AHA ACLS Final Exam 2026/2027 – Verified Detailed
Questions & Answers with Detailed Rationales |
Complete Exam Prep
SECTION 1 — INITIAL ASSESSMENT & HIGH-QUALITY CPR
1. An adult suddenly collapses and is unresponsive. What should the healthcare
professional do first?
A. Obtain a 12-lead ECG
B. Assess responsiveness and breathing and activate the emergency response
C. Establish IV access
D. Administer epinephrine
Answer: B
Rationale: Initial assessment should rapidly establish whether the patient is
responsive and breathing normally. If cardiac arrest is suspected, the emergency
response should be activated and resuscitation begun without unnecessary delay.
2. Which breathing pattern should be treated as abnormal in an unresponsive
adult?
A. Normal quiet breathing
B. Agonal gasping
C. Regular deep breathing after exercise
D. Normal sleeping respirations
Answer: B
Rationale: Agonal gasping is not normal breathing and may occur during cardiac
arrest. An unresponsive patient who is only gasping should be treated as being in
cardiac arrest until proven otherwise.
,3. What is the recommended adult chest-compression rate?
A. 60–80/min
B. 80–90/min
C. 100–120/min
D. 130–160/min
Answer: C
Rationale: High-quality adult CPR requires a compression rate of 100–120/min.
Rates that are too slow reduce perfusion, whereas excessive rates may reduce
compression depth and recoil.
4. What is the recommended adult compression depth?
A. 1–2 cm
B. 3–4 cm
C. At least 5 cm while avoiding excessive depth
D. More than 7 cm
Answer: C
Rationale: Adult chest compressions should be approximately 5–6 cm deep.
Adequate depth produces effective blood flow while excessive depth can increase
injury without improving outcomes.
5. Which action allows the heart to refill during CPR?
A. Leaning on the chest
B. Complete chest recoil
C. Increasing compression rate
D. Prolonging pauses
Answer: B
Rationale: Complete chest recoil allows venous blood to return to the heart
between compressions. Leaning on the chest can reduce venous return.
,6. How frequently should rescuers generally rotate the compressor?
A. Every 30 seconds
B. About every 2 minutes
C. Every 10 minutes
D. Only after ROSC
Answer: B
Rationale: Compressor fatigue can decrease CPR quality. Rotation approximately
every 2 minutes helps maintain appropriate compression depth and rate.
7. What compression-to-ventilation ratio is used for adult CPR without an
advanced airway?
A. 15:2
B. 20:2
C. 30:2
D. 50:5
Answer: C
Rationale: Adult CPR without an advanced airway uses 30 compressions followed
by 2 ventilations.
8. What is the primary reason to minimize interruptions in chest compressions?
A. Prevent airway obstruction
B. Maintain coronary and cerebral perfusion
C. Increase oxygen consumption
D. Reduce ECG artifact
Answer: B
Rationale: Coronary perfusion pressure falls rapidly when compressions stop.
Minimizing interruptions helps maintain blood flow to the heart and brain.
, 9. A defibrillator arrives during CPR. What should happen?
A. Continue CPR for another 10 minutes
B. Apply the pads and analyze the rhythm as soon as practical
C. Give atropine first
D. Obtain a full medical history
Answer: B
Rationale: Early rhythm assessment determines whether the patient has a
shockable rhythm. If VF/pVT is present, defibrillation should not be unnecessarily
delayed.
10. Which rhythm is shockable?
A. Asystole
B. PEA
C. VF
D. Sinus bradycardia
Answer: C
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are
shockable rhythms.
11. Which rhythm is nonshockable?
A. VF
B. pVT
C. PEA
D. Coarse VF
Answer: C
Rationale: PEA is a nonshockable cardiac-arrest rhythm. Management consists of
high-quality CPR, epinephrine, and treatment of reversible causes.
Questions & Answers with Detailed Rationales |
Complete Exam Prep
SECTION 1 — INITIAL ASSESSMENT & HIGH-QUALITY CPR
1. An adult suddenly collapses and is unresponsive. What should the healthcare
professional do first?
A. Obtain a 12-lead ECG
B. Assess responsiveness and breathing and activate the emergency response
C. Establish IV access
D. Administer epinephrine
Answer: B
Rationale: Initial assessment should rapidly establish whether the patient is
responsive and breathing normally. If cardiac arrest is suspected, the emergency
response should be activated and resuscitation begun without unnecessary delay.
2. Which breathing pattern should be treated as abnormal in an unresponsive
adult?
A. Normal quiet breathing
B. Agonal gasping
C. Regular deep breathing after exercise
D. Normal sleeping respirations
Answer: B
Rationale: Agonal gasping is not normal breathing and may occur during cardiac
arrest. An unresponsive patient who is only gasping should be treated as being in
cardiac arrest until proven otherwise.
,3. What is the recommended adult chest-compression rate?
A. 60–80/min
B. 80–90/min
C. 100–120/min
D. 130–160/min
Answer: C
Rationale: High-quality adult CPR requires a compression rate of 100–120/min.
Rates that are too slow reduce perfusion, whereas excessive rates may reduce
compression depth and recoil.
4. What is the recommended adult compression depth?
A. 1–2 cm
B. 3–4 cm
C. At least 5 cm while avoiding excessive depth
D. More than 7 cm
Answer: C
Rationale: Adult chest compressions should be approximately 5–6 cm deep.
Adequate depth produces effective blood flow while excessive depth can increase
injury without improving outcomes.
5. Which action allows the heart to refill during CPR?
A. Leaning on the chest
B. Complete chest recoil
C. Increasing compression rate
D. Prolonging pauses
Answer: B
Rationale: Complete chest recoil allows venous blood to return to the heart
between compressions. Leaning on the chest can reduce venous return.
,6. How frequently should rescuers generally rotate the compressor?
A. Every 30 seconds
B. About every 2 minutes
C. Every 10 minutes
D. Only after ROSC
Answer: B
Rationale: Compressor fatigue can decrease CPR quality. Rotation approximately
every 2 minutes helps maintain appropriate compression depth and rate.
7. What compression-to-ventilation ratio is used for adult CPR without an
advanced airway?
A. 15:2
B. 20:2
C. 30:2
D. 50:5
Answer: C
Rationale: Adult CPR without an advanced airway uses 30 compressions followed
by 2 ventilations.
8. What is the primary reason to minimize interruptions in chest compressions?
A. Prevent airway obstruction
B. Maintain coronary and cerebral perfusion
C. Increase oxygen consumption
D. Reduce ECG artifact
Answer: B
Rationale: Coronary perfusion pressure falls rapidly when compressions stop.
Minimizing interruptions helps maintain blood flow to the heart and brain.
, 9. A defibrillator arrives during CPR. What should happen?
A. Continue CPR for another 10 minutes
B. Apply the pads and analyze the rhythm as soon as practical
C. Give atropine first
D. Obtain a full medical history
Answer: B
Rationale: Early rhythm assessment determines whether the patient has a
shockable rhythm. If VF/pVT is present, defibrillation should not be unnecessarily
delayed.
10. Which rhythm is shockable?
A. Asystole
B. PEA
C. VF
D. Sinus bradycardia
Answer: C
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are
shockable rhythms.
11. Which rhythm is nonshockable?
A. VF
B. pVT
C. PEA
D. Coarse VF
Answer: C
Rationale: PEA is a nonshockable cardiac-arrest rhythm. Management consists of
high-quality CPR, epinephrine, and treatment of reversible causes.
