ACLS FINAL TEST (2025-2026 Verified) Real
Questions | Exam Solutions | Correct Answer Keys
✓ 100% Accurate & Verified Questions and Answers
Question 1
A 68‑year‑old male collapses in the emergency department. While initiating CPR, you obtain a
single‑lead ECG that shows a wide‑complex tachycardia with a rate of 190/min and a regular
rhythm. Which immediate intervention is most appropriate?
A) Synchronized cardioversion at 100 J
B) Administer 300 mg IV amiodarone
C) Begin unsynchronized defibrillation at 200 J
D) Increase ventilation rate to 12 breaths/min
✓ Correct Answer: Synchronized cardioversion at 100 J
RATIONALE
A stable wide‑complex tachycardia is treated with synchronized cardioversion before drug therapy.
Question 2
During a code, after the third unsynchronized shock for ventricular fibrillation, the patient remains
in VF. What is the next recommended medication and dose?
A) Lidocaine 1 mg/kg IV bolus
B) Epinephrine 0.5 mg IV push
C) Amiodarone 150 mg IV push
D) Magnesium sulfate 2 g IV over 5 min
✓ Correct Answer: Amiodarone 150 mg IV push
RATIONALE
After three shocks, the guideline recommends a 150 mg IV amiodarone bolus for refractory VF.
,Question 3
A 55‑year‑old woman with a known history of atrial fibrillation presents with chest pain and a heart
rate of 140/min, narrow‑complex tachycardia on ECG. She is hemodynamically unstable. Which
action should be taken first?
A) Administer 6 mg IV digoxin
B) Perform immediate synchronized cardioversion
C) Give 100 µg IV metoprolol
D) Start a rapid IV infusion of diltiazem
✓ Correct Answer: Perform immediate synchronized cardioversion
RATIONALE
Unstable tachyarrhythmias require immediate synchronized cardioversion regardless of underlying
rhythm.
Question 4
In a post‑cardiac‑arrest patient who remains comatose after ROSC, which temperature target is
recommended for therapeutic hypothermia?
A) 28‑30 °C
B) 30‑32 °C
C) 32‑36 °C
D) 36‑38 °C
✓ Correct Answer: 32‑36 °C
RATIONALE
Current guidelines endorse a target temperature of 32‑36 °C for at least 24 hours after ROSC.
, Question 5
A paramedic crew arrives to a 72‑year‑old man with witnessed cardiac arrest. After two minutes of
high‑quality CPR, a monophasic defibrillator displays a shockable rhythm. What is the maximum
allowable pause in chest compressions for charging the defibrillator?
A) 5 seconds
B) 10 seconds
C) 15 seconds
D) 20 seconds
✓ Correct Answer: 10 seconds
RATIONALE
Guidelines limit compression pauses for defibrillation charging to no more than 10 seconds.
Question 6
During a code, a team member repeatedly calls for a medication dose that exceeds the
recommended maximum. What is the most appropriate response by the team leader?
A) Ignore the request to maintain flow
B) Delegate the decision to another team member
C) Address the error immediately and clarify the correct dose
D) Allow the dose and document the deviation after the event
✓ Correct Answer: Address the error immediately and clarify the correct dose
RATIONALE
Immediate correction of medication errors prevents patient harm and maintains safety.
Questions | Exam Solutions | Correct Answer Keys
✓ 100% Accurate & Verified Questions and Answers
Question 1
A 68‑year‑old male collapses in the emergency department. While initiating CPR, you obtain a
single‑lead ECG that shows a wide‑complex tachycardia with a rate of 190/min and a regular
rhythm. Which immediate intervention is most appropriate?
A) Synchronized cardioversion at 100 J
B) Administer 300 mg IV amiodarone
C) Begin unsynchronized defibrillation at 200 J
D) Increase ventilation rate to 12 breaths/min
✓ Correct Answer: Synchronized cardioversion at 100 J
RATIONALE
A stable wide‑complex tachycardia is treated with synchronized cardioversion before drug therapy.
Question 2
During a code, after the third unsynchronized shock for ventricular fibrillation, the patient remains
in VF. What is the next recommended medication and dose?
A) Lidocaine 1 mg/kg IV bolus
B) Epinephrine 0.5 mg IV push
C) Amiodarone 150 mg IV push
D) Magnesium sulfate 2 g IV over 5 min
✓ Correct Answer: Amiodarone 150 mg IV push
RATIONALE
After three shocks, the guideline recommends a 150 mg IV amiodarone bolus for refractory VF.
,Question 3
A 55‑year‑old woman with a known history of atrial fibrillation presents with chest pain and a heart
rate of 140/min, narrow‑complex tachycardia on ECG. She is hemodynamically unstable. Which
action should be taken first?
A) Administer 6 mg IV digoxin
B) Perform immediate synchronized cardioversion
C) Give 100 µg IV metoprolol
D) Start a rapid IV infusion of diltiazem
✓ Correct Answer: Perform immediate synchronized cardioversion
RATIONALE
Unstable tachyarrhythmias require immediate synchronized cardioversion regardless of underlying
rhythm.
Question 4
In a post‑cardiac‑arrest patient who remains comatose after ROSC, which temperature target is
recommended for therapeutic hypothermia?
A) 28‑30 °C
B) 30‑32 °C
C) 32‑36 °C
D) 36‑38 °C
✓ Correct Answer: 32‑36 °C
RATIONALE
Current guidelines endorse a target temperature of 32‑36 °C for at least 24 hours after ROSC.
, Question 5
A paramedic crew arrives to a 72‑year‑old man with witnessed cardiac arrest. After two minutes of
high‑quality CPR, a monophasic defibrillator displays a shockable rhythm. What is the maximum
allowable pause in chest compressions for charging the defibrillator?
A) 5 seconds
B) 10 seconds
C) 15 seconds
D) 20 seconds
✓ Correct Answer: 10 seconds
RATIONALE
Guidelines limit compression pauses for defibrillation charging to no more than 10 seconds.
Question 6
During a code, a team member repeatedly calls for a medication dose that exceeds the
recommended maximum. What is the most appropriate response by the team leader?
A) Ignore the request to maintain flow
B) Delegate the decision to another team member
C) Address the error immediately and clarify the correct dose
D) Allow the dose and document the deviation after the event
✓ Correct Answer: Address the error immediately and clarify the correct dose
RATIONALE
Immediate correction of medication errors prevents patient harm and maintains safety.
