1
2025\2026 ACLS Exams A & B questions and
answers with Answer Keys
EXAM
Prepare for your ACLS certification with the 2025/2026 ACLS Exams A and B.
Includes student answer sheets, answer keys, and annotated explanations. Ideal
f or healthcare professionals. ACLS exam, ACLS practice test, Advanced Cardiac
Life Support, ACLS certification, healthcare exam, nursing student, paramedic
exam, medical study guide, ACLS 2025\2026, emergency medicine, AHA ACLS,
exam prep, medical certification, resuscitation training, ECG rhythms
,2
1. You arrive at a patient in cardiac arrest. The monitor shows pulseless
ventricular tachycardia. What is the next step?
• A) Start CPR, administer epinephrine
• B) Defibrillate immediately and resume CPR
• C) Give amiodarone only
• D) Observe and monitor
• Rationale: Pulseless VT is a shockable rhythm. Immediate defibrillation is
critical.
2. A patient has ROSC (Return of Spontaneous Circulation). What is the first
step in post-cardiac arrest care?
• A) Administer amiodarone
• B) Optimize ventilation and oxygenation
• C) Start immediate defibrillation
• D) Give aspirin
• Rationale: Post-arrest care focuses on maintaining oxygenation, perfusion,
and identifying the cause of arrest.
3. A 62-year-old male in ventricular fibrillation (VF) remains unresponsive after
the first defibrillation and 2 minutes of CPR. What is the next appropriate
medication?
• A) Epinephrine 1 mg IV/IO
• B) Amiodarone 300 mg IV/IO
• C) Lidocaine 1 mg/kg IV/IO
• D) Magnesium sulfate 2 g IV
• Rationale: After the first shock, continue CPR for 2 minutes and give
epinephrine every 3-5 minutes. Amiodarone is added after the third shock if
VF/pulseless VT persists.
4. Which medication is recommended for a patient in asystole?
,3
• A) Aspirin
• B) Epinephrine
• C) Amiodarone
• D) Adenosine
• Rationale: Asystole is non-shockable. Epinephrine every 3-5 minutes is
recommended during CPR.
5. What is the recommended compression rate for performing CPR?
• A) 60-80 per minute
• B) 80-100 per minute
• C) 100-120 per minute
• D) 140-160 per minute
• Rationale: Current guidelines recommend 100-120 compressions per
minute.
6. 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?
A. Establish vascular access.
B. Obtain the patient’s history.
C. Resume chest compressions.
D. Terminate the resuscitative effort.
Answer: C. Resume chest compressions.
Rationale: The presence of an organized rhythm on the monitor does not guarantee
that it is a perfusing rhythm. Since the patient is pulseless, this represents
Pulseless Electrical Activity (PEA). The immediate priority is to resume high-quality
chest compressions to perfuse the heart and brain. Pausing to establish access or
obtain history would delay critical perfusion .
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7. What is a common but sometimes fatal mistake in cardiac arrest
management?
A. Failure to obtain vascular access
B. Prolonged periods of no ventilations
C. Failure to perform endotracheal intubation
D. Prolonged interruptions in chest compressions
Answer: D. Prolonged interruptions in chest compressions.
Rationale: Coronary and cerebral perfusion pressure drops to zero the moment
chest compressions stop. Prolonged interruptions (e.g., for pulse checks,
intubation, or vascular access) are strongly associated with decreased rates of
Return of Spontaneous Circulation (ROSC) and survival .
8. Which action is a component of high-quality chest compressions?
A. Allowing complete chest recoil
B. Chest compressions without ventilation
C. 60 to 100 compressions per minute with a 15:2 ratio
D. Uninterrupted compressions at a depth of 1½ inches
Answer: A. Allowing complete chest recoil.
Rationale: Complete chest recoil allows the heart to fully refill with blood (venous
return) before the next compression. The other options are incorrect: the
compression rate should be 100-120/min, depth should be at least 2 inches (not
1.5), and compressions are not performed without ventilation in a standard cardiac
arrest (unless using a supraglottic airway) .
2025\2026 ACLS Exams A & B questions and
answers with Answer Keys
EXAM
Prepare for your ACLS certification with the 2025/2026 ACLS Exams A and B.
Includes student answer sheets, answer keys, and annotated explanations. Ideal
f or healthcare professionals. ACLS exam, ACLS practice test, Advanced Cardiac
Life Support, ACLS certification, healthcare exam, nursing student, paramedic
exam, medical study guide, ACLS 2025\2026, emergency medicine, AHA ACLS,
exam prep, medical certification, resuscitation training, ECG rhythms
,2
1. You arrive at a patient in cardiac arrest. The monitor shows pulseless
ventricular tachycardia. What is the next step?
• A) Start CPR, administer epinephrine
• B) Defibrillate immediately and resume CPR
• C) Give amiodarone only
• D) Observe and monitor
• Rationale: Pulseless VT is a shockable rhythm. Immediate defibrillation is
critical.
2. A patient has ROSC (Return of Spontaneous Circulation). What is the first
step in post-cardiac arrest care?
• A) Administer amiodarone
• B) Optimize ventilation and oxygenation
• C) Start immediate defibrillation
• D) Give aspirin
• Rationale: Post-arrest care focuses on maintaining oxygenation, perfusion,
and identifying the cause of arrest.
3. A 62-year-old male in ventricular fibrillation (VF) remains unresponsive after
the first defibrillation and 2 minutes of CPR. What is the next appropriate
medication?
• A) Epinephrine 1 mg IV/IO
• B) Amiodarone 300 mg IV/IO
• C) Lidocaine 1 mg/kg IV/IO
• D) Magnesium sulfate 2 g IV
• Rationale: After the first shock, continue CPR for 2 minutes and give
epinephrine every 3-5 minutes. Amiodarone is added after the third shock if
VF/pulseless VT persists.
4. Which medication is recommended for a patient in asystole?
,3
• A) Aspirin
• B) Epinephrine
• C) Amiodarone
• D) Adenosine
• Rationale: Asystole is non-shockable. Epinephrine every 3-5 minutes is
recommended during CPR.
5. What is the recommended compression rate for performing CPR?
• A) 60-80 per minute
• B) 80-100 per minute
• C) 100-120 per minute
• D) 140-160 per minute
• Rationale: Current guidelines recommend 100-120 compressions per
minute.
6. 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?
A. Establish vascular access.
B. Obtain the patient’s history.
C. Resume chest compressions.
D. Terminate the resuscitative effort.
Answer: C. Resume chest compressions.
Rationale: The presence of an organized rhythm on the monitor does not guarantee
that it is a perfusing rhythm. Since the patient is pulseless, this represents
Pulseless Electrical Activity (PEA). The immediate priority is to resume high-quality
chest compressions to perfuse the heart and brain. Pausing to establish access or
obtain history would delay critical perfusion .
, 4
7. What is a common but sometimes fatal mistake in cardiac arrest
management?
A. Failure to obtain vascular access
B. Prolonged periods of no ventilations
C. Failure to perform endotracheal intubation
D. Prolonged interruptions in chest compressions
Answer: D. Prolonged interruptions in chest compressions.
Rationale: Coronary and cerebral perfusion pressure drops to zero the moment
chest compressions stop. Prolonged interruptions (e.g., for pulse checks,
intubation, or vascular access) are strongly associated with decreased rates of
Return of Spontaneous Circulation (ROSC) and survival .
8. Which action is a component of high-quality chest compressions?
A. Allowing complete chest recoil
B. Chest compressions without ventilation
C. 60 to 100 compressions per minute with a 15:2 ratio
D. Uninterrupted compressions at a depth of 1½ inches
Answer: A. Allowing complete chest recoil.
Rationale: Complete chest recoil allows the heart to fully refill with blood (venous
return) before the next compression. The other options are incorrect: the
compression rate should be 100-120/min, depth should be at least 2 inches (not
1.5), and compressions are not performed without ventilation in a standard cardiac
arrest (unless using a supraglottic airway) .
