ACLS FINAL EXAM
2026/2027 Actual Exam - 50 Verified Questions and
Correct Answers
Advanced Cardiovascular Life Support Certification - Final Assessment
Aligned with AHA ACLS Provider Manual, AHA Guidelines for CPR and Emergency Cardiovascular Care (2025 Update),
and ACLS Course Curriculum Standards (2026/2027 Edition)
Total Questions: 50 | Format: Multiple Choice (A-D) | Cognitive Levels: 20% Recall, 50% Application, 30% Analysis |
Question Style: 80% Scenario-Based, 20% Direct Knowledge
Sections: (1) BLS & Primary Assessment - 6; (2) Respiratory Arrest & Airway Management - 6; (3) Acute Coronary Syndromes
(ACS) - 4; (4) Acute Stroke Management - 5; (5) Bradyarrhythmias & Management - 5; (6) Tachyarrhythmias & Management -
5; (7) Cardiac Arrest Algorithms (V-Fib/V-Tach, Asystole/PEA) - 5; (8) Post-Cardiac Arrest Care & Recovery - 5; (9)
Pharmacology & Medication Management - 4; (10) Team Dynamics, Ethics, & Special Considerations - 5.
Special Inclusions: 15 scenario-based questions requiring algorithm application and prioritization; 10 questions on arrhythmia
identification and management; 10 questions on pharmacology and medication management.
ACLS Final Exam (2026/2027) - Advanced Cardiovascular Life Support Certification Page 1
,AHA ACLS Provider Manual & Guidelines for CPR/ECC (2025 Update) - Final Assessment
Section 1: BLS & Primary Assessment
This section addresses high-quality CPR (rate, depth, recoil, minimizing interruptions), team roles, AED use,
compression-to-ventilation ratios, and the primary/secondary assessment using the CAB (Circulation, Airway, Breathing)
approach to identify immediate life threats.
Q1: A 56-year-old male collapses in the hospital lobby. A nurse assesses responsiveness, finds no pulse, and
calls for help. The AED arrives. Per 2025 AHA BLS guidelines, what is the recommended compression rate
and depth for adult high-quality CPR?
A. Rate of 80-100 compressions/min, depth of at least 3 inches
B. Rate of 100-120 compressions/min, depth of at least 2 inches (5 cm) but not exceeding 2.4 inches (6 cm)
*[CORRECT]*
C. Rate of 120-140 compressions/min, depth of 1.5 inches
D. Rate of 60-80 compressions/min, depth of 2.5 inches
Correct Answer: B
Rationale: Per the 2025 AHA BLS guidelines, high-quality adult CPR is delivered at a rate of 100-120 compressions per minute
with a depth of at least 2 inches (5 cm) but not exceeding 2.4 inches (6 cm). Compressions that are too deep or too rapid can
reduce cardiac output and increase rib fracture risk; compressions that are too shallow or too slow fail to generate adequate
coronary and cerebral perfusion. Full chest recoil between compressions is essential to allow venous return.
Q2: A 64-year-old female is found unresponsive. A pulse check is performed. Per AHA BLS guidelines, what
is the maximum duration of the pulse check for a healthcare provider?
A. 5 seconds
B. 10 seconds *[CORRECT]*
C. 15 seconds
D. 30 seconds
Correct Answer: B
Rationale: The 2025 AHA BLS guidelines recommend that pulse checks for healthcare providers take no more than 10 seconds.
If a pulse is not definitely felt within 10 seconds, CPR should begin immediately. Prolonged pulse checks delay chest
compressions and reduce survival. Agonal gasps are not normal breathing and indicate the need for CPR.
Q3: A witnessed arrest occurs in the ICU. Two nurses are present. One nurse begins compressions while the
second prepares the defibrillator. Per AHA team dynamics, what is the recommended
compression-to-ventilation ratio for adult CPR with an advanced airway NOT yet in place?
A. 15:2
B. 30:2 *[CORRECT]*
C. 50:2
D. Continuous compressions with 1 breath every 6 seconds
Correct Answer: B
Rationale: For adult CPR without an advanced airway, the AHA recommends a 30:2 compression-to-ventilation ratio (30
compressions followed by 2 breaths). Once an advanced airway (e.g., endotracheal tube or supraglottic airway) is in place, the
ratio changes to continuous compressions with 10 breaths per minute (1 breath every 6 seconds). The 15:2 ratio is used for
pediatric 2-rescuer CPR.
ACLS Final Exam (2026/2027) - Advanced Cardiovascular Life Support Certification Page 2
, AHA ACLS Provider Manual & Guidelines for CPR/ECC (2025 Update) - Final Assessment
Q4: During a code, the team leader requests a pulse check after 2 minutes of CPR. The compressor pauses
compressions while the nurse palpates the carotid pulse. The pause lasts 25 seconds. What is the most
appropriate action by the team leader?
A. Accept the pause as appropriate to ensure accuracy
B. Instruct the team that pulse checks must be brief (<=10 seconds) and chest compression interruptions must
be minimized to maintain coronary perfusion *[CORRECT]*
C. Increase the next round of CPR duration to compensate
D. Discontinue CPR efforts
Correct Answer: B
Rationale: Per the 2025 AHA guidelines, pulse checks and rhythm checks should take no more than 10 seconds, and chest
compression interruptions must be minimized to maximize coronary and cerebral perfusion. Prolonged pauses (>10 seconds)
reduce survival. Team leaders should actively minimize interruptions and use closed-loop communication to coordinate pulse
checks during rhythm analysis.
Q5: An AED is applied to a patient in cardiac arrest. The AED analyzes the rhythm and advises a shock.
What is the correct sequence of actions per AHA BLS guidelines?
A. Continue CPR during the shock
B. Stop CPR, ensure no one is touching the patient, deliver the shock, and immediately resume CPR starting
with compressions *[CORRECT]*
C. Remove the AED pads and continue CPR
D. Wait 60 seconds before delivering the shock
Correct Answer: B
Rationale: Per AHA BLS guidelines, when the AED advises a shock, the rescuer must stop CPR, ensure that no one is touching
the patient ("All clear!"), deliver the shock, and immediately resume chest compressions. CPR should not be performed during
shock delivery. Pads should not be removed. The AED should not delay shock delivery for an extended period.
Q6: A patient in cardiac arrest has ROSC achieved after 12 minutes. The team must perform the immediate
post-arrest assessment. Which assessment approach does the AHA ACLS algorithm recommend?
A. ABC (Airway, Breathing, Circulation)
B. CAB (Circulation, Airway, Breathing) followed by the secondary assessment (HPI and ROS) *[CORRECT]*
C. Only check breathing
D. Only check pulse
Correct Answer: B
Rationale: Per AHA ACLS guidelines, the primary assessment follows the CAB sequence: Circulation (pulse check, CPR if no
pulse), Airway (open and maintain airway), Breathing (ventilate if inadequate). This is followed by the secondary assessment,
which evaluates History, Past medical history, and Review of systems (HPI) and Signs, Observations, and Symptoms (ROS) to
identify reversible causes. The CAB approach prioritizes circulation over airway/breathing.
ACLS Final Exam (2026/2027) - Advanced Cardiovascular Life Support Certification Page 3
2026/2027 Actual Exam - 50 Verified Questions and
Correct Answers
Advanced Cardiovascular Life Support Certification - Final Assessment
Aligned with AHA ACLS Provider Manual, AHA Guidelines for CPR and Emergency Cardiovascular Care (2025 Update),
and ACLS Course Curriculum Standards (2026/2027 Edition)
Total Questions: 50 | Format: Multiple Choice (A-D) | Cognitive Levels: 20% Recall, 50% Application, 30% Analysis |
Question Style: 80% Scenario-Based, 20% Direct Knowledge
Sections: (1) BLS & Primary Assessment - 6; (2) Respiratory Arrest & Airway Management - 6; (3) Acute Coronary Syndromes
(ACS) - 4; (4) Acute Stroke Management - 5; (5) Bradyarrhythmias & Management - 5; (6) Tachyarrhythmias & Management -
5; (7) Cardiac Arrest Algorithms (V-Fib/V-Tach, Asystole/PEA) - 5; (8) Post-Cardiac Arrest Care & Recovery - 5; (9)
Pharmacology & Medication Management - 4; (10) Team Dynamics, Ethics, & Special Considerations - 5.
Special Inclusions: 15 scenario-based questions requiring algorithm application and prioritization; 10 questions on arrhythmia
identification and management; 10 questions on pharmacology and medication management.
ACLS Final Exam (2026/2027) - Advanced Cardiovascular Life Support Certification Page 1
,AHA ACLS Provider Manual & Guidelines for CPR/ECC (2025 Update) - Final Assessment
Section 1: BLS & Primary Assessment
This section addresses high-quality CPR (rate, depth, recoil, minimizing interruptions), team roles, AED use,
compression-to-ventilation ratios, and the primary/secondary assessment using the CAB (Circulation, Airway, Breathing)
approach to identify immediate life threats.
Q1: A 56-year-old male collapses in the hospital lobby. A nurse assesses responsiveness, finds no pulse, and
calls for help. The AED arrives. Per 2025 AHA BLS guidelines, what is the recommended compression rate
and depth for adult high-quality CPR?
A. Rate of 80-100 compressions/min, depth of at least 3 inches
B. Rate of 100-120 compressions/min, depth of at least 2 inches (5 cm) but not exceeding 2.4 inches (6 cm)
*[CORRECT]*
C. Rate of 120-140 compressions/min, depth of 1.5 inches
D. Rate of 60-80 compressions/min, depth of 2.5 inches
Correct Answer: B
Rationale: Per the 2025 AHA BLS guidelines, high-quality adult CPR is delivered at a rate of 100-120 compressions per minute
with a depth of at least 2 inches (5 cm) but not exceeding 2.4 inches (6 cm). Compressions that are too deep or too rapid can
reduce cardiac output and increase rib fracture risk; compressions that are too shallow or too slow fail to generate adequate
coronary and cerebral perfusion. Full chest recoil between compressions is essential to allow venous return.
Q2: A 64-year-old female is found unresponsive. A pulse check is performed. Per AHA BLS guidelines, what
is the maximum duration of the pulse check for a healthcare provider?
A. 5 seconds
B. 10 seconds *[CORRECT]*
C. 15 seconds
D. 30 seconds
Correct Answer: B
Rationale: The 2025 AHA BLS guidelines recommend that pulse checks for healthcare providers take no more than 10 seconds.
If a pulse is not definitely felt within 10 seconds, CPR should begin immediately. Prolonged pulse checks delay chest
compressions and reduce survival. Agonal gasps are not normal breathing and indicate the need for CPR.
Q3: A witnessed arrest occurs in the ICU. Two nurses are present. One nurse begins compressions while the
second prepares the defibrillator. Per AHA team dynamics, what is the recommended
compression-to-ventilation ratio for adult CPR with an advanced airway NOT yet in place?
A. 15:2
B. 30:2 *[CORRECT]*
C. 50:2
D. Continuous compressions with 1 breath every 6 seconds
Correct Answer: B
Rationale: For adult CPR without an advanced airway, the AHA recommends a 30:2 compression-to-ventilation ratio (30
compressions followed by 2 breaths). Once an advanced airway (e.g., endotracheal tube or supraglottic airway) is in place, the
ratio changes to continuous compressions with 10 breaths per minute (1 breath every 6 seconds). The 15:2 ratio is used for
pediatric 2-rescuer CPR.
ACLS Final Exam (2026/2027) - Advanced Cardiovascular Life Support Certification Page 2
, AHA ACLS Provider Manual & Guidelines for CPR/ECC (2025 Update) - Final Assessment
Q4: During a code, the team leader requests a pulse check after 2 minutes of CPR. The compressor pauses
compressions while the nurse palpates the carotid pulse. The pause lasts 25 seconds. What is the most
appropriate action by the team leader?
A. Accept the pause as appropriate to ensure accuracy
B. Instruct the team that pulse checks must be brief (<=10 seconds) and chest compression interruptions must
be minimized to maintain coronary perfusion *[CORRECT]*
C. Increase the next round of CPR duration to compensate
D. Discontinue CPR efforts
Correct Answer: B
Rationale: Per the 2025 AHA guidelines, pulse checks and rhythm checks should take no more than 10 seconds, and chest
compression interruptions must be minimized to maximize coronary and cerebral perfusion. Prolonged pauses (>10 seconds)
reduce survival. Team leaders should actively minimize interruptions and use closed-loop communication to coordinate pulse
checks during rhythm analysis.
Q5: An AED is applied to a patient in cardiac arrest. The AED analyzes the rhythm and advises a shock.
What is the correct sequence of actions per AHA BLS guidelines?
A. Continue CPR during the shock
B. Stop CPR, ensure no one is touching the patient, deliver the shock, and immediately resume CPR starting
with compressions *[CORRECT]*
C. Remove the AED pads and continue CPR
D. Wait 60 seconds before delivering the shock
Correct Answer: B
Rationale: Per AHA BLS guidelines, when the AED advises a shock, the rescuer must stop CPR, ensure that no one is touching
the patient ("All clear!"), deliver the shock, and immediately resume chest compressions. CPR should not be performed during
shock delivery. Pads should not be removed. The AED should not delay shock delivery for an extended period.
Q6: A patient in cardiac arrest has ROSC achieved after 12 minutes. The team must perform the immediate
post-arrest assessment. Which assessment approach does the AHA ACLS algorithm recommend?
A. ABC (Airway, Breathing, Circulation)
B. CAB (Circulation, Airway, Breathing) followed by the secondary assessment (HPI and ROS) *[CORRECT]*
C. Only check breathing
D. Only check pulse
Correct Answer: B
Rationale: Per AHA ACLS guidelines, the primary assessment follows the CAB sequence: Circulation (pulse check, CPR if no
pulse), Airway (open and maintain airway), Breathing (ventilate if inadequate). This is followed by the secondary assessment,
which evaluates History, Past medical history, and Review of systems (HPI) and Signs, Observations, and Symptoms (ROS) to
identify reversible causes. The CAB approach prioritizes circulation over airway/breathing.
ACLS Final Exam (2026/2027) - Advanced Cardiovascular Life Support Certification Page 3
