ADVANCED CARDIAC LIFE SUPPORT (ACLS) FINAL
EXAM 2026 – COMPLETE STUDY GUIDE &
QUESTIONS AND ANSWERS
1. A 20-year-old man with respiratory depression is brought to the emergency
department by his parents. Opioid overdose is suspected, and an initial dose of naloxone
is administered at 10 p.m. The patient does not respond to this initial dose. The team
would expect to administer a second dose after how many minutes?
● a. 1 minute
● b. 2 minutes
● c. 5 minutes
● d. 10 minutes
Answer: b. 2 minutes
2. A 28-year-old pregnant patient who resides in transitional housing presents to
the emergency department with complaints of feeling feverish and very faint. The
patient tells the emergency nurse that she does not know when she became pregnant.
Upon palpation, the fundus is not at or above the umbilicus. The patient's condition
quickly deteriorates and she goes into cardiac arrest. If available and able to be used
without impeding or delaying the resuscitation effort, what diagnostic tool could be
used to guide decision-making in the care of this patient?
● a. CT scan
● b. Point-of-care ultrasound
● c. MRI
● d. X-ray
Answer: b. Point-of-care ultrasound
3. A 30-year-old patient has been brought to the emergency department in cardiac
arrest. The cardiac monitor shows a specific rhythm. Interpretation of this rhythm
would suggest which of the following as a possible precipitating factor?
● a. Myocardial infarction
● b. Electrocution
● c. Drug overdose
● d. Hypothermia
Answer: b. Electrocution
,ADVANCED CARDIAC LIFE SUPPORT (ACLS) FINAL
EXAM 2026 – COMPLETE STUDY GUIDE &
QUESTIONS AND ANSWERS
4. A 35-year-old female patient's ECG is consistent with STEMI. The ECG reveals
a new ST-segment elevation at the J point in leads V2 and V3 of at least which size?
● a. 0.05 mV
● b. 0.10 mV
● c. 0.15 mV
● d. 0.20 mV
Answer: c. 0.15 mV
5. A 42-year-old woman presents to the emergency department with complaints of
fatigue, shortness of breath, back pain and nausea. A 12-lead ECG is obtained and
shows ST-segment depression in leads II, III, and aVF and intermittent runs of
nonsustained ventricular tachycardia. Cardiac serum markers are elevated. These
findings suggest which condition?
● a. Stable angina
● b. High-risk non-ST-segment elevation ACS (NSTE-ACS)
● c. STEMI
● d. Pericarditis
Answer: b. High-risk non-ST-segment elevation ACS (NSTE-ACS)
6. A member of the resuscitation team is preparing to administer medications
intravenously to a patient in cardiac arrest. The team member should follow each
peripherally administered drug dose with a normal saline flush. How much would the
team member give?
● a. 5 mL
● b. 10 to 20 mL
● c. 20 to 30 mL
● d. 50 mL
Answer: b. 10 to 20 mL
7. A member of the resuscitation team is preparing to defibrillate a patient in
cardiac arrest using a biphasic defibrillator. The team member would set the energy
dose according to the manufacturer's recommendations, which is usually:
, ADVANCED CARDIAC LIFE SUPPORT (ACLS) FINAL
EXAM 2026 – COMPLETE STUDY GUIDE &
QUESTIONS AND ANSWERS
● a. 100 joules
● b. 120 to 200 joules
● c. 200 to 300 joules
● d. 360 joules
Answer: b. 120 to 200 joules
8. A patient arrives at the emergency department complaining of shortness of
breath. The patient has a long history of chronic obstructive pulmonary disease.
Assessment reveals respiratory failure. Which action would be the initial priority to
address the respiratory failure?
● a. Administer high-flow oxygen
● b. Assisted ventilation with BVM resuscitator
● c. Intubation
● d. Nebulized bronchodilators
Answer: b. Assisted ventilation with BVM resuscitator
9. A patient comes to the emergency department complaining of palpitations and
"some shortness of breath." Cardiac monitoring is initiated and reveals a specific ECG
rhythm strip. The provider interprets this strip as indicating which arrhythmia?
● a. Atrial fibrillation
● b. Atrial flutter
● c. Supraventricular tachycardia
● d. Ventricular tachycardia
Answer: b. Atrial flutter
10. A patient enters the emergency department in respiratory compromise. The
team is monitoring the patient using capnography and identifies that ETCO2 levels are
initially 33 mmHg and later 40 mmHg. From these readings, the team identifies that the
patient is progressing in what stage of respiratory compromise?
● a. Respiratory distress
● b. Respiratory failure
● c. Respiratory arrest
EXAM 2026 – COMPLETE STUDY GUIDE &
QUESTIONS AND ANSWERS
1. A 20-year-old man with respiratory depression is brought to the emergency
department by his parents. Opioid overdose is suspected, and an initial dose of naloxone
is administered at 10 p.m. The patient does not respond to this initial dose. The team
would expect to administer a second dose after how many minutes?
● a. 1 minute
● b. 2 minutes
● c. 5 minutes
● d. 10 minutes
Answer: b. 2 minutes
2. A 28-year-old pregnant patient who resides in transitional housing presents to
the emergency department with complaints of feeling feverish and very faint. The
patient tells the emergency nurse that she does not know when she became pregnant.
Upon palpation, the fundus is not at or above the umbilicus. The patient's condition
quickly deteriorates and she goes into cardiac arrest. If available and able to be used
without impeding or delaying the resuscitation effort, what diagnostic tool could be
used to guide decision-making in the care of this patient?
● a. CT scan
● b. Point-of-care ultrasound
● c. MRI
● d. X-ray
Answer: b. Point-of-care ultrasound
3. A 30-year-old patient has been brought to the emergency department in cardiac
arrest. The cardiac monitor shows a specific rhythm. Interpretation of this rhythm
would suggest which of the following as a possible precipitating factor?
● a. Myocardial infarction
● b. Electrocution
● c. Drug overdose
● d. Hypothermia
Answer: b. Electrocution
,ADVANCED CARDIAC LIFE SUPPORT (ACLS) FINAL
EXAM 2026 – COMPLETE STUDY GUIDE &
QUESTIONS AND ANSWERS
4. A 35-year-old female patient's ECG is consistent with STEMI. The ECG reveals
a new ST-segment elevation at the J point in leads V2 and V3 of at least which size?
● a. 0.05 mV
● b. 0.10 mV
● c. 0.15 mV
● d. 0.20 mV
Answer: c. 0.15 mV
5. A 42-year-old woman presents to the emergency department with complaints of
fatigue, shortness of breath, back pain and nausea. A 12-lead ECG is obtained and
shows ST-segment depression in leads II, III, and aVF and intermittent runs of
nonsustained ventricular tachycardia. Cardiac serum markers are elevated. These
findings suggest which condition?
● a. Stable angina
● b. High-risk non-ST-segment elevation ACS (NSTE-ACS)
● c. STEMI
● d. Pericarditis
Answer: b. High-risk non-ST-segment elevation ACS (NSTE-ACS)
6. A member of the resuscitation team is preparing to administer medications
intravenously to a patient in cardiac arrest. The team member should follow each
peripherally administered drug dose with a normal saline flush. How much would the
team member give?
● a. 5 mL
● b. 10 to 20 mL
● c. 20 to 30 mL
● d. 50 mL
Answer: b. 10 to 20 mL
7. A member of the resuscitation team is preparing to defibrillate a patient in
cardiac arrest using a biphasic defibrillator. The team member would set the energy
dose according to the manufacturer's recommendations, which is usually:
, ADVANCED CARDIAC LIFE SUPPORT (ACLS) FINAL
EXAM 2026 – COMPLETE STUDY GUIDE &
QUESTIONS AND ANSWERS
● a. 100 joules
● b. 120 to 200 joules
● c. 200 to 300 joules
● d. 360 joules
Answer: b. 120 to 200 joules
8. A patient arrives at the emergency department complaining of shortness of
breath. The patient has a long history of chronic obstructive pulmonary disease.
Assessment reveals respiratory failure. Which action would be the initial priority to
address the respiratory failure?
● a. Administer high-flow oxygen
● b. Assisted ventilation with BVM resuscitator
● c. Intubation
● d. Nebulized bronchodilators
Answer: b. Assisted ventilation with BVM resuscitator
9. A patient comes to the emergency department complaining of palpitations and
"some shortness of breath." Cardiac monitoring is initiated and reveals a specific ECG
rhythm strip. The provider interprets this strip as indicating which arrhythmia?
● a. Atrial fibrillation
● b. Atrial flutter
● c. Supraventricular tachycardia
● d. Ventricular tachycardia
Answer: b. Atrial flutter
10. A patient enters the emergency department in respiratory compromise. The
team is monitoring the patient using capnography and identifies that ETCO2 levels are
initially 33 mmHg and later 40 mmHg. From these readings, the team identifies that the
patient is progressing in what stage of respiratory compromise?
● a. Respiratory distress
● b. Respiratory failure
● c. Respiratory arrest
