ACLS Practice Questions

ACLS Practice Questions With Answers

These questions were written by our instructors to help you revise before an ACLS course or renewal. They are not taken from the AHA exam, but they test the same decisions the written test and Megacode check.

How to use them

Answer each one before reading the explanation. If you miss more than two, revisit the arrest, bradycardia and tachycardia guides before your course.

Practice questions

1. A monitored patient suddenly becomes unresponsive with no pulse; the monitor shows ventricular fibrillation. What is the first priority?

  1. Give adrenaline
  2. Defibrillate as soon as possible, with CPR until the defibrillator is ready
  3. Secure an advanced airway

Answer: B. For VF, early defibrillation with high-quality CPR is the priority. Drugs and airway come after.

2. What should the team do immediately after a shock?

  1. Check the pulse
  2. Resume CPR, starting with compressions, for about 2 minutes
  3. Analyse the rhythm again

Answer: B. Resume compressions straight away; the next rhythm check is after about 2 minutes.

3. In asystole, which drug is given as soon as feasible?

  1. Amiodarone
  2. Adrenaline (epinephrine)
  3. Atropine

Answer: B. Adrenaline is given as soon as feasible in the non-shockable pathway.

4. Which of these is an H in the H's and T's?

  1. Hypovolaemia
  2. Hypertension
  3. Hyperglycaemia

Answer: A. The H's are hypovolaemia, hypoxia, hydrogen ion (acidosis), hypo-/hyperkalaemia and hypothermia.

5. A patient with a pulse has a heart rate of 36, low blood pressure and confusion. What is the first drug?

  1. Adenosine
  2. Atropine
  3. Amiodarone

Answer: B. Atropine is first-line for symptomatic bradycardia; pacing or an infusion follows if it is ineffective.

6. A patient with a regular narrow-complex tachycardia at 190 is stable. After vagal manoeuvres fail, what is next?

  1. Adenosine
  2. Immediate defibrillation
  3. Atropine

Answer: A. Adenosine is used for stable regular narrow-complex tachycardia.

7. An unstable patient has a tachyarrhythmia with a pulse. What is the treatment?

  1. Unsynchronised defibrillation
  2. Synchronised cardioversion
  3. Observation

Answer: B. Unstable tachycardia with a pulse is treated with synchronised cardioversion.

8. After an advanced airway is placed during CPR, how often are breaths given to an adult?

  1. Every 2 seconds
  2. About every 6 seconds, with continuous compressions
  3. 2 breaths after every 30 compressions

Answer: B. About one breath every 6 seconds (10 a minute) without pausing compressions.

9. During CPR, waveform capnography shows an end-tidal CO2 persistently below 10 mmHg. What does this suggest?

  1. CPR quality should be improved
  2. Return of circulation
  3. The tube is in perfect position

Answer: A. A persistently low reading suggests poor CPR quality; an abrupt sustained rise can indicate ROSC.

10. Which rhythm is NOT shockable?

  1. Ventricular fibrillation
  2. Pulseless ventricular tachycardia
  3. Pulseless electrical activity

Answer: C. PEA and asystole are non-shockable.

11. Why is closed-loop communication used by the team leader?

  1. It is faster to shout to the whole room
  2. It confirms each instruction was heard and completed
  3. It replaces the recorder

Answer: B. The receiver repeats the instruction and confirms when it is done.

12. A patient with suspected acute stroke arrives. Which fact matters most for treatment decisions?

  1. Time last known well
  2. Blood group
  3. Height

Answer: A. Eligibility for time-dependent treatments depends on when the patient was last known to be well.

How did you do?

Aim for at least 10 out of 12. For gaps, revise VF and pulseless VT, bradycardia, tachycardia and capnography. The ACLS exam guide explains the real test.

Other life support and first aid courses: BLS Course · PALS Course · First Aid Course · Training calendar

Frequently asked questions

Are these the real ACLS exam questions?

No, they were written by our instructors for revision.

What is on the ACLS written test?

Applied questions on the course cases: rhythms, algorithms, drugs, post-arrest care, ACS, stroke and team dynamics.

How do I prepare for the Megacode?

Talk through each algorithm aloud as team leader; see our Megacode guide.

Is the ACLS test open book?

Your instructor explains what resources are allowed on the day.

What topics come up most?

The arrest pathways, stable versus unstable decisions, and drug choices.

Book an AHA ACLS course in Abu Dhabi

Safety First Medical Services is an American Heart Association training centre on Al Reem Island. HeartCode blended ACLS, classroom ACLS and on-site group ACLS for hospitals and clinics, with a two-year AHA ACLS Provider eCard on completion.

See ACLS dates and register ACLS course overview Group booking enquiry

Sources and further reading

What we teach follows the awarding body and the UAE health authorities. For the definitive position on a course or licensing question, these are the places to check.

Last reviewed by the training team at Safety First Medical Services, an American Heart Association training centre at Addax Office Tower, Al Reem Island, Abu Dhabi. Call +971 55 761 9841 or email training@safetyfirstmed.ae.