BLS Instructor Exam – 250 | MCQs (2026–
2027) QUESTIONS & ANSWERS | LATEST
UPDATE
EXAM DESCRIPTION
This exam covers advanced BLS (Basic Life Support) Instructor-level competencies as per AHA
(American Heart Association) and ILCOR 2025–2026 guidelines. Topics include: adult,
pediatric, and infant CPR techniques; AED use and troubleshooting; airway management; team
dynamics and debriefing; BLS course facilitation and instructor responsibilities; special
resuscitation scenarios (drowning, pregnancy, opioid overdose); recognition of cardiac arrest
rhythms; high-quality CPR metrics; post-resuscitation care; and instructor evaluation and
remediation protocols. This is designed for certified BLS Instructors and those seeking
instructor-level certification.
SECTION 1: HIGH-QUALITY CPR – ADULT
1. What is the recommended compression rate for high-quality adult CPR?
A) 80–100 compressions/min
B) 100–120 compressions/min (correct answer)
C) 120–140 compressions/min
D) 60–80 compressions/min
Rationale: The AHA 2020–2025 guidelines specify a compression rate of 100–120/min. Rates
below 100 are inadequate; rates above 120 are associated with shallower compressions and
worse outcomes.
2. What is the correct compression depth for an adult victim?
A) At least 1.5 inches
B) At least 3 inches
C) At least 2 inches (correct answer)
D) Exactly 2.5 inches
,Rationale: AHA recommends at least 2 inches (5 cm) but not more than 2.4 inches (6 cm) for
adults. Excessive depth can cause rib fractures and internal injury.
3. What does "allow full chest recoil" mean during CPR?
A) Pause compressions every 10 cycles
B) Lift hands completely off the chest between compressions (correct answer)
C) Apply light pressure between compressions
D) Rotate rescuers every 5 compressions
Rationale: Full recoil allows the heart to refill with blood between compressions. Leaning on the
chest impairs venous return and reduces CPR effectiveness.
4. What is the maximum allowable interruption in chest compressions during CPR?
A) 5 seconds
B) 20 seconds
C) 10 seconds (correct answer)
D) 15 seconds
Rationale: Minimizing interruptions to less than 10 seconds is a key component of high-quality
CPR. Prolonged pauses reduce coronary and cerebral perfusion pressure.
5. A rescuer is performing CPR. After every 30 compressions, what should follow?
A) Check the pulse
B) Deliver 2 rescue breaths (correct answer)
C) Deliver 5 rescue breaths
D) Switch compressors
Rationale: The 30:2 ratio (30 compressions: 2 breaths) is standard for single-rescuer adult CPR.
This ratio optimizes both circulatory support and ventilation.
6. During CPR, which finding indicates compressions are effective?
A) Cyanosis resolving in the lips (correct answer)
B) Pupil dilation
C) Absence of breath sounds
, D) A flat line on the monitor
Rationale: Resolution of cyanosis (bluish discoloration) indicates improved oxygenation and
suggests compressions are generating adequate cardiac output.
7. What is the target chest compression fraction (CCF) for high-quality CPR?
A) Greater than 50%
B) Greater than 60% (correct answer)
C) Greater than 40%
D) Greater than 80%
Rationale: A CCF greater than 60% is associated with improved survival. CCF refers to the
proportion of resuscitation time that compressions are being actively performed.
8. A BLS Instructor notices a student is compressing at 130/min but only reaching 1.5 inches
depth. What is the MOST likely cause?
A) Correct technique
B) Rate too slow
C) Compression rate is too fast, reducing depth (correct answer)
D) The student needs rest
Rationale: Excessively fast rates are associated with shallower compressions due to incomplete
muscle relaxation and poor body mechanics. Rate should be corrected to 100–120/min.
9. When should a rescuer switch compression roles during a team resuscitation?
A) Every 5 minutes
B) Every 2 minutes or 5 cycles of CPR (correct answer)
C) Only when the compressor asks for a break
D) Every 10 minutes
Rationale: Compressor fatigue causes degradation in CPR quality within 2 minutes. Rotating
every 2 minutes (or 5 cycles of 30:2) maintains compression quality.
10. Which of the following best defines "passive ventilation" during CPR without an advanced
airway?
, A) Mouth-to-nose breathing
B) Allowing air to escape freely during compression release (correct answer)
C) Using a pocket mask only
D) Ventilating without pausing compressions
Rationale: Passive ventilation relies on chest recoil to draw air in without active rescue breaths.
This may occur in compression-only CPR scenarios where ventilation is limited.
SECTION 2: AED USE AND TROUBLESHOOTING
11. When is the earliest an AED should be applied during a cardiac arrest response?
A) After 5 cycles of CPR
B) As soon as it is available (correct answer)
C) After 2 minutes of CPR
D) Only if the victim has no pulse after 3 minutes
Rationale: Early defibrillation is critical. For every minute without defibrillation in ventricular
fibrillation (VF), survival decreases by 7–10%. Apply the AED as soon as it arrives.
12. After delivering an AED shock, what should the rescuer do IMMEDIATELY?
A) Check the pulse for 10 seconds
B) Resume CPR starting with chest compressions (correct answer)
C) Wait for the AED to re-analyze
D) Apply a second shock
Rationale: CPR should resume immediately after a shock without a pulse check, as it takes time
for the heart to establish a perfusing rhythm. A pulse check occurs after 2 minutes of CPR.
13. An AED pad is placed over a medication patch on the victim's chest. What should the rescuer
do?
A) Place the pad over the patch anyway
B) Remove the patch, wipe the area, then apply the pad (correct answer)
C) Move the pad to the thigh
D) Use the back pad position only
Rationale: Medication patches (e.g., nitroglycerin, nicotine) can block electricity and cause
burns. Remove the patch, wipe the skin clean, and then apply the AED pad.
2027) QUESTIONS & ANSWERS | LATEST
UPDATE
EXAM DESCRIPTION
This exam covers advanced BLS (Basic Life Support) Instructor-level competencies as per AHA
(American Heart Association) and ILCOR 2025–2026 guidelines. Topics include: adult,
pediatric, and infant CPR techniques; AED use and troubleshooting; airway management; team
dynamics and debriefing; BLS course facilitation and instructor responsibilities; special
resuscitation scenarios (drowning, pregnancy, opioid overdose); recognition of cardiac arrest
rhythms; high-quality CPR metrics; post-resuscitation care; and instructor evaluation and
remediation protocols. This is designed for certified BLS Instructors and those seeking
instructor-level certification.
SECTION 1: HIGH-QUALITY CPR – ADULT
1. What is the recommended compression rate for high-quality adult CPR?
A) 80–100 compressions/min
B) 100–120 compressions/min (correct answer)
C) 120–140 compressions/min
D) 60–80 compressions/min
Rationale: The AHA 2020–2025 guidelines specify a compression rate of 100–120/min. Rates
below 100 are inadequate; rates above 120 are associated with shallower compressions and
worse outcomes.
2. What is the correct compression depth for an adult victim?
A) At least 1.5 inches
B) At least 3 inches
C) At least 2 inches (correct answer)
D) Exactly 2.5 inches
,Rationale: AHA recommends at least 2 inches (5 cm) but not more than 2.4 inches (6 cm) for
adults. Excessive depth can cause rib fractures and internal injury.
3. What does "allow full chest recoil" mean during CPR?
A) Pause compressions every 10 cycles
B) Lift hands completely off the chest between compressions (correct answer)
C) Apply light pressure between compressions
D) Rotate rescuers every 5 compressions
Rationale: Full recoil allows the heart to refill with blood between compressions. Leaning on the
chest impairs venous return and reduces CPR effectiveness.
4. What is the maximum allowable interruption in chest compressions during CPR?
A) 5 seconds
B) 20 seconds
C) 10 seconds (correct answer)
D) 15 seconds
Rationale: Minimizing interruptions to less than 10 seconds is a key component of high-quality
CPR. Prolonged pauses reduce coronary and cerebral perfusion pressure.
5. A rescuer is performing CPR. After every 30 compressions, what should follow?
A) Check the pulse
B) Deliver 2 rescue breaths (correct answer)
C) Deliver 5 rescue breaths
D) Switch compressors
Rationale: The 30:2 ratio (30 compressions: 2 breaths) is standard for single-rescuer adult CPR.
This ratio optimizes both circulatory support and ventilation.
6. During CPR, which finding indicates compressions are effective?
A) Cyanosis resolving in the lips (correct answer)
B) Pupil dilation
C) Absence of breath sounds
, D) A flat line on the monitor
Rationale: Resolution of cyanosis (bluish discoloration) indicates improved oxygenation and
suggests compressions are generating adequate cardiac output.
7. What is the target chest compression fraction (CCF) for high-quality CPR?
A) Greater than 50%
B) Greater than 60% (correct answer)
C) Greater than 40%
D) Greater than 80%
Rationale: A CCF greater than 60% is associated with improved survival. CCF refers to the
proportion of resuscitation time that compressions are being actively performed.
8. A BLS Instructor notices a student is compressing at 130/min but only reaching 1.5 inches
depth. What is the MOST likely cause?
A) Correct technique
B) Rate too slow
C) Compression rate is too fast, reducing depth (correct answer)
D) The student needs rest
Rationale: Excessively fast rates are associated with shallower compressions due to incomplete
muscle relaxation and poor body mechanics. Rate should be corrected to 100–120/min.
9. When should a rescuer switch compression roles during a team resuscitation?
A) Every 5 minutes
B) Every 2 minutes or 5 cycles of CPR (correct answer)
C) Only when the compressor asks for a break
D) Every 10 minutes
Rationale: Compressor fatigue causes degradation in CPR quality within 2 minutes. Rotating
every 2 minutes (or 5 cycles of 30:2) maintains compression quality.
10. Which of the following best defines "passive ventilation" during CPR without an advanced
airway?
, A) Mouth-to-nose breathing
B) Allowing air to escape freely during compression release (correct answer)
C) Using a pocket mask only
D) Ventilating without pausing compressions
Rationale: Passive ventilation relies on chest recoil to draw air in without active rescue breaths.
This may occur in compression-only CPR scenarios where ventilation is limited.
SECTION 2: AED USE AND TROUBLESHOOTING
11. When is the earliest an AED should be applied during a cardiac arrest response?
A) After 5 cycles of CPR
B) As soon as it is available (correct answer)
C) After 2 minutes of CPR
D) Only if the victim has no pulse after 3 minutes
Rationale: Early defibrillation is critical. For every minute without defibrillation in ventricular
fibrillation (VF), survival decreases by 7–10%. Apply the AED as soon as it arrives.
12. After delivering an AED shock, what should the rescuer do IMMEDIATELY?
A) Check the pulse for 10 seconds
B) Resume CPR starting with chest compressions (correct answer)
C) Wait for the AED to re-analyze
D) Apply a second shock
Rationale: CPR should resume immediately after a shock without a pulse check, as it takes time
for the heart to establish a perfusing rhythm. A pulse check occurs after 2 minutes of CPR.
13. An AED pad is placed over a medication patch on the victim's chest. What should the rescuer
do?
A) Place the pad over the patch anyway
B) Remove the patch, wipe the area, then apply the pad (correct answer)
C) Move the pad to the thigh
D) Use the back pad position only
Rationale: Medication patches (e.g., nitroglycerin, nicotine) can block electricity and cause
burns. Remove the patch, wipe the skin clean, and then apply the AED pad.
