ACLS FINAL EXAM PRACTICE EXAMINATION 2026–
2027 — ADVANCED CARDIOVASCULAR LIFE
SUPPORT STUDY GUIDE | LATEST UPDATE 2026/2027 |
PRACTICE QUESTIONS AND ANSWERS | EXAM
REVIEW | 100% CORRECT ANSWERS | VERIFIED
SOLUTIONS | ALREADY GRADED A+
1. What is the recommended compression depth for adult high-quality CPR?
A) 1 inch (2.5 cm)
B) 1.5 inches (4 cm)
C) 2 to 2.4 inches (5 to 6 cm)
D) 3 inches (7.5 cm)
Correct Answer: C
High-quality adult chest compressions should be at least 2 inches (5 cm) but no
more than 2.4 inches (6 cm). This depth improves cardiac output while minimizing
injury risk. 1–1.5 inches is too shallow, and 3 inches may cause harm.
2. What is the recommended chest compression rate for adult CPR?
A) 60–80 per minute
B) 80–100 per minute
C) 100–120 per minute
D) 120–140 per minute
Correct Answer: C
The optimal compression rate is 100–120 per minute. Slower rates reduce
perfusion, and faster rates can decrease venous return and depth.
3. A patient is in cardiac arrest. The monitor shows ventricular fibrillation.
What is the immediate next step?
A) Administer epinephrine
, B) Start CPR and deliver a shock as soon as a defibrillator is available
C) Insert an advanced airway
D) Give amiodarone
Correct Answer: B
For VF/pulseless VT, immediately start CPR and defibrillate as soon as possible.
Epinephrine and amiodarone are given after the first shock while continuing CPR.
Advanced airway is not the first priority.
4. What is the correct sequence for the BLS Chain of Survival for adult in-
hospital cardiac arrest?
A) Early CPR, early defibrillation, early advanced care, post-cardiac arrest
care
B) Early recognition, early CPR, early defibrillation, early advanced care,
post-cardiac arrest care
C) Defibrillation first, then CPR
D) Advanced airway first, then CPR
Correct Answer: B
The in-hospital adult chain includes early recognition and prevention, early CPR,
early defibrillation, early advanced care, and post-cardiac arrest care. CPR and
defibrillation are prioritized before advanced airway.
5. After two minutes of CPR, the rhythm is still ventricular fibrillation. What is
the next intervention?
A) Give amiodarone 300 mg IV
B) Give a second shock and resume CPR immediately
C) Administer atropine 1 mg
D) Start transcutaneous pacing
Correct Answer: B
If VF persists after 2 minutes of CPR, a second shock is delivered, followed
immediately by CPR. Amiodarone is given after the second shock? Actually current
AHA: shock, CPR 2 min, rhythm check, shock if still VF/pVT, then epinephrine 1
mg; amiodarone after third shock? Need check algorithm: VF/pVT: Shock -> CPR 2
, min -> rhythm check -> shock -> epinephrine 1 mg after second shock? Actually
epinephrine is given after second shock? Let's recall: VF/pVT algorithm: Start CPR,
give oxygen, attach monitor/defibrillator. Check rhythm: shockable -> shock #1 ->
CPR 2 min -> rhythm check: shockable -> shock #2 -> epinephrine 1 mg, consider
advanced airway -> CPR 2 min -> rhythm check: shockable -> shock #3 ->
amiodarone 300 mg -> CPR... So second shock then epinephrine. The question
asks after two minutes of CPR, rhythm still VF, next intervention: shock #2, then
epinephrine. Among options, B second shock correct. C atropine no, D pacing no.
A amiodarone later. So B.
6. What is the initial dose of epinephrine in cardiac arrest?
A) 0.5 mg IV
B) 1 mg IV/IO
C) 2 mg IV
D) 10 mg IV
Correct Answer: B
Epinephrine is given 1 mg IV/IO every 3–5 minutes during cardiac arrest. It
increases coronary and cerebral perfusion pressure. 0.5 mg is too low; 2 mg and
10 mg are not standard initial doses.
7. A patient with pulseless ventricular tachycardia is being resuscitated. After
the third shock, what medication should be given?
A) Atropine 1 mg
B) Amiodarone 300 mg IV/IO
C) Magnesium sulfate 1 g
D) Epinephrine 10 mg
Correct Answer: B
Amiodarone 300 mg IV/IO is given after the third shock for refractory VF/pulseless
VT. A second dose of 150 mg may be given after the fifth shock. Atropine is not
indicated for VF. Magnesium is for torsades de pointes. Epinephrine is 1 mg, not 10
mg.
2027 — ADVANCED CARDIOVASCULAR LIFE
SUPPORT STUDY GUIDE | LATEST UPDATE 2026/2027 |
PRACTICE QUESTIONS AND ANSWERS | EXAM
REVIEW | 100% CORRECT ANSWERS | VERIFIED
SOLUTIONS | ALREADY GRADED A+
1. What is the recommended compression depth for adult high-quality CPR?
A) 1 inch (2.5 cm)
B) 1.5 inches (4 cm)
C) 2 to 2.4 inches (5 to 6 cm)
D) 3 inches (7.5 cm)
Correct Answer: C
High-quality adult chest compressions should be at least 2 inches (5 cm) but no
more than 2.4 inches (6 cm). This depth improves cardiac output while minimizing
injury risk. 1–1.5 inches is too shallow, and 3 inches may cause harm.
2. What is the recommended chest compression rate for adult CPR?
A) 60–80 per minute
B) 80–100 per minute
C) 100–120 per minute
D) 120–140 per minute
Correct Answer: C
The optimal compression rate is 100–120 per minute. Slower rates reduce
perfusion, and faster rates can decrease venous return and depth.
3. A patient is in cardiac arrest. The monitor shows ventricular fibrillation.
What is the immediate next step?
A) Administer epinephrine
, B) Start CPR and deliver a shock as soon as a defibrillator is available
C) Insert an advanced airway
D) Give amiodarone
Correct Answer: B
For VF/pulseless VT, immediately start CPR and defibrillate as soon as possible.
Epinephrine and amiodarone are given after the first shock while continuing CPR.
Advanced airway is not the first priority.
4. What is the correct sequence for the BLS Chain of Survival for adult in-
hospital cardiac arrest?
A) Early CPR, early defibrillation, early advanced care, post-cardiac arrest
care
B) Early recognition, early CPR, early defibrillation, early advanced care,
post-cardiac arrest care
C) Defibrillation first, then CPR
D) Advanced airway first, then CPR
Correct Answer: B
The in-hospital adult chain includes early recognition and prevention, early CPR,
early defibrillation, early advanced care, and post-cardiac arrest care. CPR and
defibrillation are prioritized before advanced airway.
5. After two minutes of CPR, the rhythm is still ventricular fibrillation. What is
the next intervention?
A) Give amiodarone 300 mg IV
B) Give a second shock and resume CPR immediately
C) Administer atropine 1 mg
D) Start transcutaneous pacing
Correct Answer: B
If VF persists after 2 minutes of CPR, a second shock is delivered, followed
immediately by CPR. Amiodarone is given after the second shock? Actually current
AHA: shock, CPR 2 min, rhythm check, shock if still VF/pVT, then epinephrine 1
mg; amiodarone after third shock? Need check algorithm: VF/pVT: Shock -> CPR 2
, min -> rhythm check -> shock -> epinephrine 1 mg after second shock? Actually
epinephrine is given after second shock? Let's recall: VF/pVT algorithm: Start CPR,
give oxygen, attach monitor/defibrillator. Check rhythm: shockable -> shock #1 ->
CPR 2 min -> rhythm check: shockable -> shock #2 -> epinephrine 1 mg, consider
advanced airway -> CPR 2 min -> rhythm check: shockable -> shock #3 ->
amiodarone 300 mg -> CPR... So second shock then epinephrine. The question
asks after two minutes of CPR, rhythm still VF, next intervention: shock #2, then
epinephrine. Among options, B second shock correct. C atropine no, D pacing no.
A amiodarone later. So B.
6. What is the initial dose of epinephrine in cardiac arrest?
A) 0.5 mg IV
B) 1 mg IV/IO
C) 2 mg IV
D) 10 mg IV
Correct Answer: B
Epinephrine is given 1 mg IV/IO every 3–5 minutes during cardiac arrest. It
increases coronary and cerebral perfusion pressure. 0.5 mg is too low; 2 mg and
10 mg are not standard initial doses.
7. A patient with pulseless ventricular tachycardia is being resuscitated. After
the third shock, what medication should be given?
A) Atropine 1 mg
B) Amiodarone 300 mg IV/IO
C) Magnesium sulfate 1 g
D) Epinephrine 10 mg
Correct Answer: B
Amiodarone 300 mg IV/IO is given after the third shock for refractory VF/pulseless
VT. A second dose of 150 mg may be given after the fifth shock. Atropine is not
indicated for VF. Magnesium is for torsades de pointes. Epinephrine is 1 mg, not 10
mg.
