2025\2026 ACLS Exams A and B questions
and answers with Answer Keys
Section 1: High-Quality CPR & BLS Assessment (Questions 1–30)
1. A patient collapses in the emergency department. After verifying
unresponsiveness and activating the emergency response team, what is the next
priority assessment?
A. Open the airway
B. Check for a pulse
C. Deliver two rescue breaths
D. Administer epinephrine
Correct Answer: B
Rationale: After determining unresponsiveness and activating the emergency
response system, the next step is to simultaneously check for breathing and a
central pulse for no more than 10 seconds. If no pulse is detected, begin high-
quality CPR immediately. Opening the airway and delivering breaths occur as part
of the CPR cycle, but pulse verification must come first to confirm the need for
compressions.
2. During CPR on an adult patient, the compressor delivers compressions at a
rate of 130 per minute. Which statement best describes the appropriate action?
A. Continue at this rate; faster compressions improve perfusion
B. Slow the rate to 100–120 per minute
C. Slow the rate to 80–100 per minute
D. Increase the depth to compensate for the faster rate
Correct Answer: B
, Rationale: The recommended compression rate for adult CPR is 100–120
compressions per minute. Rates exceeding 120 per minute are associated with
decreased compression depth and inadequate chest recoil, which reduces
coronary perfusion pressure and cardiac output. The provider should slow the rate
to the recommended range.
3. A resuscitation team is performing CPR on a patient in cardiac arrest. The
team leader observes that the compressor is allowing complete chest recoil after
each compression. What is the significance of this observation?
A. Complete recoil increases intrathoracic pressure
B. Complete recoil allows for venous return to the heart
C. Complete recoil should be avoided to maintain pressure
D. Complete recoil is only necessary during ventilation
Correct Answer: B
Rationale: Allowing complete chest recoil after each compression is essential
for high-quality CPR. Full recoil creates negative intrathoracic pressure, which
facilitates venous return to the right heart and improves cardiac output during the
decompression phase. Leaning on the chest between compressions impedes
venous return and reduces the effectiveness of CPR.
4. What is the maximum allowable interruption in chest compressions during a
resuscitation attempt?
A. 5 seconds
B. 10 seconds
C. 15 seconds
D. 20 seconds
Correct Answer: B
, Rationale: Interruptions in chest compressions should be limited to no longer
than 10 seconds. When compressions stop, blood flow to the brain and heart
ceases, and coronary perfusion pressure falls rapidly. Prolonged interruptions
(rhythm checks, pulse checks, intubation attempts) significantly decrease the
likelihood of return of spontaneous circulation (ROSC) and survival.
5. A team member asks how often compressors should rotate during a
resuscitation attempt. What is the correct response?
A. Every 1 minute
B. Every 2 minutes
C. Every 5 minutes
D. Only when the compressor reports fatigue
Correct Answer: B
Rationale: Compressors should switch approximately every 2 minutes or
sooner if fatigued. High-quality compressions require adequate depth and rate,
and fatigue degrades both within 1–2 minutes even when the compressor does
not perceive fatigue. Rotating during rhythm checks minimizes interruptions and
maintains compression quality.
6. During a cardiac arrest, the team leader notes that the chest compression
fraction (CCF) is 45%. What is the minimum CCF target for optimal outcomes?
A. 40%
B. 50%
C. 60%
D. 80%
Correct Answer: C
Rationale: Chest compression fraction (CCF) is the proportion of time spent
performing compressions during a cardiac arrest. The minimum target is at least
, 60%, with an ideal goal of 80% or higher. A CCF of 45% is inadequate and indicates
excessive interruptions in compressions, which reduces coronary perfusion
pressure and decreases survival.
7. A patient is found unresponsive by a healthcare provider. The provider
observes agonal gasps. What is the appropriate interpretation of this finding?
A. The patient has adequate breathing
B. The patient is in respiratory distress
C. The patient likely has a pulse
D. Agonal gasps are a sign of cardiac arrest
Correct Answer: D
Rationale: Agonal gasps are irregular, gasping breaths that occur in the first
minutes after sudden cardiac arrest. They are not normal breathing and should be
treated as a sign of cardiac arrest. Healthcare providers must recognize agonal
gasps as a cardiac arrest presentation and initiate CPR immediately if no pulse is
detected.
8. After confirming that an adult patient is unresponsive, pulseless, and not
breathing, the team begins CPR. What compression-to-ventilation ratio should
be used before an advanced airway is placed?
A. 15:2
B. 30:2
C. 30:1
D. 15:1
Correct Answer: B
Rationale: For adult CPR with one or two rescuers before placement of an
advanced airway, the compression-to-ventilation ratio is 30:2. This ratio balances
the need for adequate perfusion with the need for oxygen delivery. Once an
and answers with Answer Keys
Section 1: High-Quality CPR & BLS Assessment (Questions 1–30)
1. A patient collapses in the emergency department. After verifying
unresponsiveness and activating the emergency response team, what is the next
priority assessment?
A. Open the airway
B. Check for a pulse
C. Deliver two rescue breaths
D. Administer epinephrine
Correct Answer: B
Rationale: After determining unresponsiveness and activating the emergency
response system, the next step is to simultaneously check for breathing and a
central pulse for no more than 10 seconds. If no pulse is detected, begin high-
quality CPR immediately. Opening the airway and delivering breaths occur as part
of the CPR cycle, but pulse verification must come first to confirm the need for
compressions.
2. During CPR on an adult patient, the compressor delivers compressions at a
rate of 130 per minute. Which statement best describes the appropriate action?
A. Continue at this rate; faster compressions improve perfusion
B. Slow the rate to 100–120 per minute
C. Slow the rate to 80–100 per minute
D. Increase the depth to compensate for the faster rate
Correct Answer: B
, Rationale: The recommended compression rate for adult CPR is 100–120
compressions per minute. Rates exceeding 120 per minute are associated with
decreased compression depth and inadequate chest recoil, which reduces
coronary perfusion pressure and cardiac output. The provider should slow the rate
to the recommended range.
3. A resuscitation team is performing CPR on a patient in cardiac arrest. The
team leader observes that the compressor is allowing complete chest recoil after
each compression. What is the significance of this observation?
A. Complete recoil increases intrathoracic pressure
B. Complete recoil allows for venous return to the heart
C. Complete recoil should be avoided to maintain pressure
D. Complete recoil is only necessary during ventilation
Correct Answer: B
Rationale: Allowing complete chest recoil after each compression is essential
for high-quality CPR. Full recoil creates negative intrathoracic pressure, which
facilitates venous return to the right heart and improves cardiac output during the
decompression phase. Leaning on the chest between compressions impedes
venous return and reduces the effectiveness of CPR.
4. What is the maximum allowable interruption in chest compressions during a
resuscitation attempt?
A. 5 seconds
B. 10 seconds
C. 15 seconds
D. 20 seconds
Correct Answer: B
, Rationale: Interruptions in chest compressions should be limited to no longer
than 10 seconds. When compressions stop, blood flow to the brain and heart
ceases, and coronary perfusion pressure falls rapidly. Prolonged interruptions
(rhythm checks, pulse checks, intubation attempts) significantly decrease the
likelihood of return of spontaneous circulation (ROSC) and survival.
5. A team member asks how often compressors should rotate during a
resuscitation attempt. What is the correct response?
A. Every 1 minute
B. Every 2 minutes
C. Every 5 minutes
D. Only when the compressor reports fatigue
Correct Answer: B
Rationale: Compressors should switch approximately every 2 minutes or
sooner if fatigued. High-quality compressions require adequate depth and rate,
and fatigue degrades both within 1–2 minutes even when the compressor does
not perceive fatigue. Rotating during rhythm checks minimizes interruptions and
maintains compression quality.
6. During a cardiac arrest, the team leader notes that the chest compression
fraction (CCF) is 45%. What is the minimum CCF target for optimal outcomes?
A. 40%
B. 50%
C. 60%
D. 80%
Correct Answer: C
Rationale: Chest compression fraction (CCF) is the proportion of time spent
performing compressions during a cardiac arrest. The minimum target is at least
, 60%, with an ideal goal of 80% or higher. A CCF of 45% is inadequate and indicates
excessive interruptions in compressions, which reduces coronary perfusion
pressure and decreases survival.
7. A patient is found unresponsive by a healthcare provider. The provider
observes agonal gasps. What is the appropriate interpretation of this finding?
A. The patient has adequate breathing
B. The patient is in respiratory distress
C. The patient likely has a pulse
D. Agonal gasps are a sign of cardiac arrest
Correct Answer: D
Rationale: Agonal gasps are irregular, gasping breaths that occur in the first
minutes after sudden cardiac arrest. They are not normal breathing and should be
treated as a sign of cardiac arrest. Healthcare providers must recognize agonal
gasps as a cardiac arrest presentation and initiate CPR immediately if no pulse is
detected.
8. After confirming that an adult patient is unresponsive, pulseless, and not
breathing, the team begins CPR. What compression-to-ventilation ratio should
be used before an advanced airway is placed?
A. 15:2
B. 30:2
C. 30:1
D. 15:1
Correct Answer: B
Rationale: For adult CPR with one or two rescuers before placement of an
advanced airway, the compression-to-ventilation ratio is 30:2. This ratio balances
the need for adequate perfusion with the need for oxygen delivery. Once an
