ACLS EXAM 2025 WITH RATIONALES
1. What is the first action when a patient is found unresponsive and not breathing?
A) Check for a pulse
B) Start chest compressions
C) Activate emergency response and call for help
D) Begin ventilation
Answer: C) Activate emergency response and call for help.
Rationale: The first step is to activate the emergency response system and call for help. It’s
essential to get help quickly in case of a cardiac arrest situation to initiate appropriate medical
intervention.
2. What is the correct compression depth for adult CPR?
A) 1-1.5 inches
B) 1.5-2 inches
C) At least 2 inches
D) More than 3 inches
Answer: C) At least 2 inches.
Rationale: The recommended compression depth for adult CPR is at least 2 inches. This
ensures effective circulation during chest compressions.
3. How often should epinephrine be administered during a cardiac arrest?
A) Every 1-2 minutes
B) Every 3-5 minutes
C) Every 6-10 minutes
D) Every 10-15 minutes
Answer: B) Every 3-5 minutes.
Rationale: Epinephrine should be administered every 3-5 minutes during cardiac arrest to
increase the chances of return of spontaneous circulation (ROSC).
4. What is the first medication used in the management of a shockable rhythm like VF or pVT?
A) Amiodarone
B) Lidocaine
,C) Epinephrine
D) Atropine
Answer: C) Epinephrine.
Rationale: Epinephrine is the first drug administered during cardiac arrest for shockable
rhythms like VF or pVT. It helps improve perfusion to vital organs, including the heart and
brain.
5. What is the first-line treatment for symptomatic bradycardia?
A) Epinephrine
B) Atropine
C) Amiodarone
D) Dopamine
Answer: B) Atropine.
Rationale: Atropine is the first-line treatment for symptomatic bradycardia as it increases heart
rate by blocking the effects of the vagus nerve.
6. How should a patient in ventricular fibrillation (VF) be treated?
A) Perform synchronized cardioversion
B) Perform defibrillation with high-energy shock
C) Administer atropine
D) Start chest compressions and continue CPR
Answer: B) Perform defibrillation with high-energy shock.
Rationale: VF is a shockable rhythm, and defibrillation with high-energy shocks is the most
effective treatment to restore normal rhythm.
7. What is the target compression rate during CPR for adults?
A) 60-80 compressions/min
B) 80-100 compressions/min
C) 100-120 compressions/min
D) 120-140 compressions/min
Answer: C) 100-120 compressions/min.
Rationale: The optimal compression rate for adult CPR is 100-120 compressions per minute.
This rate ensures that blood circulation is maintained adequately during resuscitation.
, 8. What is the first drug administered for a patient with suspected anaphylaxis in an emergency
setting?
A) Epinephrine
B) Diphenhydramine
C) Hydrocortisone
D) Atropine
Answer: A) Epinephrine.
Rationale: Epinephrine is the first-line treatment for anaphylaxis, as it helps reverse the effects
of severe allergic reactions by constricting blood vessels, relaxing muscles, and opening the
airways.
9. What is the correct dose of epinephrine for adult cardiac arrest?
A) 0.5 mg every 3-5 minutes
B) 1 mg every 3-5 minutes
C) 3 mg every 10 minutes
D) 5 mg every 5 minutes
Answer: B) 1 mg every 3-5 minutes.
Rationale: In adult cardiac arrest, 1 mg of epinephrine should be administered every 3-5
minutes to improve the chances of survival.
10. What is the first action when a patient is in respiratory arrest but has a pulse?
A) Perform chest compressions
B) Start positive pressure ventilation
C) Administer epinephrine
D) Start CPR
Answer: B) Start positive pressure ventilation.
Rationale: In respiratory arrest with a pulse, the priority is to support breathing through
positive pressure ventilation until spontaneous breathing returns.
11. How should you confirm correct placement of an endotracheal tube?
A) Visualize tube placement via video laryngoscope
B) Listen for bilateral breath sounds
C) Measure the tube depth at the teeth
D) Observe for chest rise and fall
1. What is the first action when a patient is found unresponsive and not breathing?
A) Check for a pulse
B) Start chest compressions
C) Activate emergency response and call for help
D) Begin ventilation
Answer: C) Activate emergency response and call for help.
Rationale: The first step is to activate the emergency response system and call for help. It’s
essential to get help quickly in case of a cardiac arrest situation to initiate appropriate medical
intervention.
2. What is the correct compression depth for adult CPR?
A) 1-1.5 inches
B) 1.5-2 inches
C) At least 2 inches
D) More than 3 inches
Answer: C) At least 2 inches.
Rationale: The recommended compression depth for adult CPR is at least 2 inches. This
ensures effective circulation during chest compressions.
3. How often should epinephrine be administered during a cardiac arrest?
A) Every 1-2 minutes
B) Every 3-5 minutes
C) Every 6-10 minutes
D) Every 10-15 minutes
Answer: B) Every 3-5 minutes.
Rationale: Epinephrine should be administered every 3-5 minutes during cardiac arrest to
increase the chances of return of spontaneous circulation (ROSC).
4. What is the first medication used in the management of a shockable rhythm like VF or pVT?
A) Amiodarone
B) Lidocaine
,C) Epinephrine
D) Atropine
Answer: C) Epinephrine.
Rationale: Epinephrine is the first drug administered during cardiac arrest for shockable
rhythms like VF or pVT. It helps improve perfusion to vital organs, including the heart and
brain.
5. What is the first-line treatment for symptomatic bradycardia?
A) Epinephrine
B) Atropine
C) Amiodarone
D) Dopamine
Answer: B) Atropine.
Rationale: Atropine is the first-line treatment for symptomatic bradycardia as it increases heart
rate by blocking the effects of the vagus nerve.
6. How should a patient in ventricular fibrillation (VF) be treated?
A) Perform synchronized cardioversion
B) Perform defibrillation with high-energy shock
C) Administer atropine
D) Start chest compressions and continue CPR
Answer: B) Perform defibrillation with high-energy shock.
Rationale: VF is a shockable rhythm, and defibrillation with high-energy shocks is the most
effective treatment to restore normal rhythm.
7. What is the target compression rate during CPR for adults?
A) 60-80 compressions/min
B) 80-100 compressions/min
C) 100-120 compressions/min
D) 120-140 compressions/min
Answer: C) 100-120 compressions/min.
Rationale: The optimal compression rate for adult CPR is 100-120 compressions per minute.
This rate ensures that blood circulation is maintained adequately during resuscitation.
, 8. What is the first drug administered for a patient with suspected anaphylaxis in an emergency
setting?
A) Epinephrine
B) Diphenhydramine
C) Hydrocortisone
D) Atropine
Answer: A) Epinephrine.
Rationale: Epinephrine is the first-line treatment for anaphylaxis, as it helps reverse the effects
of severe allergic reactions by constricting blood vessels, relaxing muscles, and opening the
airways.
9. What is the correct dose of epinephrine for adult cardiac arrest?
A) 0.5 mg every 3-5 minutes
B) 1 mg every 3-5 minutes
C) 3 mg every 10 minutes
D) 5 mg every 5 minutes
Answer: B) 1 mg every 3-5 minutes.
Rationale: In adult cardiac arrest, 1 mg of epinephrine should be administered every 3-5
minutes to improve the chances of survival.
10. What is the first action when a patient is in respiratory arrest but has a pulse?
A) Perform chest compressions
B) Start positive pressure ventilation
C) Administer epinephrine
D) Start CPR
Answer: B) Start positive pressure ventilation.
Rationale: In respiratory arrest with a pulse, the priority is to support breathing through
positive pressure ventilation until spontaneous breathing returns.
11. How should you confirm correct placement of an endotracheal tube?
A) Visualize tube placement via video laryngoscope
B) Listen for bilateral breath sounds
C) Measure the tube depth at the teeth
D) Observe for chest rise and fall
