ACLS CERTIFICATION EXAMINATION TEST
2026 COMPREHENSIVE Q AND A STUDY
GUIDE
◉ You are evaluating a 58-year-old man with chest pain. The blood
pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored
respiratory rate is 14 breaths/min, and the pulse oximetry reading is
97%. What assessment step is most important now?
Answer: Obtaining a 12 lead ECG.
◉ What is the preferred method of access for epi administration
during cardiac arrest in most pts?
Answer: Peripheral IV
◉ An AED does not promptly analyze a rythm. What is your next
step?
Answer: Begin chest compressions.
◉ You have completed 2 minutes of CPR. The ECG monitor displays
the lead II rhythm below, 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?
,Answer: Administer 1mg of epinephrine
◉ During a pause in CPR, you see this lead II ECG rhythm on the
monitor. The patient has no pulse. What is the next action?
Answer: Resume compressions
◉ What is a common but sometimes fatal mistake in cardiac arrest
management?
Answer: Prolonged interruptions in chest compressions.
◉ Which action is a componant of high-quality chest comressions?
Answer: Allowing complete chest recoil
◉ Which action increases the chance of successful conversion of
ventricular fibrillation?
Answer: Providing quality compressions immediately before a
defibrillation attempt.
◉ Which situation BEST describes pulseless electrical activity?
Answer: Sinus rythm without a pulse
◉ What is the BEST strategy for performing high-quality CPR on a
patient with an advanced airway in place?
, Answer: Provide continuous chest compressions without pauses and
10 ventilations per minute.
◉ Three minutes after witnessing a cardiac arrest, one member of
your team inserts an endotracheal tube while another performs
continuous chest compressions. During subsequent ventilation, you
notice the presence of a waveform on the capnography screen and a
PETCO2 level of 8 mm Hg. What is the significance of this finding?
Answer: Chest compressions may not be effective.
◉ The use of quantitative capnography in intubated patients
Answer: allows for monitoring of CPR quality.
◉ For the past 25 minutes, an EMS crew has attempted resuscitation
of a patient who originally presented in ventricular fibrillation. After
the first shock, the ECG screen displayed asystole, which has
persisted despite 2 doses of epinephrine, a fluid bolus, and high-
quality CPR. What is your next treatment?
Answer: Consider terminating resuscitive efforts after consulting
medical control.
◉ Which is a safe and effective practice within the defibrillation
sequence?
Answer: Be sure oxygen is not blowing over the patient's chest
during the shock.
2026 COMPREHENSIVE Q AND A STUDY
GUIDE
◉ You are evaluating a 58-year-old man with chest pain. The blood
pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored
respiratory rate is 14 breaths/min, and the pulse oximetry reading is
97%. What assessment step is most important now?
Answer: Obtaining a 12 lead ECG.
◉ What is the preferred method of access for epi administration
during cardiac arrest in most pts?
Answer: Peripheral IV
◉ An AED does not promptly analyze a rythm. What is your next
step?
Answer: Begin chest compressions.
◉ You have completed 2 minutes of CPR. The ECG monitor displays
the lead II rhythm below, 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?
,Answer: Administer 1mg of epinephrine
◉ During a pause in CPR, you see this lead II ECG rhythm on the
monitor. The patient has no pulse. What is the next action?
Answer: Resume compressions
◉ What is a common but sometimes fatal mistake in cardiac arrest
management?
Answer: Prolonged interruptions in chest compressions.
◉ Which action is a componant of high-quality chest comressions?
Answer: Allowing complete chest recoil
◉ Which action increases the chance of successful conversion of
ventricular fibrillation?
Answer: Providing quality compressions immediately before a
defibrillation attempt.
◉ Which situation BEST describes pulseless electrical activity?
Answer: Sinus rythm without a pulse
◉ What is the BEST strategy for performing high-quality CPR on a
patient with an advanced airway in place?
, Answer: Provide continuous chest compressions without pauses and
10 ventilations per minute.
◉ Three minutes after witnessing a cardiac arrest, one member of
your team inserts an endotracheal tube while another performs
continuous chest compressions. During subsequent ventilation, you
notice the presence of a waveform on the capnography screen and a
PETCO2 level of 8 mm Hg. What is the significance of this finding?
Answer: Chest compressions may not be effective.
◉ The use of quantitative capnography in intubated patients
Answer: allows for monitoring of CPR quality.
◉ For the past 25 minutes, an EMS crew has attempted resuscitation
of a patient who originally presented in ventricular fibrillation. After
the first shock, the ECG screen displayed asystole, which has
persisted despite 2 doses of epinephrine, a fluid bolus, and high-
quality CPR. What is your next treatment?
Answer: Consider terminating resuscitive efforts after consulting
medical control.
◉ Which is a safe and effective practice within the defibrillation
sequence?
Answer: Be sure oxygen is not blowing over the patient's chest
during the shock.
