Page 1 of 50
ACLS 2026 FINAL STUDY GUIDE COMPLETE
(150) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED
EXPLANATIONS|GUARANTEED PASS.
ACLS
Prepare confidently with the ACLS Final Study Guide featuring practice
questions covering advanced cardiovascular life support, cardiac
rhythms, airway management, emergency medications, resuscitation
procedures, and patient assessment. This study resource helps
reinforce critical life-saving concepts and supports effective
certification exam preparation. Designed to improve clinical decision-
making and boost confidence in emergency response situations.
Suitable for nursing, paramedic, and healthcare professionals.
MULTIPLE CHOICE.
SECTION 1: CORE CONCEPTS s HIGH-QUALITY CPR (Questions 1–20)
Q1.
What is the recommended compression depth for an adult during high-quality CPR?
A. 1.5 inches (4 cm)
B. 2–2.4 inches (5–6 cm)
C. 2.5–3 inches (6.5–7.5 cm)
D. At least 3 inches (8 cm)
Verified Answer: B
Rationale: 2020 AHA guidelines recommend a compression depth of at least 2 inches (5
cm) but no more than 2.4 inches (6 cm). Excessive depth increases injury risk without
improving outcomes.
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Q2.
What is the target chest compression fraction (CCF) during ACLS resuscitation?
A. ≥ 50%
B. ≥ 60%
C. ≥ 80%
D. 100%
Verified Answer: B
Rationale: AHA recommends a CCF of at least 60%, aiming for as high as possible (ideally
>80%). Higher CCF correlates with improved survival from cardiac arrest.
Q3.
After delivering a shock with a biphasic defibrillator, what should the team do immediately?
A. Check for a pulse
B. Resume CPR starting with chest compressions
C. Analyze rhythm
D. Give epinephrine
Verified Answer: B
Rationale: Immediately after defibrillation, resume CPR beginning with chest
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compressions for 2 minutes before reanalyzing rhythm. Pause only for rhythm check or
pulse check if ROSC is suspected.
Q4.
A patient is in cardiac arrest. The monitor shows fine ventricular fibrillation. What is the first
action?
A. Defibrillate at 200 J biphasic
B. Administer epinephrine 1 mg IV
C. Start high-quality CPR
D. Perform endotracheal intubation
Verified Answer: C
Rationale: High-quality CPR is always the first action in any cardiac arrest. Defibrillation is
prioritized for VF/pVT, but CPR must begin immediately while preparing defibrillator.
Q5.
What is the recommended compression-to-ventilation ratio for a single rescuer performing
adult CPR with an advanced airway in place?
A. 30:2
B. 15:2
C. Continuous compressions at 100–120/min with asynchronous ventilations every 6
seconds
D. 30:2 with breaths given during compression release
Verified Answer: C
Rationale: With an advanced airway (ETT or supraglottic device), providers deliver
continuous compressions at 100–120/min and give 1 breath every 6 seconds (10
breaths/min) without pausing compressions.
Q6.
Which medication and dose is recommended for refractory VF/pVT after the second shock?
A. Epinephrine 1 mg IV push, then amiodarone 300 mg
B. Lidocaine 1.5 mg/kg IV push
C. Amiodarone 150 mg IV push
D. Magnesium 2 g IV push
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Verified Answer: A
Rationale: After the second shock, administer epinephrine 1 mg IV/IO. Amiodarone 300 mg
is given after the third shock or if VF/pVT recurs. Epinephrine is the first-line vasopressor.
Q7.
What is the maximum interval for rhythm checks during cardiac arrest?
A. Every 30 seconds
B. Every 1 minute
C. Every 2 minutes
D. Every 5 minutes
Verified Answer: C
Rationale: Rhythm checks should occur every 2 minutes (after five cycles of 30:2 or after 2
minutes of continuous compressions with an advanced airway). Prolonged pauses reduce
CCF and survival.
Q8.
During CPR, a patient’s ETCO₂ reading suddenly increases from 15 mmHg to 45 mmHg.
What does this indicate?
A. Deterioration of cardiac output
B. ROSC (Return of Spontaneous Circulation)
C. Displacement of the endotracheal tube
D. Malignant hyperthermia
Verified Answer: B
Rationale: A sudden sustained rise in ETCO₂ to >40 mmHg often indicates ROSC due to
restored pulmonary blood flow. Use ETCO₂ to confirm ROSC along with pulse check.
QG.
What is the correct initial energy dose for biphasic defibrillation in adult VF/pVT?
A. 120–200 J (per manufacturer recommendation)
B. 360 J (fixed)
C. 200–300 J
D. 50–100 J
ACLS 2026 FINAL STUDY GUIDE COMPLETE
(150) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED
EXPLANATIONS|GUARANTEED PASS.
ACLS
Prepare confidently with the ACLS Final Study Guide featuring practice
questions covering advanced cardiovascular life support, cardiac
rhythms, airway management, emergency medications, resuscitation
procedures, and patient assessment. This study resource helps
reinforce critical life-saving concepts and supports effective
certification exam preparation. Designed to improve clinical decision-
making and boost confidence in emergency response situations.
Suitable for nursing, paramedic, and healthcare professionals.
MULTIPLE CHOICE.
SECTION 1: CORE CONCEPTS s HIGH-QUALITY CPR (Questions 1–20)
Q1.
What is the recommended compression depth for an adult during high-quality CPR?
A. 1.5 inches (4 cm)
B. 2–2.4 inches (5–6 cm)
C. 2.5–3 inches (6.5–7.5 cm)
D. At least 3 inches (8 cm)
Verified Answer: B
Rationale: 2020 AHA guidelines recommend a compression depth of at least 2 inches (5
cm) but no more than 2.4 inches (6 cm). Excessive depth increases injury risk without
improving outcomes.
, Page 2 of 50
Q2.
What is the target chest compression fraction (CCF) during ACLS resuscitation?
A. ≥ 50%
B. ≥ 60%
C. ≥ 80%
D. 100%
Verified Answer: B
Rationale: AHA recommends a CCF of at least 60%, aiming for as high as possible (ideally
>80%). Higher CCF correlates with improved survival from cardiac arrest.
Q3.
After delivering a shock with a biphasic defibrillator, what should the team do immediately?
A. Check for a pulse
B. Resume CPR starting with chest compressions
C. Analyze rhythm
D. Give epinephrine
Verified Answer: B
Rationale: Immediately after defibrillation, resume CPR beginning with chest
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compressions for 2 minutes before reanalyzing rhythm. Pause only for rhythm check or
pulse check if ROSC is suspected.
Q4.
A patient is in cardiac arrest. The monitor shows fine ventricular fibrillation. What is the first
action?
A. Defibrillate at 200 J biphasic
B. Administer epinephrine 1 mg IV
C. Start high-quality CPR
D. Perform endotracheal intubation
Verified Answer: C
Rationale: High-quality CPR is always the first action in any cardiac arrest. Defibrillation is
prioritized for VF/pVT, but CPR must begin immediately while preparing defibrillator.
Q5.
What is the recommended compression-to-ventilation ratio for a single rescuer performing
adult CPR with an advanced airway in place?
A. 30:2
B. 15:2
C. Continuous compressions at 100–120/min with asynchronous ventilations every 6
seconds
D. 30:2 with breaths given during compression release
Verified Answer: C
Rationale: With an advanced airway (ETT or supraglottic device), providers deliver
continuous compressions at 100–120/min and give 1 breath every 6 seconds (10
breaths/min) without pausing compressions.
Q6.
Which medication and dose is recommended for refractory VF/pVT after the second shock?
A. Epinephrine 1 mg IV push, then amiodarone 300 mg
B. Lidocaine 1.5 mg/kg IV push
C. Amiodarone 150 mg IV push
D. Magnesium 2 g IV push
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Verified Answer: A
Rationale: After the second shock, administer epinephrine 1 mg IV/IO. Amiodarone 300 mg
is given after the third shock or if VF/pVT recurs. Epinephrine is the first-line vasopressor.
Q7.
What is the maximum interval for rhythm checks during cardiac arrest?
A. Every 30 seconds
B. Every 1 minute
C. Every 2 minutes
D. Every 5 minutes
Verified Answer: C
Rationale: Rhythm checks should occur every 2 minutes (after five cycles of 30:2 or after 2
minutes of continuous compressions with an advanced airway). Prolonged pauses reduce
CCF and survival.
Q8.
During CPR, a patient’s ETCO₂ reading suddenly increases from 15 mmHg to 45 mmHg.
What does this indicate?
A. Deterioration of cardiac output
B. ROSC (Return of Spontaneous Circulation)
C. Displacement of the endotracheal tube
D. Malignant hyperthermia
Verified Answer: B
Rationale: A sudden sustained rise in ETCO₂ to >40 mmHg often indicates ROSC due to
restored pulmonary blood flow. Use ETCO₂ to confirm ROSC along with pulse check.
QG.
What is the correct initial energy dose for biphasic defibrillation in adult VF/pVT?
A. 120–200 J (per manufacturer recommendation)
B. 360 J (fixed)
C. 200–300 J
D. 50–100 J
