ACLS Final Exam | Complete Practice Questions, Correct
Answers & Detailed Rationales (2026/2027)
Question 1
What is the recommended chest compression rate for an adult in
cardiac arrest?
• A. 60 to 80 compressions per minute
• B. 80 to 100 compressions per minute
• C. 100 to 120 compressions per minute
• D. At least 140 compressions per minute
Correct Answer: C. 100 to 120 compressions per minute
Detailed Rationale: High-quality CPR requires a compression rate of 100
to 120 compressions per minute to optimize coronary and cerebral
perfusion during cardiac arrest.
Question 2
What is the recommended minimum chest compression depth for an
adult cardiac arrest patient?
• A. At least 1 inch (2.5 cm)
• B. At least 1.5 inches (4 cm)
• C. At least 2 inches (5 cm), not exceeding 2.4 inches (6 cm)
• D. At least 3 inches (7.5 cm)
,Correct Answer: C. At least 2 inches (5 cm), not exceeding 2.4 inches (6
cm)
Detailed Rationale: Compressing at least 2 inches ensures adequate
blood flow, while avoiding depths greater than 2.4 inches prevents
structural injury to the chest wall and internal organs.
Question 3
What is the compression-to-ventilation ratio for adult CPR when an
advanced airway is NOT in place?
• A. 15:1
• B. 15:2
• C. 30:2
• D. Continuous compressions with 1 breath every 10 seconds
Correct Answer: C. 30:2
Detailed Rationale: For single or multiple rescuers providing CPR to an
adult without an advanced airway, the standard ratio is 30
compressions followed by 2 rescue breaths.
Question 4
Which of the following rhythms are considered shockable during cardiac
arrest?
• A. Asystole and Pulseless Electrical Activity (PEA)
• B. Ventricular Fibrillation (VF) and Pulseless Ventricular
Tachycardia (pVT)
• C. Symptomatic bradycardia and third-degree heart block
, • D. Sinus tachycardia and supraventricular tachycardia
Correct Answer: B. Ventricular Fibrillation (VF) and Pulseless Ventricular
Tachycardia (pVT)
Detailed Rationale: Defibrillation is indicated only for shockable
rhythms, specifically Ventricular Fibrillation and pulseless Ventricular
Tachycardia. Asystole and PEA are non-shockable rhythms.
Question 5
What is the standard first-line medication administered during cardiac
arrest for any rhythm (shockable or non-shockable)?
• A. Amiodarone 300 mg IV
• B. Atropine 1 mg IV
• C. Epinephrine 1 mg IV/IO every 3 to 5 minutes
• D. Lidocaine 1.5 mg/kg IV
Correct Answer: C. Epinephrine 1 mg IV/IO every 3 to 5 minutes
Detailed Rationale: Epinephrine provides alpha-adrenergic
vasoconstriction, increasing coronary and cerebral perfusion pressure
during CPR. It is given every 3 to 5 minutes in both shockable and non-
shockable arrests.
Question 6
What is the initial recommended dose of Amiodarone for refractory
ventricular fibrillation or pulseless ventricular tachycardia?
• A. 150 mg IV push
• B. 300 mg IV/IO push
, • C. 150 mg IV infusion over 10 minutes
• D. 450 mg IV push
Correct Answer: B. 300 mg IV/IO push
Detailed Rationale: For cardiac arrest unresponsive to CPR and
defibrillation, the first dose of Amiodarone is a 300 mg bolus, which can
be followed by a second dose of 150 mg if needed.
Question 7
What is the alternative antiarrhythmic drug to Amiodarone that can be
used in refractory VF/pVT?
• A. Procainamide
• B. Lidocaine (1 to 1.5 mg/kg for the first dose)
• C. Magnesium sulfate
• D. Verapamil
Correct Answer: B. Lidocaine (1 to 1.5 mg/kg for the first dose)
Detailed Rationale: Lidocaine is an acceptable alternative
antiarrhythmic if amiodarone is unavailable. The initial dose is 1 to 1.5
mg/kg.
Question 8
What quantitative measurement via waveform capnography indicates
high-quality CPR performance and correlates with adequate chest
compression efficacy?
• A. EtCO2 less than 10 mmHg
• B. EtCO2 of at least 10 mmHg (ideally 20 mmHg or greater)
Answers & Detailed Rationales (2026/2027)
Question 1
What is the recommended chest compression rate for an adult in
cardiac arrest?
• A. 60 to 80 compressions per minute
• B. 80 to 100 compressions per minute
• C. 100 to 120 compressions per minute
• D. At least 140 compressions per minute
Correct Answer: C. 100 to 120 compressions per minute
Detailed Rationale: High-quality CPR requires a compression rate of 100
to 120 compressions per minute to optimize coronary and cerebral
perfusion during cardiac arrest.
Question 2
What is the recommended minimum chest compression depth for an
adult cardiac arrest patient?
• A. At least 1 inch (2.5 cm)
• B. At least 1.5 inches (4 cm)
• C. At least 2 inches (5 cm), not exceeding 2.4 inches (6 cm)
• D. At least 3 inches (7.5 cm)
,Correct Answer: C. At least 2 inches (5 cm), not exceeding 2.4 inches (6
cm)
Detailed Rationale: Compressing at least 2 inches ensures adequate
blood flow, while avoiding depths greater than 2.4 inches prevents
structural injury to the chest wall and internal organs.
Question 3
What is the compression-to-ventilation ratio for adult CPR when an
advanced airway is NOT in place?
• A. 15:1
• B. 15:2
• C. 30:2
• D. Continuous compressions with 1 breath every 10 seconds
Correct Answer: C. 30:2
Detailed Rationale: For single or multiple rescuers providing CPR to an
adult without an advanced airway, the standard ratio is 30
compressions followed by 2 rescue breaths.
Question 4
Which of the following rhythms are considered shockable during cardiac
arrest?
• A. Asystole and Pulseless Electrical Activity (PEA)
• B. Ventricular Fibrillation (VF) and Pulseless Ventricular
Tachycardia (pVT)
• C. Symptomatic bradycardia and third-degree heart block
, • D. Sinus tachycardia and supraventricular tachycardia
Correct Answer: B. Ventricular Fibrillation (VF) and Pulseless Ventricular
Tachycardia (pVT)
Detailed Rationale: Defibrillation is indicated only for shockable
rhythms, specifically Ventricular Fibrillation and pulseless Ventricular
Tachycardia. Asystole and PEA are non-shockable rhythms.
Question 5
What is the standard first-line medication administered during cardiac
arrest for any rhythm (shockable or non-shockable)?
• A. Amiodarone 300 mg IV
• B. Atropine 1 mg IV
• C. Epinephrine 1 mg IV/IO every 3 to 5 minutes
• D. Lidocaine 1.5 mg/kg IV
Correct Answer: C. Epinephrine 1 mg IV/IO every 3 to 5 minutes
Detailed Rationale: Epinephrine provides alpha-adrenergic
vasoconstriction, increasing coronary and cerebral perfusion pressure
during CPR. It is given every 3 to 5 minutes in both shockable and non-
shockable arrests.
Question 6
What is the initial recommended dose of Amiodarone for refractory
ventricular fibrillation or pulseless ventricular tachycardia?
• A. 150 mg IV push
• B. 300 mg IV/IO push
, • C. 150 mg IV infusion over 10 minutes
• D. 450 mg IV push
Correct Answer: B. 300 mg IV/IO push
Detailed Rationale: For cardiac arrest unresponsive to CPR and
defibrillation, the first dose of Amiodarone is a 300 mg bolus, which can
be followed by a second dose of 150 mg if needed.
Question 7
What is the alternative antiarrhythmic drug to Amiodarone that can be
used in refractory VF/pVT?
• A. Procainamide
• B. Lidocaine (1 to 1.5 mg/kg for the first dose)
• C. Magnesium sulfate
• D. Verapamil
Correct Answer: B. Lidocaine (1 to 1.5 mg/kg for the first dose)
Detailed Rationale: Lidocaine is an acceptable alternative
antiarrhythmic if amiodarone is unavailable. The initial dose is 1 to 1.5
mg/kg.
Question 8
What quantitative measurement via waveform capnography indicates
high-quality CPR performance and correlates with adequate chest
compression efficacy?
• A. EtCO2 less than 10 mmHg
• B. EtCO2 of at least 10 mmHg (ideally 20 mmHg or greater)
