ACLS Exam Version B 2025 Test Questions Answers

1) A patient is receiving ventilation support via bag-valve-mask (BVM) resuscitator. Capnography is established and a blood gas is obtained to evaluate the adequacy of the ventilations. Which arterial carbon dioxide (PaCO₂) value signifies adequate ventilations?

2) A patient with acute renal failure experiences cardiac arrest. The ECG showed peaked T waves before arrest. What is the likely cause?

3) What is the most common cardiac rhythm observed in adults within the first minute following a cardiac arrest?

4) A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient’s blood pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16 breaths/min, and the pulse oximetry reading is 96%. The lead II ECG is displayed below. A patent peripheral IV is in place. What is the next action?

5) A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is diaphoretic, with associated shortness of breath. The blood pressure is 130/88 mm Hg, the heart rate is 110/min, the respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. The patient’s 12-lead ECG shows ST-segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is a patent peripheral IV. The pain is described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses of nitroglycerin. What is the next action?

6) Family members found a 45-year-old woman unresponsive in bed. The patient is unconscious and in respiratory arrest. What is the recommended initial airway management technique?

7) A patient in the telemetry unit is receiving continuous cardiac monitoring. The patient has a history of myocardial infarction. The patient’s ECG rhythm strip shows no relationship between P waves and QRS complexes, and the RR interval is constant. Which arrhythmia is indicated?

8) A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing. The blood pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate is 12 breaths/min, and the pulse oximetry reading is 95%. The lead II ECG displays a wide-complex tachycardia. What is the next action after establishing an IV and obtaining a 12-lead ECG?

9) A patient with dyspnea, low blood pressure, and altered mental status arrives at the emergency department. The ECG shows bradycardia. Which medication should the team administer?

10) An 80-year-old woman presents to the emergency department with dizziness. She now states she is asymptomatic after walking around. Her blood pressure is 102/72 mm Hg. She is alert and oriented. Her lead II ECG is below. After you start an IV, what is the next action?

11) A resuscitation team is debriefing following a recent event. A patient experienced cardiac arrest, and advanced life support was initiated. The patient required the placement of an advanced airway to maintain airway patency. Which statement indicates that the team performed high-quality CPR?

12) Which of the following is an acceptable method of selecting an appropriately sized oropharyngeal airway (OPA)?

13) Which is an appropriate and important intervention to perform for a patient who achieves ROSC during an out-of-hospital resuscitation?

14) What is the immediate danger of excessive ventilation during the post–cardiac arrest period for patients who achieve ROSC?

15) What is the recommended dose of epinephrine for the treatment of hypotension in a post– cardiac arrest patient who achieves ROSC?

16) A patient comes to the emergency department complaining of palpitations and shortness of breath. Cardiac monitoring shows a “sawtooth” pattern on ECG. What is the rhythm?

17) Cardiac monitoring reveals ventricular fibrillation. What should be the team’s priority action in addition to high-quality CPR?

18) A patient is experiencing respiratory distress secondary to an exacerbation of chronic obstructive pulmonary disease. The patient begins to exhibit signs and symptoms of worsening respiratory function and experiences respiratory arrest. The team intervenes, delivering ventilations via BVM resuscitator. The team should provide ventilations at a rate of 1 ventilation:

19) A patient enters the emergency department in respiratory compromise. The team is monitoring the patient using capnography and identifies that ETCO₂ levels are initially 33 mmHg and later 40 mmHg. From these readings, the team identifies that the patient is progressing in what stage of respiratory compromise?

20) A patient in respiratory distress and with a blood pressure of 70/50 mm Hg presents with the following lead II ECG rhythm:

What is the appropriate next intervention?

21) The ECG rhythm strip of a patient with dizziness and shortness of breath reveals sinus bradycardia. Which medications could be responsible for this rhythm?

22) A postoperative patient in the ICU reports new chest pain. What actions have the highest priority?

23) What is the recommended energy dose for biphasic synchronized cardioversion of atrial fibrillation?

24) What is the recommended duration of therapeutic hypothermia after reaching the target temperature?

25) A patient’s ECG reveals a narrow QRS complex with a regular rhythm, indicating a narrow-complex supraventricular tachyarrhythmia. The patient is stable. Which intervention should be initiated first?

26) A patient is in cardiac arrest. The underlying cause is thought to be opioid toxicity. Which statement accurately describes the use of naloxone for this patient?

27) A 30-year-old patient in cardiac arrest has a rhythm consistent with ventricular fibrillation. What is a possible cause?

28) A team member prepares to defibrillate a patient in cardiac arrest using a biphasic defibrillator. What is the typical energy dose?

29) A patient with bradycardia and signs of hemodynamic compromise does not respond to atropine. Which interventions could the healthcare provider use next? (Select all that apply)

30) Which is a contraindication to nitroglycerin administration in the management of acute coronary syndromes?

31) A patient has a witnessed loss of consciousness. The lead II ECG reveals this rhythm:

What is the appropriate next intervention?

32) Cardiac monitoring indicates a wide-complex tachyarrhythmia with a pulse and no hemodynamic compromise. What action is appropriate?

33) A responder is caring for a patient with a history of congestive heart failure. The patient is experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of 190/min. The patient’s lead II ECG is displayed below.

Which of the following terms best describes this patient?

34) What is the danger of routinely administering high concentrations of oxygen during the post– cardiac arrest period for patients who achieve ROSC?

35) What is the purpose of a medical emergency team (MET) or rapid response team (RRT)?

36) What is the most appropriate intervention for a rapidly deteriorating patient who has this lead II ECG?

37) A patient arrives at the emergency department complaining of shortness of breath. The patient has a long history of chronic obstructive pulmonary disease. Assessment reveals respiratory failure. Which action would be the initial priority to address the respiratory failure?

38) A 20-year-old man with respiratory depression is brought to the emergency department by his parents. Opioid overdose is suspected, and an initial dose of naloxone is administered at 10 p.m. The patient does not respond to this initial dose. The team would expect to administer a second dose after how many minutes?

39) A patient is pulseless. The cardiac monitor shows a very fast, wide QRS rhythm. What rhythm is this?

40) Assessment of a patient reveals an ETCO₂ level of 55 mmHg and an arterial oxygen saturation (SaO₂) level of 88%. The provider would interpret these findings as indicative of which condition?

41) During cardiac arrest, medications are given through a peripheral IV line. Each dose should be followed by how much saline?

42) An ECG strip shows a rhythm with no distinct P waves and irregularly irregular QRS complexes. Which arrhythmia is this?

43) You are evaluating a 58-year-old man with chest pain. The blood pressure is 92/50 mm Hg, the heart rate is 92/min, the nonlabored respiratory rate is 14 breaths/min, and the pulse oximetry reading is 97%. What assessment step is most important now?

44) What is the recommended target temperature range for achieving therapeutic hypothermia after cardiac arrest?

45) You are receiving a radio report from an EMS team en route with a patient who may be having an acute stroke. The hospital CT scanner is not working at this time. What should you do in this situation?

46) What is the recommended initial intervention for managing hypotension in the immediate period after return of spontaneous circulation (ROSC)?

47) What is the recommended assisted ventilation rate for patients in respiratory arrest with a perfusing rhythm?

48) Assessment of a patient in the emergency department reveals that the patient is experiencing respiratory compromise. From the assessment, the team identifies that the patient is in the earliest stage of this condition. Which stage would this be?

49) A responsive patient is choking. What method should the provider use first to clear the obstructed airway?

50) The following capnogram is from a patient experiencing respiratory distress. At which point in the waveform would the patient's ETCO₂ level be measured?