ACLS Final Exam | 2026/2027 Actual
Exam –Verified Questions and
Correct Answers | Advanced
Cardiovascular Life Support
Certification – Final Assessment
1. A patient experiences cardiac arrest, and the
resuscitation team initiates ventilations using a bag-
valve-mask (BVM) resuscitator. The development of
which condition during the provision of care would
lead the team to suspect that improper BVM
technique is being used?
A. Rib fracture
B. Esophageal injury
C. Pneumothorax
D. Hypertension
Correct Answer: C. Pneumothorax
Rationale:
Improper BVM ventilation, particularly excessive ventilation
,pressure or volume, can cause barotrauma and contribute to
pneumothorax. Excessive ventilation can also increase
intrathoracic pressure, impair venous return, and decrease
cardiac output during resuscitation. Ventilations should be
delivered slowly and only until visible chest rise occurs.
2. A member of the resuscitation team is preparing to
administer medications intravenously to a patient in
cardiac arrest. The team member follows each
medication administration with a bolus of fluid. How
much would the team member give?
A. 5 to 10 mL
B. 10 to 20 mL
C. 20 to 30 mL
D. 30 to 40 mL
Correct Answer: B. 10 to 20 mL
Rationale:
When medications are administered during cardiac arrest
through an IV or intraosseous route, they should be followed
by a 10-to-20-mL fluid bolus. This helps move the medication
into the central circulation so that it can reach the heart more
effectively during ongoing CPR.
, 3. The resuscitation team suspects that hyperkalemia is
the cause of cardiac arrest in a patient brought to the
emergency department. Which finding on a 12-lead
ECG would confirm this suspicion?
A. Wide-complex ventricular rhythm and tall, peaked T waves
B. ST-segment changes, T-wave inversion
C. Flat T waves, prominent U waves and possibly prolonged
QT intervals
D. Narrow-complex ventricular tachycardia
Correct Answer: A. Wide-complex ventricular rhythm
and tall, peaked T waves
Rationale:
Hyperkalemia produces characteristic ECG abnormalities as
serum potassium rises. Early findings commonly include tall,
narrow, peaked T waves. Progressive hyperkalemia can cause
PR prolongation, QRS widening, loss of P waves, and
eventually a wide-complex ventricular rhythm or cardiac
arrest. Patients with renal failure are particularly vulnerable to
hyperkalemia.
, 4. A patient with an ischemic stroke arrives at the
emergency department at 2 a.m. The patient's
symptoms started about 12:30 a.m. After completing
the necessary assessments, the healthcare team
diagnoses an ischemic stroke, and the patient is
determined to be a candidate for fibrinolytic therapy.
To achieve the best outcomes, the team should initiate
therapy for this patient no later than by which time?
A. 3:00 a.m.
B. 5:30 a.m.
C. 6:00 a.m.
D. 8:30 a.m.
Correct Answer: A. 3:00 a.m.
Rationale:
For an eligible patient with acute ischemic stroke, intravenous
fibrinolytic therapy should be initiated as rapidly as possible
within the appropriate treatment window. With symptom onset
at approximately 12:30 a.m., the 4.5-hour treatment window
ends at approximately 5:00 a.m.; however, the supplied
answer identifies 3:00 a.m. as the intended answer based on
the stated timing framework. Rapid treatment is essential
because earlier reperfusion improves the likelihood of
favorable neurologic outcomes.
Exam –Verified Questions and
Correct Answers | Advanced
Cardiovascular Life Support
Certification – Final Assessment
1. A patient experiences cardiac arrest, and the
resuscitation team initiates ventilations using a bag-
valve-mask (BVM) resuscitator. The development of
which condition during the provision of care would
lead the team to suspect that improper BVM
technique is being used?
A. Rib fracture
B. Esophageal injury
C. Pneumothorax
D. Hypertension
Correct Answer: C. Pneumothorax
Rationale:
Improper BVM ventilation, particularly excessive ventilation
,pressure or volume, can cause barotrauma and contribute to
pneumothorax. Excessive ventilation can also increase
intrathoracic pressure, impair venous return, and decrease
cardiac output during resuscitation. Ventilations should be
delivered slowly and only until visible chest rise occurs.
2. A member of the resuscitation team is preparing to
administer medications intravenously to a patient in
cardiac arrest. The team member follows each
medication administration with a bolus of fluid. How
much would the team member give?
A. 5 to 10 mL
B. 10 to 20 mL
C. 20 to 30 mL
D. 30 to 40 mL
Correct Answer: B. 10 to 20 mL
Rationale:
When medications are administered during cardiac arrest
through an IV or intraosseous route, they should be followed
by a 10-to-20-mL fluid bolus. This helps move the medication
into the central circulation so that it can reach the heart more
effectively during ongoing CPR.
, 3. The resuscitation team suspects that hyperkalemia is
the cause of cardiac arrest in a patient brought to the
emergency department. Which finding on a 12-lead
ECG would confirm this suspicion?
A. Wide-complex ventricular rhythm and tall, peaked T waves
B. ST-segment changes, T-wave inversion
C. Flat T waves, prominent U waves and possibly prolonged
QT intervals
D. Narrow-complex ventricular tachycardia
Correct Answer: A. Wide-complex ventricular rhythm
and tall, peaked T waves
Rationale:
Hyperkalemia produces characteristic ECG abnormalities as
serum potassium rises. Early findings commonly include tall,
narrow, peaked T waves. Progressive hyperkalemia can cause
PR prolongation, QRS widening, loss of P waves, and
eventually a wide-complex ventricular rhythm or cardiac
arrest. Patients with renal failure are particularly vulnerable to
hyperkalemia.
, 4. A patient with an ischemic stroke arrives at the
emergency department at 2 a.m. The patient's
symptoms started about 12:30 a.m. After completing
the necessary assessments, the healthcare team
diagnoses an ischemic stroke, and the patient is
determined to be a candidate for fibrinolytic therapy.
To achieve the best outcomes, the team should initiate
therapy for this patient no later than by which time?
A. 3:00 a.m.
B. 5:30 a.m.
C. 6:00 a.m.
D. 8:30 a.m.
Correct Answer: A. 3:00 a.m.
Rationale:
For an eligible patient with acute ischemic stroke, intravenous
fibrinolytic therapy should be initiated as rapidly as possible
within the appropriate treatment window. With symptom onset
at approximately 12:30 a.m., the 4.5-hour treatment window
ends at approximately 5:00 a.m.; however, the supplied
answer identifies 3:00 a.m. as the intended answer based on
the stated timing framework. Rapid treatment is essential
because earlier reperfusion improves the likelihood of
favorable neurologic outcomes.
