AHA ACLS Provider (Advanced Cardiovascular Life Support)

During adult CPR, what is the recommended chest compression rate per the 2025 AHA Guidelines?

• A100–120 compressions per minute
• B80–100 compressions per minute
• C60–80 compressions per minute
• D120–140 compressions per minute

What is the recommended chest compression depth for an average adult during CPR?

• AAt least 1 inch (2.5 cm)
• BAt least 1.5 inches (4 cm)
• CAt least 2 inches (5 cm) and no more than 2.4 inches (6 cm)
• DAt least 3 inches (7.5 cm)

To optimize the chest compression fraction during a resuscitation, rescuers should aim to keep the fraction at what minimum target?

• AAt least 40%
• BAt least 60% (ideally 80% or higher)
• CAt least 50%
• DExactly 100%

How often should compressors switch roles during a prolonged resuscitation to limit fatigue?

• AEvery 30 seconds
• BEvery 5 minutes
• CEvery 2 minutes (or sooner if fatigued)
• DOnly when visibly exhausted

For an adult in cardiac arrest with NO advanced airway, what compression-to-ventilation ratio should a two-rescuer team use?

• A15:2
• B30:2
• C10:1
• DContinuous compressions with no ventilations

What is the single most important factor for survival in witnessed adult ventricular fibrillation arrest?

• AEarly epinephrine administration
• BEarly advanced airway placement
• CEarly amiodarone administration
• DEarly defibrillation with high-quality CPR

After delivering a shock for VF, what should the team do immediately?

• AResume chest compressions immediately for 2 minutes
• BCheck the pulse for up to 10 seconds
• CReanalyze the rhythm immediately
• DAdminister epinephrine before resuming CPR

When using an AED on an adult with a hairy chest that prevents pad adhesion, what is the best action?

• ADo not use the AED
• BPour water on the chest before applying pads
• CPress firmly, and if needed remove hair by quickly pulling off a set of pads or shaving t…
• DPlace pads over clothing

Allowing complete chest recoil between compressions is important primarily because it:

• AReduces rescuer fatigue
• BAllows venous return and ventricular refilling, improving perfusion
• CPrevents rib fractures
• DIncreases compression rate

A high-quality CPR rescuer should limit interruptions in compressions to no more than what duration?

• ALess than 60 seconds
• BLess than 30 seconds
• CLess than 10 seconds
• DInterruptions do not matter if compressions are deep

In the adult cardiac arrest algorithm, which two rhythms are shockable?

• AAsystole and PEA
• BSinus bradycardia and first-degree AV block
• CVentricular fibrillation and pulseless ventricular tachycardia
• DAtrial fibrillation and atrial flutter

What is the recommended first defibrillation energy dose using a biphasic defibrillator for adult VF/pVT (when the manufacturer dose is unknown)?

• A50 J
• B30 J
• C360 J always
• D120–200 J (manufacturer recommendation; use maximum if unknown)

For subsequent shocks in refractory adult VF/pVT with a biphasic defibrillator, the energy should be:

• AAlways reduced by half
• BThe same as or higher than the first shock
• CAlways 50 J
• DDiscontinued after the second shock

What is the standard dose and interval for epinephrine in adult cardiac arrest?

• A1 mg IV/IO every 3–5 minutes
• B0.1 mg IV every 10 minutes
• C1 mg IV once only
• D3 mg IV every 5 minutes

In non-shockable arrest (asystole/PEA), when should epinephrine be administered?

• AOnly after the first shock
• BAs soon as feasible after recognizing the arrest
• CAfter 4 cycles of CPR
• DOnly if the patient has an advanced airway

What is the first dose of amiodarone for refractory VF/pVT, and what is the second dose?

• A150 mg then 150 mg IV/IO
• B300 mg then 150 mg IV/IO
• C300 mg then 300 mg IV/IO
• D100 mg then 50 mg IV/IO

If amiodarone is unavailable for refractory VF/pVT, what is the first lidocaine dose?

• A0.5 mg/kg
• B3 mg/kg
• C1–1.5 mg/kg IV/IO
• D5 mg/kg

For shockable arrest, after which shock is the first dose of epinephrine typically given in the ACLS algorithm?

• ABefore the first shock
• BAfter the fourth shock
• CAfter the second shock
• DOnly after ROSC

The 'H's' of reversible causes of cardiac arrest include all of the following EXCEPT:

• AHypovolemia
• BHypoxia
• CHydrogen ion (acidosis)
• DHyperthyroidism

Which of the following is one of the 'T's' of reversible causes of cardiac arrest?

• ATension pneumothorax
• BTachypnea
• CTinnitus
• DThrombocytopenia

A patient in PEA arrest has distended neck veins, tracheal deviation, and absent breath sounds on one side. What is the most likely reversible cause and treatment?

• AHypovolemia — give fluids
• BCardiac tamponade — pericardiocentesis
• CTension pneumothorax — needle decompression
• DHypothermia — rewarming

During a cardiac arrest, a sudden, sustained rise in end-tidal CO2 (e.g., from 12 to 38 mm Hg) most likely indicates:

• AEndotracheal tube displacement
• BReturn of spontaneous circulation (ROSC)
• CWorsening acidosis
• DHypoventilation

During CPR, a persistently low ETCO2 (less than 10 mm Hg) after 20 minutes of resuscitation suggests:

• AEffective high-quality CPR
• BHyperventilation
• CLow likelihood of ROSC and poor compression quality or perfusion
• DImminent ROSC

In confirmed or suspected hyperkalemic cardiac arrest, which medication is given to stabilize the cardiac membrane?

• ASodium bicarbonate alone
• BAtropine
• CMagnesium sulfate
• DCalcium chloride or calcium gluconate

Magnesium sulfate is specifically indicated during cardiac arrest for which rhythm?

• AAsystole
• BMonomorphic VT
• CNarrow-complex SVT
• DTorsades de pointes (polymorphic VT with prolonged QT)

During asystole, what is the appropriate management regarding defibrillation?

• ADo not shock; provide CPR, epinephrine, and treat reversible causes
• BDeliver a single shock immediately
• CShock only if asystole persists 2 minutes
• DDeliver synchronized cardioversion

What does PEA (pulseless electrical activity) describe?

• AA chaotic rhythm with no organized electrical activity
• BA rhythm that always responds to defibrillation
• COrganized electrical activity on the monitor without a palpable pulse
• DSinus rhythm with a strong pulse

Which statement about routine sodium bicarbonate in cardiac arrest is correct?

• AIt should be given routinely after the first epinephrine dose
• BIt is not recommended for routine use and is reserved for specific situations (e.g., hype…
• CIt should replace epinephrine
• DIt is the first-line drug for VF

During CPR with no advanced airway in place, what should rescuers do to avoid harm from over-ventilation?

• AHyperventilate to keep ETCO2 high
• BDeliver 2 breaths after every 30 compressions, each over 1 second producing visible chest…
• CGive continuous large breaths
• DAvoid ventilations entirely for the first 10 minutes

A patient in cardiac arrest has a known massive pulmonary embolism. Which reversible-cause-directed therapy may be considered?

• AAtropine
• BAdenosine
• CFibrinolytic therapy (thrombolysis)
• DCalcium chloride

After ROSC, the team notes recurrent VF. What is the appropriate immediate action?

• AWithhold antiarrhythmics
• BBegin transcutaneous pacing
• CGive atropine
• DDefibrillate and resume the cardiac arrest algorithm; consider an antiarrhythmic infusion

What is the preferred route for drug administration during cardiac arrest if IV access is not immediately available?

• AEndotracheal route
• BIntramuscular route
• CSubcutaneous route
• DIntraosseous (IO) access

During a pulseless VT arrest, the rhythm converts after a shock to an organized rhythm. The next best step is to:

• ACheck for a pulse and assess the patient
• BImmediately give amiodarone 300 mg
• CDefibrillate again
• DRestart epinephrine immediately

Which best describes the role of the rhythm check in the adult cardiac arrest algorithm?

• APerformed continuously without pausing compressions
• BPerformed approximately every 2 minutes, limiting the pause to under 10 seconds
• CPerformed every 30 seconds
• DPerformed only once at the start of the arrest

A patient suspected of opioid overdose is in respiratory arrest with a pulse. In addition to ventilation, what medication is indicated?

• AEpinephrine 1 mg IV
• BAmiodarone
• CAtropine
• DNaloxone

What is the first-line drug for symptomatic bradycardia with a pulse in the adult bradycardia algorithm?

• AAdenosine 6 mg
• BAmiodarone 150 mg
• CAtropine 1 mg IV
• DEpinephrine 1 mg IV bolus

In the bradycardia algorithm, atropine 1 mg may be repeated every 3–5 minutes up to what maximum total dose?

• A3 mg
• B2 mg
• C1 mg
• D6 mg