AHA BLS Exam Review
Questions and Answers
Comprehensive 90-Question Examination Preparation Series
8 Content Domains • Aligned with Current AHA BLS Provider Manual and Guidelines
Instructions: This review contains 90 multiple-choice questions distributed across eight content domains aligned
with the current AHA BLS Provider Manual and Guidelines: (1) Chain of Survival; (2) High-Quality CPR
Components; (3) Adult BLS Single Rescuer; (4) Adult Team-Based CPR; (5) Pediatric BLS (Child & Infant); (6)
Airway Management and Ventilation; (7) AED Operation and Special Situations; and (8) Team Dynamics,
Choking Relief, and Special Resuscitation Situations. Each question has four options (A–D) with exactly one
correct response marked **[CORRECT]**. Rationales include AHA Guidelines citations and BLS sequence
reasoning. Recommended time: 60 minutes.
Section 1: BLS Course Overview and Chain of Survival (Adult, Pediatric, In-Hospital, &
Out-of-Hospital)
Q1. What is the first link in the adult out-of-hospital Chain of Survival?
A. Early CPR
B. Activation of emergency response
C. Prevention of arrest **[CORRECT]**
D. Immediate defibrillation
Correct Answer: C
Rationale: The 2020 AHA Guidelines list 'Prevention of arrest' as the first link in the out-of-hospital Chain of Survival,
recognizing that community-based prevention and early recognition have the greatest population impact. Choice B is actually
the first response link (after prevention). Choice A (early CPR) is the second response link. Choice D (immediate
defibrillation) is the third response link.
Q2. Which is NOT a link in the AHA adult in-hospital Chain of Survival?
A. Surveillance and prevention
B. Recognition and activation
C. Immediate defibrillation **[CORRECT]**
D. Post-cardiac arrest care
Correct Answer: C
Rationale: The adult in-hospital Chain of Survival consists of: (1) Surveillance and prevention; (2) Recognition and
activation of the emergency response; (3) High-quality CPR; (4) Defibrillation; (5) Post-cardiac arrest care. 'Immediate
defibrillation' is not a named link—'Defibrillation' is, and it is intentionally separated from 'Recognition and activation.'
Choice A, B, and D are explicit named links in the in-hospital chain.
Q3. The fifth link in the adult Chain of Survival is:
A. Immediate defibrillation
B. Post-cardiac arrest care **[CORRECT]**
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C. Early CPR
D. Advanced airway placement
Correct Answer: B
Rationale: Per the 2020 AHA Guidelines, the fifth link is 'Post-cardiac arrest care,' which includes ROSC optimization,
targeted temperature management, and multidisciplinary care. Choice C is the second response link. Choice A is the third
link. Choice D is an advanced intervention, not a named link.
Q4. Which distinguishes the pediatric out-of-hospital Chain of Survival from the adult chain?
A. The pediatric chain has only three links
B. The pediatric chain begins with prevention of arrest **[CORRECT]**
C. The pediatric chain omits defibrillation
D. The pediatric chain begins with immediate high-quality CPR rather than prevention
Correct Answer: B
Rationale: The pediatric out-of-hospital Chain of Survival begins with 'Prevention of arrest,' reflecting that most pediatric
arrests are respiratory in origin and preventable. Choice A is incorrect; the pediatric chain has the same number of links.
Choice C is incorrect; defibrillation is included. Choice D reverses the adult/pediatric emphasis—adult chain emphasizes
rapid response.
Q5. The most common cause of cardiac arrest in children is:
A. Ventricular fibrillation
B. Respiratory failure or shock **[CORRECT]**
C. Acute myocardial infarction
D. Sudden cardiac death
Correct Answer: B
Rationale: Most pediatric cardiac arrests are hypoxic/asphyxial, resulting from respiratory failure or shock, which is why
early ventilation is prioritized in pediatric BLS. Choice A (VF) is the most common initial rhythm in adult arrests. Choice C is
an adult cause. Choice D is rare in children.
Q6. A lone rescuer witnesses a sudden adult collapse in a mall. After confirming unresponsiveness and no
normal breathing, the rescuer should first:
A. Begin chest compressions
B. Activate the emergency response system and retrieve an AED **[CORRECT]**
C. Open the airway and deliver 2 breaths
D. Check for a pulse for up to 60 seconds
Correct Answer: B
Rationale: Per AHA BLS sequence, a lone rescuer who witnesses a sudden collapse should first activate the emergency
response system and retrieve an AED (or send someone to do so), then begin CPR. Choice A is appropriate for an
unwitnessed arrest with no AED available; in a witnessed arrest, activation and AED retrieval take priority. Choice C
follows compressions. Choice D is incorrect; pulse check should take no more than 5-10 seconds.
Q7. In the in-hospital setting, the cardiac arrest team's first action upon arrival should be:
A. Deliver an unsynchronized shock
B. Confirm cardiac arrest and begin high-quality CPR **[CORRECT]**
C. Intubate immediately
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D. Administer epinephrine before compressions
Correct Answer: B
Rationale: The in-hospital Chain of Survival emphasizes prompt recognition and activation of the response team, followed
by immediate high-quality CPR. Choice A is only appropriate for a shockable rhythm confirmed by the team leader. Choice
C delays compressions. Choice D delays high-quality CPR.
Q8. Which statement about the adult Chain of Survival is correct?
A. Survival rates double when each link is strengthened **[CORRECT]**
B. Each link is independent and does not affect others
C. The chain applies only to witnessed arrests
D. The chain ends once ROSC is achieved
Correct Answer: A
Rationale: The Chain of Survival is interdependent: strengthening each link multiplies the effect of the others, dramatically
improving survival. Choice B is incorrect; links are interdependent. Choice C is incorrect; the chain applies to both witnessed
and unwitnessed arrests. Choice D is incorrect; post-arrest care continues after ROSC.
Q9. What is the minimum number of links required for effective implementation of the Chain of
Survival?
A. Two links
B. Three links
C. Five links
D. All links must be present **[CORRECT]**
Correct Answer: D
Rationale: All links must be present for the Chain of Survival to be complete; omitting any link weakens the entire system
and reduces survival. Choice A, B, and C are insufficient because the chain's effectiveness depends on all links working
together.
Q10. The 2020 AHA Guidelines added which link to the adult in-hospital Chain of Survival?
A. Recovery **[CORRECT]**
B. Advanced airway
C. Mechanical CPR devices
D. Extracorporeal CPR
Correct Answer: A
Rationale: The 2020 AHA Guidelines added 'Recovery' as a new link (sixth link) in the Chain of Survival, addressing the
physical, cognitive, and emotional recovery of survivors. Choice B is an advanced intervention, not a link. Choice C is a
mechanical device option. Choice D is an advanced therapy, not a foundational link.
Section 2: High-Quality CPR Components (Rate, Depth, Recoil, Minimizing
Interruptions, & Feedback Devices)
Q11. The recommended adult chest compression rate is:
A. 80-100 compressions per minute
B. 100-120 compressions per minute **[CORRECT]**
American Heart Association Basic Life Support - Aligned with Current AHA BLS Provider Manual and Guidelines
Questions and Answers
Comprehensive 90-Question Examination Preparation Series
8 Content Domains • Aligned with Current AHA BLS Provider Manual and Guidelines
Instructions: This review contains 90 multiple-choice questions distributed across eight content domains aligned
with the current AHA BLS Provider Manual and Guidelines: (1) Chain of Survival; (2) High-Quality CPR
Components; (3) Adult BLS Single Rescuer; (4) Adult Team-Based CPR; (5) Pediatric BLS (Child & Infant); (6)
Airway Management and Ventilation; (7) AED Operation and Special Situations; and (8) Team Dynamics,
Choking Relief, and Special Resuscitation Situations. Each question has four options (A–D) with exactly one
correct response marked **[CORRECT]**. Rationales include AHA Guidelines citations and BLS sequence
reasoning. Recommended time: 60 minutes.
Section 1: BLS Course Overview and Chain of Survival (Adult, Pediatric, In-Hospital, &
Out-of-Hospital)
Q1. What is the first link in the adult out-of-hospital Chain of Survival?
A. Early CPR
B. Activation of emergency response
C. Prevention of arrest **[CORRECT]**
D. Immediate defibrillation
Correct Answer: C
Rationale: The 2020 AHA Guidelines list 'Prevention of arrest' as the first link in the out-of-hospital Chain of Survival,
recognizing that community-based prevention and early recognition have the greatest population impact. Choice B is actually
the first response link (after prevention). Choice A (early CPR) is the second response link. Choice D (immediate
defibrillation) is the third response link.
Q2. Which is NOT a link in the AHA adult in-hospital Chain of Survival?
A. Surveillance and prevention
B. Recognition and activation
C. Immediate defibrillation **[CORRECT]**
D. Post-cardiac arrest care
Correct Answer: C
Rationale: The adult in-hospital Chain of Survival consists of: (1) Surveillance and prevention; (2) Recognition and
activation of the emergency response; (3) High-quality CPR; (4) Defibrillation; (5) Post-cardiac arrest care. 'Immediate
defibrillation' is not a named link—'Defibrillation' is, and it is intentionally separated from 'Recognition and activation.'
Choice A, B, and D are explicit named links in the in-hospital chain.
Q3. The fifth link in the adult Chain of Survival is:
A. Immediate defibrillation
B. Post-cardiac arrest care **[CORRECT]**
American Heart Association Basic Life Support - Aligned with Current AHA BLS Provider Manual and Guidelines
,AHA BLS Exam Review | Questions and Answers Page 2
C. Early CPR
D. Advanced airway placement
Correct Answer: B
Rationale: Per the 2020 AHA Guidelines, the fifth link is 'Post-cardiac arrest care,' which includes ROSC optimization,
targeted temperature management, and multidisciplinary care. Choice C is the second response link. Choice A is the third
link. Choice D is an advanced intervention, not a named link.
Q4. Which distinguishes the pediatric out-of-hospital Chain of Survival from the adult chain?
A. The pediatric chain has only three links
B. The pediatric chain begins with prevention of arrest **[CORRECT]**
C. The pediatric chain omits defibrillation
D. The pediatric chain begins with immediate high-quality CPR rather than prevention
Correct Answer: B
Rationale: The pediatric out-of-hospital Chain of Survival begins with 'Prevention of arrest,' reflecting that most pediatric
arrests are respiratory in origin and preventable. Choice A is incorrect; the pediatric chain has the same number of links.
Choice C is incorrect; defibrillation is included. Choice D reverses the adult/pediatric emphasis—adult chain emphasizes
rapid response.
Q5. The most common cause of cardiac arrest in children is:
A. Ventricular fibrillation
B. Respiratory failure or shock **[CORRECT]**
C. Acute myocardial infarction
D. Sudden cardiac death
Correct Answer: B
Rationale: Most pediatric cardiac arrests are hypoxic/asphyxial, resulting from respiratory failure or shock, which is why
early ventilation is prioritized in pediatric BLS. Choice A (VF) is the most common initial rhythm in adult arrests. Choice C is
an adult cause. Choice D is rare in children.
Q6. A lone rescuer witnesses a sudden adult collapse in a mall. After confirming unresponsiveness and no
normal breathing, the rescuer should first:
A. Begin chest compressions
B. Activate the emergency response system and retrieve an AED **[CORRECT]**
C. Open the airway and deliver 2 breaths
D. Check for a pulse for up to 60 seconds
Correct Answer: B
Rationale: Per AHA BLS sequence, a lone rescuer who witnesses a sudden collapse should first activate the emergency
response system and retrieve an AED (or send someone to do so), then begin CPR. Choice A is appropriate for an
unwitnessed arrest with no AED available; in a witnessed arrest, activation and AED retrieval take priority. Choice C
follows compressions. Choice D is incorrect; pulse check should take no more than 5-10 seconds.
Q7. In the in-hospital setting, the cardiac arrest team's first action upon arrival should be:
A. Deliver an unsynchronized shock
B. Confirm cardiac arrest and begin high-quality CPR **[CORRECT]**
C. Intubate immediately
American Heart Association Basic Life Support - Aligned with Current AHA BLS Provider Manual and Guidelines
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D. Administer epinephrine before compressions
Correct Answer: B
Rationale: The in-hospital Chain of Survival emphasizes prompt recognition and activation of the response team, followed
by immediate high-quality CPR. Choice A is only appropriate for a shockable rhythm confirmed by the team leader. Choice
C delays compressions. Choice D delays high-quality CPR.
Q8. Which statement about the adult Chain of Survival is correct?
A. Survival rates double when each link is strengthened **[CORRECT]**
B. Each link is independent and does not affect others
C. The chain applies only to witnessed arrests
D. The chain ends once ROSC is achieved
Correct Answer: A
Rationale: The Chain of Survival is interdependent: strengthening each link multiplies the effect of the others, dramatically
improving survival. Choice B is incorrect; links are interdependent. Choice C is incorrect; the chain applies to both witnessed
and unwitnessed arrests. Choice D is incorrect; post-arrest care continues after ROSC.
Q9. What is the minimum number of links required for effective implementation of the Chain of
Survival?
A. Two links
B. Three links
C. Five links
D. All links must be present **[CORRECT]**
Correct Answer: D
Rationale: All links must be present for the Chain of Survival to be complete; omitting any link weakens the entire system
and reduces survival. Choice A, B, and C are insufficient because the chain's effectiveness depends on all links working
together.
Q10. The 2020 AHA Guidelines added which link to the adult in-hospital Chain of Survival?
A. Recovery **[CORRECT]**
B. Advanced airway
C. Mechanical CPR devices
D. Extracorporeal CPR
Correct Answer: A
Rationale: The 2020 AHA Guidelines added 'Recovery' as a new link (sixth link) in the Chain of Survival, addressing the
physical, cognitive, and emotional recovery of survivors. Choice B is an advanced intervention, not a link. Choice C is a
mechanical device option. Choice D is an advanced therapy, not a foundational link.
Section 2: High-Quality CPR Components (Rate, Depth, Recoil, Minimizing
Interruptions, & Feedback Devices)
Q11. The recommended adult chest compression rate is:
A. 80-100 compressions per minute
B. 100-120 compressions per minute **[CORRECT]**
American Heart Association Basic Life Support - Aligned with Current AHA BLS Provider Manual and Guidelines
