With All The Correct Answers Johns Hopkins
This ACLS Exam Version A & B (2025 Update) test bank offers 300 unique multiple-choice
questions with verified answers and detailed rationales. It covers BLS, rhythm recognition,
ACLS medications, airway management, and post-cardiac arrest care. Ideal for healthcare
professionals, students, and anyone preparing for ACLS certification exams.
1. An activated AED does not promptly analyze the rhythm. What is your next action?
A. Begin chest compressions.
B. Discontinue the resuscitation attempt.
C. Check all AED connections and reanalyze.
D. Rotate AED electrodes to an alternate position.
C. Check all AED connections and reanalyze.
Rationale: If an AED does not analyze promptly, check the electrode pad connections,
ensure good skin contact, and then prompt the AED to reanalyze. Starting
compressions is important but it is best to correct mechanical or connection issues
first to allow rhythm analysis. Discontinuing is inappropriate unless the patient is
obviously dead, and rotating electrodes is not standard procedure.
2. You have completed 2 minutes of CPR. The ECG monitor displays ventricular
fibrillation, and the patient has no pulse. Another member of your team resumes
chest compressions, and an IV is in place. What management step is your next
priority?
A. Administer 1 mg of epinephrine IV.
B. Administer 300 mg of amiodarone IV.
C. Deliver a shock using the defibrillator.
D. Continue CPR for another 2 minutes before shocking.
,C. Deliver a shock using the defibrillator.
Rationale: The priority for VF/pVT is immediate defibrillation. The shock should be
delivered as soon as the defibrillator is available and charged. Epinephrine and
amiodarone are administered after the first shock, during the next cycle of CPR.
3. What is the recommended compression rate for high-quality CPR in adults?
A. 60 to 80 compressions per minute
B. 80 to 100 compressions per minute
C. 100 to 120 compressions per minute
D. 120 to 140 compressions per minute
C. 100 to 120 compressions per minute.
Rationale: The 2020 AHA guidelines recommend a compression rate of 100 to 120 per
minute for adults. Rates faster than 120 or slower than 100 are associated with
decreased survival.
4. What is the recommended compression depth for high-quality CPR in adults?
A. At least 1 inch (2.5 cm)
B. At least 1.5 inches (4 cm)
C. At least 2 inches (5 cm)
D. At least 3 inches (7.5 cm)
C. At least 2 inches (5 cm).
Rationale: The 2020 AHA guidelines recommend a compression depth of at least 2
inches (5 cm) but not greater than 2.4 inches (6 cm) in adults. Excessive depth can
cause injury.
5. During CPR, when should the compressor switch roles?
A. Every 1 minute
B. Every 2 minutes or after 5 cycles of compressions
C. Every 5 minutes
D. Only when the compressor is tired
,B. Every 2 minutes or after 5 cycles of compressions.
Rationale: To prevent fatigue and maintain high-quality compressions, the
compressor should switch every 2 minutes (or after 5 cycles of 30 compressions
and 2 breaths). Fatigue can lead to inadequate compression depth and rate.
6. What is the correct compression-to-ventilation ratio for adult CPR without an
advanced airway?
A. 15:2
B. 30:2
C. 20:2
D. 10:2
B. 30:2.
Rationale: For adult CPR without an advanced airway, the compression-to-ventilation
ratio is 30:2. Once an advanced airway is placed, continuous compressions at 100-
120/min with 1 breath every 6 seconds (10 breaths/min) should be provided.
7. What is the correct compression-to-ventilation ratio for adult CPR with an
advanced airway in place?
A. 30:2
B. 15:2
C. Continuous compressions with 1 breath every 6 seconds
D. Continuous compressions with 1 breath every 10 seconds
C. Continuous compressions with 1 breath every 6 seconds.
Rationale: Once an advanced airway is placed, compressions are continuous and
asynchronous with ventilations. The rate of ventilation is 1 breath every 6 seconds (10
breaths/min).
8. What is the maximum interruption in chest compressions allowed during ACLS?
A. 5 seconds
B. 10 seconds
, C. 15 seconds
D. 20 seconds
B. 10 seconds.
Rationale: Interruptions in chest compressions should be minimized. The maximum
allowable interruption is 10 seconds for interventions such as rhythm analysis,
defibrillation, or intubation.
9. A patient is in cardiac arrest. You are preparing to deliver a shock. What should
you do immediately before and after the shock?
A. Check for a pulse.
B. Resume compressions immediately after the shock.
C. Administer epinephrine immediately before the shock.
D. Increase the compression rate to 150/min.
B. Resume compressions immediately after the shock.
Rationale: After delivering a shock, CPR should be resumed immediately, starting with
chest compressions. Do not check for a pulse or rhythm immediately after the shock;
resume CPR for 2 minutes before reassessing.
10. Which of the following is a sign of high-quality CPR?
A. Compressions at a rate of 80/min
B. Compressions at a depth of 1 inch
C. Full chest recoil between compressions
D. Leaning on the chest between compressions
C. Full chest recoil between compressions.
Rationale: Full chest recoil allows the heart to refill with blood between compressions.
Leaning on the chest prevents venous return and decreases cardiac output.
11. What is the recommended ventilation rate for an adult in cardiac arrest with an
advanced airway?