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ACLS 2025 EXAM UPDATED QUESTIONS WITH VERIFIED CORRECT ANSWERS
"What happens when teams rapidly assess and intervene when patients have abnormal vital
signs? - CORRECT ANSWER The number of in hospital cardiac arrest decreases"
"In addition to decreased IHCA, what are some other benefits of implementing a rapid response
system? Select all that apply. - CORRECT ANSWER Decrease ICU length of stay.
Decreased in total hospital length of stay."
"Which is the main advantage of effective teamwork? - CORRECT ANSWER Division of tasks"
"Which is the best example of a role of the team leader? - CORRECT ANSWER Models
excellent team behavior"
"Which is the best example of a role of a team member? - CORRECT ANSWER Prepared to
fulfill their role responsibilities"
"What is the primary purpose of the CPR coach on a resuscitation team? - CORRECT ANSWER
Increasing CPR quality"
"What are the 6 positions for high performance teams in resuscitation? - CORRECT ANSWER
Team leader Airway Timer/recorder Compressor (rotate every 2 minutes) Monitor/defibrillator/cpr coach IV/IO/Medications" "Which member of the high performance team has the responsibility for assigning roles
(positions)? - CORRECT ANSWER Team leader"
"Which high performance team member is part of the resuscitation triangle? - CORRECT
ANSWER Monitor/defibrillator/cpr coach"
"How do you calculate the chest compression fraction (CCF)? What is ideal percentage? -
CORRECT ANSWER Divide chest compression time by total code time. You want this at least
60% but ideally greater than 80%"
"Which component of effective high-performance teams is represented by the use of real-time
feedback devices? - CORRECT ANSWER Quality"
"How do you calculate Coronary Perfusion Pressure (CPP)? - CORRECT ANSWER Aortic
diastolic pressure "minus" Right Atrial Diastolic Pressure"
"How do interruptions in chest compressions negatively impact survival after cardiac arrest? -
CORRECT ANSWER Decrease coronary perfusion pressure"
"What is the only intervention that can restore an organized rhythm in patients with ventricular
fibrillation (VF)? - CORRECT ANSWER Early and effective defibrillation"
"The initial assessment reveals a conscious patient. The patients airway is patent and an advanced airway is not indicated.
Which action in the primary assessment should you perform next? - CORRECT ANSWER
Administer oxygen as needed"
"Which action is part of secondary assessment of a conscious patient? - CORRECT ANSWER
Formulate a differential diagnosis"
"Which of the following are the "H's" causes of reversible cardiac arrest? Select all that apply: -
CORRECT ANSWER Hypothermia
Hypoxia Hyperkalemia/hypokalemia Hypovolemia Acidosis"
"Which of the following are the "T" causes of reversible cardiac arrest? - CORRECT ANSWER
Tension pneumothorax Toxins Cardiac tamponade Pulmonary thrombosis Coronary thrombosis" "What is the only intervention that can restore an organized rhythm in patients with ventricular
fibrillation (VF)? - CORRECT ANSWER Early and effective defibrillation"
"Upon reviewing a patients 12-lead ECG, you note ST-segment elevation of 2mm in leads II, III and aVF.
How would you classify these ECG findings? - CORRECT ANSWER ST-segment elevation
myocardial infarction" "Upon reviewing a patients 12 lead ECG, you note ST elevation of 2mm in leads II, III, and aVF.
How would you classify these ECG findings? - CORRECT ANSWER ST segment elevation MI"
"Which action is part of the secondary assessment of a conscious patient? - CORRECT
ANSWER Formulate a different diagnosis"
"What is the most common type of stroke? - CORRECT ANSWER Ischemic stroke"
"What type of stroke occurs when a blood vessel in the brain suddenly ruptures into the
surrounding tissue? - CORRECT ANSWER Hemorrhagic stroke"
"Which is a sign of a stroke? - CORRECT ANSWER Trouble speaking"
"Which is a symptom of stroke? - CORRECT ANSWER Sudden trouble seeing"
"What are the 3 components of the Cincinnati Prehospital stroke scale? - CORRECT ANSWER
Facial droop Arm drift Abnormal speech" "What is the estimated probability of the prehospital stroke scale with 1 abnormal finding when
scored by prehospital providers? - CORRECT ANSWER 72%"
"What is a stroke severity tool that helps EMS differentiate a large vessel occlusion stroke from a
non-large vessel occlusion stroke? - CORRECT ANSWER Los Angeles motor scale"
"What is an advantage of EMS alerting the receiving facility of the impending arrival of a patient
with suspected acute ischemic stroke? - CORRECT ANSWER The hospital can perform more
efficient evaluation and management"
"What is the time for neurological assessment by the stroke team or designee and noncontrast
computed tomography or magnetic resonance imaging performed after the hospital arrival? -
CORRECT ANSWER 20 min"
"What is the time goal for initiation of fibrinolytic therapy for patients w/o contraindications after
hospital arrival - CORRECT ANSWER 45 min"
"What is the door-to device time for direct-arriving patients with acute ischemic stroke treated
with endovascular therapy? - CORRECT ANSWER 90 min"
"Evidence suggest that there is a higher likelihood of good to excellent functional outcome when
alteplase is given to adults with an acute ischemic stroke within what time frame? - CORRECT
ANSWER 3 hours"
"What is the maximum time for last known normal when endovascular therapy can be
performed? - CORRECT ANSWER 24 hours"
"What is the maximum time from last known normal when intra arterial thrombolysis for select
patients can be used for treatment? - CORRECT ANSWER 6 hours"
"What is the time goal for initiation of fibrinolytic therapy in appropriate patients without
contraindications after hospital arrival? - CORRECT ANSWER 45 min"
"Identify the systolic blood pressure threshold for withholding fibrinolytic therapy to otherwise
eligible patients with acute ischemic stroke. - CORRECT ANSWER 185"
"Identify the diastolic blood pressure threshold for withholding fibrinolytic therapy to otherwise
eligible patients with acute ischemic stroke. - CORRECT ANSWER 110"
"What blood glucose level should trigger administration of IV or subq insulin for a patient with
acute ischemic stroke? - CORRECT ANSWER 180"
"What tidal volume typically maintains normal oxygenation and elimination of carbon dioxide? -
CORRECT ANSWER 6-8"
"What is a contraindication of the use of an oropharyngeal airway? - CORRECT ANSWER
Conscious patient"
"The pt is not responding well to ventilation and suctioning. You decide to intubate the pt. In addition to clinical assessment, what is the single most reliable method of confirming and
monitoring correct placement of the ET tube? - CORRECT ANSWER Quantitative waveform
capnography" "During analysis of the patients ECG, you note the presence of more P waves than QRS complexes. You also note the absence of a relationship between the P wave and the QRS complex.
What type of atrioventricular block is most likely present? - CORRECT ANSWER Third-degree"
"Symptomatic bradycardia is defined by a heart rate less than ___ beats per minute - CORRECT
ANSWER 50"
"Which signs and symptoms indicate a symptomatic bradycardia? - CORRECT ANSWER
Shortness of breath Chest Pain Hypotension Altered mental status" "During analysis of the pt's EKG, you note the presence of more P waves than QRS complexes. You also note all PR intervals have a uniform length, but random QRS complexes are dropped. What
type of AV block is most likely present? - CORRECT ANSWER Second-degree type II"
"What is the first line treatment for unstable bradycardia? - CORRECT ANSWER Atropine"
"What is the recommended first dose of IV atropine for the management of bradycardia? -
CORRECT ANSWER 1 mg IV"
"What is a complication of IV atropine when administered in doses of less than 0.5 mg? -
CORRECT ANSWER Further slowing of the heart rate"
"What is the recommended infusion rate of epinephrine in the management of symptomatic
bradycardia unresponsive to atropine? - CORRECT ANSWER 2 to 10 mcg per minute"
"A 75 year old man presents to the emergency department. His wife states that he fainted 45 minutes ago, while watching TV. She said he has had episodes of confusion and fatigue during the past week. The patient presents with HR 30/min (weak pulse), BP 66/43 mmHG, RR of 20/min, SpO2 89%. He is alert and responsive.
What should your next steps be to assess and treat this patient? - CORRECT ANSWER Establish
IV
Obtain 12 lead Maintain airway and administer O2 as needed"
"What is the patient's rhythm? - CORRECT ANSWER Third-degree AV block"
"You determine patient has poor perfusion.
What is your next step? - CORRECT ANSWER Administer atropine 1 mg IV"
"Patient does not respond to atropine. The vital signs are HR 34/min, BP 66/43 mm HG, RR 18/min, and SpO2 91%. He is responsive, but dizzy.
What option do you have to treat the patient? - CORRECT ANSWER Initiate transcutaneous
pacing Administer epinephrine 2-10mcg/min Administer dopamine 5-20 mvg/kg/min" "The patient does not respond to treatments. The vital signs are HR 40/min (weak pulse), BP 66/43 mmHG, RR 18/min, and SpO2 91%. He is responsive but states that he feels tired.
What should you consider? - CORRECT ANSWER Prepare for transvenous pacing
Seek expert consultation" "You are treating a patient with a heart rate of 186/min. Which symptom (if present) suggest
unstable tachycardia? - CORRECT ANSWER Hypotension"
"What is the first-line treatment for unstable tachycardia? - CORRECT ANSWER
Cardioversion" "The width of the QRS in a patient presenting with tachycardia is 0.16 seconds. Each QRS complex has a visible P wave.
What additional assessment and stabilization activities should be completed within the first 10
min after the patient's arrival? - CORRECT ANSWER Check glucose
Complete neurologic screening Order an emergent CT scan or MRI of the brain and review pt history Establish IV access Activate the stroke team"
"What needs to be completed for this pt within 20 mins after hospital arrival? - CORRECT
ANSWER Neurologic assessment"
"As part of the neurologic assessment, you perform a physical and neurologic examination. What
are some general questions you need to ask? - CORRECT ANSWER What other symptoms do
you have? When did the symptoms start? Do you take any medications? Do you have any allergies?"
"What is the average respiratory rate for an adult at rest? - CORRECT ANSWER 12 to 20/min"
"A 59 year old patient is reporting difficulty breathing. Physical exam reveals nasal flaring, intercostal interaction and use of accessory muscles. RR is 28 breaths per minute. O2 sat is 92% PETCO2 is 36 mmHg.
How would you categorize this patent's condition? - CORRECT ANSWER Respiratory distress"
"An 18 year old patient is reporting difficulty breathing and is displaying increased respiratory effort. Auscultation reveals bilateral wheezing. The respiratory rate is 28 breaths per minute. Oxygen saturations is 91%. PETCO2 is 44 mmHg.
How would you categorize this patient's condition? - CORRECT ANSWER Respiratory Distress"
"A 75 year old patient is having difficulty breathing, with increased respiratory effort. The patient has history of emphysema. The patient is drowsy. Auscultation reveals bilateral wheezing, although the lung sounds are difficult to auscultate. RR is 38/min. O2 sat = 85%, PETCO2= 49mmHg.
How would you categorize this patient's condition? - CORRECT ANSWER Respiratory failure"
"What is the term of the rise in arterial CO2 levels typically associated with respiratory failure? -
CORRECT ANSWER Hypercapnia"
"How much tidal volume must provide with a bag-mask device to produce visible chest rise for an
adult patient in respiratory arrest? - CORRECT ANSWER 6 to 7 mL/kg"
"What device on a resuscitation bag-mask device may prevent sufficient tidal volume in patients
with poor lung compliance? - CORRECT ANSWER Pressure-relief value"
"Patients with perfusing rhythms should receive ventilations once every ___ seconds - CORRECT
ANSWER 6 seconds"
"What is the most effective way to deliver bag-mask ventilation? - CORRECT ANSWER Using a
2-person technique" "How long should the second rescuer squeeze the bag mask device when providing 2-rescuer
ventilation? - CORRECT ANSWER 1 second"
"When performing the jaw-thrust maneuver on patients with suspected cervical spine injury,
where should you place your fingers? - CORRECT ANSWER Just under the angel of the lower
jaw" "When you use a bag-mask device, you should deliver approximately 500 to ___ ml tidal volume.
CORRECT ANSWER 600"
"Which is a contraindication to the use of procainamide infusion in the management of stable
wide complex tachycardia? - CORRECT ANSWER Prolonged QT interval"
"What is the recommended first dose of amiodarone for management of stable wide complex
tachycardia? - CORRECT ANSWER 150 mg IV"
"A 72 year old male patient has been suffering from progressive dizziness and bouts of palpitations after exercising last night. His symptoms reappeared and worsened this morning. The patient is conscious and alert, HR 180/min, a weak radial pulse, BP 110/78 mm Hg, and SpO 96%.
"In addition to hypoxia, what is the most common underlying, potentially reversible cause of
pulseless electrical activity? - CORRECT ANSWER Hypovolemia"
"Which therapy is not supported by evidence for use in patients with cardiac arrest secondary to
hypothermia? - CORRECT ANSWER Antiarrhythmics"
"Which alteration to the standard ACLS algorithm is appropriate for patients whose cardiac arrest
is caused by hypothermia? - CORRECT ANSWER Medications spaced at longer intervals"
"A patient with suspected opioid poisoning is not breathing normally but has a pulse. What is your
next step? - CORRECT ANSWER Provide rescue breathing and give naloxone"
"Depending on training and clinical circumstance, how can rescuers administer naloxone? -
CORRECT ANSWER Intramuscularly
Intravenously Intranasally" "You are preparing to provide electrical cardioversion. You are monitoring the patient's ECG and have applied the defibrillation pads to the patient's bare chest. You have delivered sufficient sedation and have turned the defibrillator on.
What is the next step you should perform? - CORRECT ANSWER Activate the sync control
button." "A patient with a ventricular assist device (VAD) is not breathing, has signs of inadequate perfusion, and is unconscious. You determine the VAD is functioning. After endotracheal intubation, the patient has a PETCO2 of 12mm Hg.
What is your next action? - CORRECT ANSWER Perform external chest compressions"
"What is the recommended CPR positions for a third trimester gravid patient? - CORRECT
ANSWER Supine with manual left lateral uterine displacement"
"what alterations are recommended for resuscitation to 3rd trimester gravid patients in cardiac
arrest - CORRECT ANSWER No dosing alterations are recommended"
"When should resuscitation Team Leaders activate the protocol for perimortem cesarean
delivery? - CORRECT ANSWER As soon as cardiac arrest is identified in a pregnant patient."
"How quickly should resuscitation Team Leaders consider perimortem cesarean delivery after
beginning resuscitative efforts if return of spontaneous circulation has not been achieved? -
CORRECT ANSWER 5 minutes"
"When titrating inspired oxygen, which arterial oxyhemoglobin saturation value lies within
recommended range for a patient who achieves return of spontaneous circulation? - CORRECT
ANSWER 95%"
"When adjusting ventilation rates, which PETCO2 value lies within the recommended range for a
patient who achieves return to spontaneous circulation? - CORRECT ANSWER 40 mm Hg"
"What is the recommended fluid bolus dose for patients who are hypotensive during the post-
cardiac arrest phase? - CORRECT ANSWER 1 to 2 L"
"What is the recommended norepinephrine dose for hypotensive patients during the post-
cardiac arrest phase? - CORRECT ANSWER 0.1 to 0.5 mcg/kg per minute"
"What is the recommended starting IV infusion dose of epinephrine for pts in cardiac arrest who
achieve ROSC and need vasopressor support? - CORRECT ANSWER 2 to 10 mcg per minute"
"What is the mean arterial pressure target when adminsitering epinephrinie to patients in cardiac
arrest who achieve ROSC and need vasopressor support? - CORRECT ANSWER 65 mm Hg"
"What is the purpose of obtaining a 12-lead ECG early during the post-cardiac arrest care phase?
CORRECT ANSWER To detect ST-segment elevation or left bundle branch block"
"During the post-cardiac arrest care period, the 12-lead ECG reveals an STEMI.
Which step has the highest priority? - CORRECT ANSWER Coronary angiography"
"If the patient is not following commands, starts targeted temperature management as soon as
possible with what targeted temperature range? - CORRECT ANSWER 32 to 36 C"
What is your next intervention? - CORRECT ANSWER Administer amiodarone 300mg IV"
"After 2 more minutes of CPR, you conduct a rhythm check and pulse check, confirming absence of a pulse.
Based on the organized rhythm below, describe the patient's condition? - CORRECT ANSWER
PEA"
"Once PEA is identified and there are no signs of ROSC, you continue CPR. What is your next step
for appropriate care for this patient? - CORRECT ANSWER Administer epinephrine 1mg IV"
"After 2 minutes of CPR, you conduct another rhythm check and determine that the patient has the following rhythm and is showing signs of ROSC.
How do you continue treating this patient? - CORRECT ANSWER Move to the Adult Post-
Cardiac Arrest Care Algorithm" "A 70 year old woman suffered a sudden cardiac arrest. After a 10 minute resuscitation attempt, she is showing signs of ROSC. She is intubated and has an IV established. She has a palpable pulse of 65/min, SpO2 94%, ETCO2 of 38 mmHg, and BP 82/55 mm Hg.
What are your highest priorities? - CORRECT ANSWER Maintaining SpO2 92-98%
Maintaining PaCO2 35- Ventilating patient-10 breaths/minute" "In addition to managing the airway and respiratory parameters, which step is also prioritized
during the initial stabilization phase? - CORRECT ANSWER Treating hypotension"
"Match the treatment for hypotension to the proper initial dosage for an adult based on the AHA
guidelines. - CORRECT ANSWER NS or LR --> 1 to 2 L
Epinephrine --> 2 to 10 mcg per minute Dopamine --> 5 to 20 mcg/kg per minute Norepinephrine IV --> 0.1 to 0.5 mcg/kg per minute" "The patient's ventilation and BP have responded to treatment. What other lab or diagnostic tests
would be appropriate to consider at this time for reversible causes? - CORRECT ANSWER
Temperature 12 lead ECG
Troponin Test"
"You obtain a 12-lead ECG. What is the most appropriate action to take next? - CORRECT
ANSWER Transfer the patient to a cardiac cath lab for percutaneous coronary intervention"
"The patient is unable to follow verbal commands. What intervention should the team consider?
CORRECT ANSWER Targeted temperature management"
"Which of the following are immediately available as feedback from CPR performance monitors?
- CORRECT ANSWER Chest compression rate Compression depth Compression recoil"
"What is the normal PETCO2 range? - CORRECT ANSWER 35 to 45 mm Hg"
"What is the main determinant of end-tidal carbon dioxide (ETCO2) measurement during CPR? -
CORRECT ANSWER Blood delivery to the lungs"
"What is the only CPR performance monitor typically available for measuring a physiologic end
point outside of a hospital setting? - CORRECT ANSWER End-tidal carbon dioxide (ETCO2)"
"What invasive CPR performance measure reflects changes in cardiac output due to chest compressions, if oxygen consumption, arterial oxygen saturation, and hemoglobin remain
constant? - CORRECT ANSWER Central venous oxygen saturation"
"A 49 year old female patient arrives at the hospital, saying she has chest discomfort and palpitations that have occurred for the past several hours. She feels cold, sweaty, and weak. The patient is awake and alert. She states that she does not have any medical history and has never felt like this before. She mentions that she feels like she may pass out.
Which of the following are initial steps of the primary assessment? - CORRECT ANSWER
Assess ABCs Establish IV access Obtain a 12-lead ECG Monitor heart rhythm and vital signs" "The patient is placed on the heart monitor.
"The patient remains in ventricular fibrillation after another 2 minutes of CPR.
What additional medication can you administer? - CORRECT ANSWER Amiodarone 300mg IV"
"The patient is showing signs of ROSC. She has a palpable pulse, HR 65/min, SpO2 94%, ETCO 38mm Hg, and BP 82/55 mmHg.
Which are the highest priority interventions per the adult post cardiac arrest care algorithm? -
CORRECT ANSWER Maintaining a target PaCO2 between 35 and 45 mmHg
Maintaining SpO2 92 to 98% Ventilating the patient with 10 breaths per minute" "In addition to managing the airway and respiratory parameters, which step is also prioritized
during the initial stabilization phase? - CORRECT ANSWER Treating hypotension"
“What element of a system of care is represented by properly functioning resuscitation
equipment? - CORRECT ANSWER Structure"
"What is the first link in the out-of-hospital cardiac arrest (OHCA) chain of survival? - CORRECT
ANSWER Activation of emergency reponse"
"What are signs of clinical deterioration that would prompt the activation of rapid response
system? - CORRECT ANSWER Symptomatic hypertension
Seizure Unexplained agitation" "What is the primary purpose of a rapid response team (RRT) or medical emergency team (MET)?
- CORRECT ANSWER To improve patient outcomes by identifying and treating early clinical deterioration"
"Which is an example of knowledge sharing by a team leader? - CORRECT ANSWER Asking for
suggestions about interventions"
"Which is an example of summarizing and reevaluating? - CORRECT ANSWER Increasing
monitoring of the patients condition deteriorates"
"Which is a step of closed-loop communication? - CORRECT ANSWER Confirming task
completion before assigning another task"
"Which are examples of mutual respect? Select all that apply: - CORRECT ANSWER
Acknowledging correctly completed tasks in a positive way Ensuring that only one person talks at a time"
"What are the components of high quality CPR? Select all that apply: - CORRECT ANSWER
Compression depth of at least 2 inches (5cm) Switching compressors every 2 minutes Avoiding excessive ventilation Complete chest recoil after each compression Interruption limited to under 10 seconds" "How quickly does the chance of survival decline for every minute of defibrillation delay in
patients with ventricular fibrillation who do receive bystander CPR? - CORRECT ANSWER 7-
"What is the advantage of a systematic approach to patient assessment? - CORRECT ANSWER
Reduces the chances of missing important signs and symptoms"
"What is the first step in the systematic approach to patient assessment? - CORRECT ANSWER
Initial impression" "What is the maximum amount of time you should simultaneously perform pulse and breathing
checks? - CORRECT ANSWER 10 seconds"
"While performing the BLS Assessment, you initiate high- quality CPR and assist ventilation with a bag mask device. The AED does not recommend a shock.
Which action in the Primary assessment should you perform first? - CORRECT ANSWER
Determine is the patients airway is patent" "Obtaining a what is the most important assessment tool for a patient displaying signs and
symptoms of acute coronary syndrome? - CORRECT ANSWER 12 lead ekg"
"What is the time goal for how quickly you should complete a fibrinolytic checklist once the
patient arrives in the emergency department? - CORRECT ANSWER 10 minutes"
"When should oxygen be administered? - CORRECT ANSWER If the patient is dyspneic or
hypoxemic, has obvious signs of heart failure, or has an arterial o2 saturation that is less than 90% or unknown."
