ACLS 2026 – Complete Study
Guide, Practice Questions &
Verified Answers
1. Which of these tests should be performed for a patient
with suspected stroke as early as possible, but no more
than 20 minutes after hospital arrival?
A. MRI of the brain
B. Noncontrast CT scan of the head
C. Carotid ultrasound
D. Cerebral angiography
Correct Answer: B. Noncontrast CT scan of the head
Rationale:
A noncontrast CT scan of the head should be performed
rapidly in a patient with suspected acute stroke because it can
quickly determine whether intracranial hemorrhage is present.
This distinction is critical before administering fibrinolytic
therapy. Although an early ischemic stroke may not yet be
visible on CT, the scan is highly effective for identifying
,hemorrhage and excluding other major intracranial
abnormalities.
2. Which best describes this rhythm?
A. Sinus tachycardia
B. Monomorphic ventricular tachycardia
C. Atrial fibrillation
D. Torsades de pointes
Correct Answer: B. Monomorphic ventricular tachycardia
Rationale:
Monomorphic ventricular tachycardia (VT) is characterized by
a rapid wide-complex rhythm with QRS complexes that have
a consistent appearance from beat to beat. VT originates in the
ventricles and can significantly reduce cardiac output.
Management depends on whether the patient has a pulse and
whether the rhythm is stable or unstable.
3. Which is an acceptable method of selecting an
appropriately sized oropharyngeal airway?
,A. Measure from the tip of the nose to the earlobe
B. Measure from the corner of the mouth to the angle of the
mandible
C. Measure from the chin to the forehead
D. Measure from the nostril to the tragus
Correct Answer: B. Measure from the corner of the mouth
to the angle of the mandible
Rationale:
An appropriately sized oropharyngeal airway should extend
from the corner of the mouth to approximately the angle of the
mandible. Proper sizing helps maintain airway patency while
reducing the risk of obstruction or trauma. An airway that is
too short may fail to displace the tongue, whereas one that is
too long may obstruct the airway or cause injury.
4. You are caring for a patient with a suspected stroke
whose symptoms started 2 hours ago. The CT scan was
normal, with no signs of hemorrhage. The patient does not
have any contraindications to fibrinolytic therapy. Which
treatment is best for this patient?
, A. Delay treatment until MRI confirms the stroke
B. Give aspirin only
C. Give fibrinolytic therapy as soon as possible and consider
endovascular therapy
D. Administer anticoagulation before fibrinolytic therapy
Correct Answer: C. Give fibrinolytic therapy as soon as
possible and consider endovascular therapy
Rationale:
A patient with acute ischemic stroke who presents within an
appropriate treatment window, has no intracranial hemorrhage
on imaging, and has no contraindications may be eligible for
IV fibrinolytic therapy. Treatment should not be unnecessarily
delayed because earlier reperfusion is associated with better
neurologic outcomes. Eligible patients may also require
evaluation for endovascular thrombectomy when a large-
vessel occlusion is suspected.
5. Which is the recommended next step after a
defibrillation attempt?
A. Immediately check the pulse
B. Resume CPR, starting with chest compressions
Guide, Practice Questions &
Verified Answers
1. Which of these tests should be performed for a patient
with suspected stroke as early as possible, but no more
than 20 minutes after hospital arrival?
A. MRI of the brain
B. Noncontrast CT scan of the head
C. Carotid ultrasound
D. Cerebral angiography
Correct Answer: B. Noncontrast CT scan of the head
Rationale:
A noncontrast CT scan of the head should be performed
rapidly in a patient with suspected acute stroke because it can
quickly determine whether intracranial hemorrhage is present.
This distinction is critical before administering fibrinolytic
therapy. Although an early ischemic stroke may not yet be
visible on CT, the scan is highly effective for identifying
,hemorrhage and excluding other major intracranial
abnormalities.
2. Which best describes this rhythm?
A. Sinus tachycardia
B. Monomorphic ventricular tachycardia
C. Atrial fibrillation
D. Torsades de pointes
Correct Answer: B. Monomorphic ventricular tachycardia
Rationale:
Monomorphic ventricular tachycardia (VT) is characterized by
a rapid wide-complex rhythm with QRS complexes that have
a consistent appearance from beat to beat. VT originates in the
ventricles and can significantly reduce cardiac output.
Management depends on whether the patient has a pulse and
whether the rhythm is stable or unstable.
3. Which is an acceptable method of selecting an
appropriately sized oropharyngeal airway?
,A. Measure from the tip of the nose to the earlobe
B. Measure from the corner of the mouth to the angle of the
mandible
C. Measure from the chin to the forehead
D. Measure from the nostril to the tragus
Correct Answer: B. Measure from the corner of the mouth
to the angle of the mandible
Rationale:
An appropriately sized oropharyngeal airway should extend
from the corner of the mouth to approximately the angle of the
mandible. Proper sizing helps maintain airway patency while
reducing the risk of obstruction or trauma. An airway that is
too short may fail to displace the tongue, whereas one that is
too long may obstruct the airway or cause injury.
4. You are caring for a patient with a suspected stroke
whose symptoms started 2 hours ago. The CT scan was
normal, with no signs of hemorrhage. The patient does not
have any contraindications to fibrinolytic therapy. Which
treatment is best for this patient?
, A. Delay treatment until MRI confirms the stroke
B. Give aspirin only
C. Give fibrinolytic therapy as soon as possible and consider
endovascular therapy
D. Administer anticoagulation before fibrinolytic therapy
Correct Answer: C. Give fibrinolytic therapy as soon as
possible and consider endovascular therapy
Rationale:
A patient with acute ischemic stroke who presents within an
appropriate treatment window, has no intracranial hemorrhage
on imaging, and has no contraindications may be eligible for
IV fibrinolytic therapy. Treatment should not be unnecessarily
delayed because earlier reperfusion is associated with better
neurologic outcomes. Eligible patients may also require
evaluation for endovascular thrombectomy when a large-
vessel occlusion is suspected.
5. Which is the recommended next step after a
defibrillation attempt?
A. Immediately check the pulse
B. Resume CPR, starting with chest compressions
