2026 Advanced Cardiovascular Life
Support (ACLS) Provider Certification
Examination Original Practice Questions
With Answers and Rationales
Question 1
A 58-year-old patient suddenly collapses in a hospital hallway.
The patient is unresponsive and has occasional gasping
respirations. A healthcare professional checks for a pulse but
cannot definitively feel one within 10 seconds. What should
the rescuer do next?
Correct Answer: B
Rationale: An unresponsive adult with absent or abnormal
breathing and no definite pulse within 10 seconds should be
treated as cardiac arrest. CPR should begin immediately.
Question 2
Which chest-compression rate is recommended for an adult
in cardiac arrest?
A. 60–80/min
B. 80–100/min
C. 100–120/min
D. 120–140/min
Correct Answer: C
,Rationale: High-quality adult CPR requires chest compressions
at approximately 100–120/min.
Question 3
What is the recommended minimum chest-compression
depth for an average adult?
A. 2 cm
B. 3 cm
C. 5 cm
D. 7 cm
Correct Answer: C
Rationale: Adult chest compressions should be at least 5 cm
deep while avoiding excessive depth greater than
approximately 6 cm.
Question 4
A CPR team is performing compressions. Which action most
directly improves coronary perfusion during CPR?
A. Leaning on the chest between compressions
B. Allowing complete chest recoil
C. Increasing ventilation frequency
D. Pausing frequently to check the pulse
Correct Answer: B
Rationale: Complete chest recoil allows venous return and
helps maintain coronary perfusion pressure.
Question 5
,When an adult cardiac arrest patient does not have an
advanced airway, what compression-to-ventilation ratio
should generally be used?
A. 5:1
B. 15:2
C. 30:2
D. 50:2
Correct Answer: C
Rationale: Adult CPR without an advanced airway uses 30
compressions followed by 2 breaths.
Question 6
A patient has an advanced airway placed during cardiac
arrest. Which ventilation strategy is appropriate?
A. Two breaths after every 30 compressions
B. One breath every 2 seconds with pauses in compressions
C. One breath every 6 seconds with continuous compressions
D. One breath every 10 seconds with pauses in compressions
Correct Answer: C
Rationale: Once an advanced airway is in place, continuous
chest compressions are maintained while approximately 10
breaths/min are delivered.
Question 7
During CPR, the end-tidal carbon dioxide suddenly increases
from 12 mm Hg to 38 mm Hg. What should the team
suspect?
, A. Severe hyperventilation
B. Return of spontaneous circulation
C. Worsening pulmonary edema
D. Esophageal intubation
Correct Answer: B
Rationale: An abrupt increase in ETCO₂ can be an important
indicator of ROSC during CPR.
Question 8
Which finding suggests that CPR quality should be
reassessed?
A. Stable ETCO₂
B. Increasing ETCO₂
C. Low or progressively decreasing ETCO₂
D. Normal capillary refill
Correct Answer: C
Rationale: Low or decreasing ETCO₂ during CPR may indicate
inadequate chest-compression quality or another problem
requiring reassessment.
Question 9
A team is preparing for a rhythm check after 2 minutes of
CPR. Which action is most appropriate?
A. Continue the pulse check for 30 seconds
B. Minimize the pause and rapidly determine the rhythm
C. Stop CPR for a complete neurological examination
D. Administer atropine before evaluating the rhythm
Support (ACLS) Provider Certification
Examination Original Practice Questions
With Answers and Rationales
Question 1
A 58-year-old patient suddenly collapses in a hospital hallway.
The patient is unresponsive and has occasional gasping
respirations. A healthcare professional checks for a pulse but
cannot definitively feel one within 10 seconds. What should
the rescuer do next?
Correct Answer: B
Rationale: An unresponsive adult with absent or abnormal
breathing and no definite pulse within 10 seconds should be
treated as cardiac arrest. CPR should begin immediately.
Question 2
Which chest-compression rate is recommended for an adult
in cardiac arrest?
A. 60–80/min
B. 80–100/min
C. 100–120/min
D. 120–140/min
Correct Answer: C
,Rationale: High-quality adult CPR requires chest compressions
at approximately 100–120/min.
Question 3
What is the recommended minimum chest-compression
depth for an average adult?
A. 2 cm
B. 3 cm
C. 5 cm
D. 7 cm
Correct Answer: C
Rationale: Adult chest compressions should be at least 5 cm
deep while avoiding excessive depth greater than
approximately 6 cm.
Question 4
A CPR team is performing compressions. Which action most
directly improves coronary perfusion during CPR?
A. Leaning on the chest between compressions
B. Allowing complete chest recoil
C. Increasing ventilation frequency
D. Pausing frequently to check the pulse
Correct Answer: B
Rationale: Complete chest recoil allows venous return and
helps maintain coronary perfusion pressure.
Question 5
,When an adult cardiac arrest patient does not have an
advanced airway, what compression-to-ventilation ratio
should generally be used?
A. 5:1
B. 15:2
C. 30:2
D. 50:2
Correct Answer: C
Rationale: Adult CPR without an advanced airway uses 30
compressions followed by 2 breaths.
Question 6
A patient has an advanced airway placed during cardiac
arrest. Which ventilation strategy is appropriate?
A. Two breaths after every 30 compressions
B. One breath every 2 seconds with pauses in compressions
C. One breath every 6 seconds with continuous compressions
D. One breath every 10 seconds with pauses in compressions
Correct Answer: C
Rationale: Once an advanced airway is in place, continuous
chest compressions are maintained while approximately 10
breaths/min are delivered.
Question 7
During CPR, the end-tidal carbon dioxide suddenly increases
from 12 mm Hg to 38 mm Hg. What should the team
suspect?
, A. Severe hyperventilation
B. Return of spontaneous circulation
C. Worsening pulmonary edema
D. Esophageal intubation
Correct Answer: B
Rationale: An abrupt increase in ETCO₂ can be an important
indicator of ROSC during CPR.
Question 8
Which finding suggests that CPR quality should be
reassessed?
A. Stable ETCO₂
B. Increasing ETCO₂
C. Low or progressively decreasing ETCO₂
D. Normal capillary refill
Correct Answer: C
Rationale: Low or decreasing ETCO₂ during CPR may indicate
inadequate chest-compression quality or another problem
requiring reassessment.
Question 9
A team is preparing for a rhythm check after 2 minutes of
CPR. Which action is most appropriate?
A. Continue the pulse check for 30 seconds
B. Minimize the pause and rapidly determine the rhythm
C. Stop CPR for a complete neurological examination
D. Administer atropine before evaluating the rhythm
