ACLS Final Test 2027 | Practice Questions & Correct
Answers | Complete Exam Review & Study Guide
1. Which type of atrioventricular block best describes this rhythm?
A) First-degree
B) Second-degree type I
C) *Second-degree type II
D) Third-degree
Answer: C
Rationale: Second-degree type II (Mobitz II) shows constant PR intervals with intermittent dropped QRS
complexes, often progressing to complete heart block.
2. Your patient is in cardiac arrest and has been intubated. To assess CPR quality, which should you
do?
A) *Monitor the patient's PETCO2
B) Check the patient's pupils
C) Palpate the carotid pulse
D) Auscultate breath sounds
Answer: A
Rationale: PETCO2 >10 mmHg suggests adequate compressions; a sudden rise indicates ROSC.
3. Which facility is the most appropriate EMS destination for a patient with sudden cardiac arrest
who achieved return of spontaneous circulation in the field?
A) Nearest hospital
B) Trauma center
C) Primary stroke center
D) *Coronary reperfusion-capable medical center
,Answer: D
Rationale: Post-arrest patients need PCI capability; transport to a center with coronary reperfusion.
4. Which of the following signs is a likely indicator of cardiac arrest in an unresponsive patient?
A) Bradycardia
B) Hypertension
C) *Agonal gasps
D) Pupil dilation
Answer: C
Rationale: Agonal gasps are ineffective, irregular breaths common in cardiac arrest; start CPR
immediately.
5. Which type of atrioventricular block best describes this rhythm?
A) First-degree
B) *Second-degree atrioventricular block type I
C) Second-degree type II
D) Third-degree
Answer: B
Rationale: Type I (Wenckebach) shows progressive PR prolongation until a QRS is dropped.
6. To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag?
A) Once every 2 seconds
B) *Once every 5 to 6 seconds
C) Once every 10 seconds
D) Once every 15 seconds
Answer: B
Rationale: 10-12 breaths/min (one every 5-6 seconds) prevents hyperventilation and maintains cardiac
output.
, 7. In addition to clinical assessment, which is the most reliable method to confirm and monitor
correct placement of an endotracheal tube?
A) Chest X-ray
B) Auscultation
C) *Continuous waveform capnography
D) Pulse oximetry
Answer: C
Rationale: Waveform capnography is the gold standard for confirming and monitoring ETT placement.
8. 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 the best for this patient?
A) Aspirin only
B) *Start fibrinolytic therapy as soon as possible
C) Heparin infusion
D) Observation
Answer: B
Rationale: Ischemic stroke within 3-4.5 hours with normal CT and no contraindications warrants IV
fibrinolytics.
9. Which best describes this rhythm?
A) First-degree AV block
B) Second-degree type I
C) Second-degree type II
D) *Third-degree atrioventricular block
Answer: D
Answers | Complete Exam Review & Study Guide
1. Which type of atrioventricular block best describes this rhythm?
A) First-degree
B) Second-degree type I
C) *Second-degree type II
D) Third-degree
Answer: C
Rationale: Second-degree type II (Mobitz II) shows constant PR intervals with intermittent dropped QRS
complexes, often progressing to complete heart block.
2. Your patient is in cardiac arrest and has been intubated. To assess CPR quality, which should you
do?
A) *Monitor the patient's PETCO2
B) Check the patient's pupils
C) Palpate the carotid pulse
D) Auscultate breath sounds
Answer: A
Rationale: PETCO2 >10 mmHg suggests adequate compressions; a sudden rise indicates ROSC.
3. Which facility is the most appropriate EMS destination for a patient with sudden cardiac arrest
who achieved return of spontaneous circulation in the field?
A) Nearest hospital
B) Trauma center
C) Primary stroke center
D) *Coronary reperfusion-capable medical center
,Answer: D
Rationale: Post-arrest patients need PCI capability; transport to a center with coronary reperfusion.
4. Which of the following signs is a likely indicator of cardiac arrest in an unresponsive patient?
A) Bradycardia
B) Hypertension
C) *Agonal gasps
D) Pupil dilation
Answer: C
Rationale: Agonal gasps are ineffective, irregular breaths common in cardiac arrest; start CPR
immediately.
5. Which type of atrioventricular block best describes this rhythm?
A) First-degree
B) *Second-degree atrioventricular block type I
C) Second-degree type II
D) Third-degree
Answer: B
Rationale: Type I (Wenckebach) shows progressive PR prolongation until a QRS is dropped.
6. To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag?
A) Once every 2 seconds
B) *Once every 5 to 6 seconds
C) Once every 10 seconds
D) Once every 15 seconds
Answer: B
Rationale: 10-12 breaths/min (one every 5-6 seconds) prevents hyperventilation and maintains cardiac
output.
, 7. In addition to clinical assessment, which is the most reliable method to confirm and monitor
correct placement of an endotracheal tube?
A) Chest X-ray
B) Auscultation
C) *Continuous waveform capnography
D) Pulse oximetry
Answer: C
Rationale: Waveform capnography is the gold standard for confirming and monitoring ETT placement.
8. 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 the best for this patient?
A) Aspirin only
B) *Start fibrinolytic therapy as soon as possible
C) Heparin infusion
D) Observation
Answer: B
Rationale: Ischemic stroke within 3-4.5 hours with normal CT and no contraindications warrants IV
fibrinolytics.
9. Which best describes this rhythm?
A) First-degree AV block
B) Second-degree type I
C) Second-degree type II
D) *Third-degree atrioventricular block
Answer: D
