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ACLS 2025 Practice Test –
Verified Questions with
Correct Answers & AHA
2025 Guidelines | A+ Graded
Cardiac Arrest Management
1. You find an unresponsive adult patient with no breathing or pulse. After activating the
emergency response system, what is your next action?
A. Administer 1 mg epinephrine IV
B. Start chest compressions at 100–120/min
C. Apply an AED and wait for analysis
D. Provide rescue breaths
Rationale : Per AHA 2025 Guidelines, high-quality CPR is the priority in cardiac
arrest. Chest compressions at 100–120/min restore circulation in the absence of a pulse,
initiated immediately after confirming unresponsiveness and activating the emergency
response. Epinephrine, AED analysis, and rescue breaths follow CPR.
2. During CPR, the ECG shows ventricular fibrillation (VF). What is the priority
intervention?
A. Administer amiodarone 300 mg IV
B. Deliver a defibrillation shock
C. Insert an advanced airway
D. Give epinephrine 1 mg IV
Rationale : VF is a shockable rhythm requiring immediate defibrillation to restore
sinus rhythm, as per AHA 2025 Guidelines. Medications and airway management are
secondary to defibrillation.
3. A patient in cardiac arrest has an advanced airway. What is the recommended ventilation
rate?
A. 12–20 breaths/min
B. 8–10 breaths/min
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C. 20–24 breaths/min
D. 4–6 breaths/min
Rationale : AHA 2025 Guidelines recommend 8–10 breaths/min (1 breath every 6
seconds) for patients with an advanced airway during cardiac arrest to avoid
hyperventilation, which can reduce venous return.
4. Clinical Scenario: A patient in cardiac arrest receives 2 minutes of CPR. The rhythm is
asystole. What is the next priority?
A. Defibrillate immediately
B. Administer epinephrine 1 mg IV
C. Perform synchronized cardioversion
D. Administer amiodarone 300 mg IV
Rationale : Asystole is a non-shockable rhythm. AHA 2025 Guidelines prioritize
epinephrine 1 mg IV every 3–5 minutes to enhance perfusion during CPR. Amiodarone is
used for shockable rhythms, and cardioversion is inappropriate.
5. (SATA) Which are components of high-quality CPR? (Select all that apply)
A. Compression depth of at least 2 inches
B. Compression rate of 80–90/min
C. Allowing full chest recoil
D. Minimizing interruptions
E. Compressing at 1 inch depth
Rationale : High-quality CPR, per AHA 2025 Guidelines, includes a compression
depth of 2–2.4 inches, rate of 100–120/min, full chest recoil, and minimal interruptions.
A rate of 80–90/min and 1-inch depth are inadequate.
Arrhythmia Recognition and Management
6. A patient presents with chest pain and a heart rate of 180/min. The ECG shows a narrow-
complex tachycardia. What is the first intervention?
A. Administer amiodarone 150 mg IV
B. Perform vagal maneuvers
C. Defibrillate immediately
D. Administer atropine 0.5 mg IV
Rationale : For stable narrow-complex tachycardia (e.g., SVT), AHA 2025
Guidelines recommend vagal maneuvers as the first intervention to slow the heart rate.
Amiodarone, defibrillation, and atropine are inappropriate for stable SVT.
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7. A patient in the ED has a heart rate of 35/min and dizziness. The ECG shows sinus
bradycardia. What is the first-line treatment?
A. Adenosine 6 mg IV
B. Atropine 0.5 mg IV
C. Amiodarone 300 mg IV
D. Synchronized cardioversion
Rationale : Symptomatic bradycardia is treated with atropine 0.5 mg IV every 3–5
minutes (max 3 mg), per AHA 2025 Guidelines. Adenosine is for SVT, amiodarone for
ventricular arrhythmias, and cardioversion for unstable rhythms.
8. A patient’s ECG shows ventricular tachycardia (VT) with a pulse. The patient is stable.
What is the recommended treatment?
A. Defibrillation
B. Amiodarone 150 mg IV over 10 minutes
C. Epinephrine 1 mg IV
D. Atropine 0.5 mg IV
Rationale : Stable VT with a pulse is treated with antiarrhythmics like amiodarone
150 mg IV over 10 minutes, per AHA 2025 Guidelines. Defibrillation is for pulseless
VT, and epinephrine/atropine are incorrect.
9. Clinical Scenario: A patient has a wide-complex tachycardia at 190/min, BP 70/40
mmHg, and is diaphoretic. What is the priority intervention?
A. Administer adenosine 6 mg IV
B. Perform synchronized cardioversion
C. Give epinephrine 1 mg IV
D. Administer atropine 0.5 mg IV
Rationale : Unstable wide-complex tachycardia (e.g., VT) with hypotension
requires immediate synchronized cardioversion, per AHA 2025 Guidelines. Adenosine,
epinephrine, and atropine are inappropriate.
10. Which ECG finding confirms pulseless electrical activity (PEA)?
A. Ventricular fibrillation
B. Organized rhythm without a pulse
C. Asystole
D. Ventricular tachycardia
Rationale : PEA is an organized rhythm (e.g., sinus) without a pulse, requiring
CPR and epinephrine, per AHA 2025 Guidelines. VF and VT are shockable, and asystole
is flatline.
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ACLS 2025 Practice Test –
Verified Questions with
Correct Answers & AHA
2025 Guidelines | A+ Graded
Cardiac Arrest Management
1. You find an unresponsive adult patient with no breathing or pulse. After activating the
emergency response system, what is your next action?
A. Administer 1 mg epinephrine IV
B. Start chest compressions at 100–120/min
C. Apply an AED and wait for analysis
D. Provide rescue breaths
Rationale : Per AHA 2025 Guidelines, high-quality CPR is the priority in cardiac
arrest. Chest compressions at 100–120/min restore circulation in the absence of a pulse,
initiated immediately after confirming unresponsiveness and activating the emergency
response. Epinephrine, AED analysis, and rescue breaths follow CPR.
2. During CPR, the ECG shows ventricular fibrillation (VF). What is the priority
intervention?
A. Administer amiodarone 300 mg IV
B. Deliver a defibrillation shock
C. Insert an advanced airway
D. Give epinephrine 1 mg IV
Rationale : VF is a shockable rhythm requiring immediate defibrillation to restore
sinus rhythm, as per AHA 2025 Guidelines. Medications and airway management are
secondary to defibrillation.
3. A patient in cardiac arrest has an advanced airway. What is the recommended ventilation
rate?
A. 12–20 breaths/min
B. 8–10 breaths/min
P a g e 1 | 20
, 2
C. 20–24 breaths/min
D. 4–6 breaths/min
Rationale : AHA 2025 Guidelines recommend 8–10 breaths/min (1 breath every 6
seconds) for patients with an advanced airway during cardiac arrest to avoid
hyperventilation, which can reduce venous return.
4. Clinical Scenario: A patient in cardiac arrest receives 2 minutes of CPR. The rhythm is
asystole. What is the next priority?
A. Defibrillate immediately
B. Administer epinephrine 1 mg IV
C. Perform synchronized cardioversion
D. Administer amiodarone 300 mg IV
Rationale : Asystole is a non-shockable rhythm. AHA 2025 Guidelines prioritize
epinephrine 1 mg IV every 3–5 minutes to enhance perfusion during CPR. Amiodarone is
used for shockable rhythms, and cardioversion is inappropriate.
5. (SATA) Which are components of high-quality CPR? (Select all that apply)
A. Compression depth of at least 2 inches
B. Compression rate of 80–90/min
C. Allowing full chest recoil
D. Minimizing interruptions
E. Compressing at 1 inch depth
Rationale : High-quality CPR, per AHA 2025 Guidelines, includes a compression
depth of 2–2.4 inches, rate of 100–120/min, full chest recoil, and minimal interruptions.
A rate of 80–90/min and 1-inch depth are inadequate.
Arrhythmia Recognition and Management
6. A patient presents with chest pain and a heart rate of 180/min. The ECG shows a narrow-
complex tachycardia. What is the first intervention?
A. Administer amiodarone 150 mg IV
B. Perform vagal maneuvers
C. Defibrillate immediately
D. Administer atropine 0.5 mg IV
Rationale : For stable narrow-complex tachycardia (e.g., SVT), AHA 2025
Guidelines recommend vagal maneuvers as the first intervention to slow the heart rate.
Amiodarone, defibrillation, and atropine are inappropriate for stable SVT.
P a g e 2 | 20
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7. A patient in the ED has a heart rate of 35/min and dizziness. The ECG shows sinus
bradycardia. What is the first-line treatment?
A. Adenosine 6 mg IV
B. Atropine 0.5 mg IV
C. Amiodarone 300 mg IV
D. Synchronized cardioversion
Rationale : Symptomatic bradycardia is treated with atropine 0.5 mg IV every 3–5
minutes (max 3 mg), per AHA 2025 Guidelines. Adenosine is for SVT, amiodarone for
ventricular arrhythmias, and cardioversion for unstable rhythms.
8. A patient’s ECG shows ventricular tachycardia (VT) with a pulse. The patient is stable.
What is the recommended treatment?
A. Defibrillation
B. Amiodarone 150 mg IV over 10 minutes
C. Epinephrine 1 mg IV
D. Atropine 0.5 mg IV
Rationale : Stable VT with a pulse is treated with antiarrhythmics like amiodarone
150 mg IV over 10 minutes, per AHA 2025 Guidelines. Defibrillation is for pulseless
VT, and epinephrine/atropine are incorrect.
9. Clinical Scenario: A patient has a wide-complex tachycardia at 190/min, BP 70/40
mmHg, and is diaphoretic. What is the priority intervention?
A. Administer adenosine 6 mg IV
B. Perform synchronized cardioversion
C. Give epinephrine 1 mg IV
D. Administer atropine 0.5 mg IV
Rationale : Unstable wide-complex tachycardia (e.g., VT) with hypotension
requires immediate synchronized cardioversion, per AHA 2025 Guidelines. Adenosine,
epinephrine, and atropine are inappropriate.
10. Which ECG finding confirms pulseless electrical activity (PEA)?
A. Ventricular fibrillation
B. Organized rhythm without a pulse
C. Asystole
D. Ventricular tachycardia
Rationale : PEA is an organized rhythm (e.g., sinus) without a pulse, requiring
CPR and epinephrine, per AHA 2025 Guidelines. VF and VT are shockable, and asystole
is flatline.
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