AHA ACLS WRITTEN TEST STUDY GUIDE
2026 – COMPLETE CONCEPT REVIEW &
PRACTICE MATERIALS (LATEST EDITION)
1. What is the recommended depth of chest compressions for an adult victim?
a) At least 1 inch (2.5 cm)
b) At least 2 inches (5 cm) ✓
c) At least 2.5 inches (6 cm)
d) 1.5 to 2 inches (4 to 5 cm)
2. What is the recommended rate for performing chest compressions?
a) 60 to 80 per minute
b) 80 to 100 per minute
c) 100 to 120 per minute ✓
d) 120 to 140 per minute
3. The compression-to-ventilation ratio for 2-rescuer adult CPR is:
a) 15:2
b) 30:2 ✓
c) 5:1
d) Continuous compressions with 10 breaths/minute
4. The primary purpose of allowing full chest recoil during CPR is to:
a) Reduce rescuer fatigue
b) Allow the heart to refill with blood ✓
c) Prevent rib fractures
d) Check for a pulse
5. For an unresponsive adult victim with abnormal breathing (agonal gasps), the first action
should be to:
a) Begin chest compressions ✓
b) Open the airway and give 2 breaths
c) Activate the emergency response system
d) Check for a carotid pulse for 10 seconds
Section 2: The ACLS Survey & Systems of Care
, 6. The "B" in the ACLS Primary Survey stands for:
a) Bag-valve-mask
b) Bicarbonate
c) Breathing ✓
d) Blood pressure
7. The sequence of the BLS/ACLS Survey is:
a) Airway, Breathing, Circulation, Differential Diagnosis
b) Check Rhythm, Shock, Compressions, Drugs
c) Circulation, Airway, Breathing, Defibrillation ✓
d) Recognition, CPR, Defibrillation, Advanced Care
8. The purpose of "closing the loop" in communication during a resuscitation is to:
a) Ensure all team members hear and acknowledge instructions ✓
b) Prepare the patient for transport
c) Document the final rhythm
d) Order post-cardiac arrest care
9. Which of the following is a critical component of post-cardiac arrest care?
a) Immediate withdrawal of care if GCS is low
b) Targeted Temperature Management (TTM) ✓
c) Rapid infusion of cold IV fluids only
d) Avoiding vasopressors to protect the heart
10. Integrated post-cardiac arrest care includes careful management of:
a) Oxygenation, Blood Pressure, and Temperature ✓
b) Urine output only
c) Pain management and sedation only
d) Early prognostication within 6 hours
Section 3: Airway Management
11. The preferred method for verifying correct placement of an advanced airway device is:
a) Listening over the epigastrium
b) Clinical assessment and continuous waveform capnography ✓
c) Pulse oximetry reading
d) Chest X-ray
12. After placement of an endotracheal tube during ongoing CPR, ventilations should be
provided at what rate?
a) One breath every 3-5 seconds (10-12 breaths/min) ✓
, b) One breath every 6 seconds (10 breaths/min)
c) One breath every 10 seconds (6 breaths/min)
d) Synchronized with compressions at a 30:2 ratio
13. A patient with a suspected head injury requires intubation. In addition to securing the
airway, the team should prioritize:
a) Avoiding all sedatives
b) Preventing hyperventilation unless signs of herniation ✓
c) Immediate hyperventilation to reduce ICP
d) Using the largest possible tube
14. Waveform capnography showing a sudden drop in end-tidal CO2 (ETCO2) during CPR
may indicate:
a) Return of spontaneous circulation (ROSC)
b) Displacement of the advanced airway ✓
c) Improved quality of compressions
d) Metabolic alkalosis
Section 4: Bradycardia & Tachycardia Algorithms
15. A patient is alert but dizzy with a heart rate of 42 bpm and a blood pressure of 88/50
mmHg. The ECG shows a sinus bradycardia. The first-line treatment is:
a) Atropine 0.5 mg IV ✓
b) Transcutaneous pacing
c) Dopamine infusion
d) Observation only
16. For a patient with symptomatic bradycardia that is unresponsive to atropine, the next
intervention is:
a) Epinephrine infusion
b) Transcutaneous Pacing ✓
c) Amiodarone bolus
d) Cardioversion
17. A patient is confused with a heart rate of 160 bpm, regular, and a BP of 100/60. The
monitor shows a narrow-complex tachycardia. The patient has no pulse deficits. The
appropriate first intervention is:
a) Synchronized cardioversion
b) Adenosine 6 mg rapid IV push ✓
, c) Amiodarone 150 mg IV
d) Valsalva maneuver
18. If the first dose of Adenosine is ineffective for a stable narrow-complex tachycardia, the
second dose should be:
a) Adenosine 6 mg IV push
b) Adenosine 12 mg IV push ✓
c) Verapamil 5 mg IV
d) Immediate cardioversion
19. A patient is alert with a wide-complex tachycardia at 180 bpm and a BP of 118/70. You
are uncertain if it is VT or SVT with aberrancy. The appropriate drug choice per ACLS is:
a) Adenosine
b) Diltiazem
c) Amiodarone ✓
d) Digoxin
20. A patient with a wide-complex tachycardia is unconscious, hypotensive (70/40), and has
signs of shock. The immediate treatment is:
a) Amiodarone 150 mg IV over 10 minutes
b) Synchronized cardioversion ✓
c) Unsynchronized defibrillation
d) Lidocaine 1.5 mg/kg IV
Section 5: Cardiac Arrest Rhythms & The ACLS Algorithms
21. The most common initial rhythm in witnessed adult sudden cardiac arrest is:
a) Pulseless Electrical Activity (PEA)
b) Asystole
c) Ventricular Fibrillation (VF) ✓
d) Sinus Tachycardia
22. The primary treatment for Ventricular Fibrillation (VF) is:
a) Rapid epinephrine administration
b) High-quality CPR and defibrillation ✓
c) Atropine administration
d) Transcutaneous pacing
23. The recommended energy dose for the first biphasic defibrillation shock for VF is:
a) 50-100 J
b) Manufacturer's recommendation (e.g., 120-200 J) ✓
2026 – COMPLETE CONCEPT REVIEW &
PRACTICE MATERIALS (LATEST EDITION)
1. What is the recommended depth of chest compressions for an adult victim?
a) At least 1 inch (2.5 cm)
b) At least 2 inches (5 cm) ✓
c) At least 2.5 inches (6 cm)
d) 1.5 to 2 inches (4 to 5 cm)
2. What is the recommended rate for performing chest compressions?
a) 60 to 80 per minute
b) 80 to 100 per minute
c) 100 to 120 per minute ✓
d) 120 to 140 per minute
3. The compression-to-ventilation ratio for 2-rescuer adult CPR is:
a) 15:2
b) 30:2 ✓
c) 5:1
d) Continuous compressions with 10 breaths/minute
4. The primary purpose of allowing full chest recoil during CPR is to:
a) Reduce rescuer fatigue
b) Allow the heart to refill with blood ✓
c) Prevent rib fractures
d) Check for a pulse
5. For an unresponsive adult victim with abnormal breathing (agonal gasps), the first action
should be to:
a) Begin chest compressions ✓
b) Open the airway and give 2 breaths
c) Activate the emergency response system
d) Check for a carotid pulse for 10 seconds
Section 2: The ACLS Survey & Systems of Care
, 6. The "B" in the ACLS Primary Survey stands for:
a) Bag-valve-mask
b) Bicarbonate
c) Breathing ✓
d) Blood pressure
7. The sequence of the BLS/ACLS Survey is:
a) Airway, Breathing, Circulation, Differential Diagnosis
b) Check Rhythm, Shock, Compressions, Drugs
c) Circulation, Airway, Breathing, Defibrillation ✓
d) Recognition, CPR, Defibrillation, Advanced Care
8. The purpose of "closing the loop" in communication during a resuscitation is to:
a) Ensure all team members hear and acknowledge instructions ✓
b) Prepare the patient for transport
c) Document the final rhythm
d) Order post-cardiac arrest care
9. Which of the following is a critical component of post-cardiac arrest care?
a) Immediate withdrawal of care if GCS is low
b) Targeted Temperature Management (TTM) ✓
c) Rapid infusion of cold IV fluids only
d) Avoiding vasopressors to protect the heart
10. Integrated post-cardiac arrest care includes careful management of:
a) Oxygenation, Blood Pressure, and Temperature ✓
b) Urine output only
c) Pain management and sedation only
d) Early prognostication within 6 hours
Section 3: Airway Management
11. The preferred method for verifying correct placement of an advanced airway device is:
a) Listening over the epigastrium
b) Clinical assessment and continuous waveform capnography ✓
c) Pulse oximetry reading
d) Chest X-ray
12. After placement of an endotracheal tube during ongoing CPR, ventilations should be
provided at what rate?
a) One breath every 3-5 seconds (10-12 breaths/min) ✓
, b) One breath every 6 seconds (10 breaths/min)
c) One breath every 10 seconds (6 breaths/min)
d) Synchronized with compressions at a 30:2 ratio
13. A patient with a suspected head injury requires intubation. In addition to securing the
airway, the team should prioritize:
a) Avoiding all sedatives
b) Preventing hyperventilation unless signs of herniation ✓
c) Immediate hyperventilation to reduce ICP
d) Using the largest possible tube
14. Waveform capnography showing a sudden drop in end-tidal CO2 (ETCO2) during CPR
may indicate:
a) Return of spontaneous circulation (ROSC)
b) Displacement of the advanced airway ✓
c) Improved quality of compressions
d) Metabolic alkalosis
Section 4: Bradycardia & Tachycardia Algorithms
15. A patient is alert but dizzy with a heart rate of 42 bpm and a blood pressure of 88/50
mmHg. The ECG shows a sinus bradycardia. The first-line treatment is:
a) Atropine 0.5 mg IV ✓
b) Transcutaneous pacing
c) Dopamine infusion
d) Observation only
16. For a patient with symptomatic bradycardia that is unresponsive to atropine, the next
intervention is:
a) Epinephrine infusion
b) Transcutaneous Pacing ✓
c) Amiodarone bolus
d) Cardioversion
17. A patient is confused with a heart rate of 160 bpm, regular, and a BP of 100/60. The
monitor shows a narrow-complex tachycardia. The patient has no pulse deficits. The
appropriate first intervention is:
a) Synchronized cardioversion
b) Adenosine 6 mg rapid IV push ✓
, c) Amiodarone 150 mg IV
d) Valsalva maneuver
18. If the first dose of Adenosine is ineffective for a stable narrow-complex tachycardia, the
second dose should be:
a) Adenosine 6 mg IV push
b) Adenosine 12 mg IV push ✓
c) Verapamil 5 mg IV
d) Immediate cardioversion
19. A patient is alert with a wide-complex tachycardia at 180 bpm and a BP of 118/70. You
are uncertain if it is VT or SVT with aberrancy. The appropriate drug choice per ACLS is:
a) Adenosine
b) Diltiazem
c) Amiodarone ✓
d) Digoxin
20. A patient with a wide-complex tachycardia is unconscious, hypotensive (70/40), and has
signs of shock. The immediate treatment is:
a) Amiodarone 150 mg IV over 10 minutes
b) Synchronized cardioversion ✓
c) Unsynchronized defibrillation
d) Lidocaine 1.5 mg/kg IV
Section 5: Cardiac Arrest Rhythms & The ACLS Algorithms
21. The most common initial rhythm in witnessed adult sudden cardiac arrest is:
a) Pulseless Electrical Activity (PEA)
b) Asystole
c) Ventricular Fibrillation (VF) ✓
d) Sinus Tachycardia
22. The primary treatment for Ventricular Fibrillation (VF) is:
a) Rapid epinephrine administration
b) High-quality CPR and defibrillation ✓
c) Atropine administration
d) Transcutaneous pacing
23. The recommended energy dose for the first biphasic defibrillation shock for VF is:
a) 50-100 J
b) Manufacturer's recommendation (e.g., 120-200 J) ✓
