200+ Free BLS / ACLS Practice Questions

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Question 1

Score: 0/0

A patient presents with a heart rate of 180 bpm, BP of 70/40, altered mental status, and diaphoresis. The first action in the ACLS tachycardia algorithm for this UNSTABLE patient is:

Obtain a 12-lead ECG and analyze the rhythm

Adenosine 6 mg IV rapid push

Amiodarone 150 mg IV over 10 minutes

Immediate synchronized cardioversion

to track

2026 Statistics

Key Facts: BLS / ACLS Exam

84%

BLS Passing Score

21/25 questions

100–120

Compressions/Min

AHA 2025 guidelines

2 years

Certification Valid

BLS and ACLS

32–37.5°C

TTM Target Range

AHA 2023 update

$50–$290

Course Fee

BLS vs ACLS

200+

Practice Questions Here

OpenExamPrep question bank

BLS certification requires hands-on CPR/AED skills testing plus a written exam at 84% or higher. ACLS requires BLS-level proficiency, skills testing, and an ACLS written exam at 84% or higher under current AHA course-completion materials. Both certifications are valid for 2 years. BLS costs about $30–$75; ACLS commonly costs $150–$290. The 2025 AHA CPR and ECC Guidelines are now current, with the 2023 adult ACLS focused update incorporated into post-arrest temperature-control practice.

Sample BLS / ACLS Practice Questions

Try these sample questions to test your BLS / ACLS exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1An unresponsive adult is found in a hallway. After confirming the scene is safe, what is the FIRST action a lone rescuer should take?

A.Begin chest compressions immediately

B.Open the airway and check for breathing

C.Tap and shout to check responsiveness, then activate the emergency response system

D.Apply the AED pads before doing anything else

Explanation: The BLS sequence begins with confirming unresponsiveness by tapping and shouting. If unresponsive and not breathing normally, the lone rescuer activates the emergency response system (or sends a bystander to call 911) and retrieves an AED before or simultaneously with starting CPR. Activating EMS first ensures advanced help is on the way.

2What is the recommended compression rate for adult CPR according to the 2020 AHA guidelines?

A.60–80 compressions per minute

B.80–100 compressions per minute

C.100–120 compressions per minute

D.120–140 compressions per minute

Explanation: The AHA recommends 100–120 compressions per minute for adult CPR. Rates below 100 are too slow and reduce coronary perfusion pressure; rates above 120 are too fast and reduce compression depth and recoil time. This range applies to adults, children, and infants.

3During adult CPR, a healthcare provider should compress the chest to a depth of:

A.At least 1 inch (2.5 cm)

B.At least 1.5 inches (4 cm)

C.At least 2 inches (5 cm), but no more than 2.4 inches (6 cm)

D.At least 3 inches (7.5 cm)

Explanation: Current AHA guidelines specify adult chest compressions should be at least 2 inches (5 cm) but no more than 2.4 inches (6 cm). Compressions shallower than 2 inches fail to generate adequate stroke volume. Compressions deeper than 2.4 inches are associated with increased injury risk, particularly rib fractures and internal organ damage.

4Which of the following BEST describes the concept of "full chest recoil" in CPR?

A.Leaning on the chest between compressions to maintain consistent depth

B.Allowing the chest to return to its normal resting position after each compression before delivering the next

C.Compressing the sternum downward by lifting the entire body off the chest between compressions

D.Pressing the heel of the hand firmly against the sternum after each compression

Explanation: Full chest recoil means allowing the chest to completely return to its natural position between compressions without leaning on it. Leaning prevents the heart from refilling with blood, reducing stroke volume during the next compression. Good recoil is as important as compression depth for generating cardiac output.

5A 2-rescuer BLS team is performing CPR on an adult with an advanced airway in place. What is the correct ventilation rate?

A.1 breath every 3–5 seconds (12–20 breaths/min)

B.1 breath every 5–6 seconds (10–12 breaths/min)

C.1 breath every 6–8 seconds (8–10 breaths/min)

D.1 breath every 2–3 seconds synchronized with compressions

Explanation: Once an advanced airway (ET tube, supraglottic device) is in place, compressions are continuous at 100–120/min and ventilations are delivered asynchronously at 1 breath every 5–6 seconds (10–12 breaths/min). Faster rates cause hyperventilation, reduce venous return, and decrease coronary perfusion pressure. The old 30:2 ratio continues only when NO advanced airway is in place.

6During CPR on an adult without an advanced airway, what is the compression-to-ventilation ratio for 2 rescuers?

A.15:1

B.15:2

C.30:1

D.30:2

Explanation: For adults, the compression-to-ventilation ratio is 30:2 regardless of the number of rescuers when NO advanced airway is in place. Each ventilation should take 1 second and produce visible chest rise. The 30:2 ratio for adults maximizes compression time while still providing ventilation; pediatric 2-rescuer ratio is 15:2.

7An AED is attached to a patient in cardiac arrest. The AED analyzes and advises "No Shock." What should the rescuer do NEXT?

A.Deliver a shock anyway since the rhythm may be shockable

B.Immediately resume CPR, beginning with chest compressions

C.Check the patient's pulse for up to 10 seconds before continuing CPR

D.Reposition the AED pads and re-analyze

Explanation: A "No Shock Advised" message means the rhythm is non-shockable (PEA or asystole). CPR should be resumed immediately — compressions first — without a pulse check, as the AED analysis already assessed the rhythm. Minimizing interruptions to chest compressions is critical; pulse checks should be brief (< 10 seconds) and only done when there is a specific clinical reason.

8When applying AED pads to a patient, where should the pads be placed?

A.Both pads on the anterior chest, one over the heart and one on the right upper chest

B.One pad on the right upper chest (below the clavicle) and one on the lower left chest (below the axilla)

C.One pad over the sternum and one on the patient's back

D.One pad on the right lower rib cage and one on the left upper chest

Explanation: Standard AED pad placement is anterolateral: right pad on the right upper chest just below the clavicle, and left pad on the lower-left chest below the axilla. This placement allows the electrical vector to traverse the heart (ventricular mass) optimally. An anteroposterior alternative (chest and back) is acceptable but less common. Pad cables connect to the AED and must not cross.

9How long should you check for a pulse in an unresponsive adult who is not breathing normally?

A.Up to 5 seconds

B.Up to 10 seconds

C.Up to 20 seconds

D.Until the pulse is definitively confirmed or excluded

Explanation: A pulse check should take no more than 10 seconds. If you cannot definitively feel a pulse within 10 seconds, or are unsure, begin CPR immediately. This limit prevents harmful delays in starting compressions. Lay rescuers are not trained to check pulses — they initiate CPR for any unresponsive, non-normally-breathing person.

10When performing CPR, the AHA recommends minimizing interruptions to chest compressions. What is the maximum recommended pause time for pulse checks or rhythm analysis?

A.Less than 5 seconds

B.Less than 10 seconds

C.Less than 15 seconds

D.Less than 20 seconds

Explanation: Any interruption to chest compressions should be less than 10 seconds. Chest compressions build coronary perfusion pressure over time; every interruption drops that pressure to zero and requires multiple compressions to rebuild. High-quality CPR is defined in part by minimizing these pauses (targeting a chest compression fraction > 60%).

About the BLS / ACLS Exam

The AHA BLS and ACLS certifications are the gold standard for healthcare providers. BLS covers CPR for adults, children, and infants; AED use; and 2-rescuer CPR. ACLS builds on BLS with cardiac arrest algorithms (VF/pVT, PEA/asystole), arrhythmia management, pharmacology, stroke, ACS, and special resuscitation situations.

Questions

25 scored questions

Time Limit

45–60 minutes

Passing Score

84% written plus required hands-on skills testing

Exam Fee

$50–$290 (AHA / Authorized Training Centers)

BLS / ACLS Exam Content Outline

25%

BLS Skills & CPR Technique

Adult/child/infant CPR, AED operation, airway management, rescue breathing, 2-rescuer CPR

25%

Cardiac Arrest Management

VF/pVT algorithm, PEA/asystole algorithm, Hs & Ts, ROSC, post-cardiac arrest care

20%

Arrhythmia Management

Bradycardia algorithm (atropine, TCP), tachycardia algorithm (cardioversion, adenosine), rhythm recognition

15%

ACLS Pharmacology

Epinephrine, amiodarone, lidocaine, atropine, adenosine, IV/IO access routes and doses

15%

Special Resuscitation Situations

Stroke (FAST, tPA), ACS (MONA, PCI), pregnancy, hypothermia, drowning, opioid overdose, pediatric differences

How to Pass the BLS / ACLS Exam

What You Need to Know

Passing score: 84% written plus required hands-on skills testing
Exam length: 25 questions
Time limit: 45–60 minutes
Exam fee: $50–$290

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

BLS / ACLS Study Tips from Top Performers

1Know the VF/pVT algorithm: CPR → shock → CPR 2 min → check rhythm. Epinephrine 1 mg after first or second shock. Amiodarone 300 mg then 150 mg for refractory VF

2PEA/asystole is never shocked — focus on CPR quality and reversible causes (Hs & Ts)

3The 6 Hs: Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo/Hyperkalemia, Hypothermia, Hypoglycemia. The 5 Ts: Tension pneumothorax, Tamponade, Toxins, Thrombosis (pulmonary), Thrombosis (coronary)

4Bradycardia: atropine 1 mg q3-5 min (max 3 mg) -> transcutaneous pacing -> dopamine/epinephrine infusion

5Stable tachycardia: rate control or cardioversion based on QRS width and regularity. Unstable (chest pain/hypotension/AMS) → synchronized cardioversion immediately

6Post-ROSC targets: MAP ≥65 mmHg, SpO2 92–98%, ETCO2 35–45 mmHg, glucose 100–180 mg/dL, temperature 32–37.5°C

Frequently Asked Questions

What is the BLS passing score?

The AHA BLS written exam requires a passing score of 84%, which means getting at least 21 out of 25 questions correct. In addition to the written exam, you must demonstrate hands-on CPR skills including correct compression rate (100–120/min), depth (2–2.4 inches), full chest recoil, and AED operation.

How many questions are on the ACLS exam?

AHA ACLS course-completion materials require completing the course, passing all skills tests, and passing the written exam with at least 84%. The exam covers cardiac arrest algorithms, rhythm interpretation, pharmacology, systematic assessment, post-arrest care, acute coronary syndromes, stroke, and team-based megacode performance.

How long is BLS/ACLS certification valid?

Both BLS and ACLS certifications are valid for 2 years from the date of successful completion. Renewal courses are shorter (4–6 hours for BLS, 8–10 hours for ACLS) compared to initial certification courses.

Do I need BLS before taking ACLS?

Yes. AHA ACLS requires current BLS certification as a prerequisite. You must demonstrate BLS-level CPR proficiency before enrolling in ACLS. Some training centers offer BLS + ACLS combination courses completed in 1–2 days.

What are the AHA 2023 TTM updates?

The 2023 adult ACLS focused update reframed targeted temperature management as deliberate temperature control for adults who do not follow commands after ROSC. The updated recommendation supports selecting and maintaining a constant temperature between 33°C and 37.5°C, with fever prevention after the initial control period.

What is the compression rate for adult CPR?

The AHA adult BLS guidance uses a compression rate of 100–120 per minute. Adult compression depth should be at least 2 inches (5 cm) while avoiding excessive depth beyond 2.4 inches (6 cm). Allow complete chest recoil between compressions and minimize pauses.