American Red Cross ALS | Advanced Life Support Exam Study Guide & Practice Test 2026/2027
Start chest compressions of at least 100 per min. You find an unresponsive pt. who is not breathing. After activating the emergency
response system, you determine there is no pulse. What is your next action?
Obtaining a 12 lead ECG. You are evaluating a 58-year-old man with chest pain. The blood pressure is
92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14
breaths/min, and the pulse oximetry reading is 97%. What assessment step is
most important now?
Peripheral IV What is the preferred method of access for epi administration during cardiac
arrest in most pts?
Begin chest compressions. An AED does not promptly analyze a rythm. What is your next step?
Administer 1mg of epinephrine You have completed 2 minutes of CPR. The ECG monitor displays the lead II
rhythm below, and the patient has no pulse. Another member of your team
resumes chest compressions, and an IV is in place. What management step is
your next priority?
Resume compressions During a pause in CPR, you see this lead II ECG rhythm on the monitor. The
patient has no pulse. What is the next action?
Prolonged interruptions in chest compressions. What is a common but sometimes fatal mistake in cardiac arrest management?
Allowing complete chest recoil Which action is a componant of high-quality chest comressions?
Providing quality compressions immediately before a Which action increases the chance of successful conversion of ventricular
defibrillation attempt. fibrillation?
Sinus rythm without a pulse Which situation BEST describes pulseless electrical activity?
Provide continuous chest compressions without pauses What is the BEST strategy for performing high-quality CPR on a patient with an
and 10 ventilations per minute. advanced airway in place?
Chest compressions may not be effective. Three minutes after witnessing a cardiac arrest, one member of your team
inserts an endotracheal tube while another performs continuous chest
compressions. During subsequent ventilation, you notice the presence of a
waveform on the capnography screen and a PETCO2 level of 8 mm Hg. What is
the significance of this finding?
allows for monitoring of CPR quality. The use of quantitative capnography in intubated patients
, American Red Cross ALS | Advanced Life Support Exam Study Guide & Practice Test 2026/2027
Consider terminating resuscitive efforts after consulting For the past 25 minutes, an EMS crew has attempted resuscitation of a patient
medical control. who originally presented in ventricular fibrillation. After the first shock, the ECG
screen displayed asystole, which has persisted despite 2 doses of epinephrine, a
fluid bolus, and high-quality CPR. What is your next treatment?
Be sure oxygen is not blowing over the patient's chest Which is a safe and effective practice within the defibrillation sequence?
during the shock.
Begin chest compressions. During your assessment, your patient suddenly loses consciousness. After
calling for help and determining that the patient is not breathing, you are unsure
whether the patient has a pulse. What is your next action?
Hands-free pads allow for a more rapid defibrillation. What is an advantage of using hands-free defibrillation pads instead of
defibrillation paddles?
Continue CPR while charging the defibrillator. What action is recommended to help minimize interruptions in chest
compressions during CPR?
Early defibrillation Which action is included in the BLS survey?
Amioderone 300mg Which drug and dose are recommended for the management of a patient in
refractory ventricular fibrillation?
10 seconds or less What is the appropriate interval for an interruption in chest compressions?
PETCO2 ≥10 mm Hg Which of the following is a sign of effective CPR?
Identifying and treating early clinical deterioration. What is the primary purpose of a medical emergency team (MET) or rapid
response team (RRT)?
Switch providers about every 2 minutes or every 5 Which action improves the quality of chest compressions delivered during a
compression cycles. resuscitation attempt?
1 breath every 5-6 seconds What is the appropriate ventilation strategy for an adult in respiratory arrest with
a pulse rate of 80/min?
Atropine 0.5mg A patient presents to the emergency department with new onset of dizziness and
fatigue. On examination, the patient's heart rate is 35/min, the blood pressure is
70/50 mm Hg, the respiratory rate is 22 breaths/min, and the oxygen saturation is
95%. What is the appropriate first medication?
2 to 10 mcg/kg per minute A patient with dizziness and shortness of breath with a sinus bradycardia of
40/min. The initial atropine dose was ineffective, and your monitor/defibrillator is
not equipped with a transcutaneous pacemaker. What is the appropriate dose of
dopamine for this patient?
, American Red Cross ALS | Advanced Life Support Exam Study Guide & Practice Test 2026/2027
Vagal manuever. A patient has sudden onset of dizziness. The patient's heart rate is 180/min,
blood pressure is 110/70 mm Hg, respiratory rate is 18 breaths/min, and pulse
oximetry reading is 98% on room air. The lead II ECG is shown below:
Adenosine 6mg IV push A monitored patient in the ICU developed a sudden onset of narrow-complex
tachycardia at a rate of 220/min. The patient's blood pressure is 128/58 mm Hg,
the PETCO2 is 38 mm Hg, and the pulse oximetry reading is 98%. There is
vascular access at the left internal jugular vein, and the patient has not been
given any vasoactive drugs. A 12-lead ECG confirms a supraventricular
tachycardia with no evidence of ischemia or infarction. The heart rate has not
responded to vagal maneuvers. What is the next recommended intervention?
Divert the patient to a hospital 15 minutes away with CT You are receiving a radio report from an EMS team en route with a patient who
capabilities. may be having an acute stroke. The hospital CT scanner is not working at this
time. What should you do in this situation?
Evidence of rigor mortis. Choose an appropriate indication to stop or withhold resuscitative efforts.
Obtain a 12 lead ECG. A 49-year-old woman arrives in the emergency department with persistent
epigastric pain. She had been taking oral antacids for the past 6 hours because
she thought she had heartburn. The initial blood pressure is 118/72 mm Hg, the
heart rate is 92/min and regular, the nonlabored respiratory rate is 14
breaths/min, and the pulse oximetry reading is 96%. Which is the most
appropriate intervention to perform next?
Simple airway manuevers and assisted ventilations. A patient in respiratory failure becomes apneic but continues to have a strong
pulse. The heart rate is dropping rapidly and now shows a sinus bradycardia at a
rate of 30/min. What intervention has the highest priority?
Suction during withdrawal but for no longer than 10 What is the appropriate procedure for endotracheal tube suctioning after the
seconds. appropriate catheter is selected?
Atropine 0.5mg While treating a patient with dizziness, a blood pressure of 68/30 mm Hg, and
cool, clammy skin, you see this lead II ECG rhythm:What is the first intervention
?
Cincinnati Prehospital Stroke Scale assessment A 68-year-old woman experienced a sudden onset of right arm weakness. EMS
personnel measure a blood pressure of 140/90 mm Hg, a heart rate of 78/min, a
nonlabored respiratory rate of 14 breaths/min, and a pulse oximetry reading of
97%. The lead II ECG displays sinus rhythm. What is the most appropriate action
for the EMS team to perform next?
Head CT scan EMS is transporting a patient with a positive prehospital stroke assessment.
Upon arrival in the emergency department, the initial blood pressure is 138/78
mm Hg, the pulse rate is 80/min, the respiratory rate is 12 breaths/min, and the
pulse oximetry reading is 95% on room air. The lead II ECG displays sinus
rhythm. The blood glucose level is within normal limits. What intervention should
you perform next?
8-10 breaths per minute What is the proper ventilation rate for a patient in cardiac arrest who has an
advanced airway in place?
Start chest compressions of at least 100 per min. You find an unresponsive pt. who is not breathing. After activating the emergency
response system, you determine there is no pulse. What is your next action?
Obtaining a 12 lead ECG. You are evaluating a 58-year-old man with chest pain. The blood pressure is
92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14
breaths/min, and the pulse oximetry reading is 97%. What assessment step is
most important now?
Peripheral IV What is the preferred method of access for epi administration during cardiac
arrest in most pts?
Begin chest compressions. An AED does not promptly analyze a rythm. What is your next step?
Administer 1mg of epinephrine You have completed 2 minutes of CPR. The ECG monitor displays the lead II
rhythm below, and the patient has no pulse. Another member of your team
resumes chest compressions, and an IV is in place. What management step is
your next priority?
Resume compressions During a pause in CPR, you see this lead II ECG rhythm on the monitor. The
patient has no pulse. What is the next action?
Prolonged interruptions in chest compressions. What is a common but sometimes fatal mistake in cardiac arrest management?
Allowing complete chest recoil Which action is a componant of high-quality chest comressions?
Providing quality compressions immediately before a Which action increases the chance of successful conversion of ventricular
defibrillation attempt. fibrillation?
Sinus rythm without a pulse Which situation BEST describes pulseless electrical activity?
Provide continuous chest compressions without pauses What is the BEST strategy for performing high-quality CPR on a patient with an
and 10 ventilations per minute. advanced airway in place?
Chest compressions may not be effective. Three minutes after witnessing a cardiac arrest, one member of your team
inserts an endotracheal tube while another performs continuous chest
compressions. During subsequent ventilation, you notice the presence of a
waveform on the capnography screen and a PETCO2 level of 8 mm Hg. What is
the significance of this finding?
allows for monitoring of CPR quality. The use of quantitative capnography in intubated patients
, American Red Cross ALS | Advanced Life Support Exam Study Guide & Practice Test 2026/2027
Consider terminating resuscitive efforts after consulting For the past 25 minutes, an EMS crew has attempted resuscitation of a patient
medical control. who originally presented in ventricular fibrillation. After the first shock, the ECG
screen displayed asystole, which has persisted despite 2 doses of epinephrine, a
fluid bolus, and high-quality CPR. What is your next treatment?
Be sure oxygen is not blowing over the patient's chest Which is a safe and effective practice within the defibrillation sequence?
during the shock.
Begin chest compressions. During your assessment, your patient suddenly loses consciousness. After
calling for help and determining that the patient is not breathing, you are unsure
whether the patient has a pulse. What is your next action?
Hands-free pads allow for a more rapid defibrillation. What is an advantage of using hands-free defibrillation pads instead of
defibrillation paddles?
Continue CPR while charging the defibrillator. What action is recommended to help minimize interruptions in chest
compressions during CPR?
Early defibrillation Which action is included in the BLS survey?
Amioderone 300mg Which drug and dose are recommended for the management of a patient in
refractory ventricular fibrillation?
10 seconds or less What is the appropriate interval for an interruption in chest compressions?
PETCO2 ≥10 mm Hg Which of the following is a sign of effective CPR?
Identifying and treating early clinical deterioration. What is the primary purpose of a medical emergency team (MET) or rapid
response team (RRT)?
Switch providers about every 2 minutes or every 5 Which action improves the quality of chest compressions delivered during a
compression cycles. resuscitation attempt?
1 breath every 5-6 seconds What is the appropriate ventilation strategy for an adult in respiratory arrest with
a pulse rate of 80/min?
Atropine 0.5mg A patient presents to the emergency department with new onset of dizziness and
fatigue. On examination, the patient's heart rate is 35/min, the blood pressure is
70/50 mm Hg, the respiratory rate is 22 breaths/min, and the oxygen saturation is
95%. What is the appropriate first medication?
2 to 10 mcg/kg per minute A patient with dizziness and shortness of breath with a sinus bradycardia of
40/min. The initial atropine dose was ineffective, and your monitor/defibrillator is
not equipped with a transcutaneous pacemaker. What is the appropriate dose of
dopamine for this patient?
, American Red Cross ALS | Advanced Life Support Exam Study Guide & Practice Test 2026/2027
Vagal manuever. A patient has sudden onset of dizziness. The patient's heart rate is 180/min,
blood pressure is 110/70 mm Hg, respiratory rate is 18 breaths/min, and pulse
oximetry reading is 98% on room air. The lead II ECG is shown below:
Adenosine 6mg IV push A monitored patient in the ICU developed a sudden onset of narrow-complex
tachycardia at a rate of 220/min. The patient's blood pressure is 128/58 mm Hg,
the PETCO2 is 38 mm Hg, and the pulse oximetry reading is 98%. There is
vascular access at the left internal jugular vein, and the patient has not been
given any vasoactive drugs. A 12-lead ECG confirms a supraventricular
tachycardia with no evidence of ischemia or infarction. The heart rate has not
responded to vagal maneuvers. What is the next recommended intervention?
Divert the patient to a hospital 15 minutes away with CT You are receiving a radio report from an EMS team en route with a patient who
capabilities. may be having an acute stroke. The hospital CT scanner is not working at this
time. What should you do in this situation?
Evidence of rigor mortis. Choose an appropriate indication to stop or withhold resuscitative efforts.
Obtain a 12 lead ECG. A 49-year-old woman arrives in the emergency department with persistent
epigastric pain. She had been taking oral antacids for the past 6 hours because
she thought she had heartburn. The initial blood pressure is 118/72 mm Hg, the
heart rate is 92/min and regular, the nonlabored respiratory rate is 14
breaths/min, and the pulse oximetry reading is 96%. Which is the most
appropriate intervention to perform next?
Simple airway manuevers and assisted ventilations. A patient in respiratory failure becomes apneic but continues to have a strong
pulse. The heart rate is dropping rapidly and now shows a sinus bradycardia at a
rate of 30/min. What intervention has the highest priority?
Suction during withdrawal but for no longer than 10 What is the appropriate procedure for endotracheal tube suctioning after the
seconds. appropriate catheter is selected?
Atropine 0.5mg While treating a patient with dizziness, a blood pressure of 68/30 mm Hg, and
cool, clammy skin, you see this lead II ECG rhythm:What is the first intervention
?
Cincinnati Prehospital Stroke Scale assessment A 68-year-old woman experienced a sudden onset of right arm weakness. EMS
personnel measure a blood pressure of 140/90 mm Hg, a heart rate of 78/min, a
nonlabored respiratory rate of 14 breaths/min, and a pulse oximetry reading of
97%. The lead II ECG displays sinus rhythm. What is the most appropriate action
for the EMS team to perform next?
Head CT scan EMS is transporting a patient with a positive prehospital stroke assessment.
Upon arrival in the emergency department, the initial blood pressure is 138/78
mm Hg, the pulse rate is 80/min, the respiratory rate is 12 breaths/min, and the
pulse oximetry reading is 95% on room air. The lead II ECG displays sinus
rhythm. The blood glucose level is within normal limits. What intervention should
you perform next?
8-10 breaths per minute What is the proper ventilation rate for a patient in cardiac arrest who has an
advanced airway in place?
