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ACLS PRACTICE QUESTIONS BANK (2026–2027)
DRUGS, DOSAGES, AND CLINICAL SCENARIOS,
MULTIPLE CHOICE ANSWERS WITH
RATIONALES HIGH YIELD CONTENT
Section 1: Cardiac Arrest – VF / pVT (Questions 1–20)
**1. A patient is in ventricular fibrillation after a third shock. The first
dose of amiodarone should be:**
- A) 150 mg IV push
- B) 300 mg IV push
- C) 1 mg/kg IV
- D) 5 mg/kg over 20 minutes
**Answer: B) 300 mg IV push**
*Rationale:* The first dose of amiodarone for refractory VF/pVT is 300
mg IV/IO push. Second dose is 150 mg.
---
**2. How often should epinephrine 1 mg be given during cardiac
arrest?**
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- A) Every 1–2 minutes
- B) Every 3–5 minutes
- C) Every 10 minutes
- D) Only once after defibrillation
**Answer: B) Every 3–5 minutes**
*Rationale:* Epinephrine 1 mg (1:10,000) is given IV/IO every 3–5
minutes throughout cardiac arrest.
---
**3. Which drug is indicated specifically for Torsades de Pointes?**
- A) Amiodarone 300 mg
- B) Lidocaine 1.5 mg/kg
- C) Magnesium sulfate 1–2 g
- D) Epinephrine 1 mg
**Answer: C) Magnesium sulfate 1–2 g**
*Rationale:* Magnesium is not routine in VF/pVT but is first-line for
Torsades de Pointes.
---
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**4. A patient remains in pulseless VT after epinephrine and one dose of
amiodarone. What is the second-line antiarrhythmic?**
- A) Procainamide 20 mg/min
- B) Lidocaine 0.5–0.75 mg/kg
- C) Adenosine 12 mg
- D) Atropine 1 mg
**Answer: B) Lidocaine 0.5–0.75 mg/kg**
*Rationale:* Lidocaine is an alternative to amiodarone. Second dose is
0.5–0.75 mg/kg (max total 3 mg/kg).
---
**5. Which statement about epinephrine in cardiac arrest is TRUE
(2026–2027)?**
- A) It is no longer recommended
- B) It should be given only after 5 shocks
- C) It remains first-line for all rhythms
- D) It is given as 1:1,000 concentration
**Answer: C) It remains first-line for all rhythms**
*Rationale:* Epinephrine 1 mg (1:10,000) is still the first-line
vasopressor in cardiac arrest.
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---
**6. What is the maximum total dose of lidocaine for refractory VF?**
- A) 1 mg/kg
- B) 3 mg/kg
- C) 5 mg/kg
- D) 10 mg/kg
**Answer: B) 3 mg/kg**
*Rationale:* First dose 1–1.5 mg/kg, second dose 0.5–0.75 mg/kg, max
total 3 mg/kg.
---
**7. You have given 300 mg amiodarone for refractory VF. The rhythm
persists. Your next amiodarone dose is:**
- A) 150 mg
- B) 300 mg
- C) 450 mg
- D) Do not repeat
**Answer: A) 150 mg**
ACLS PRACTICE QUESTIONS BANK (2026–2027)
DRUGS, DOSAGES, AND CLINICAL SCENARIOS,
MULTIPLE CHOICE ANSWERS WITH
RATIONALES HIGH YIELD CONTENT
Section 1: Cardiac Arrest – VF / pVT (Questions 1–20)
**1. A patient is in ventricular fibrillation after a third shock. The first
dose of amiodarone should be:**
- A) 150 mg IV push
- B) 300 mg IV push
- C) 1 mg/kg IV
- D) 5 mg/kg over 20 minutes
**Answer: B) 300 mg IV push**
*Rationale:* The first dose of amiodarone for refractory VF/pVT is 300
mg IV/IO push. Second dose is 150 mg.
---
**2. How often should epinephrine 1 mg be given during cardiac
arrest?**
,2|Page
- A) Every 1–2 minutes
- B) Every 3–5 minutes
- C) Every 10 minutes
- D) Only once after defibrillation
**Answer: B) Every 3–5 minutes**
*Rationale:* Epinephrine 1 mg (1:10,000) is given IV/IO every 3–5
minutes throughout cardiac arrest.
---
**3. Which drug is indicated specifically for Torsades de Pointes?**
- A) Amiodarone 300 mg
- B) Lidocaine 1.5 mg/kg
- C) Magnesium sulfate 1–2 g
- D) Epinephrine 1 mg
**Answer: C) Magnesium sulfate 1–2 g**
*Rationale:* Magnesium is not routine in VF/pVT but is first-line for
Torsades de Pointes.
---
,3|Page
**4. A patient remains in pulseless VT after epinephrine and one dose of
amiodarone. What is the second-line antiarrhythmic?**
- A) Procainamide 20 mg/min
- B) Lidocaine 0.5–0.75 mg/kg
- C) Adenosine 12 mg
- D) Atropine 1 mg
**Answer: B) Lidocaine 0.5–0.75 mg/kg**
*Rationale:* Lidocaine is an alternative to amiodarone. Second dose is
0.5–0.75 mg/kg (max total 3 mg/kg).
---
**5. Which statement about epinephrine in cardiac arrest is TRUE
(2026–2027)?**
- A) It is no longer recommended
- B) It should be given only after 5 shocks
- C) It remains first-line for all rhythms
- D) It is given as 1:1,000 concentration
**Answer: C) It remains first-line for all rhythms**
*Rationale:* Epinephrine 1 mg (1:10,000) is still the first-line
vasopressor in cardiac arrest.
, 4|Page
---
**6. What is the maximum total dose of lidocaine for refractory VF?**
- A) 1 mg/kg
- B) 3 mg/kg
- C) 5 mg/kg
- D) 10 mg/kg
**Answer: B) 3 mg/kg**
*Rationale:* First dose 1–1.5 mg/kg, second dose 0.5–0.75 mg/kg, max
total 3 mg/kg.
---
**7. You have given 300 mg amiodarone for refractory VF. The rhythm
persists. Your next amiodarone dose is:**
- A) 150 mg
- B) 300 mg
- C) 450 mg
- D) Do not repeat
**Answer: A) 150 mg**
