AHA ACLS EXAM 2025/2026 – VERIFIED AND
CORRECT QUESTIONS AND ANSWERS | A+
GRADED | UPDATED 2025 EDITION
This comprehensive review for the American Heart Association Advanced Cardiovascular Life
Support (ACLS) certification exam (2025 edition) features 100 verified multiple-choice
questions aligned with AHA guidelines. Questions cover BLS/ACLS algorithms, pharmacology,
airway management, and team dynamics. Each question includes four options, the correct answer
in RED, and a detailed rationale with AHA rationale, pharmacology details, and tips for
certification success.
Question 1: In an adult cardiac arrest, what is the priority action after confirming
unresponsiveness and no breathing?
A. Check for a pulse
B. Start CPR with 30 compressions to 2 breaths
C. Apply AED pads
D. Insert an advanced airway
Correct Answer: B. Start CPR with 30 compressions to 2 breaths
Rationale: AHA ACLS emphasizes immediate high-quality CPR (rate 100-120/min, depth 2-2.4
inches) to restore circulation; pulse check is integrated into first compression cycle. AED (C)
next if available; airway (D) later. Tip: CAB over ABC; minimize pauses.
Question 2: What is the recommended defibrillation energy for biphasic manual
defibrillator in VF/pulseless VT?
A. 50-75 J
B. 120-200 J
C. 300 J
D. 360 J
Correct Answer: B. 120-200 J
Rationale: AHA 2020 guidelines: Biphasic 120-200 J initial, subsequent same or higher;
monophasic 360 J (C). Resume CPR immediately post-shock. Tip: Know biphasic vs
monophasic; always CPR 2 min post-shock.
Question 3: For a witnessed cardiac arrest in a public place with AED available, what is the
sequence?
A. Call 911, get AED, CPR, shock if advised
B. CPR first, then call 911
C. Shock immediately without CPR
, D. Wait for EMS
Correct Answer: A. Call 911, get AED, CPR, shock if advised
Rationale: AHA chain of survival: Immediate CPR (30:2), AED analysis/shock, continue cycles
until ROSC or advanced care. B if alone; C no; D delays. Tip: Witnessed - AED fast;
unwitnessed - CPR first.
Question 4: What is the dose and route for epinephrine in cardiac arrest?
A. 1 mg IV/IO every 3-5 min
B. 1 mg ET
C. 0.5 mg IV
D. 2 mg IV
Correct Answer: A. 1 mg IV/IO every 3-5 min
Rationale: Epinephrine 1 mg q3-5 min (0.01 mg/kg pediatric); IV/IO preferred over ET.
Enhances perfusion during CPR. Tip: Every cycle; avoid high-dose.
Question 5: In asystole/PEA, what is the priority rhythm check?
A. Every 2 minutes with CPR pauses <10 sec
B. Continuous without pause
C. Only at 5 min
D. No rhythm check
Correct Answer: A. Every 2 minutes with CPR pauses <10 sec
Rationale: AHA: Minimize interruptions; assess for shockable rhythm. Treat reversible causes
(Hs/Ts). Tip: CPR >80% time.
Question 6: What is the initial shockable rhythm in adult cardiac arrest?
A. Asystole
B. VF/pulseless VT
C. Bradycardia
D. Tachycardia with pulse
Correct Answer: B. VF/pulseless VT
Rationale: Shockable rhythms require defibrillation; non-shockable (A, C, D) CPR/epi. VF
coarse fine; VT monomorphic/polymorphic.
Question 7: The dose of amiodarone for refractory VF/pVT is:
300 mg IV/IO push
Rationale: AHA: 300 mg initial, 150 mg second; antiarrhythmic stabilizes membrane. Tip:
Follow with lidocaine if no response.
CORRECT QUESTIONS AND ANSWERS | A+
GRADED | UPDATED 2025 EDITION
This comprehensive review for the American Heart Association Advanced Cardiovascular Life
Support (ACLS) certification exam (2025 edition) features 100 verified multiple-choice
questions aligned with AHA guidelines. Questions cover BLS/ACLS algorithms, pharmacology,
airway management, and team dynamics. Each question includes four options, the correct answer
in RED, and a detailed rationale with AHA rationale, pharmacology details, and tips for
certification success.
Question 1: In an adult cardiac arrest, what is the priority action after confirming
unresponsiveness and no breathing?
A. Check for a pulse
B. Start CPR with 30 compressions to 2 breaths
C. Apply AED pads
D. Insert an advanced airway
Correct Answer: B. Start CPR with 30 compressions to 2 breaths
Rationale: AHA ACLS emphasizes immediate high-quality CPR (rate 100-120/min, depth 2-2.4
inches) to restore circulation; pulse check is integrated into first compression cycle. AED (C)
next if available; airway (D) later. Tip: CAB over ABC; minimize pauses.
Question 2: What is the recommended defibrillation energy for biphasic manual
defibrillator in VF/pulseless VT?
A. 50-75 J
B. 120-200 J
C. 300 J
D. 360 J
Correct Answer: B. 120-200 J
Rationale: AHA 2020 guidelines: Biphasic 120-200 J initial, subsequent same or higher;
monophasic 360 J (C). Resume CPR immediately post-shock. Tip: Know biphasic vs
monophasic; always CPR 2 min post-shock.
Question 3: For a witnessed cardiac arrest in a public place with AED available, what is the
sequence?
A. Call 911, get AED, CPR, shock if advised
B. CPR first, then call 911
C. Shock immediately without CPR
, D. Wait for EMS
Correct Answer: A. Call 911, get AED, CPR, shock if advised
Rationale: AHA chain of survival: Immediate CPR (30:2), AED analysis/shock, continue cycles
until ROSC or advanced care. B if alone; C no; D delays. Tip: Witnessed - AED fast;
unwitnessed - CPR first.
Question 4: What is the dose and route for epinephrine in cardiac arrest?
A. 1 mg IV/IO every 3-5 min
B. 1 mg ET
C. 0.5 mg IV
D. 2 mg IV
Correct Answer: A. 1 mg IV/IO every 3-5 min
Rationale: Epinephrine 1 mg q3-5 min (0.01 mg/kg pediatric); IV/IO preferred over ET.
Enhances perfusion during CPR. Tip: Every cycle; avoid high-dose.
Question 5: In asystole/PEA, what is the priority rhythm check?
A. Every 2 minutes with CPR pauses <10 sec
B. Continuous without pause
C. Only at 5 min
D. No rhythm check
Correct Answer: A. Every 2 minutes with CPR pauses <10 sec
Rationale: AHA: Minimize interruptions; assess for shockable rhythm. Treat reversible causes
(Hs/Ts). Tip: CPR >80% time.
Question 6: What is the initial shockable rhythm in adult cardiac arrest?
A. Asystole
B. VF/pulseless VT
C. Bradycardia
D. Tachycardia with pulse
Correct Answer: B. VF/pulseless VT
Rationale: Shockable rhythms require defibrillation; non-shockable (A, C, D) CPR/epi. VF
coarse fine; VT monomorphic/polymorphic.
Question 7: The dose of amiodarone for refractory VF/pVT is:
300 mg IV/IO push
Rationale: AHA: 300 mg initial, 150 mg second; antiarrhythmic stabilizes membrane. Tip:
Follow with lidocaine if no response.
