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ACLS Post Test 1, 2, 3 & 4 Actual Questions (2025) | Verified Answers | 100% Guaranteed Pass

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Ace your ACLS certification! Get the complete 2025/2026 ACLS Post Test bundle for Tests 1, 2, 3 & 4. Features actual questions with verified answers and detailed rationales. Our proven guide is your key to a guaranteed pass.

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ACLS Post Test 1, 2, 3 & 4 Actual Questions
(2025) | Verified Answers | 100%
Guaranteed Pass


Question 1: A 58-year-old male collapses in the hospital lobby. A code blue is called. The first
responder arrives and finds the patient unresponsive, not breathing, and pulseless. What is the
FIRST action the responder should take? A. Start chest compressions B. Open the airway and
give 2 rescue breaths C. Attach the AED/defibrillator D. Check for a carotid pulse for 10 seconds

Correct Answer: A Rationale: According to the 2025 AHA guidelines, if an adult patient is
unresponsive, not breathing, and pulseless, the first action is to start high-quality chest
compressions immediately. Pulse checks are not recommended for lay responders and
should not delay the initiation of CPR. Opening the airway and giving breaths (B) is only
recommended if the responder is trained and the patient is not breathing but has a pulse.
Attaching the AED (C) is important but should not delay the start of compressions. Checking for
a pulse (D) is not the first action and can delay CPR.



Question 2: During CPR, what is the recommended compression rate for adults according to
the 2025 AHA guidelines? A. 80–100 compressions per minute B. 100–120 compressions per
minute C. 120–140 compressions per minute D. At least 60 compressions per minute

Correct Answer: B Rationale: The 2025 AHA guidelines recommend a compression rate of
100–120 compressions per minute for adults. Rates below 100 (A, D) are insufficient for
adequate perfusion, and rates above 120 (C) may compromise compression depth and recoil.



Question 3: A patient in cardiac arrest is receiving high-quality CPR. The AED arrives and is
applied. The AED advises "No shock indicated." What is the NEXT step? A. Resume CPR
immediately for 2 minutes B. Check for a pulse C. Administer epinephrine D. Insert an advanced
airway

Correct Answer: A Rationale: If the AED advises "No shock indicated," the next step is to
resume CPR immediately for 2 minutes before reanalyzing the rhythm. Checking for a pulse
(B) is not recommended during CPR unless the patient shows signs of life. Administering

,epinephrine (C) or inserting an advanced airway (D) should not interrupt compressions unless
the patient is intubated or IV/IO access is already established.



Question 4: A 65-year-old female is in cardiac arrest. The monitor shows the rhythm below:

Copy
____
| |
| |
__| |__
| |
|____|

What is the rhythm, and what is the FIRST intervention? A. Ventricular fibrillation; defibrillate
immediately B. Pulseless electrical activity; start CPR and epinephrine C. Asystole; start CPR
and epinephrine D. Ventricular tachycardia; administer amiodarone

Correct Answer: A Rationale: The rhythm shown is coarse ventricular fibrillation (V-fib),
which is a shockable rhythm. The first intervention is immediate defibrillation. CPR should be
resumed immediately after the shock. PEA (B) and asystole (C) are non-shockable rhythms.
V-tach (D) may be shockable if pulseless, but the rhythm shown is V-fib.



Question 5: A patient is in pulseless ventricular tachycardia. The defibrillator is charged to 200J
for the first shock. After the shock, the rhythm persists. What is the NEXT energy dose for the
second shock? A. 200J B. 300J C. 360J D. The same or higher energy dose as the first shock

Correct Answer: D Rationale: For pulseless V-tach/V-fib, the 2025 AHA guidelines
recommend using the same or higher energy dose for subsequent shocks. The exact energy
level depends on the defibrillator (biphasic or monophasic). For biphasic defibrillators, the
manufacturer’s recommended dose (often 120–200J) is used, and the same or higher dose is
repeated if the rhythm persists.



Question 6: A patient is in cardiac arrest. The team leader assigns roles. Which of the following
is the MOST important role during the first 2 minutes of a cardiac arrest? A. Airway manager B.
Compressor C. IV/IO access provider D. Defibrillator operator

Correct Answer: B Rationale: The compressor is the most critical role during the first 2
minutes of cardiac arrest, as high-quality chest compressions are the foundation of effective

, CPR. Airway management (A), IV/IO access (C), and defibrillation (D) are important but
secondary to uninterrupted compressions.



Question 7: A patient is in refractory ventricular fibrillation. High-quality CPR is ongoing. What is
the recommended timing for epinephrine administration? A. Every 3–5 minutes B. Every 2
minutes C. After every defibrillation attempt D. Only after ROSC is achieved

Correct Answer: A Rationale: Epinephrine is administered every 3–5 minutes during cardiac
arrest for non-shockable and shockable rhythms (after initial defibrillation attempts). It should not
be given more frequently (B) or only after defibrillation (C). It is not given after ROSC (D).



Question 8: A patient is in asystole. The team has established IV access. What is the FIRST
drug to administer? A. Epinephrine 1 mg B. Atropine 1 mg C. Amiodarone 300 mg D. Magnesium
sulfate 2 g

Correct Answer: A Rationale: For asystole , the first drug is epinephrine 1 mg IV/IO , repeated
every 3–5 minutes. Atropine (B) is no longer recommended for routine use in asystole or PEA.
Amiodarone (C) and magnesium (D) are not indicated for asystole.



Question 9: A patient is in pulseless electrical activity (PEA). The team has established IO
access. What is the FIRST intervention after confirming PEA? A. Administer epinephrine 1 mg B.
Perform immediate defibrillation C. Start high-quality CPR D. Administer atropine 1 mg

Correct Answer: C Rationale: For PEA, the first intervention is to start or continue
high-quality CPR for 2 minutes. Epinephrine (A) is given after CPR is ongoing. Defibrillation (B)
is not indicated for PEA. Atropine (D) is not recommended for routine use in PEA.



Question 10: A patient is in refractory V-fib. The team has administered epinephrine and
performed defibrillation twice. What is the NEXT drug to consider? A. Amiodarone 300 mg B.
Lidocaine 1–1.5 mg/kg C. Magnesium sulfate 2 g D. Atropine 1 mg

Correct Answer: A Rationale: For refractory V-fib/V-tach, after epinephrine and defibrillation,
the next drug is amiodarone 300 mg IV/IO . Lidocaine (B) is an alternative if amiodarone is
unavailable. Magnesium (C) is used for torsades de pointes. Atropine (D) is not indicated for
V-fib.

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