AMERICAN RED CROSS BLS FINAL EXAM VERSION 3
1. A second provider is handling equipment while the team leader protects continuity of care. During a
time-critical resuscitation, during CPR an adult begins moving and taking spontaneous breaths. Which
instruction should the team leader give? Consider how the choice affects both immediate patient care and
overall CPR quality.
A. Deliver one more shock before checking the patient.
B. Continue compressions for a full 2-minute cycle regardless of movement.
C. Remove the AED pads and leave the patient unattended.
D. Stop CPR and AED use, then check breathing and a central pulse while minimizing the pause.
Correct Answer: D. Stop CPR and AED use, then check breathing and a central pulse while minimizing the
pause.
Rationale: Movement or spontaneous breathing may indicate ROSC. Stop CPR and AED use, assess breathing
and a carotid or femoral pulse, then provide appropriate monitoring and care.
2. The team must act without creating an unnecessary pause in compressions or ventilation. A second
rescuer arrives just as the situation changes: A 6-year-old child in cardiac arrest needs an AED.
Pediatric-specific pads are available. Which approach is preferred?
A. Place both pads side by side on the abdomen.
B. Use the pediatric pads and follow the AED-specific placement instructions.
C. Do not use an AED until the child is at least 8 years old.
D. Use adult pads because pediatric pads deliver too little energy.
Correct Answer: B. Use the pediatric pads and follow the AED-specific placement instructions.
Rationale: Current Red Cross guidance recommends pediatric AED pads and device-specific instructions for
infants and children when available.
3. Roles have already been assigned, so the remaining decision is the patient-care priority. The patient
response forces the team to revise its plan. An adult is unresponsive and not breathing effectively, but a
definite pulse is present. What ventilation rate is appropriate? Assessment Finding Pulse Present Breathing
Absent / ineffective
A. Give 2 ventilations after every 15 compressions.
B. Give 1 ventilation every 2 to 3 seconds.
C. Give 1 ventilation every 6 seconds.
D. Give 1 ventilation every 12 seconds.
Correct Answer: C. Give 1 ventilation every 6 seconds.
Rationale: For adult respiratory arrest with a pulse, provide 1 ventilation every 6 seconds and continue
reassessment.
4. The response team is working under time pressure and wants the next action to match current guidance.
Resources are limited and the team must choose the most appropriate BLS action. A 6-month-old infant is
in cardiac arrest. What compression depth is appropriate?
A. At least one-third the chest depth, about 1.5 inches (4 cm).
B. About 2.5 inches (6.4 cm).
C. Only until the sternum begins to move.
D. About 0.5 inch (1.3 cm).
Correct Answer: A. At least one-third the chest depth, about 1.5 inches (4 cm).
Rationale: For infants, compress at least one-third the anteroposterior chest depth, approximately 1.5 inches (4
cm).
5. Another rescuer is available to assist, but the clinical decision still has to be made correctly. The team
leader must make a rapid decision. The compressor says the compressions are becoming tiring and
shallower after several cycles. What team action best protects CPR quality? Consider how the choice
affects both immediate patient care and overall CPR quality.
A. Continue with the same compressor until an AED shock is delivered.
B. Rotate compressors after every 30 compressions.
C. Stop CPR for 30 seconds while the next compressor gets into position.
D. Rotate compressors about every 2 minutes with minimal interruption.
Correct Answer: D. Rotate compressors about every 2 minutes with minimal interruption.
,Rationale: Compressor fatigue reduces depth and quality. Teams should plan to switch compressors about every
2 minutes while minimizing the pause.
6. The leader is coordinating simultaneous tasks and needs one clear instruction for the bedside provider. A
second rescuer arrives just as the situation changes: A CPR coach is watching the compression rate during
child CPR. Which rate should be maintained? Pediatric CPR metric Observed value Compression rate
118/min
A. 130 to 150 compressions per minute.
B. 80 to 90 compressions per minute.
C. 100 to 120 compressions per minute.
D. 60 to 80 compressions per minute.
Correct Answer: C. 100 to 120 compressions per minute.
Rationale: The target compression rate is 100 to 120 per minute for children and infants.
7. The patient condition is being reassessed in real time as the team prepares the next intervention. The
patient response forces the team to revise its plan. A provider is delivering manual ventilations during
adult BLS. How should each ventilation generally be delivered?
A. Only after a 20-second pause in compressions.
B. Over 5 seconds to maximize oxygen transfer.
C. Over about 1 second, just enough to produce visible chest rise.
D. As rapidly as possible in less than 0.25 second.
Correct Answer: C. Over about 1 second, just enough to produce visible chest rise.
Rationale: BLS ventilations are delivered over about 1 second and should make the chest begin to rise without
excessive volume.
8. Effective oxygenation and ventilation have already been established, so the team is now deciding whether
circulation remains adequate. Equipment is ready and the team is waiting for a concise direction that
preserves high-quality BLS. Several actions are being considered at once. An infant has a pulse of 52/min
with cyanosis, weak pulses and poor perfusion despite adequate oxygenation and ventilation. Which option
should take priority? Select the option that remains correct after considering both the immediate
physiologic problem and the need to minimize interruption of lifesaving care. Finding Value Pulse 48/min
Perfusion Pale; weak, thready pulse
A. Apply an AED and shock immediately without CPR.
B. Continue ventilation only until the pulse reaches zero.
C. Start CPR.
D. Place the infant in a recovery position.
Correct Answer: C. Start CPR.
Rationale: For a child or infant, a pulse at or below 60/min with signs of poor perfusion despite adequate
oxygenation and ventilation is an indication to begin CPR.
9. A second provider is handling equipment while the team leader protects continuity of care. A second
rescuer arrives just as the situation changes: A rescued adult is unresponsive, not breathing and pulseless
after a drowning process. How should CPR begin?
A. Begin with 30 compressions before any ventilations.
B. Give abdominal thrusts to expel water.
C. Delay CPR until the lungs can be suctioned.
D. Open the airway and give 2 ventilations before beginning the 30:2 CPR sequence.
Correct Answer: D. Open the airway and give 2 ventilations before beginning the 30:2 CPR sequence.
Rationale: For cardiac arrest following drowning, Red Cross guidance starts resuscitation with 2 ventilations
because hypoxia is central to the arrest.
10. The team must act without creating an unnecessary pause in compressions or ventilation. The patient
response forces the team to revise its plan. A provider is preparing to compress the chest of an infant in
cardiac arrest. Which technique is recommended by current Red Cross guidance?
A. Compress over the left side of the chest with one fingertip.
B. Use two fists on the lower sternum.
C. Use the two-thumb/encircling hands technique.
D. Use both palms stacked as for an adult.
Correct Answer: C. Use the two-thumb/encircling hands technique.
, Rationale: Current Red Cross guidance recommends the two-thumb/encircling hands technique for infant chest
compressions.
11. Roles have already been assigned, so the remaining decision is the patient-care priority. Resources are
limited and the team must choose the most appropriate BLS action. A pulse check and equipment
adjustment create a 16-second pause in adult chest compressions. How should the team improve this
performance? Consider how the choice affects both immediate patient care and overall CPR quality. CPR
quality metric Observed value Longest pause 18 sec
A. Perform pulse checks after every 30 compressions.
B. Plan tasks so compression interruptions are kept under 10 seconds whenever possible.
C. Extend each pause to 20 seconds so all tasks can be completed at once.
D. Stop compressions whenever another provider needs to communicate.
Correct Answer: B. Plan tasks so compression interruptions are kept under 10 seconds whenever possible.
Rationale: Interruptions reduce coronary and cerebral perfusion. Necessary pauses should be minimized and
generally kept under 10 seconds.
12. The response team is working under time pressure and wants the next action to match current
guidance. A second rescuer arrives just as the situation changes: A suspected opioid-overdose patient is
pulseless and not breathing. Naloxone is immediately available. What is the priority? Select the option that
remains correct after considering both the immediate physiologic problem and the need to minimize
interruption of lifesaving care.
A. Delay all care until a toxicology screen is available.
B. Provide rescue breaths only because opioids never cause cardiac arrest.
C. Start high-quality CPR immediately and give naloxone without delaying CPR.
D. Give naloxone and wait several minutes before starting CPR.
Correct Answer: C. Start high-quality CPR immediately and give naloxone without delaying CPR.
Rationale: Once cardiac arrest is present, high-quality CPR and AED use are priorities. Naloxone may be given,
but it must not delay resuscitation.
13. Another rescuer is available to assist, but the clinical decision still has to be made correctly. The team is
trying to minimize delays while following current BLS guidance. A single healthcare provider is
performing CPR on a 5-year-old child without an advanced airway. Which compression-to-ventilation
ratio should be used?
A. Continuous compressions with no ventilations.
B. 5:1.
C. 15:2.
D. 30:2.
Correct Answer: D. 30:2.
Rationale: For a child or infant, one healthcare professional uses a 30:2 compression-to-ventilation ratio.
14. The leader is coordinating simultaneous tasks and needs one clear instruction for the bedside provider.
The team is trying to minimize delays while following current BLS guidance. An AED advises a shock and
the shock is delivered to an adult in cardiac arrest. What should the team do immediately afterward?
A. Check the pulse for 30 seconds before doing anything else.
B. Resume CPR immediately, beginning with chest compressions.
C. Wait for the AED to announce a second shock.
D. Give five rescue breaths before resuming compressions.
Correct Answer: B. Resume CPR immediately, beginning with chest compressions.
Rationale: After a shock, immediately resume CPR for about 2 minutes or until the AED is ready to analyze
again.
15. The patient condition is being reassessed in real time as the team prepares the next intervention. The
team is trying to minimize delays while following current BLS guidance. A child with respiratory failure is
being reassessed. Which finding is most consistent with poor perfusion? Consider how the choice affects
both immediate patient care and overall CPR quality.
A. Warm dry skin with brisk capillary refill and strong pulses.
B. Cool, mottled skin with weak pulses and delayed capillary refill.
C. Pink skin with immediate capillary refill.
D. Normal interaction and a strong regular pulse.
1. A second provider is handling equipment while the team leader protects continuity of care. During a
time-critical resuscitation, during CPR an adult begins moving and taking spontaneous breaths. Which
instruction should the team leader give? Consider how the choice affects both immediate patient care and
overall CPR quality.
A. Deliver one more shock before checking the patient.
B. Continue compressions for a full 2-minute cycle regardless of movement.
C. Remove the AED pads and leave the patient unattended.
D. Stop CPR and AED use, then check breathing and a central pulse while minimizing the pause.
Correct Answer: D. Stop CPR and AED use, then check breathing and a central pulse while minimizing the
pause.
Rationale: Movement or spontaneous breathing may indicate ROSC. Stop CPR and AED use, assess breathing
and a carotid or femoral pulse, then provide appropriate monitoring and care.
2. The team must act without creating an unnecessary pause in compressions or ventilation. A second
rescuer arrives just as the situation changes: A 6-year-old child in cardiac arrest needs an AED.
Pediatric-specific pads are available. Which approach is preferred?
A. Place both pads side by side on the abdomen.
B. Use the pediatric pads and follow the AED-specific placement instructions.
C. Do not use an AED until the child is at least 8 years old.
D. Use adult pads because pediatric pads deliver too little energy.
Correct Answer: B. Use the pediatric pads and follow the AED-specific placement instructions.
Rationale: Current Red Cross guidance recommends pediatric AED pads and device-specific instructions for
infants and children when available.
3. Roles have already been assigned, so the remaining decision is the patient-care priority. The patient
response forces the team to revise its plan. An adult is unresponsive and not breathing effectively, but a
definite pulse is present. What ventilation rate is appropriate? Assessment Finding Pulse Present Breathing
Absent / ineffective
A. Give 2 ventilations after every 15 compressions.
B. Give 1 ventilation every 2 to 3 seconds.
C. Give 1 ventilation every 6 seconds.
D. Give 1 ventilation every 12 seconds.
Correct Answer: C. Give 1 ventilation every 6 seconds.
Rationale: For adult respiratory arrest with a pulse, provide 1 ventilation every 6 seconds and continue
reassessment.
4. The response team is working under time pressure and wants the next action to match current guidance.
Resources are limited and the team must choose the most appropriate BLS action. A 6-month-old infant is
in cardiac arrest. What compression depth is appropriate?
A. At least one-third the chest depth, about 1.5 inches (4 cm).
B. About 2.5 inches (6.4 cm).
C. Only until the sternum begins to move.
D. About 0.5 inch (1.3 cm).
Correct Answer: A. At least one-third the chest depth, about 1.5 inches (4 cm).
Rationale: For infants, compress at least one-third the anteroposterior chest depth, approximately 1.5 inches (4
cm).
5. Another rescuer is available to assist, but the clinical decision still has to be made correctly. The team
leader must make a rapid decision. The compressor says the compressions are becoming tiring and
shallower after several cycles. What team action best protects CPR quality? Consider how the choice
affects both immediate patient care and overall CPR quality.
A. Continue with the same compressor until an AED shock is delivered.
B. Rotate compressors after every 30 compressions.
C. Stop CPR for 30 seconds while the next compressor gets into position.
D. Rotate compressors about every 2 minutes with minimal interruption.
Correct Answer: D. Rotate compressors about every 2 minutes with minimal interruption.
,Rationale: Compressor fatigue reduces depth and quality. Teams should plan to switch compressors about every
2 minutes while minimizing the pause.
6. The leader is coordinating simultaneous tasks and needs one clear instruction for the bedside provider. A
second rescuer arrives just as the situation changes: A CPR coach is watching the compression rate during
child CPR. Which rate should be maintained? Pediatric CPR metric Observed value Compression rate
118/min
A. 130 to 150 compressions per minute.
B. 80 to 90 compressions per minute.
C. 100 to 120 compressions per minute.
D. 60 to 80 compressions per minute.
Correct Answer: C. 100 to 120 compressions per minute.
Rationale: The target compression rate is 100 to 120 per minute for children and infants.
7. The patient condition is being reassessed in real time as the team prepares the next intervention. The
patient response forces the team to revise its plan. A provider is delivering manual ventilations during
adult BLS. How should each ventilation generally be delivered?
A. Only after a 20-second pause in compressions.
B. Over 5 seconds to maximize oxygen transfer.
C. Over about 1 second, just enough to produce visible chest rise.
D. As rapidly as possible in less than 0.25 second.
Correct Answer: C. Over about 1 second, just enough to produce visible chest rise.
Rationale: BLS ventilations are delivered over about 1 second and should make the chest begin to rise without
excessive volume.
8. Effective oxygenation and ventilation have already been established, so the team is now deciding whether
circulation remains adequate. Equipment is ready and the team is waiting for a concise direction that
preserves high-quality BLS. Several actions are being considered at once. An infant has a pulse of 52/min
with cyanosis, weak pulses and poor perfusion despite adequate oxygenation and ventilation. Which option
should take priority? Select the option that remains correct after considering both the immediate
physiologic problem and the need to minimize interruption of lifesaving care. Finding Value Pulse 48/min
Perfusion Pale; weak, thready pulse
A. Apply an AED and shock immediately without CPR.
B. Continue ventilation only until the pulse reaches zero.
C. Start CPR.
D. Place the infant in a recovery position.
Correct Answer: C. Start CPR.
Rationale: For a child or infant, a pulse at or below 60/min with signs of poor perfusion despite adequate
oxygenation and ventilation is an indication to begin CPR.
9. A second provider is handling equipment while the team leader protects continuity of care. A second
rescuer arrives just as the situation changes: A rescued adult is unresponsive, not breathing and pulseless
after a drowning process. How should CPR begin?
A. Begin with 30 compressions before any ventilations.
B. Give abdominal thrusts to expel water.
C. Delay CPR until the lungs can be suctioned.
D. Open the airway and give 2 ventilations before beginning the 30:2 CPR sequence.
Correct Answer: D. Open the airway and give 2 ventilations before beginning the 30:2 CPR sequence.
Rationale: For cardiac arrest following drowning, Red Cross guidance starts resuscitation with 2 ventilations
because hypoxia is central to the arrest.
10. The team must act without creating an unnecessary pause in compressions or ventilation. The patient
response forces the team to revise its plan. A provider is preparing to compress the chest of an infant in
cardiac arrest. Which technique is recommended by current Red Cross guidance?
A. Compress over the left side of the chest with one fingertip.
B. Use two fists on the lower sternum.
C. Use the two-thumb/encircling hands technique.
D. Use both palms stacked as for an adult.
Correct Answer: C. Use the two-thumb/encircling hands technique.
, Rationale: Current Red Cross guidance recommends the two-thumb/encircling hands technique for infant chest
compressions.
11. Roles have already been assigned, so the remaining decision is the patient-care priority. Resources are
limited and the team must choose the most appropriate BLS action. A pulse check and equipment
adjustment create a 16-second pause in adult chest compressions. How should the team improve this
performance? Consider how the choice affects both immediate patient care and overall CPR quality. CPR
quality metric Observed value Longest pause 18 sec
A. Perform pulse checks after every 30 compressions.
B. Plan tasks so compression interruptions are kept under 10 seconds whenever possible.
C. Extend each pause to 20 seconds so all tasks can be completed at once.
D. Stop compressions whenever another provider needs to communicate.
Correct Answer: B. Plan tasks so compression interruptions are kept under 10 seconds whenever possible.
Rationale: Interruptions reduce coronary and cerebral perfusion. Necessary pauses should be minimized and
generally kept under 10 seconds.
12. The response team is working under time pressure and wants the next action to match current
guidance. A second rescuer arrives just as the situation changes: A suspected opioid-overdose patient is
pulseless and not breathing. Naloxone is immediately available. What is the priority? Select the option that
remains correct after considering both the immediate physiologic problem and the need to minimize
interruption of lifesaving care.
A. Delay all care until a toxicology screen is available.
B. Provide rescue breaths only because opioids never cause cardiac arrest.
C. Start high-quality CPR immediately and give naloxone without delaying CPR.
D. Give naloxone and wait several minutes before starting CPR.
Correct Answer: C. Start high-quality CPR immediately and give naloxone without delaying CPR.
Rationale: Once cardiac arrest is present, high-quality CPR and AED use are priorities. Naloxone may be given,
but it must not delay resuscitation.
13. Another rescuer is available to assist, but the clinical decision still has to be made correctly. The team is
trying to minimize delays while following current BLS guidance. A single healthcare provider is
performing CPR on a 5-year-old child without an advanced airway. Which compression-to-ventilation
ratio should be used?
A. Continuous compressions with no ventilations.
B. 5:1.
C. 15:2.
D. 30:2.
Correct Answer: D. 30:2.
Rationale: For a child or infant, one healthcare professional uses a 30:2 compression-to-ventilation ratio.
14. The leader is coordinating simultaneous tasks and needs one clear instruction for the bedside provider.
The team is trying to minimize delays while following current BLS guidance. An AED advises a shock and
the shock is delivered to an adult in cardiac arrest. What should the team do immediately afterward?
A. Check the pulse for 30 seconds before doing anything else.
B. Resume CPR immediately, beginning with chest compressions.
C. Wait for the AED to announce a second shock.
D. Give five rescue breaths before resuming compressions.
Correct Answer: B. Resume CPR immediately, beginning with chest compressions.
Rationale: After a shock, immediately resume CPR for about 2 minutes or until the AED is ready to analyze
again.
15. The patient condition is being reassessed in real time as the team prepares the next intervention. The
team is trying to minimize delays while following current BLS guidance. A child with respiratory failure is
being reassessed. Which finding is most consistent with poor perfusion? Consider how the choice affects
both immediate patient care and overall CPR quality.
A. Warm dry skin with brisk capillary refill and strong pulses.
B. Cool, mottled skin with weak pulses and delayed capillary refill.
C. Pink skin with immediate capillary refill.
D. Normal interaction and a strong regular pulse.
