AHA ACLS Final Exam ACTUAL
EXAM 2026/2027 | Complete Exam-
Style Q&A | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION A: CARDIAC ARREST ALGORITHMS
Q1. A 68-year-old male collapses in the emergency department. The nurse assesses the patient and
finds him unresponsive, apneic, and pulseless. The cardiac monitor shows ventricular fibrillation. Which
action should the team take first?
A. Establish IV access and administer epinephrine
B. Perform immediate defibrillation. [CORRECT]
C. Initiate transcutaneous pacing
D. Administer amiodarone 300 mg IV push
Correct Answer: B
Rationale: Ventricular fibrillation is a shockable rhythm requiring immediate unsynchronized
defibrillation as the highest priority intervention in the adult cardiac arrest algorithm; high-quality CPR
should be performed while the defibrillator is charging, and defibrillation should occur within 3 minutes
of collapse to maximize survival.
Q2. A patient in cardiac arrest has been receiving high-quality CPR. The initial rhythm was ventricular
fibrillation, and the team has delivered one shock. The rhythm remains V-fib. Which medication should
be administered next?
A. Atropine 1 mg IV
B. Epinephrine 1 mg IV every 3-5 minutes. [CORRECT]
C. Lidocaine 1-1.5 mg/kg IV
D. Dopamine 5-10 mcg/kg/min infusion
Correct Answer: B
Rationale: After the first shock for persistent or recurrent ventricular fibrillation, epinephrine 1 mg IV or
IO should be administered every 3-5 minutes during CPR; vasopressors improve coronary perfusion
pressure and increase the likelihood of return of spontaneous circulation during resuscitation.
, Q3. A patient in pulseless ventricular tachycardia has received two shocks and one dose of epinephrine.
The rhythm remains pulseless V-tach. Which antiarrhythmic is the first-line agent according to current
AHA guidelines?
A. Lidocaine 1-1.5 mg/kg IV
B. Amiodarone 300 mg IV push. [CORRECT]
C. Procainamide 100 mg IV every 5 minutes
D. Sotalol 100 mg IV
Correct Answer: B
Rationale: Amiodarone 300 mg IV push is the first-line antiarrhythmic for shock-refractory ventricular
fibrillation or pulseless ventricular tachycardia per the AHA adult cardiac arrest algorithm; a second dose
of 150 mg may be considered for recurrent or refractory VF/pVT.
Q4. A patient in cardiac arrest is found to be in pulseless electrical activity (PEA) with a heart rate of 40
bpm on the monitor. The team is performing high-quality CPR. Which medication is indicated?
A. Atropine 1 mg IV
B. Epinephrine 1 mg IV every 3-5 minutes. [CORRECT]
C. Adenosine 6 mg rapid IV push
D. Amiodarone 300 mg IV push
Correct Answer: B
Rationale: Epinephrine 1 mg IV or IO every 3-5 minutes is the primary medication for pulseless electrical
activity and asystole; atropine is no longer recommended for PEA or asystole in the AHA ACLS
guidelines, and the focus should be on high-quality CPR while identifying and treating reversible causes.
Q5. A patient in asystole has been receiving CPR for 10 minutes. The team has administered epinephrine
per protocol. Which action is most important to improve outcomes?
A. Administer sodium bicarbonate
B. Identify and treat reversible causes (H's and T's). [CORRECT]
C. Perform synchronized cardioversion
D. Administer calcium chloride
Correct Answer: B
Rationale: The H's and T's (Hypovolemia, Hypoxia, Hydrogen ion/acidosis, Hypo/Hyperkalemia,
Hypothermia, Tension pneumothorax, Tamponade, Toxins, Thrombosis-pulmonary, Thrombosis-
coronary) represent reversible causes of cardiac arrest that must be identified and treated during
resuscitation to improve the likelihood of return of spontaneous circulation.
Q6. During CPR, the team leader notes that chest compressions are being performed at a rate of 80 per
minute. The team leader should instruct the compressor to:
A. Continue at the current rate
B. Increase the rate to 100-120 compressions per minute. [CORRECT]
C. Slow down to 60 compressions per minute
EXAM 2026/2027 | Complete Exam-
Style Q&A | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION A: CARDIAC ARREST ALGORITHMS
Q1. A 68-year-old male collapses in the emergency department. The nurse assesses the patient and
finds him unresponsive, apneic, and pulseless. The cardiac monitor shows ventricular fibrillation. Which
action should the team take first?
A. Establish IV access and administer epinephrine
B. Perform immediate defibrillation. [CORRECT]
C. Initiate transcutaneous pacing
D. Administer amiodarone 300 mg IV push
Correct Answer: B
Rationale: Ventricular fibrillation is a shockable rhythm requiring immediate unsynchronized
defibrillation as the highest priority intervention in the adult cardiac arrest algorithm; high-quality CPR
should be performed while the defibrillator is charging, and defibrillation should occur within 3 minutes
of collapse to maximize survival.
Q2. A patient in cardiac arrest has been receiving high-quality CPR. The initial rhythm was ventricular
fibrillation, and the team has delivered one shock. The rhythm remains V-fib. Which medication should
be administered next?
A. Atropine 1 mg IV
B. Epinephrine 1 mg IV every 3-5 minutes. [CORRECT]
C. Lidocaine 1-1.5 mg/kg IV
D. Dopamine 5-10 mcg/kg/min infusion
Correct Answer: B
Rationale: After the first shock for persistent or recurrent ventricular fibrillation, epinephrine 1 mg IV or
IO should be administered every 3-5 minutes during CPR; vasopressors improve coronary perfusion
pressure and increase the likelihood of return of spontaneous circulation during resuscitation.
, Q3. A patient in pulseless ventricular tachycardia has received two shocks and one dose of epinephrine.
The rhythm remains pulseless V-tach. Which antiarrhythmic is the first-line agent according to current
AHA guidelines?
A. Lidocaine 1-1.5 mg/kg IV
B. Amiodarone 300 mg IV push. [CORRECT]
C. Procainamide 100 mg IV every 5 minutes
D. Sotalol 100 mg IV
Correct Answer: B
Rationale: Amiodarone 300 mg IV push is the first-line antiarrhythmic for shock-refractory ventricular
fibrillation or pulseless ventricular tachycardia per the AHA adult cardiac arrest algorithm; a second dose
of 150 mg may be considered for recurrent or refractory VF/pVT.
Q4. A patient in cardiac arrest is found to be in pulseless electrical activity (PEA) with a heart rate of 40
bpm on the monitor. The team is performing high-quality CPR. Which medication is indicated?
A. Atropine 1 mg IV
B. Epinephrine 1 mg IV every 3-5 minutes. [CORRECT]
C. Adenosine 6 mg rapid IV push
D. Amiodarone 300 mg IV push
Correct Answer: B
Rationale: Epinephrine 1 mg IV or IO every 3-5 minutes is the primary medication for pulseless electrical
activity and asystole; atropine is no longer recommended for PEA or asystole in the AHA ACLS
guidelines, and the focus should be on high-quality CPR while identifying and treating reversible causes.
Q5. A patient in asystole has been receiving CPR for 10 minutes. The team has administered epinephrine
per protocol. Which action is most important to improve outcomes?
A. Administer sodium bicarbonate
B. Identify and treat reversible causes (H's and T's). [CORRECT]
C. Perform synchronized cardioversion
D. Administer calcium chloride
Correct Answer: B
Rationale: The H's and T's (Hypovolemia, Hypoxia, Hydrogen ion/acidosis, Hypo/Hyperkalemia,
Hypothermia, Tension pneumothorax, Tamponade, Toxins, Thrombosis-pulmonary, Thrombosis-
coronary) represent reversible causes of cardiac arrest that must be identified and treated during
resuscitation to improve the likelihood of return of spontaneous circulation.
Q6. During CPR, the team leader notes that chest compressions are being performed at a rate of 80 per
minute. The team leader should instruct the compressor to:
A. Continue at the current rate
B. Increase the rate to 100-120 compressions per minute. [CORRECT]
C. Slow down to 60 compressions per minute
