Advanced Life Support (ALS) Online Session Final Exam –
New Questions and Verified Answers ( Update)|
Grade A+
This comprehensive study guide is designed to prepare you for the Advanced Life Support
(ALS) Online Session Final Exam. This exam covers advanced cardiac life support (ACLS)
algorithms, ECG rhythm interpretation, airway management, pharmacology, post-cardiac
arrest care, and stroke protocols. The following 250-question test bank contains accurate
solutions and rationales, updated for the 2026/2027 curriculum.
Instructions: Read each question carefully and select the best answer. Use the provided
rationale to ensure you understand the underlying principle of the question.
1. A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a
narrow-complex supraventricular tachycardia. The patient is hemodynamically stable.
Which intervention would be initiated first?
Answer: Vagal maneuvers
Rationale: For a patient who is hemodynamically stable and experiencing a narrow-
complex supraventricular tachycardia, vagal maneuvers are attempted first. If ineffective,
adenosine is given.
2. A patient's capnogram reveals the following waveform. Which segment would the
healthcare provider interpret as reflecting the beginning of exhalation?
Answer: A-B
Rationale: The A-B segment is the respiratory baseline that represents the beginning of
exhalation.
3. A patient experiencing an unstable bradyarrhythmia does not respond to atropine or
transcutaneous pacing. Which intervention would the healthcare provider use next?
,Answer: Administration of an epinephrine infusion.
Rationale: Epinephrine or dopamine may be administered to patients with symptomatic
bradycardia if atropine and transcutaneous pacing are not effective.
4. A patient with a suspected stroke arrives at the emergency department at 7:10 p.m.
The stroke team ensures that a neurologic assessment and brain computed tomography or
magnetic resonance imaging is obtained by which time?
Answer: 7:30 p.m.
Rationale: In accordance with National Institute of Neurological Disorders and Stroke
guidelines, the stroke team, emergency physician or other expert must conduct a
neurologic assessment and obtain computed tomography or magnetic resonance imaging
within 20 minutes after the patient's arrival in the emergency department. That would be
7:30 p.m. for this patient.
5. A patient in the telemetry unit is stable. Cardiac monitoring indicates the patient has
ventricular tachycardia with a pulse. Further assessment reveals that the corrected QT
interval is greater than 0.46 seconds. Which treatment would be appropriate at this time?
Answer: Synchronized cardioversion
Rationale: For a patient with ventricular tachycardia who is stable, has a pulse and has a
corrected QT interval greater than 0.46 seconds, synchronized cardioversion is the
recommended treatment.
6. A resuscitation team is debriefing following a recent event. A patient experienced
cardiac arrest, and advanced cardiac life support was initiated. The patient required the
placement of an advanced airway to maintain airway patency. Which statement indicates
that the team performed high-quality CPR?
Answer: "We delivered 1 ventilation every 6 seconds and chest compressions at a rate of
100 to 120 compressions per minute."
Rationale: When an advanced airway has been placed in a patient who is in cardiac
arrest, compressions and ventilations are delivered continuously with no interruptions. One
provider delivers 1 ventilation every 6 seconds, while the second provider performs
compressions at a rate of 100 to 120 compressions per minute.
,7. A healthcare provider initiates ventilations to ensure adequate breathing and
oxygenation. While ventilations are being performed, capnography is established to
evaluate the adequacy of the ventilations. The healthcare provider determines that
ventilations are adequate based on which end-tidal carbon dioxide (ETCO2) value?
Answer: 35 to 45 mmHg
Rationale: End-tidal carbon dioxide values in the range of 35 to 45 mmHg confirm
adequacy of ventilation.
8. An ECG strip of a patient in the emergency department reveals the following rhythm.
Which feature would the healthcare provider interpret as indicating atrial fibrillation?
Answer: Absence of discrete P waves and presence of irregularly irregular QRS
complexes.
Rationale: The two key features of atrial fibrillation on ECG are the absence of discrete P
waves and the presence of irregularly irregular QRS complexes.
9. A patient in cardiac arrest experiences return of spontaneous circulation. As part of
post-cardiac arrest care, the patient is receiving mechanical ventilation. Which finding(s)
would indicate the need for change in the ventilator settings to optimize the patient's
ventilation and oxygenation?
Answer: 1. ETCO2 50 mmHg
2. PaCO2 35 mmHg
3. SaO2 92%
Rationale: Mechanical ventilation should be started at a rate of 10 to 12 breaths per
minute and adjusted as necessary to keep ETCO2 levels in the range of 35 to 40 mmHg
and PaCO2 levels in the range of 40 to 45 mmHg. The minimum fraction of inspired
oxygen necessary to maintain an SaO2 of at least 94% is used.
10. The following capnogram is from a patient experiencing...
Answer: D
Rationale: (Refers to the visual capnogram). The waveform correlates to the specific
clinical presentation of the patient.
, 11. What is the first drug recommended in the cardiac arrest algorithm for a shockable
rhythm?
Answer: Epinephrine
Rationale: Epinephrine is the primary vasopressor used in cardiac arrest to increase
coronary and cerebral perfusion pressure.
12. Amiodarone or lidocaine can be given for which rhythm?
Answer: Ventricular fibrillation / Pulseless Ventricular Tachycardia (VF/pVT) refractory to
shock
Rationale: Antiarrhythmics are considered if VF/pVT persists after 2-3 shocks and the
administration of epinephrine.
13. How often should epinephrine be administered during cardiac arrest?
Answer: Every 3 to 5 minutes
Rationale: The standard ACLS dose is 1 mg IV/IO every 3 to 5 minutes.
14. What is the recommended compression rate for adult CPR?
Answer: 100 to 120 compressions per minute
Rationale: High-quality CPR requires a rate of 100 to 120 compressions per minute.
15. What is the recommended compression depth for an adult?
Answer: At least 2 inches (5 cm)
Rationale: Compressions must be at least 2 inches deep but not exceed 2.4 inches (6 cm).
16. What is the ratio of compressions to breaths for a single rescuer performing CPR on
an adult?
New Questions and Verified Answers ( Update)|
Grade A+
This comprehensive study guide is designed to prepare you for the Advanced Life Support
(ALS) Online Session Final Exam. This exam covers advanced cardiac life support (ACLS)
algorithms, ECG rhythm interpretation, airway management, pharmacology, post-cardiac
arrest care, and stroke protocols. The following 250-question test bank contains accurate
solutions and rationales, updated for the 2026/2027 curriculum.
Instructions: Read each question carefully and select the best answer. Use the provided
rationale to ensure you understand the underlying principle of the question.
1. A patient's ECG reveals a narrow QRS complex with a regular rhythm, indicating a
narrow-complex supraventricular tachycardia. The patient is hemodynamically stable.
Which intervention would be initiated first?
Answer: Vagal maneuvers
Rationale: For a patient who is hemodynamically stable and experiencing a narrow-
complex supraventricular tachycardia, vagal maneuvers are attempted first. If ineffective,
adenosine is given.
2. A patient's capnogram reveals the following waveform. Which segment would the
healthcare provider interpret as reflecting the beginning of exhalation?
Answer: A-B
Rationale: The A-B segment is the respiratory baseline that represents the beginning of
exhalation.
3. A patient experiencing an unstable bradyarrhythmia does not respond to atropine or
transcutaneous pacing. Which intervention would the healthcare provider use next?
,Answer: Administration of an epinephrine infusion.
Rationale: Epinephrine or dopamine may be administered to patients with symptomatic
bradycardia if atropine and transcutaneous pacing are not effective.
4. A patient with a suspected stroke arrives at the emergency department at 7:10 p.m.
The stroke team ensures that a neurologic assessment and brain computed tomography or
magnetic resonance imaging is obtained by which time?
Answer: 7:30 p.m.
Rationale: In accordance with National Institute of Neurological Disorders and Stroke
guidelines, the stroke team, emergency physician or other expert must conduct a
neurologic assessment and obtain computed tomography or magnetic resonance imaging
within 20 minutes after the patient's arrival in the emergency department. That would be
7:30 p.m. for this patient.
5. A patient in the telemetry unit is stable. Cardiac monitoring indicates the patient has
ventricular tachycardia with a pulse. Further assessment reveals that the corrected QT
interval is greater than 0.46 seconds. Which treatment would be appropriate at this time?
Answer: Synchronized cardioversion
Rationale: For a patient with ventricular tachycardia who is stable, has a pulse and has a
corrected QT interval greater than 0.46 seconds, synchronized cardioversion is the
recommended treatment.
6. A resuscitation team is debriefing following a recent event. A patient experienced
cardiac arrest, and advanced cardiac life support was initiated. The patient required the
placement of an advanced airway to maintain airway patency. Which statement indicates
that the team performed high-quality CPR?
Answer: "We delivered 1 ventilation every 6 seconds and chest compressions at a rate of
100 to 120 compressions per minute."
Rationale: When an advanced airway has been placed in a patient who is in cardiac
arrest, compressions and ventilations are delivered continuously with no interruptions. One
provider delivers 1 ventilation every 6 seconds, while the second provider performs
compressions at a rate of 100 to 120 compressions per minute.
,7. A healthcare provider initiates ventilations to ensure adequate breathing and
oxygenation. While ventilations are being performed, capnography is established to
evaluate the adequacy of the ventilations. The healthcare provider determines that
ventilations are adequate based on which end-tidal carbon dioxide (ETCO2) value?
Answer: 35 to 45 mmHg
Rationale: End-tidal carbon dioxide values in the range of 35 to 45 mmHg confirm
adequacy of ventilation.
8. An ECG strip of a patient in the emergency department reveals the following rhythm.
Which feature would the healthcare provider interpret as indicating atrial fibrillation?
Answer: Absence of discrete P waves and presence of irregularly irregular QRS
complexes.
Rationale: The two key features of atrial fibrillation on ECG are the absence of discrete P
waves and the presence of irregularly irregular QRS complexes.
9. A patient in cardiac arrest experiences return of spontaneous circulation. As part of
post-cardiac arrest care, the patient is receiving mechanical ventilation. Which finding(s)
would indicate the need for change in the ventilator settings to optimize the patient's
ventilation and oxygenation?
Answer: 1. ETCO2 50 mmHg
2. PaCO2 35 mmHg
3. SaO2 92%
Rationale: Mechanical ventilation should be started at a rate of 10 to 12 breaths per
minute and adjusted as necessary to keep ETCO2 levels in the range of 35 to 40 mmHg
and PaCO2 levels in the range of 40 to 45 mmHg. The minimum fraction of inspired
oxygen necessary to maintain an SaO2 of at least 94% is used.
10. The following capnogram is from a patient experiencing...
Answer: D
Rationale: (Refers to the visual capnogram). The waveform correlates to the specific
clinical presentation of the patient.
, 11. What is the first drug recommended in the cardiac arrest algorithm for a shockable
rhythm?
Answer: Epinephrine
Rationale: Epinephrine is the primary vasopressor used in cardiac arrest to increase
coronary and cerebral perfusion pressure.
12. Amiodarone or lidocaine can be given for which rhythm?
Answer: Ventricular fibrillation / Pulseless Ventricular Tachycardia (VF/pVT) refractory to
shock
Rationale: Antiarrhythmics are considered if VF/pVT persists after 2-3 shocks and the
administration of epinephrine.
13. How often should epinephrine be administered during cardiac arrest?
Answer: Every 3 to 5 minutes
Rationale: The standard ACLS dose is 1 mg IV/IO every 3 to 5 minutes.
14. What is the recommended compression rate for adult CPR?
Answer: 100 to 120 compressions per minute
Rationale: High-quality CPR requires a rate of 100 to 120 compressions per minute.
15. What is the recommended compression depth for an adult?
Answer: At least 2 inches (5 cm)
Rationale: Compressions must be at least 2 inches deep but not exceed 2.4 inches (6 cm).
16. What is the ratio of compressions to breaths for a single rescuer performing CPR on
an adult?
