AHA ACLS Final Exam | Complete Practice Questions, Answers
& Detailed Explanations and solutions 2026/2027
Question 1
What is the correct sequence of the AHA Adult Out-of-Hospital Cardiac
Arrest (OHCA) Chain of Survival?
• A. Early activation of emergency response, early high-quality CPR,
rapid defibrillation, advanced resuscitation, post-cardiac arrest
care, and recovery
• B. Immediate defibrillation, airway intubation, IV medications, and
transport
• C. Patient assessment, administration of epinephrine, ECG
monitoring, and discharge
• D. Immediate chest compressions followed exclusively by
advanced cardiac life support without defibrillation
Correct Answer: A. Early activation of emergency response, early high-
quality CPR, rapid defibrillation, advanced resuscitation, post-cardiac
arrest care, and recovery
Detailed Rationale: The AHA Adult Chain of Survival emphasizes a
structured continuum of care starting with early recognition and
activation, prompt high-quality CPR, rapid AED/defibrillation, advanced
life support, comprehensive post-arrest care, and long-term recovery.
Question 2
,What is the first critical action a healthcare provider should take upon
encountering an unresponsive adult victim in a pre-hospital setting?
• A. Verify scene safety and check for responsiveness (tap and
shout)
• B. Immediately administer 1 mg of intravenous epinephrine
• C. Begin rescue breathing without checking a pulse
• D. Apply AED pads immediately before checking breathing
Correct Answer: A. Verify scene safety and check for responsiveness
(tap and shout)
Detailed Rationale: Ensuring scene safety protects both the rescuer and
the victim. Checking responsiveness determines if cardiac arrest
protocols need to be initiated before calling for help and retrieving an
AED.
Question 3
What is the recommended compression-to-ventilation ratio for adult
single-rescuer CPR without an advanced airway in place?
• A. 30 compressions to 2 ventilations
• B. 15 compressions to 2 ventilations
• C. 5 compressions to 1 ventilation
• D. Continuous compressions with 1 ventilation every 6 seconds
Correct Answer: A. 30 compressions to 2 ventilations
Detailed Rationale: For single rescuers performing adult CPR without an
advanced airway, the standard ratio is 30 chest compressions followed
,by 2 rescue breaths to optimize perfusion while providing necessary
oxygenation.
Question 4
What is the recommended rate range for performing chest
compressions during adult CPR?
• A. 100 to 120 compressions per minute
• B. 60 to 80 compressions per minute
• C. 140 to 160 compressions per minute
• D. Exactly 80 compressions per minute
Correct Answer: A. 100 to 120 compressions per minute
Detailed Rationale: Clinical studies demonstrate that chest compression
rates between 100 and 120 per minute optimize cardiac output and
coronary perfusion pressure during cardiac arrest resuscitation.
Question 5
What is the recommended target depth for chest compressions in an
adult victim?
• A. At least 2 inches (5 cm) but no greater than 2.4 inches (6 cm)
• B. Exactly 1 inch (2.5 cm)
• C. 3 to 4 inches (7.5 to 10 cm)
• D. As deep as possible regardless of limits
Correct Answer: A. At least 2 inches (5 cm) but no greater than 2.4
inches (6 cm)
, Detailed Rationale: Adequate compression depth is necessary to
generate sufficient blood flow, but depths exceeding 2.4 inches can
cause internal trauma and reduce resuscitation efficacy.
Question 6
How frequently should compressors switch roles during team-based
CPR to prevent fatigue and maintain high-quality compressions?
• A. Approximately every 2 minutes (or after about 5 cycles of 30:2)
• B. Every 10 minutes
• C. Only when the compressor complains of exhaustion
• D. Every 30 seconds
Correct Answer: A. Approximately every 2 minutes (or after about 5
cycles of 30:2)
Detailed Rationale: Compressor fatigue sets in rapidly, often within 2
minutes, degrading compression depth and rate even if the provider
feels capable. Regular rotation during rhythm checks maintains quality.
Question 7
What is the primary purpose of pausing chest compressions during an
AED rhythm analysis?
• A. To allow the device to accurately analyze the cardiac rhythm
without artifact from motion
• B. To allow the resuscitation team to rest
• C. To administer routine intravenous fluids
• D. To check pupillary reflexes
& Detailed Explanations and solutions 2026/2027
Question 1
What is the correct sequence of the AHA Adult Out-of-Hospital Cardiac
Arrest (OHCA) Chain of Survival?
• A. Early activation of emergency response, early high-quality CPR,
rapid defibrillation, advanced resuscitation, post-cardiac arrest
care, and recovery
• B. Immediate defibrillation, airway intubation, IV medications, and
transport
• C. Patient assessment, administration of epinephrine, ECG
monitoring, and discharge
• D. Immediate chest compressions followed exclusively by
advanced cardiac life support without defibrillation
Correct Answer: A. Early activation of emergency response, early high-
quality CPR, rapid defibrillation, advanced resuscitation, post-cardiac
arrest care, and recovery
Detailed Rationale: The AHA Adult Chain of Survival emphasizes a
structured continuum of care starting with early recognition and
activation, prompt high-quality CPR, rapid AED/defibrillation, advanced
life support, comprehensive post-arrest care, and long-term recovery.
Question 2
,What is the first critical action a healthcare provider should take upon
encountering an unresponsive adult victim in a pre-hospital setting?
• A. Verify scene safety and check for responsiveness (tap and
shout)
• B. Immediately administer 1 mg of intravenous epinephrine
• C. Begin rescue breathing without checking a pulse
• D. Apply AED pads immediately before checking breathing
Correct Answer: A. Verify scene safety and check for responsiveness
(tap and shout)
Detailed Rationale: Ensuring scene safety protects both the rescuer and
the victim. Checking responsiveness determines if cardiac arrest
protocols need to be initiated before calling for help and retrieving an
AED.
Question 3
What is the recommended compression-to-ventilation ratio for adult
single-rescuer CPR without an advanced airway in place?
• A. 30 compressions to 2 ventilations
• B. 15 compressions to 2 ventilations
• C. 5 compressions to 1 ventilation
• D. Continuous compressions with 1 ventilation every 6 seconds
Correct Answer: A. 30 compressions to 2 ventilations
Detailed Rationale: For single rescuers performing adult CPR without an
advanced airway, the standard ratio is 30 chest compressions followed
,by 2 rescue breaths to optimize perfusion while providing necessary
oxygenation.
Question 4
What is the recommended rate range for performing chest
compressions during adult CPR?
• A. 100 to 120 compressions per minute
• B. 60 to 80 compressions per minute
• C. 140 to 160 compressions per minute
• D. Exactly 80 compressions per minute
Correct Answer: A. 100 to 120 compressions per minute
Detailed Rationale: Clinical studies demonstrate that chest compression
rates between 100 and 120 per minute optimize cardiac output and
coronary perfusion pressure during cardiac arrest resuscitation.
Question 5
What is the recommended target depth for chest compressions in an
adult victim?
• A. At least 2 inches (5 cm) but no greater than 2.4 inches (6 cm)
• B. Exactly 1 inch (2.5 cm)
• C. 3 to 4 inches (7.5 to 10 cm)
• D. As deep as possible regardless of limits
Correct Answer: A. At least 2 inches (5 cm) but no greater than 2.4
inches (6 cm)
, Detailed Rationale: Adequate compression depth is necessary to
generate sufficient blood flow, but depths exceeding 2.4 inches can
cause internal trauma and reduce resuscitation efficacy.
Question 6
How frequently should compressors switch roles during team-based
CPR to prevent fatigue and maintain high-quality compressions?
• A. Approximately every 2 minutes (or after about 5 cycles of 30:2)
• B. Every 10 minutes
• C. Only when the compressor complains of exhaustion
• D. Every 30 seconds
Correct Answer: A. Approximately every 2 minutes (or after about 5
cycles of 30:2)
Detailed Rationale: Compressor fatigue sets in rapidly, often within 2
minutes, degrading compression depth and rate even if the provider
feels capable. Regular rotation during rhythm checks maintains quality.
Question 7
What is the primary purpose of pausing chest compressions during an
AED rhythm analysis?
• A. To allow the device to accurately analyze the cardiac rhythm
without artifact from motion
• B. To allow the resuscitation team to rest
• C. To administer routine intravenous fluids
• D. To check pupillary reflexes
