AMERICAN HEART ASSOCIATION CERTIFICATION
ACLS Final Exam
2026/2027
Official Practice Exam | 2026/2027 Edition
50 90 84% 2 Years
Questions Minutes Passing Score Recertification
TABLE OF CONTENTS
Section 1: BLS and High-Quality CPR (Q1 - Q10)
Section 2: Airway Management and ACLS Pharmacology (Q11 - Q20)
Section 3: Cardiac Arrest Algorithms (Q21 - Q32)
Section 4: Post-Cardiac Arrest Care and Acute Coronary Syndromes (Q33 - Q42)
Section 5: Bradycardia, Tachycardia, and Stroke (Q43 - Q50)
EXAM INSTRUCTIONS
This practice exam contains 50 multiple-choice questions covering the five core domains of
Advanced Cardiovascular Life Support. You have 90 minutes to complete the exam. A
minimum score of 84% (42 of 50 correct) is required to pass. Each question has four
answer choices; select the single best answer. Read each scenario carefully before
selecting your response. The correct answer and rationale are provided immediately after
each question for self-assessment purposes.
ACLS Final Exam -- 2026/2027 | Passing Score: 84% | Page 1 of 30
,Section 1: BLS and High-Quality CPR -- 2026/2027
Q1 Question 1 of 50
A 55-year-old man collapses in a shopping mall. A bystander confirms the patient is
unresponsive and is not breathing normally. The first rescuer begins chest compressions at
a rate of 100-120 per minute with a depth of at least 2 inches. After 2 minutes of CPR, the
second rescuer arrives with an AED. What should the team do immediately after the AED
pads are applied?
A. Continue chest compressions while the AED analyzes
B. Check for a pulse before using the AED
C. Deliver a shock immediately without analysis
D. Clear the patient and allow the AED to analyze
Correct Answer: D
Rationale:
Once AED pads are applied, the team should clear the patient and allow the AED to analyze the
rhythm. Interrupting compressions for analysis is necessary, but the AED must complete its analysis
before any shock decision. Checking for a pulse would delay rhythm analysis and is not recommended
before AED use.
ACLS Final Exam -- 2026/2027 | Passing Score: 84% | Page 2 of 30
, Q2 Question 2 of 50
A 68-year-old woman is found unresponsive in her home. Emergency responders note no
pulse and no breathing. High-quality CPR is initiated with a compression-to-ventilation ratio
of 30:2. The team leader wants to ensure proper chest compression fraction. What is the
minimum chest compression fraction recommended during CPR?
A. At least 50%
B. At least 60%
C. At least 70%
D. At least 80%
Correct Answer: B
Rationale:
The AHA recommends a chest compression fraction of at least 60%, meaning compressions should
be performed for at least 60% of the total CPR time. Higher fractions approaching 80% are associated
with better outcomes, but 60% is the minimum threshold. A fraction below 60% reduces coronary
perfusion and survival rates.
Q3 Question 3 of 50
During resuscitation of a 45-year-old man in ventricular fibrillation, the team has been
performing high-quality CPR and has delivered two shocks. The monitor continues to show
a shockable rhythm. The team leader asks about the recommended chest compression
rate. What is the target rate for chest compressions during adult CPR?
A. 80-100 compressions per minute
B. 60-80 compressions per minute
C. 100-120 compressions per minute
D. 120-140 compressions per minute
Correct Answer: C
Rationale:
The recommended chest compression rate for adult CPR is 100-120 compressions per minute. Rates
below 100 are too slow to maintain adequate circulation, while rates above 120 may reduce cardiac
output by shortening diastolic filling time. This rate range optimizes both coronary and cerebral
perfusion.
ACLS Final Exam -- 2026/2027 | Passing Score: 84% | Page 3 of 30
ACLS Final Exam
2026/2027
Official Practice Exam | 2026/2027 Edition
50 90 84% 2 Years
Questions Minutes Passing Score Recertification
TABLE OF CONTENTS
Section 1: BLS and High-Quality CPR (Q1 - Q10)
Section 2: Airway Management and ACLS Pharmacology (Q11 - Q20)
Section 3: Cardiac Arrest Algorithms (Q21 - Q32)
Section 4: Post-Cardiac Arrest Care and Acute Coronary Syndromes (Q33 - Q42)
Section 5: Bradycardia, Tachycardia, and Stroke (Q43 - Q50)
EXAM INSTRUCTIONS
This practice exam contains 50 multiple-choice questions covering the five core domains of
Advanced Cardiovascular Life Support. You have 90 minutes to complete the exam. A
minimum score of 84% (42 of 50 correct) is required to pass. Each question has four
answer choices; select the single best answer. Read each scenario carefully before
selecting your response. The correct answer and rationale are provided immediately after
each question for self-assessment purposes.
ACLS Final Exam -- 2026/2027 | Passing Score: 84% | Page 1 of 30
,Section 1: BLS and High-Quality CPR -- 2026/2027
Q1 Question 1 of 50
A 55-year-old man collapses in a shopping mall. A bystander confirms the patient is
unresponsive and is not breathing normally. The first rescuer begins chest compressions at
a rate of 100-120 per minute with a depth of at least 2 inches. After 2 minutes of CPR, the
second rescuer arrives with an AED. What should the team do immediately after the AED
pads are applied?
A. Continue chest compressions while the AED analyzes
B. Check for a pulse before using the AED
C. Deliver a shock immediately without analysis
D. Clear the patient and allow the AED to analyze
Correct Answer: D
Rationale:
Once AED pads are applied, the team should clear the patient and allow the AED to analyze the
rhythm. Interrupting compressions for analysis is necessary, but the AED must complete its analysis
before any shock decision. Checking for a pulse would delay rhythm analysis and is not recommended
before AED use.
ACLS Final Exam -- 2026/2027 | Passing Score: 84% | Page 2 of 30
, Q2 Question 2 of 50
A 68-year-old woman is found unresponsive in her home. Emergency responders note no
pulse and no breathing. High-quality CPR is initiated with a compression-to-ventilation ratio
of 30:2. The team leader wants to ensure proper chest compression fraction. What is the
minimum chest compression fraction recommended during CPR?
A. At least 50%
B. At least 60%
C. At least 70%
D. At least 80%
Correct Answer: B
Rationale:
The AHA recommends a chest compression fraction of at least 60%, meaning compressions should
be performed for at least 60% of the total CPR time. Higher fractions approaching 80% are associated
with better outcomes, but 60% is the minimum threshold. A fraction below 60% reduces coronary
perfusion and survival rates.
Q3 Question 3 of 50
During resuscitation of a 45-year-old man in ventricular fibrillation, the team has been
performing high-quality CPR and has delivered two shocks. The monitor continues to show
a shockable rhythm. The team leader asks about the recommended chest compression
rate. What is the target rate for chest compressions during adult CPR?
A. 80-100 compressions per minute
B. 60-80 compressions per minute
C. 100-120 compressions per minute
D. 120-140 compressions per minute
Correct Answer: C
Rationale:
The recommended chest compression rate for adult CPR is 100-120 compressions per minute. Rates
below 100 are too slow to maintain adequate circulation, while rates above 120 may reduce cardiac
output by shortening diastolic filling time. This rate range optimizes both coronary and cerebral
perfusion.
ACLS Final Exam -- 2026/2027 | Passing Score: 84% | Page 3 of 30
