TheoryACLS Practice Questions
Free ACLS practice questions with answers and plain-English explanations. Browse the PDF, video and online mock test.
ACLS Questions
Open each answer, read the explanation, then continue into the full practice flow.
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?
Show answer
✓ Correct answer: The team leader must remain free to direct, monitor, and make decisions for the entire team.
AHA ACLS guidelines designate the team leader as the coordinator who directs all actions, communicates with the team, and makes real-time decisions — a role incompatible with performing compressions, which demand full physical attention.
Q2You arrive at a patient found unresponsive. Which action is the FIRST priority in the BLS primary survey?
Show answer
✓ Correct answer: Verify scene safety before approaching the patient.
The very first step of any resuscitation is confirming that the scene is safe for rescuers, as outlined in the BLS survey; proceeding into an unsafe environment risks creating additional victims.
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?
Show answer
✓ Correct answer: Increase compression depth to at least 2 inches; rate is acceptable.
AHA guidelines specify adult compression depth of at least 2 inches (5 cm) and rate of 100-120/min; the rate of 110/min is correct, but 1.5 inches is inadequate and must be corrected.
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?
Show answer
✓ Correct answer: Absence of closed-loop communication — the team leader must verbally confirm receipt of the message.
Closed-loop communication requires that the receiver verbally acknowledges the message and the sender confirms the acknowledgment; a nod alone does not complete the loop and risks miscommunication errors.
Q5During the primary ACLS survey (ABCDE), the team has confirmed a shockable rhythm and delivered one shock. The next immediate action is:
Show answer
✓ Correct answer: Resume high-quality CPR immediately for 2 minutes before reassessing rhythm.
Per the AHA VF/pVT algorithm, after each shock CPR is resumed immediately for 2 minutes before the next rhythm and pulse check, minimizing post-shock no-flow time.
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?
Show answer
✓ Correct answer: State the concern calmly and directly to the team leader using a clear, assertive statement, then defer if the leader acknowledges it.
AHA ACLS team dynamics teach 'constructive intervention': any member may calmly voice a concern to the team leader, but must still defer to the leader's final decision unless patient safety is immediately threatened.
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?
Show answer
✓ Correct answer: CPR fraction should be kept above 60%, requiring pre-shock pauses of no more than 10 seconds.
AHA guidelines recommend minimizing all peri-shock pauses to under 10 seconds and maintaining a CPR fraction (proportion of resuscitation time with compressions) greater than 60% to optimize perfusion pressure.
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?
Show answer
✓ Correct answer: Clear role definition — team members should not take on tasks outside their assigned role without direction from the team leader.
ACLS team dynamics require clearly defined roles and that significant interventions be directed by the team leader; self-initiated role expansion without instruction can create overlap, missed tasks, or unsafe actions.
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?
Show answer
✓ Correct answer: Continue high-quality CPR, search for and treat reversible causes of PEA, and reassess rhythm and pulse after 2 minutes.
Pulseless electrical activity (PEA) is treated with uninterrupted high-quality CPR, epinephrine every 3-5 minutes, and aggressive search for the 6 Hs and 6 Ts; atropine is not indicated for PEA and cardioversion has no role.
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?
Show answer
✓ Correct answer: It informs the timing of the next epinephrine dose and whether a second amiodarone dose of 150 mg is appropriate if VF/pVT persists.
Accurate elapsed-time and medication tracking is essential for maintaining the ACLS algorithm: epinephrine recurs every 3-5 minutes, and a second amiodarone dose (150 mg) can be given for refractory VF/pVT after the initial 300 mg.
Full ACLS bank + unlimited mocks
Try 30 questions free. Unlock the complete ACLS question bank, every explanation, and unlimited timed mock exams. Practice on any device.
Unlock ACLS →