ACLS Practice Exam Bank: 600 Questions with Verified Answers & Rationales
Exam Overview
Feature Description
:--- :---
Exam Title Advanced Cardiovascular Life Support (ACLS) Comprehensive Practice Exam
Total Questions 600
Question Format Multiple Choice (4 options: A–D)
Answer Key Correct answer provided immediately after each question
Rationales Detailed explanation for every question, aligned with 2025 AHA Guidelines
Core Domains BLS & High-Quality CPR; Cardiac Arrest (VF/pVT, Asystole/PEA);
Bradycardia; Tachycardia; Pharmacology; Airway Management & Capnography; Post–
Cardiac Arrest Care; Special Situations (Opioid, Stroke, ACS); Team Dynamics; ECG
Rhythm Recognition; 2025 Guideline Updates
Target Audience Healthcare professionals preparing for ACLS certification, recertification,
or exam review
Version 2025–2026 Verified
---
Table of Contents
1. Section 1: BLS & High-Quality CPR (Questions 1–80)
2. Section 2: Cardiac Arrest – VF/pVT (Shockable Rhythms) (Questions 81–160)
3. Section 3: Cardiac Arrest – Asystole & PEA (Non-Shockable Rhythms) (Questions 161–
220)
,4. Section 4: Bradycardia with a Pulse (Questions 221–270)
5. Section 5: Tachycardia with a Pulse (Questions 271–340)
6. Section 6: ACLS Pharmacology (Questions 341–410)
7. Section 7: Airway Management & Capnography (Questions 411–460)
8. Section 8: Post–Cardiac Arrest Care (Questions 461–510)
9. Section 9: Special Situations (Opioid Overdose, Stroke, ACS) (Questions 511–550)
10. Section 10: Team Dynamics & Resuscitation Education (Questions 551–580)
11. Section 11: ECG Rhythm Recognition (Questions 581–600)
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Section 1: BLS & High-Quality CPR (Questions 1–80)
1. What is the recommended rate for chest compressions during adult CPR?
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
Answer: C. 100 to 120 compressions per minute
Rationale: The 2025 AHA Guidelines emphasize "push fast" at a rate of 100 to 120
compressions per minute to optimize coronary perfusion pressure and cardiac output.
2. What is the recommended depth for chest compressions in an average adult?
A. At least 1 inch (2.5 cm)
B. At least 1.5 inches (4 cm)
C. At least 2 inches (5 cm) but not more than 2.4 inches (6 cm)
,D. At least 3 inches (7.5 cm)
Answer: C. At least 2 inches (5 cm) but not more than 2.4 inches (6 cm)
Rationale: Compressions should be "push hard" at a depth of 2 to 2.4 inches (5–6 cm) in
adults, while avoiding excessive depth to prevent injury.
3. What is the correct compression-to-ventilation ratio for a single rescuer performing adult
CPR?
A. 15:2
B. 30:2
C. 50:2
D. 100:2
Answer: B. 30:2
Rationale: A universal compression-to-ventilation ratio of 30:2 is recommended for all
adult patients in cardiac arrest, whether one or two rescuers are present.
4. After delivering a shock from a defibrillator, what should the rescuer do immediately?
A. Check for a pulse
B. Analyze the rhythm
C. Resume chest compressions
D. Administer epinephrine
Answer: C. Resume chest compressions
Rationale: To minimize interruptions in chest compressions, CPR should be resumed
immediately after a shock for 2 minutes before rhythm or pulse checks, unless ROSC is
obvious.
5. How often should the compressor role be rotated during a resuscitation attempt?
A. Every 1 minute
, B. Every 2 minutes
C. Every 3 minutes
D. Every 4 minutes
Answer: B. Every 2 minutes
Rationale: Chest compressors should switch every 2 minutes or sooner if fatigued to
maintain consistent, high-quality compressions. This timing aligns with the rhythm check
interval.
6. Which of the following is a sign of ineffective CPR?
A. PETCO2 > 20 mm Hg
B. Diastolic intra-arterial pressure ≥ 20 mm Hg
C. PETCO2 < 10 mm Hg
D. Visible chest rise with ventilations
Answer: C. PETCO2 < 10 mm Hg
Rationale: End-tidal CO2 (PETCO2) reflects cardiac output during CPR. Values less than 10
mm Hg suggest poor perfusion and ineffective chest compressions.
7. What is the maximum allowable interruption in chest compressions?
A. Less than 5 seconds
B. Less than 10 seconds
C. Less than 15 seconds
D. Less than 20 seconds
Answer: B. Less than 10 seconds
Rationale: All interruptions in chest compressions (e.g., for rhythm checks, pulse checks,
or defibrillation) should be minimized to less than 10 seconds to maintain perfusion.
8. What should a rescuer do if an AED advises a shock but the patient is lying in snow?
Exam Overview
Feature Description
:--- :---
Exam Title Advanced Cardiovascular Life Support (ACLS) Comprehensive Practice Exam
Total Questions 600
Question Format Multiple Choice (4 options: A–D)
Answer Key Correct answer provided immediately after each question
Rationales Detailed explanation for every question, aligned with 2025 AHA Guidelines
Core Domains BLS & High-Quality CPR; Cardiac Arrest (VF/pVT, Asystole/PEA);
Bradycardia; Tachycardia; Pharmacology; Airway Management & Capnography; Post–
Cardiac Arrest Care; Special Situations (Opioid, Stroke, ACS); Team Dynamics; ECG
Rhythm Recognition; 2025 Guideline Updates
Target Audience Healthcare professionals preparing for ACLS certification, recertification,
or exam review
Version 2025–2026 Verified
---
Table of Contents
1. Section 1: BLS & High-Quality CPR (Questions 1–80)
2. Section 2: Cardiac Arrest – VF/pVT (Shockable Rhythms) (Questions 81–160)
3. Section 3: Cardiac Arrest – Asystole & PEA (Non-Shockable Rhythms) (Questions 161–
220)
,4. Section 4: Bradycardia with a Pulse (Questions 221–270)
5. Section 5: Tachycardia with a Pulse (Questions 271–340)
6. Section 6: ACLS Pharmacology (Questions 341–410)
7. Section 7: Airway Management & Capnography (Questions 411–460)
8. Section 8: Post–Cardiac Arrest Care (Questions 461–510)
9. Section 9: Special Situations (Opioid Overdose, Stroke, ACS) (Questions 511–550)
10. Section 10: Team Dynamics & Resuscitation Education (Questions 551–580)
11. Section 11: ECG Rhythm Recognition (Questions 581–600)
---
Section 1: BLS & High-Quality CPR (Questions 1–80)
1. What is the recommended rate for chest compressions during adult CPR?
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
Answer: C. 100 to 120 compressions per minute
Rationale: The 2025 AHA Guidelines emphasize "push fast" at a rate of 100 to 120
compressions per minute to optimize coronary perfusion pressure and cardiac output.
2. What is the recommended depth for chest compressions in an average adult?
A. At least 1 inch (2.5 cm)
B. At least 1.5 inches (4 cm)
C. At least 2 inches (5 cm) but not more than 2.4 inches (6 cm)
,D. At least 3 inches (7.5 cm)
Answer: C. At least 2 inches (5 cm) but not more than 2.4 inches (6 cm)
Rationale: Compressions should be "push hard" at a depth of 2 to 2.4 inches (5–6 cm) in
adults, while avoiding excessive depth to prevent injury.
3. What is the correct compression-to-ventilation ratio for a single rescuer performing adult
CPR?
A. 15:2
B. 30:2
C. 50:2
D. 100:2
Answer: B. 30:2
Rationale: A universal compression-to-ventilation ratio of 30:2 is recommended for all
adult patients in cardiac arrest, whether one or two rescuers are present.
4. After delivering a shock from a defibrillator, what should the rescuer do immediately?
A. Check for a pulse
B. Analyze the rhythm
C. Resume chest compressions
D. Administer epinephrine
Answer: C. Resume chest compressions
Rationale: To minimize interruptions in chest compressions, CPR should be resumed
immediately after a shock for 2 minutes before rhythm or pulse checks, unless ROSC is
obvious.
5. How often should the compressor role be rotated during a resuscitation attempt?
A. Every 1 minute
, B. Every 2 minutes
C. Every 3 minutes
D. Every 4 minutes
Answer: B. Every 2 minutes
Rationale: Chest compressors should switch every 2 minutes or sooner if fatigued to
maintain consistent, high-quality compressions. This timing aligns with the rhythm check
interval.
6. Which of the following is a sign of ineffective CPR?
A. PETCO2 > 20 mm Hg
B. Diastolic intra-arterial pressure ≥ 20 mm Hg
C. PETCO2 < 10 mm Hg
D. Visible chest rise with ventilations
Answer: C. PETCO2 < 10 mm Hg
Rationale: End-tidal CO2 (PETCO2) reflects cardiac output during CPR. Values less than 10
mm Hg suggest poor perfusion and ineffective chest compressions.
7. What is the maximum allowable interruption in chest compressions?
A. Less than 5 seconds
B. Less than 10 seconds
C. Less than 15 seconds
D. Less than 20 seconds
Answer: B. Less than 10 seconds
Rationale: All interruptions in chest compressions (e.g., for rhythm checks, pulse checks,
or defibrillation) should be minimized to less than 10 seconds to maintain perfusion.
8. What should a rescuer do if an AED advises a shock but the patient is lying in snow?
