ACLS Exam Questions & Answers 2026 (1–10)

Q1During a cardiac arrest resuscitation, the team leader assigns roles before CPR begins. A new nurse asks why the team leader is not doing compressions. Which response BEST explains effective team dynamics?

• ACompressions are only performed by the most experienced provider present.
• BThe team leader avoids compressions to prevent fatigue from affecting their judgment later.
• CThe team leader must remain free to direct, monitor, and make decisions for the entire team.
• DThe team leader should rotate into compressions every 2 minutes to maintain team morale.

Q2You arrive at a patient found unresponsive. Which action is the FIRST priority in the BLS primary survey?

• ACheck for a carotid pulse for up to 10 seconds.
• BVerify scene safety before approaching the patient.
• COpen the airway using a head-tilt chin-lift.
• DAttach the AED and analyze rhythm.

Q3A provider performing chest compressions on an adult patient is pushing down approximately 1.5 inches at a rate of 110/min. What correction should the team leader call out?

• AIncrease compression depth to at least 2 inches; rate is acceptable.
• BDecrease rate to 80-100/min and maintain current depth.
• CBoth rate and depth are within guideline targets; no correction needed.
• DIncrease depth to at least 2 inches and slow rate to below 100/min.

Q4Mid-resuscitation, a team member states: 'I've pushed 1 mg of epinephrine IV.' The team leader nods without responding verbally. According to ACLS team communication principles, what problem does this represent?

• AAbsence of closed-loop communication — the team leader must verbally confirm receipt of the message.
• BNodding is an acceptable form of confirmation in a high-noise resuscitation environment.
• CThe team member should have waited for explicit instruction before administering the drug.
• DThe dose of epinephrine reported is incorrect, which is the primary concern.

Q5During the primary ACLS survey (ABCDE), the team has confirmed a shockable rhythm and delivered one shock. The next immediate action is:

• ACheck the pulse for up to 10 seconds to determine whether perfusion has returned.
• BAdminister 300 mg amiodarone IV before resuming compressions.
• CReanalyze the rhythm with the defibrillator within 30 seconds of the shock.
• DResume high-quality CPR immediately for 2 minutes before reassessing rhythm.

Q6A team member who is an experienced paramedic disagrees with the team leader's decision to withhold a second dose of epinephrine. What is the MOST appropriate way for that team member to communicate concern?

• AAsk the charge nurse to intervene immediately to override the team leader's decision.
• BWait until after the resuscitation and document the disagreement in the medical record.
• CState the concern calmly and directly to the team leader using a clear, assertive statement, then defer if the leader acknowledges it.
• DAdminister the epinephrine independently because clinical judgment supersedes team hierarchy.

Q7You are leading a resuscitation and observe that compressions are being interrupted for 18 seconds each time the defibrillator charges. What target metric is being violated?

• ACPR fraction should be kept above 60%, requiring pre-shock pauses of no more than 10 seconds.
• BThe ratio of compressions to ventilations must remain 30:2 during defibrillator charging.
• CThe compression rate must not fall below 100/min during any pause.
• DPost-shock pauses longer than 15 seconds require documentation only, not correction.

Q8A resuscitation team has four members: team leader, compressor, airway provider, and IV/medication nurse. The monitor shows asystole. The airway provider spontaneously begins preparing for intubation and announces 'I'll intubate now.' What principle of team dynamics is at risk?

• ACPR fraction — verbal announcements during compressions distract other team members.
• BClosed-loop communication — intubation should only be announced after it is completed.
• CMutual respect — announcing actions aloud undermines the team leader's authority.
• DClear role definition — team members should not take on tasks outside their assigned role without direction from the team leader.

Q9A 58-year-old collapses in the ICU. CPR is in progress. The monitor shows a narrow-complex organized rhythm at 70/min with no pulse. Epinephrine 1 mg has been given. Which statement BEST guides the next 2 minutes of care?

• AContinue high-quality CPR, search for and treat reversible causes of PEA, and reassess rhythm and pulse after 2 minutes.
• BAdminister atropine 1 mg IV because the rate of 70/min represents relative bradycardia in PEA.
• CCease compressions briefly to allow the organized rhythm to generate a pulse spontaneously.
• DAttempt synchronized cardioversion at 200 J because the organized rhythm may respond to electrical therapy.

Q10During handoff at shift change, the outgoing team leader states: 'We've given two rounds of epi and one dose of amiodarone 300 mg; total downtime is 14 minutes.' The incoming team leader asks what role this information plays in ACLS framework. Which answer is MOST accurate?

• AIt informs the timing of the next epinephrine dose and whether a second amiodarone dose of 150 mg is appropriate if VF/pVT persists.
• BIt signals that resuscitation should be considered futile because more than 10 minutes have elapsed.
• CIt allows the team to document medication errors that occurred during the prior shift.
• DIt triggers mandatory administration of sodium bicarbonate based on elapsed arrest time.