ACLS Exam 2025
Question 1: Which of the following statements is not part of a high quality CPR?
Options: A. Minimizing interruptions of compressions
B. Allow the thorax to rise after each compression
C. Maintain a 15:2 ratio
D. Avoid excessive ventilation
Correct Answer: C. Maintain a 15:2 ratio
Explanation:
High-quality CPR, as per ACLS guidelines, includes minimizing interruptions in chest
compressions, allowing full chest recoil (thorax rise) after each compression, and avoiding
excessive ventilation to prevent hyperventilation. However, the compression-ventilation ratio of
15:2 is not standard for adult CPR. The correct ratio for adults with an unsecured airway (e.g.,
bag-mask ventilation) is 30:2 for a single rescuer or two rescuers in non-intubated patients. The
15:2 ratio is typically used in pediatric CPR with two rescuers and an unsecured airway, not in
adult ACLS.
Question 2: During RCPA with the patient intubated using Capnography, should we keep
it in?
Options: A. ≥20mmHg
B. ≥10mmHg
C. ≥35mmHg
D. ≥5 mmHg
Correct Answer: B. ≥10mmHg
Explanation:
Capnography measures end-tidal CO2 (EtCO2) during CPR to assess the quality of chest
compressions and circulation. An EtCO2 value of ≥10 mmHg indicates adequate perfusion and
effective CPR. Values below 10 mmHg suggest poor CPR quality or inadequate circulation,
while higher values (e.g., ≥35 mmHg) may indicate return of spontaneous circulation (ROSC).
Maintaining EtCO2 ≥10 mmHg is the standard target during CPR in intubated patients.
,Question 3: Should cricoid pressure be routinely applied to prevent bronchoaspiration and
facilitate intubation?
Options: A. True
B. False
Correct Answer: B. False
Explanation:
Routine use of cricoid pressure during intubation is no longer recommended in ACLS guidelines.
While it was historically used to prevent aspiration, studies have shown it may not be effective
and can complicate intubation by obstructing the airway or reducing visualization. Cricoid
pressure is only recommended in specific situations by trained personnel and is not a routine
practice.
Question 4: What would be the most appropriate sequence to attend a possible
Cardiorespiratory Arrest?
Options: A. Assess response, open airway, call for help, pulse, compressions, ventilations
B. Assess response, pulse, call for help, ventilate, start compressions
C. Assess response, call for help, pulse, compressions, ventilations
D. Assess response, chin front maneuver, call for help, pulse, compressions, ventilations
Correct Answer: C. Assess response, call for help, pulse, compressions, ventilations
Explanation:
The ACLS algorithm for cardiorespiratory arrest follows the CAB approach (Circulation,
Airway, Breathing). The correct sequence is:
1. Assess response (check if the patient is responsive).
2. Call for help (activate emergency response).
3. Check pulse (assess for a pulse for no more than 10 seconds).
4. Start compressions if no pulse is detected.
5. Provide ventilations after initiating compressions (30:2 ratio if not intubated).
Option A includes "open airway" prematurely, and option D includes an incorrect "chin
front maneuver." Option B prioritizes ventilation before compressions, which is incorrect.
Question 5: After defibrillation, what is the next step?
Options: A. Assess the carotid pulse and observe the monitor
B. Administer adrenalin 1 mgr IV followed by 20 ml of SF
, C. Administer 300 mgrs of amiodarone
D. Rapidly restart compressions for 2 more minutes
Correct Answer: D. Rapidly restart compressions for 2 more minutes
Explanation:
After defibrillation in ACLS, the immediate next step is to resume high-quality CPR (starting
with chest compressions) for 2 minutes before reassessing the rhythm or pulse. This ensures
continued circulation while allowing time for the heart to respond to the shock. Assessing the
pulse or administering medications (e.g., adrenaline or amiodarone) comes after the 2-minute
CPR cycle if the rhythm remains shockable or if no ROSC is achieved.
Question 6: When the Compressions Provider becomes fatigued, what is the recommended
time for change?
Options: A. After each defibrillation
B. Every 2 minutes
C. Every 1 minute
D. As long as your body can take it
Correct Answer: B. Every 2 minutes
Explanation:
ACLS guidelines recommend switching the compression provider every 2 minutes (or after
every 5 cycles of 30:2 compressions) to prevent fatigue, which can reduce CPR quality. This
coincides with rhythm checks during CPR. Switching after each defibrillation or based on
subjective fatigue is not standardized, and 1 minute is too frequent.
Question 7: What is the compression-ventilation relationship in a patient who has had a
laryngeal mask inserted?
Options: A. 200 : 20 x 2 min
B. 100:10 x 2 min
C. 30:2 x 2 min
D. 30: 2 x every 6 seconds
Correct Answer: C. 30:2 x 2 min
Explanation:
A laryngeal mask airway (LMA) is considered an advanced airway, similar to an endotracheal
tube. In patients with an advanced airway, ACLS guidelines recommend continuous chest
compressions (100–120 per minute) with ventilations delivered at a rate of 1 every 6 seconds
(approximately 10 ventilations per minute). However, the question asks for the "compression-
ventilation relationship," which traditionally refers to the ratio in non-intubated patients or during
pauses. The 30:2 ratio applies during initial CPR or in scenarios where ventilations are
Question 1: Which of the following statements is not part of a high quality CPR?
Options: A. Minimizing interruptions of compressions
B. Allow the thorax to rise after each compression
C. Maintain a 15:2 ratio
D. Avoid excessive ventilation
Correct Answer: C. Maintain a 15:2 ratio
Explanation:
High-quality CPR, as per ACLS guidelines, includes minimizing interruptions in chest
compressions, allowing full chest recoil (thorax rise) after each compression, and avoiding
excessive ventilation to prevent hyperventilation. However, the compression-ventilation ratio of
15:2 is not standard for adult CPR. The correct ratio for adults with an unsecured airway (e.g.,
bag-mask ventilation) is 30:2 for a single rescuer or two rescuers in non-intubated patients. The
15:2 ratio is typically used in pediatric CPR with two rescuers and an unsecured airway, not in
adult ACLS.
Question 2: During RCPA with the patient intubated using Capnography, should we keep
it in?
Options: A. ≥20mmHg
B. ≥10mmHg
C. ≥35mmHg
D. ≥5 mmHg
Correct Answer: B. ≥10mmHg
Explanation:
Capnography measures end-tidal CO2 (EtCO2) during CPR to assess the quality of chest
compressions and circulation. An EtCO2 value of ≥10 mmHg indicates adequate perfusion and
effective CPR. Values below 10 mmHg suggest poor CPR quality or inadequate circulation,
while higher values (e.g., ≥35 mmHg) may indicate return of spontaneous circulation (ROSC).
Maintaining EtCO2 ≥10 mmHg is the standard target during CPR in intubated patients.
,Question 3: Should cricoid pressure be routinely applied to prevent bronchoaspiration and
facilitate intubation?
Options: A. True
B. False
Correct Answer: B. False
Explanation:
Routine use of cricoid pressure during intubation is no longer recommended in ACLS guidelines.
While it was historically used to prevent aspiration, studies have shown it may not be effective
and can complicate intubation by obstructing the airway or reducing visualization. Cricoid
pressure is only recommended in specific situations by trained personnel and is not a routine
practice.
Question 4: What would be the most appropriate sequence to attend a possible
Cardiorespiratory Arrest?
Options: A. Assess response, open airway, call for help, pulse, compressions, ventilations
B. Assess response, pulse, call for help, ventilate, start compressions
C. Assess response, call for help, pulse, compressions, ventilations
D. Assess response, chin front maneuver, call for help, pulse, compressions, ventilations
Correct Answer: C. Assess response, call for help, pulse, compressions, ventilations
Explanation:
The ACLS algorithm for cardiorespiratory arrest follows the CAB approach (Circulation,
Airway, Breathing). The correct sequence is:
1. Assess response (check if the patient is responsive).
2. Call for help (activate emergency response).
3. Check pulse (assess for a pulse for no more than 10 seconds).
4. Start compressions if no pulse is detected.
5. Provide ventilations after initiating compressions (30:2 ratio if not intubated).
Option A includes "open airway" prematurely, and option D includes an incorrect "chin
front maneuver." Option B prioritizes ventilation before compressions, which is incorrect.
Question 5: After defibrillation, what is the next step?
Options: A. Assess the carotid pulse and observe the monitor
B. Administer adrenalin 1 mgr IV followed by 20 ml of SF
, C. Administer 300 mgrs of amiodarone
D. Rapidly restart compressions for 2 more minutes
Correct Answer: D. Rapidly restart compressions for 2 more minutes
Explanation:
After defibrillation in ACLS, the immediate next step is to resume high-quality CPR (starting
with chest compressions) for 2 minutes before reassessing the rhythm or pulse. This ensures
continued circulation while allowing time for the heart to respond to the shock. Assessing the
pulse or administering medications (e.g., adrenaline or amiodarone) comes after the 2-minute
CPR cycle if the rhythm remains shockable or if no ROSC is achieved.
Question 6: When the Compressions Provider becomes fatigued, what is the recommended
time for change?
Options: A. After each defibrillation
B. Every 2 minutes
C. Every 1 minute
D. As long as your body can take it
Correct Answer: B. Every 2 minutes
Explanation:
ACLS guidelines recommend switching the compression provider every 2 minutes (or after
every 5 cycles of 30:2 compressions) to prevent fatigue, which can reduce CPR quality. This
coincides with rhythm checks during CPR. Switching after each defibrillation or based on
subjective fatigue is not standardized, and 1 minute is too frequent.
Question 7: What is the compression-ventilation relationship in a patient who has had a
laryngeal mask inserted?
Options: A. 200 : 20 x 2 min
B. 100:10 x 2 min
C. 30:2 x 2 min
D. 30: 2 x every 6 seconds
Correct Answer: C. 30:2 x 2 min
Explanation:
A laryngeal mask airway (LMA) is considered an advanced airway, similar to an endotracheal
tube. In patients with an advanced airway, ACLS guidelines recommend continuous chest
compressions (100–120 per minute) with ventilations delivered at a rate of 1 every 6 seconds
(approximately 10 ventilations per minute). However, the question asks for the "compression-
ventilation relationship," which traditionally refers to the ratio in non-intubated patients or during
pauses. The 30:2 ratio applies during initial CPR or in scenarios where ventilations are
