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 man with known CAD collapses in the ED. Monitor shows a regular narrow‑complex
tachycardia at 190 bpm with a visible P wave preceding each QRS. He is hypotensive (BP 78/48)
and symptomatic. What is the most appropriate immediate management?
A) Immediate synchronized cardioversion
B) IV adenosine 6 mg rapid push
C) IV amiodarone 150 mg bolus
D) Observe and obtain a 12‑lead ECG
✓ Correct Answer: Immediate synchronized cardioversion
RATIONALE
Unstable narrow‑complex tachycardia requires immediate synchronized cardioversion.
Question 2
During a cardiac arrest, a patient is intubated and you notice the capnography waveform is flat
while compressions are ongoing. What is the most likely explanation?
A) ET tube is in the esophagus
B) Severe bronchospasm
C) Low tidal volume ventilation
D) Incorrect CO₂ sensor calibration
✓ Correct Answer: ET tube is in the esophagus
RATIONALE
A flat capnography trace despite compressions suggests an esophageal tube placement.
,Question 3
A 55‑year‑old female with out‑of‑hospital cardiac arrest achieves ROSC after 10 minutes of CPR.
Her initial post‑ROSC systolic BP is 80 mm Hg. Which intervention best addresses her
hypotension?
A) Start norepinephrine infusion
B) Administer 500 mL crystalloid bolus
C) Begin targeted temperature management at 36 °C
D) Give 1 mg epinephrine IV
✓ Correct Answer: Administer 500 mL crystalloid bolus
RATIONALE
Initial hypotension after ROSC is best treated with fluid bolus before vasopressors.
Question 4
Which of the following is the recommended compression depth for adult CPR according to the
2025 AHA guidelines?
A) At least 3 cm (1.2 in)
B) At least 4 cm (1.5 in)
C) At least 5 cm (2 in)
D) At least 6 cm (2.4 in)
✓ Correct Answer: At least 5 cm (2 in)
RATIONALE
Current guidelines specify a depth of at least 5 cm for adults.
, Question 5
A patient with witnessed ventricular fibrillation receives two unsynchronised shocks. After the
second shock, the rhythm remains VF. What is the next recommended drug and dose?
A) Epinephrine 1 mg IV push
B) Lidocaine 1 mg/kg IV push
C) Amiodarone 150 mg IV push
D) Magnesium sulfate 2 g IV over 5 min
✓ Correct Answer: Epinephrine 1 mg IV push
RATIONALE
Epinephrine 1 mg IV is given after the second shock for persistent VF.
Question 6
In a rural hospital without a cath lab, a STEMI patient achieves ROSC and is hemodynamically
stable. Which destination is most appropriate for transfer?
A) Nearest primary PCI‑capable hospital within 30 min
B) Community hospital for observation
C) Tele‑cardiology evaluation only
D) Urgent thrombolysis then transfer to PCI center
✓ Correct Answer: Urgent thrombolysis then transfer to PCI center
RATIONALE
When PCI is not immediately available, thrombolysis followed by transfer is recommended.
Questions | Exam Solutions | Correct Answer Keys
✓ 100% Accurate & Verified Questions and Answers
Question 1
A 68‑year‑old man with known CAD collapses in the ED. Monitor shows a regular narrow‑complex
tachycardia at 190 bpm with a visible P wave preceding each QRS. He is hypotensive (BP 78/48)
and symptomatic. What is the most appropriate immediate management?
A) Immediate synchronized cardioversion
B) IV adenosine 6 mg rapid push
C) IV amiodarone 150 mg bolus
D) Observe and obtain a 12‑lead ECG
✓ Correct Answer: Immediate synchronized cardioversion
RATIONALE
Unstable narrow‑complex tachycardia requires immediate synchronized cardioversion.
Question 2
During a cardiac arrest, a patient is intubated and you notice the capnography waveform is flat
while compressions are ongoing. What is the most likely explanation?
A) ET tube is in the esophagus
B) Severe bronchospasm
C) Low tidal volume ventilation
D) Incorrect CO₂ sensor calibration
✓ Correct Answer: ET tube is in the esophagus
RATIONALE
A flat capnography trace despite compressions suggests an esophageal tube placement.
,Question 3
A 55‑year‑old female with out‑of‑hospital cardiac arrest achieves ROSC after 10 minutes of CPR.
Her initial post‑ROSC systolic BP is 80 mm Hg. Which intervention best addresses her
hypotension?
A) Start norepinephrine infusion
B) Administer 500 mL crystalloid bolus
C) Begin targeted temperature management at 36 °C
D) Give 1 mg epinephrine IV
✓ Correct Answer: Administer 500 mL crystalloid bolus
RATIONALE
Initial hypotension after ROSC is best treated with fluid bolus before vasopressors.
Question 4
Which of the following is the recommended compression depth for adult CPR according to the
2025 AHA guidelines?
A) At least 3 cm (1.2 in)
B) At least 4 cm (1.5 in)
C) At least 5 cm (2 in)
D) At least 6 cm (2.4 in)
✓ Correct Answer: At least 5 cm (2 in)
RATIONALE
Current guidelines specify a depth of at least 5 cm for adults.
, Question 5
A patient with witnessed ventricular fibrillation receives two unsynchronised shocks. After the
second shock, the rhythm remains VF. What is the next recommended drug and dose?
A) Epinephrine 1 mg IV push
B) Lidocaine 1 mg/kg IV push
C) Amiodarone 150 mg IV push
D) Magnesium sulfate 2 g IV over 5 min
✓ Correct Answer: Epinephrine 1 mg IV push
RATIONALE
Epinephrine 1 mg IV is given after the second shock for persistent VF.
Question 6
In a rural hospital without a cath lab, a STEMI patient achieves ROSC and is hemodynamically
stable. Which destination is most appropriate for transfer?
A) Nearest primary PCI‑capable hospital within 30 min
B) Community hospital for observation
C) Tele‑cardiology evaluation only
D) Urgent thrombolysis then transfer to PCI center
✓ Correct Answer: Urgent thrombolysis then transfer to PCI center
RATIONALE
When PCI is not immediately available, thrombolysis followed by transfer is recommended.
