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ACLS Advanced Cardiovascular Life Support | American Heart Association 2026/2027 | 50 Practice Certification Questions & Verified Rationales

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50‑question ACLS certification exam practice set built to the AHA provider curriculum. Questions cover shockable rhythms, defibrillation energy settings, epinephrine and amiodarone dosing, the bradycardia and tachycardia algorithms, adenosine administration, H's and T's, ETCO₂ capnography, targeted temperature management, and post‑arrest care. Each answer includes a short rationale. Follow Aplusexports for more ACLS, BLS, and NCLEX resources.

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ACLS Advanced Cardiovascular Life
Support | American Heart
50 QUESTIONS




TABLE OF CONTENTS
# TOPIC
1 BLS & High-Quality CPR
2 Rhythm Recognition
3 Cardiac Arrest Algorithm
4 Bradycardia Algorithm
5 Tachycardia Algorithm
6 ACS & Stroke
7 Post–Cardiac Arrest Care
8 Airway Management
9 Reversible Causes
10 Team Dynamics




Page 1

,Q1
A client is unresponsive, apneic, and pulseless. The monitor shows a chaotic, irregular
waveform with no identifiable QRS complexes. Which rhythm is this?

A) Pulseless electrical activity

B) Asystole

C) Pulseless ventricular tachycardia

D) *Ventricular fibrillation CORRECT



Rationale
VF is a chaotic, disorganized waveform with no recognizable complexes; it is a shockable
rhythm.



Q2
During adult CPR, what is the recommended compression depth?

A) At least 1 inch

B) *At least 2 inches but no more than 2.4 inches CORRECT

C) At least 3 inches

D) 1.5 inches regardless of body size


Rationale
AHA recommends 5–6 cm (2–2.4 inches) to generate adequate cardiac output without causing
injury.



Q3
A client collapses in the hallway and is unresponsive with no pulse. An AED arrives.
What is the first action after powering on the device?

A) *Attach the pads to the client's bare chest and follow the prompts CORRECT

B) Deliver a shock immediately
C) Check the carotid pulse for 30 seconds


Page 2

, D) Give two rescue breaths before attaching pads


Rationale
The AED must analyze the rhythm before advising a shock; pads are applied first.



Q4
A client in cardiac arrest remains in VF after the second shock. Which medication should
be administered next?

A) Amiodarone 300 mg IV push

B) Atropine 1 mg IV push

C) *Epinephrine 1 mg IV/IO CORRECT

D) Adenosine 6 mg IV push


Rationale
Epinephrine 1 mg is given after the second shock and repeated every 3–5 minutes.



Q5
After the third shock in refractory VF, which antiarrhythmic does AHA recommend as
first-line?

A) Lidocaine 1–1.5 mg/kg

B) *Amiodarone 300 mg IV push CORRECT

C) Magnesium sulfate 2 g

D) Procainamide 20 mg/min


Rationale
Amiodarone 300 mg is first-line for VF/pVT unresponsive to CPR, shock, and epinephrine.




Page 3

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