2026 Advanced Cardiovascular Life
Support (ACLS) Comprehensive Review
Examination Questions Practice
Answers with Quality Rationales
1. A patient suddenly collapses, is unresponsive, and is not
breathing normally. What is the priority action?
A. Obtain a 12-lead ECG
B. Activate the emergency response system and begin CPR
C. Administer amiodarone
D. Establish an IV before beginning compressions
Rationale: An unresponsive adult with absent or abnormal
breathing should trigger immediate emergency activation
and high-quality CPR. Delaying compressions for IV access or
diagnostic testing reduces the chance of survival.
2. What is the recommended chest compression rate for
adult CPR?
A. 60–80/min
B. 80–90/min
C. 100–120/min
D. 130–150/min
,Rationale: Adult chest compressions should be performed at a
rate of 100–120 compressions per minute.
3. What is the recommended compression depth for an adult
during CPR?
A. At least 1 cm
B. Approximately 2 cm
C. Approximately 3 cm
D. At least 5 cm while avoiding excessive depth
Rationale: Adult compressions should be at least 5 cm deep
while avoiding excessive compression depth that may
increase injury without improving perfusion.
4. Which finding best indicates high-quality chest
compressions?
A. Frequent interruptions for rhythm analysis
B. Compression rate below 80/min
C. Full chest recoil between compressions
D. Continuous ventilation without compressions
Rationale: Complete chest recoil allows the heart to refill
between compressions and is essential for effective
circulation.
5. During two-rescuer adult CPR without an advanced airway,
what compression-to-ventilation ratio is generally used?
,A. 15:1
B. 30:2
C. 30:5
D. 50:2
Rationale: Adult CPR uses a 30:2 compression-to-ventilation
ratio when an advanced airway is not in place.
6. Which action minimizes interruptions in chest
compressions?
A. Performing prolonged pulse checks
B. Giving medications before restarting compressions
C. Resuming compressions immediately after rhythm
analysis or defibrillation
D. Repeatedly repositioning the patient
Rationale: Interruptions reduce coronary and cerebral
perfusion. CPR should resume immediately after rhythm
assessment or shock delivery.
7. A patient in cardiac arrest has ventricular fibrillation.
Which intervention is most likely to terminate the rhythm?
A. Atropine
B. Adenosine
C. Defibrillation
D. Transcutaneous pacing
, Rationale: Ventricular fibrillation is a shockable rhythm.
Immediate defibrillation combined with high-quality CPR is
central to treatment.
8. Which rhythm is classified as shockable during adult
cardiac arrest?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Rationale: Ventricular fibrillation and pulseless ventricular
tachycardia are shockable cardiac-arrest rhythms.
9. Which two rhythms are classified as nonshockable cardiac-
arrest rhythms?
A. VF and VT
B. Asystole and PEA
C. SVT and AF
D. Sinus rhythm and VF
Rationale: Asystole and pulseless electrical activity are
managed with high-quality CPR, epinephrine, and treatment
of reversible causes rather than defibrillation.
10. During CPR, a capnography monitor shows a sudden
sustained increase in end-tidal carbon dioxide. What may this
indicate?
Support (ACLS) Comprehensive Review
Examination Questions Practice
Answers with Quality Rationales
1. A patient suddenly collapses, is unresponsive, and is not
breathing normally. What is the priority action?
A. Obtain a 12-lead ECG
B. Activate the emergency response system and begin CPR
C. Administer amiodarone
D. Establish an IV before beginning compressions
Rationale: An unresponsive adult with absent or abnormal
breathing should trigger immediate emergency activation
and high-quality CPR. Delaying compressions for IV access or
diagnostic testing reduces the chance of survival.
2. What is the recommended chest compression rate for
adult CPR?
A. 60–80/min
B. 80–90/min
C. 100–120/min
D. 130–150/min
,Rationale: Adult chest compressions should be performed at a
rate of 100–120 compressions per minute.
3. What is the recommended compression depth for an adult
during CPR?
A. At least 1 cm
B. Approximately 2 cm
C. Approximately 3 cm
D. At least 5 cm while avoiding excessive depth
Rationale: Adult compressions should be at least 5 cm deep
while avoiding excessive compression depth that may
increase injury without improving perfusion.
4. Which finding best indicates high-quality chest
compressions?
A. Frequent interruptions for rhythm analysis
B. Compression rate below 80/min
C. Full chest recoil between compressions
D. Continuous ventilation without compressions
Rationale: Complete chest recoil allows the heart to refill
between compressions and is essential for effective
circulation.
5. During two-rescuer adult CPR without an advanced airway,
what compression-to-ventilation ratio is generally used?
,A. 15:1
B. 30:2
C. 30:5
D. 50:2
Rationale: Adult CPR uses a 30:2 compression-to-ventilation
ratio when an advanced airway is not in place.
6. Which action minimizes interruptions in chest
compressions?
A. Performing prolonged pulse checks
B. Giving medications before restarting compressions
C. Resuming compressions immediately after rhythm
analysis or defibrillation
D. Repeatedly repositioning the patient
Rationale: Interruptions reduce coronary and cerebral
perfusion. CPR should resume immediately after rhythm
assessment or shock delivery.
7. A patient in cardiac arrest has ventricular fibrillation.
Which intervention is most likely to terminate the rhythm?
A. Atropine
B. Adenosine
C. Defibrillation
D. Transcutaneous pacing
, Rationale: Ventricular fibrillation is a shockable rhythm.
Immediate defibrillation combined with high-quality CPR is
central to treatment.
8. Which rhythm is classified as shockable during adult
cardiac arrest?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Rationale: Ventricular fibrillation and pulseless ventricular
tachycardia are shockable cardiac-arrest rhythms.
9. Which two rhythms are classified as nonshockable cardiac-
arrest rhythms?
A. VF and VT
B. Asystole and PEA
C. SVT and AF
D. Sinus rhythm and VF
Rationale: Asystole and pulseless electrical activity are
managed with high-quality CPR, epinephrine, and treatment
of reversible causes rather than defibrillation.
10. During CPR, a capnography monitor shows a sudden
sustained increase in end-tidal carbon dioxide. What may this
indicate?
