answer Keys
ACLS VERSION A
Question 1
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.
Correct Answer: C
Rationale: If an AED does not analyze promptly, check the electrode pad
connections and ensure good skin contact before prompting reanalysis.
Correcting connection issues takes priority to allow rhythm analysis.
Question 2
You have completed 2 minutes of CPR. The ECG monitor displays ventricular
fibrillation, and the patient has no pulse. Another member of your team resumes
chest compressions, and an IV is in place. What management step is your next
priority?
A. Give an immediate unsynchronized shock.
B. Establish vascular access.
C. Resume chest compressions.
D. Obtain the patient’s history.
Correct Answer: A
Rationale: Ventricular fibrillation (VF) is a shockable rhythm. After the initial 2-
minute CPR cycle and confirming VF, the next priority is defibrillation. CPR should
resume immediately after shock delivery.
,Question 3
What is the preferred method of access for epinephrine administration during
cardiac arrest in most patients?
A. Intraosseous
B. Endotracheal
C. Central intravenous
D. Peripheral intravenous
Correct Answer: D
Rationale: Peripheral IV is preferred due to availability and rapid establishment. If
difficult, intraosseous (IO) access provides an excellent alternative. Endotracheal
administration is no longer preferred due to variable absorption.
Question 4
You find an unresponsive patient who is not breathing. After activating the
emergency response system, you determine that there is no pulse. What is your
next action?
A. Open the airway with a head tilt–chin lift.
B. Administer epinephrine at a dose of 1 mg/kg.
C. Deliver 2 rescue breaths each over 1 second.
D. Start chest compressions at a rate of at least 100/min.
Correct Answer: D
Rationale: For an unresponsive, apneic, pulseless patient, the immediate next
step is to start high-quality chest compressions immediately. Compressions
maintain circulation to vital organs and are key to successful resuscitation.
Question 5
You are evaluating a 58-year-old man with chest pain. Blood pressure is 92/50
mm Hg, heart rate is 92/min, nonlabored respiratory rate is 14 breaths/min, and
pulse oximetry is 97%. What assessment step is most important now?
A. PETCO₂
B. Chest x-ray
,C. Laboratory testing
D. Obtaining a 12-lead ECG
Correct Answer: D
Rationale: In a patient with chest pain and possible hemodynamic compromise
(low-normal blood pressure), obtaining a 12-lead ECG should be prioritized. The
ECG identifies ischemic changes, acute coronary syndromes, or arrhythmias and
guides urgent treatment decisions.
Question 6
During a pause in CPR, you see asystole on the monitor. The patient has no pulse.
What is the next action?
A. Establish vascular access.
B. Obtain the patient’s history.
C. Resume chest compressions.
D. Terminate the resuscitative effort.
Correct Answer: C
Rationale: Asystole is a nonshockable rhythm. Immediate resumption of high-
quality chest compressions is essential to maintain circulation and attempt ROSC.
Question 7
What is a common but sometimes fatal mistake in cardiac arrest management?
A. Failure to obtain vascular access
B. Prolonged periods of no ventilations
C. Failure to perform endotracheal intubation
D. Prolonged interruptions in chest compressions
Correct Answer: D
Rationale: Interruptions in chest compressions reduce coronary and cerebral
perfusion pressure, significantly decreasing the likelihood of ROSC and survival.
Minimizing pauses during CPR is critical.
, Question 8
Which action is a component of high-quality chest compressions?
A. Allowing complete chest recoil
B. Chest compressions without ventilation
C. 60 to 100 compressions per minute
D. Compressions at a depth of 1½ inches
Correct Answer: A
Rationale: High-quality chest compressions require full chest recoil between
compressions to allow heart chambers to refill adequately. Compressions should
be at a rate of 100-120/min and a depth of at least 2 inches (5 cm) in adults.
Question 9
Which action increases the chance of successful conversion of ventricular
fibrillation?
A. Pausing chest compressions immediately after defibrillation
B. Administering 4 quick ventilations before defibrillation
C. Using manual defibrillator paddles with light pressure
D. Providing quality compressions immediately before defibrillation
Correct Answer: D
Rationale: Providing high-quality chest compressions before defibrillation
improves myocardial oxygenation and shock efficacy. Minimizing pauses around
defibrillation improves outcomes.
Question 10
Which situation BEST describes pulseless electrical activity?
A. Asystole without a pulse
B. Sinus rhythm without a pulse
C. Torsades de pointes with a pulse
D. Ventricular tachycardia with a pulse
Correct Answer: B
Rationale: Pulseless electrical activity (PEA) is the presence of organized electrical
Answer Keys
ACLS VERSION A
Question 1
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.
Correct Answer: C
Rationale: If an AED does not analyze promptly, check the electrode pad
connections and ensure good skin contact before prompting reanalysis.
Correcting connection issues takes priority to allow rhythm analysis.
Question 2
You have completed 2 minutes of CPR. The ECG monitor displays ventricular
fibrillation, and the patient has no pulse. Another member of your team resumes
chest compressions, and an IV is in place. What management step is your next
priority?
A. Give an immediate unsynchronized shock.
B. Establish vascular access.
C. Resume chest compressions.
D. Obtain the patient’s history.
Correct Answer: A
Rationale: Ventricular fibrillation (VF) is a shockable rhythm. After the initial 2-
minute CPR cycle and confirming VF, the next priority is defibrillation. CPR should
resume immediately after shock delivery.
,Question 3
What is the preferred method of access for epinephrine administration during
cardiac arrest in most patients?
A. Intraosseous
B. Endotracheal
C. Central intravenous
D. Peripheral intravenous
Correct Answer: D
Rationale: Peripheral IV is preferred due to availability and rapid establishment. If
difficult, intraosseous (IO) access provides an excellent alternative. Endotracheal
administration is no longer preferred due to variable absorption.
Question 4
You find an unresponsive patient who is not breathing. After activating the
emergency response system, you determine that there is no pulse. What is your
next action?
A. Open the airway with a head tilt–chin lift.
B. Administer epinephrine at a dose of 1 mg/kg.
C. Deliver 2 rescue breaths each over 1 second.
D. Start chest compressions at a rate of at least 100/min.
Correct Answer: D
Rationale: For an unresponsive, apneic, pulseless patient, the immediate next
step is to start high-quality chest compressions immediately. Compressions
maintain circulation to vital organs and are key to successful resuscitation.
Question 5
You are evaluating a 58-year-old man with chest pain. Blood pressure is 92/50
mm Hg, heart rate is 92/min, nonlabored respiratory rate is 14 breaths/min, and
pulse oximetry is 97%. What assessment step is most important now?
A. PETCO₂
B. Chest x-ray
,C. Laboratory testing
D. Obtaining a 12-lead ECG
Correct Answer: D
Rationale: In a patient with chest pain and possible hemodynamic compromise
(low-normal blood pressure), obtaining a 12-lead ECG should be prioritized. The
ECG identifies ischemic changes, acute coronary syndromes, or arrhythmias and
guides urgent treatment decisions.
Question 6
During a pause in CPR, you see asystole on the monitor. The patient has no pulse.
What is the next action?
A. Establish vascular access.
B. Obtain the patient’s history.
C. Resume chest compressions.
D. Terminate the resuscitative effort.
Correct Answer: C
Rationale: Asystole is a nonshockable rhythm. Immediate resumption of high-
quality chest compressions is essential to maintain circulation and attempt ROSC.
Question 7
What is a common but sometimes fatal mistake in cardiac arrest management?
A. Failure to obtain vascular access
B. Prolonged periods of no ventilations
C. Failure to perform endotracheal intubation
D. Prolonged interruptions in chest compressions
Correct Answer: D
Rationale: Interruptions in chest compressions reduce coronary and cerebral
perfusion pressure, significantly decreasing the likelihood of ROSC and survival.
Minimizing pauses during CPR is critical.
, Question 8
Which action is a component of high-quality chest compressions?
A. Allowing complete chest recoil
B. Chest compressions without ventilation
C. 60 to 100 compressions per minute
D. Compressions at a depth of 1½ inches
Correct Answer: A
Rationale: High-quality chest compressions require full chest recoil between
compressions to allow heart chambers to refill adequately. Compressions should
be at a rate of 100-120/min and a depth of at least 2 inches (5 cm) in adults.
Question 9
Which action increases the chance of successful conversion of ventricular
fibrillation?
A. Pausing chest compressions immediately after defibrillation
B. Administering 4 quick ventilations before defibrillation
C. Using manual defibrillator paddles with light pressure
D. Providing quality compressions immediately before defibrillation
Correct Answer: D
Rationale: Providing high-quality chest compressions before defibrillation
improves myocardial oxygenation and shock efficacy. Minimizing pauses around
defibrillation improves outcomes.
Question 10
Which situation BEST describes pulseless electrical activity?
A. Asystole without a pulse
B. Sinus rhythm without a pulse
C. Torsades de pointes with a pulse
D. Ventricular tachycardia with a pulse
Correct Answer: B
Rationale: Pulseless electrical activity (PEA) is the presence of organized electrical
