ACLS — Advanced Cardiovascular Life Support Practice Test
Frequently asked questions
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A full bank of original ACLS — Advanced Cardiovascular Life Support practice questions across the official content areas, weighted like the real exam, with explanations. Free, no signup.
What is the ACLS — Advanced Cardiovascular Life Support exam like?+
A multiple-choice exam. Practice by topic here, then take the full timed mock exam to gauge readiness.
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No. Every question is 100% original, written from public primary sources with explanations. We never copy real exam questions or paid prep material.
Can I study in Chinese or Spanish?+
PrepPass practice is in English, 中文 and Español. The official exam is in English — switch the question language to English any time to rehearse the exact terminology you'll see on test day.
Sample practice questions
A few real questions from this free bank, with full explanations. Use the practice tool above for the whole set.
- 1. High-Quality BLS & AED
What is the recommended chest compression rate for high-quality CPR in an adult?
- a.60 to 80 compressions per minute
- b.80 to 100 compressions per minute
- c.100 to 120 compressions per minute
- d.120 to 140 compressions per minute
Answer: c
Explanation: Current AHA guidelines call for a compression rate of 100 to 120 per minute. Rates slower than 100 reduce coronary and cerebral perfusion, while rates faster than 120 shorten the recoil/filling phase and reduce the depth actually achieved, so the diastolic filling of the heart suffers. Staying inside the 100-120 window balances forward blood flow with adequate ventricular filling.
- 2. High-Quality BLS & AED
To maximize the chest compression fraction, interruptions in compressions should be limited to less than:
- a.5 seconds
- b.10 seconds
- c.20 seconds
- d.30 seconds
Answer: b
Explanation: Pauses in compressions (for rhythm checks, ventilation, or defibrillation) should be kept under 10 seconds. The goal is a chest compression fraction of at least 60%. Every second without compressions drops coronary perfusion pressure, which then takes several compressions to rebuild, so minimizing hands-off time directly improves the odds of ROSC.
- 3. Airway Management & Ventilation
What is the most reliable method to confirm and continuously monitor correct endotracheal tube placement during CPR?
- a.Auscultation of breath sounds alone
- b.Continuous quantitative waveform capnography
- c.Chest x-ray obtained after the code
- d.Pulse oximetry readings
Answer: b
Explanation: Continuous quantitative waveform capnography is the recommended standard for confirming and monitoring ET tube placement. It verifies the tube is in the trachea (a sustained CO2 waveform), detects dislodgement in real time, and gauges CPR quality — a sudden abrupt rise in ETCO2 often signals return of spontaneous circulation. Auscultation and oximetry are adjuncts, and a chest x-ray is too slow to guide the resuscitation.
- 4. ACLS Pharmacology
What is the correct dose and interval of epinephrine during adult cardiac arrest?
- a.0.5 mg IV/IO every 10 minutes
- b.1 mg IV/IO every 3 to 5 minutes
- c.3 mg IV/IO given once
- d.1 mg IV/IO every minute
Answer: b
Explanation: Epinephrine in cardiac arrest is 1 mg IV/IO every 3 to 5 minutes. Its alpha-adrenergic vasoconstriction raises aortic diastolic pressure and thereby coronary perfusion pressure. In non-shockable rhythms (asystole/PEA), give epinephrine as soon as feasible; in shockable rhythms (VF/pVT), give it after the first shock or two fail to convert the rhythm.
- 5. ACLS Pharmacology
A stable patient has a regular narrow-complex SVT and vagal maneuvers have failed. What is the first dose of adenosine?
- a.6 mg rapid IV push, followed by a 12 mg dose if needed
- b.1 mg slow IV push
- c.0.5 mg IV push
- d.300 mg IV bolus
Answer: a
Explanation: Adenosine is given 6 mg by rapid IV push (followed immediately by a saline flush), and if the rhythm does not convert, a 12 mg dose may follow. Its very short half-life briefly blocks AV nodal conduction, which can terminate a re-entrant SVT. It is used only for stable, regular, narrow-complex tachycardia after vagal maneuvers fail.
- 6. Rhythm Recognition (ECG)
The monitor shows a flat line, confirmed in two leads, in a pulseless patient. The correct action is to:
- a.Defibrillate immediately
- b.Perform synchronized cardioversion
- c.Continue high-quality CPR, give epinephrine, and treat reversible causes — do not shock
- d.Give adenosine 6 mg rapid IV push
Answer: c
Explanation: A confirmed flat line is asystole, a non-shockable rhythm. Management is high-quality CPR, epinephrine 1 mg every 3-5 minutes, and an active search for the H's and T's (reversible causes). Confirming asystole in more than one lead rules out 'fine VF' or a lead/equipment problem masquerading as a flat line. Defibrillation and cardioversion have no role in asystole.
- 7. Cardiac Arrest Algorithms
A patient collapses in witnessed VF arrest and a defibrillator is immediately available. The highest priority is to:
- a.Establish IV access and give epinephrine first
- b.Intubate the patient before anything else
- c.Deliver a defibrillation shock as soon as possible and then resume compressions
- d.Give amiodarone 300 mg before defibrillating
Answer: c
Explanation: For VF/pVT, the single most important intervention is early defibrillation combined with high-quality CPR. When a defibrillator is at hand for a witnessed arrest, shock as soon as it is ready, then immediately resume compressions. Drugs and advanced airway are secondary and should not delay the first shock, because the chance of successful defibrillation falls with each passing minute in VF.
- 8. Cardiac Arrest Algorithms
Immediately after delivering a defibrillation shock, the team should:
- a.Check a pulse for 30 seconds
- b.Resume chest compressions immediately and continue CPR for about 2 minutes
- c.Reanalyze the rhythm right away before touching the patient
- d.Deliver two rescue breaths before compressions
Answer: b
Explanation: After a shock, resume compressions immediately without a pulse or rhythm check, and continue CPR for about 2 minutes before the next rhythm analysis. Even when a shock is successful, an organized rhythm and a palpable pulse often take time to appear, and pausing to check wastes critical perfusion time. Minimizing the post-shock pause is a cornerstone of high-quality resuscitation.
- 9. Bradycardia & Tachycardia
A patient with wide-complex tachycardia has a pulse but is hypotensive and confused. The appropriate treatment is:
- a.Unsynchronized defibrillation
- b.Synchronized cardioversion
- c.Adenosine only, then observe
- d.No treatment; continue to observe
Answer: b
Explanation: An unstable tachycardia WITH a pulse (hypotension, altered mental status, ischemic chest pain, or signs of shock) is treated with immediate synchronized cardioversion. Synchronization times the shock to the R wave to avoid delivering energy during the vulnerable T-wave period, which could induce VF. Unsynchronized defibrillation is reserved for pulseless VT/VF.
- 10. ACS, Stroke & Post-Arrest Care
For a patient with a STEMI, the goal for first-medical-contact-to-device time with primary PCI is within:
- a.30 minutes
- b.90 minutes
- c.4 hours
- d.12 hours
Answer: b
Explanation: For STEMI, the reperfusion goal for primary percutaneous coronary intervention (PCI) is a first-medical-contact-to-device time of 90 minutes or less. 'Time is muscle' — the sooner the occluded coronary artery is reopened, the more myocardium is salvaged. When timely PCI is unavailable, fibrinolytic therapy is targeted within 30 minutes of arrival (door-to-needle).