ALS/ACLS Red Cross Final Exam []
Exam 2026 (Actual Exam) Questions
with verified Answers | Verified
Questions
ALS/ACLS Red Cross Final Exam [] Exam | Comprehensive
Examination
ALS/ACLS Red Cross Final Exam [] Exam 2026 (Actual
Exam) Questions with verified Answers actual exam
preparation document with verified questions, complete
INTRODUCTION
This document is an important and very helpful preparation
resource for ALS/ACLS Red Cross Final Exam [] Exam 2026
(Actual Exam) Questions with verified Answers. Every item
uses a focused exam stem, four response options, a keyed
response, and a clear rationale, making it easier to understand
the subject, spot distractors, and build real exam confidence.
Page 1
, Question 1
During a witnessed in-hospital ventricular fibrillation arrest, the first
defibrillation attempt fails to terminate the rhythm. Which intervention, when
integrated with ongoing high-quality CPR, most directly increases the
probability of subsequent shock success?
A. Increasing the energy setting beyond the manufacturer's maximum
recommended dose on the next shock.
B. Administering epinephrine 1 mg IV/IO immediately before the next
defibrillation attempt.
C. Performing a 2-minute cycle of chest compressions with minimal
interruption before the next shock.
D. Hyperventilating the patient with 100% oxygen via bag-mask to
correct presumed hypoxia.
Correct Answer: C - Performing a 2-minute cycle of chest
compressions with minimal interruption before the next shock.
RATIONALE
Refractory VF is often due to myocardial ischemia and metabolic
exhaustion; resuming high-quality chest compressions restores
coronary perfusion pressure, which is critical for defibrillation
success. Immediate epinephrine may improve coronary flow but does
not substitute for the mandatory 2-minute CPR cycle between shocks.
Hyperventilation raises intrathoracic pressure and reduces venous
return, worsening outcomes. Excess energy beyond manufacturer
limits increases myocardial injury without proven benefit.
Question 2
A patient with ROSC after prolonged resuscitation remains comatose with a
core temperature of 34.5°C. Which targeted temperature management
parameter best aligns with current post-cardiac arrest care guidelines?
A. Maintain a constant temperature between 32°C and 36°C for at least
24 hours, avoiding fever for 72 hours.
Page 2
, B. Rapidly rewarm to 37°C within 6 hours to prevent coagulopathy.
C. Initiate therapeutic hypothermia at 30°C for 12 hours followed by
passive rewarming.
D. Use surface cooling only if the initial rhythm was shockable.
Correct Answer: A - Maintain a constant temperature between
32°C and 36°C for at least 24 hours, avoiding fever for 72 hours.
RATIONALE
The 2025 guidelines recommend selecting a constant target
temperature between 32°C and 36°C for at least 24 hours, with strict
avoidance of fever (>37.5°C) for at least 72 hours after ROSC. Rapid
rewarming increases cerebral metabolic demand and worsens
neurologic injury. Temperatures below 32°C are not recommended
due to increased adverse effects, and TTM is indicated regardless of
initial rhythm.
Question 3
During CPR, waveform capnography suddenly drops from 35 mmHg to 8
mmHg. Which action best addresses the most likely reversible cause?
A. Immediately administer sodium bicarbonate 1 mEq/kg to correct
metabolic acidosis.
B. Check for endotracheal tube dislodgement or obstruction and verify
placement.
C. Increase the epinephrine dose to 0.2 mg/kg to overcome profound
vasoplegia.
D. Perform a precordial thump to convert presumed pulseless electrical
activity.
Correct Answer: B - Check for endotracheal tube dislodgement
or obstruction and verify placement.
Page 3
, RATIONALE
A sudden profound fall in ETCO during CPR most often indicates a
loss of pulmonary blood flow, commonly from tube dislodgement or
obstruction. Immediate verification and correction of the airway is the
priority. Sodium bicarbonate is not indicated for routine acidosis,
high-dose epinephrine is not recommended, and a precordial thump is
not a standard intervention for PEA.
Question 4
A patient with symptomatic bradycardia and a pulse has failed atropine. Which
pharmacologic or electrical intervention is most appropriate next, assuming no
contraindications?
A. Adenosine 6 mg rapid IV push followed by saline flush.
B. Dopamine infusion at 5-20 mcg/kg/min or epinephrine infusion at 2-10
mcg/min.
C. Amiodarone 150 mg IV over 10 minutes.
D. Synchronized cardioversion at 50 J.
Correct Answer: B - Dopamine infusion at 5-20 mcg/kg/min or
epinephrine infusion at 2-10 mcg/min.
RATIONALE
For symptomatic bradycardia unresponsive to atropine, the next step is
a chronotropic infusion (dopamine or epinephrine) while preparing for
transcutaneous pacing. Adenosine and amiodarone are used for
tachyarrhythmias, not bradycardia. Synchronized cardioversion is not
indicated for bradycardia; pacing is the electrical option.
Question 5
Which statement most accurately reflects the current evidence regarding
point-of-care ultrasound (POCUS) during cardiac arrest?
A. POCUS should replace pulse checks to reduce interruptions in
compressions.
Page 4
Exam 2026 (Actual Exam) Questions
with verified Answers | Verified
Questions
ALS/ACLS Red Cross Final Exam [] Exam | Comprehensive
Examination
ALS/ACLS Red Cross Final Exam [] Exam 2026 (Actual
Exam) Questions with verified Answers actual exam
preparation document with verified questions, complete
INTRODUCTION
This document is an important and very helpful preparation
resource for ALS/ACLS Red Cross Final Exam [] Exam 2026
(Actual Exam) Questions with verified Answers. Every item
uses a focused exam stem, four response options, a keyed
response, and a clear rationale, making it easier to understand
the subject, spot distractors, and build real exam confidence.
Page 1
, Question 1
During a witnessed in-hospital ventricular fibrillation arrest, the first
defibrillation attempt fails to terminate the rhythm. Which intervention, when
integrated with ongoing high-quality CPR, most directly increases the
probability of subsequent shock success?
A. Increasing the energy setting beyond the manufacturer's maximum
recommended dose on the next shock.
B. Administering epinephrine 1 mg IV/IO immediately before the next
defibrillation attempt.
C. Performing a 2-minute cycle of chest compressions with minimal
interruption before the next shock.
D. Hyperventilating the patient with 100% oxygen via bag-mask to
correct presumed hypoxia.
Correct Answer: C - Performing a 2-minute cycle of chest
compressions with minimal interruption before the next shock.
RATIONALE
Refractory VF is often due to myocardial ischemia and metabolic
exhaustion; resuming high-quality chest compressions restores
coronary perfusion pressure, which is critical for defibrillation
success. Immediate epinephrine may improve coronary flow but does
not substitute for the mandatory 2-minute CPR cycle between shocks.
Hyperventilation raises intrathoracic pressure and reduces venous
return, worsening outcomes. Excess energy beyond manufacturer
limits increases myocardial injury without proven benefit.
Question 2
A patient with ROSC after prolonged resuscitation remains comatose with a
core temperature of 34.5°C. Which targeted temperature management
parameter best aligns with current post-cardiac arrest care guidelines?
A. Maintain a constant temperature between 32°C and 36°C for at least
24 hours, avoiding fever for 72 hours.
Page 2
, B. Rapidly rewarm to 37°C within 6 hours to prevent coagulopathy.
C. Initiate therapeutic hypothermia at 30°C for 12 hours followed by
passive rewarming.
D. Use surface cooling only if the initial rhythm was shockable.
Correct Answer: A - Maintain a constant temperature between
32°C and 36°C for at least 24 hours, avoiding fever for 72 hours.
RATIONALE
The 2025 guidelines recommend selecting a constant target
temperature between 32°C and 36°C for at least 24 hours, with strict
avoidance of fever (>37.5°C) for at least 72 hours after ROSC. Rapid
rewarming increases cerebral metabolic demand and worsens
neurologic injury. Temperatures below 32°C are not recommended
due to increased adverse effects, and TTM is indicated regardless of
initial rhythm.
Question 3
During CPR, waveform capnography suddenly drops from 35 mmHg to 8
mmHg. Which action best addresses the most likely reversible cause?
A. Immediately administer sodium bicarbonate 1 mEq/kg to correct
metabolic acidosis.
B. Check for endotracheal tube dislodgement or obstruction and verify
placement.
C. Increase the epinephrine dose to 0.2 mg/kg to overcome profound
vasoplegia.
D. Perform a precordial thump to convert presumed pulseless electrical
activity.
Correct Answer: B - Check for endotracheal tube dislodgement
or obstruction and verify placement.
Page 3
, RATIONALE
A sudden profound fall in ETCO during CPR most often indicates a
loss of pulmonary blood flow, commonly from tube dislodgement or
obstruction. Immediate verification and correction of the airway is the
priority. Sodium bicarbonate is not indicated for routine acidosis,
high-dose epinephrine is not recommended, and a precordial thump is
not a standard intervention for PEA.
Question 4
A patient with symptomatic bradycardia and a pulse has failed atropine. Which
pharmacologic or electrical intervention is most appropriate next, assuming no
contraindications?
A. Adenosine 6 mg rapid IV push followed by saline flush.
B. Dopamine infusion at 5-20 mcg/kg/min or epinephrine infusion at 2-10
mcg/min.
C. Amiodarone 150 mg IV over 10 minutes.
D. Synchronized cardioversion at 50 J.
Correct Answer: B - Dopamine infusion at 5-20 mcg/kg/min or
epinephrine infusion at 2-10 mcg/min.
RATIONALE
For symptomatic bradycardia unresponsive to atropine, the next step is
a chronotropic infusion (dopamine or epinephrine) while preparing for
transcutaneous pacing. Adenosine and amiodarone are used for
tachyarrhythmias, not bradycardia. Synchronized cardioversion is not
indicated for bradycardia; pacing is the electrical option.
Question 5
Which statement most accurately reflects the current evidence regarding
point-of-care ultrasound (POCUS) during cardiac arrest?
A. POCUS should replace pulse checks to reduce interruptions in
compressions.
Page 4
