AHA ACLS Final Exam Questions and Answers with Explanation (Latest 2026/2027

AHA ACLS Final Exam Questions and Answers with
Explanation (Latest 2026/2027


The American Heart Association (AHA) ACLS final exam tests your ability to apply
advanced cardiovascular life support algorithms in high-pressure clinical scenarios.
While the AHA does not publish an official "final exam" for public use, practice questions
from verified study guides consistently cover the same core domains: high-quality CPR
metrics, rhythm recognition, pharmacology, team dynamics, and post-arrest care. Below
are representative practice questions and answers based on current AHA guidelines.




High-Quality CPR & BLS Foundations
Question 1: What is the recommended compression rate and depth for adult CPR?

 A) 80–100/min, at least 1.5 inches
 B) 100–120/min, at least 2 inches (5 cm) but not more than 2.4 inches (6 cm)
 C) 120–140/min, at least 2.5 inches
 D) 60–80/min, at least 2 inches

Correct Answer: B. AHA guidelines specify 100–120 compressions per minute at a
depth of at least 2 inches (5 cm) for adults, while avoiding excessive depth beyond 2.4
inches (6 cm) .

Question 2: What is the compression-to-ventilation ratio for a single rescuer
performing CPR on an adult without an advanced airway?

 A) 15:2
 B) 30:2
 C) 30:1
 D) 5:1

Correct Answer: B. The 30:2 ratio maximizes compressions per minute while providing
adequate ventilation. This ratio remains the standard for adults with one or multiple
rescuers when no advanced airway is in place .

, Question 3: After an advanced airway is placed (e.g., endotracheal tube), how should
ventilations be delivered during continuous chest compressions?

 A) Pause compressions for each breath
 B) 1 breath every 6 seconds (10 breaths/min) without pausing compressions
 C) 2 breaths every 30 compressions
 D) 1 breath every 2 seconds

Correct Answer: B. Once an advanced airway is secured, compressions continue
uninterrupted while ventilations are delivered at 10 breaths per minute (1 breath every 6
seconds) .

Question 4: What is the maximum allowable interruption in chest compressions?

 A) 5 seconds
 B) 10 seconds
 C) 15 seconds
 D) 30 seconds

Correct Answer: B. Interruptions should be kept under 10 seconds. Coronary perfusion
pressure declines rapidly when compressions stop, reducing the likelihood of successful
defibrillation .

Question 5: How frequently should compressors rotate during a resuscitation?

 A) Every 1 minute
 B) Every 2 minutes (or after 5 cycles of 30:2)
 C) Every 5 minutes
 D) Only when fatigued

Correct Answer: B. Compressor fatigue degrades compression quality within
approximately 2 minutes. Rotation during rhythm checks maintains high-quality
compressions .




Rhythm Recognition & Electrical Therapy
Question 6: A patient in cardiac arrest presents with ventricular fibrillation. After the first
shock and 2 minutes of CPR, VF persists. What is the next priority intervention?

, A) Amiodarone 300 mg IV
 B) Epinephrine 1 mg IV
 C) Lidocaine 1 mg/kg IV
 D) Magnesium sulfate 2 g IV

Correct Answer: B. Epinephrine 1 mg IV is administered after the first two defibrillation
attempts for persistent VF/pVT, before antiarrhythmic medications .

Question 7: After the third shock for refractory VF, which medication is recommended?

 A) Amiodarone 300 mg IV bolus
 B) Atropine 1 mg IV
 C) Adenosine 6 mg IV
 D) Dopamine infusion

Correct Answer: A. Amiodarone 300 mg IV bolus is the recommended antiarrhythmic
after epinephrine for refractory VF/pVT .

Question 8: A patient with a narrow-complex tachycardia at 160 bpm has a blood
pressure of 72/48 mmHg. What is the priority intervention?

 A) Adenosine 6 mg IV push
 B) Synchronized cardioversion
 C) Vagal maneuvers
 D) Amiodarone infusion

Correct Answer: B. Unstable narrow-complex tachycardia with hypotension requires
immediate synchronized cardioversion. Adenosine is appropriate only for stable patients
.

Question 9: After delivering a shock for a shockable rhythm, what is the immediate next
action?

 A) Check for a pulse
 B) Resume chest compressions immediately for 2 minutes
 C) Deliver a second shock
 D) Administer epinephrine

Correct Answer: B. CPR is resumed immediately after shock delivery without a pulse
check. The team performs 2 minutes of CPR before the next rhythm check to allow the
myocardium to recover .

, Pharmacology
Question 10: What is the recommended dose of epinephrine during cardiac arrest?

 A) 0.5 mg IV every 3–5 minutes
 B) 1 mg IV every 3–5 minutes
 C) 3 mg IV once
 D) 1 mg IV once only

Correct Answer: B. Epinephrine 1 mg IV is administered every 3–5 minutes during
cardiac arrest .

Question 11: What is the recommended oral dose of aspirin for a patient with
suspected acute coronary syndrome who is not allergic?

 A) 40 mg
 B) 81 mg
 C) 160–325 mg
 D) 500 mg

Correct Answer: C. Aspirin 160–325 mg chewed is the standard initial antiplatelet dose
for suspected ACS .

Question 12: What is the maximum total dose of atropine for symptomatic
bradycardia?

 A) 1 mg
 B) 2 mg
 C) 3 mg
 D) 6 mg

Correct Answer: C. Atropine is dosed at 1 mg IV every 3–5 minutes, with a maximum
total dose of 3 mg .




Team Dynamics & Communication