Cardiac Arrest Algorithms (CPR, ACLS) Practice Questions
10 free Cardiac Arrest Algorithms (CPR, ACLS) practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
What is the immediate action to take after identifying a patient in cardiac arrest?
- A Secure IV access before starting any compressions.
- B Begin chest compressions and activate emergency response.
- C Complete a full physical assessment before starting CPR.
- D Give epinephrine before beginning compressions.
Correct answer: Begin chest compressions and activate emergency response.
Early recognition with immediate high-quality chest compressions and activation of the emergency response system are the first links in the chain of survival. Delaying compressions for IV access, assessment, or drugs reduces survival.
Which of the following is included in high-quality CPR for an adult?
- A Rate of 60-70 per minute with a depth of about 4 cm.
- B Rate of 100-120 per minute, depth at least 5 cm, full recoil.
- C Rate of 140 per minute with deliberately shallow compressions.
- D Compression-only CPR with no ventilation by trained providers.
Correct answer: Rate of 100-120 per minute, depth at least 5 cm, full recoil.
High-quality adult CPR uses a rate of 100-120 compressions per minute, a depth of at least 5 cm (2 in), full chest recoil, and minimal interruptions. Slower or faster rates and shallow depth reduce perfusion.
When should epinephrine be administered in the adult cardiac arrest algorithm?
- A Only after at least three shocks in a shockable rhythm.
- B Immediately after the first shock regardless of rhythm.
- C After initial shocks if shockable, and early if non-shockable.
- D Epinephrine is no longer recommended in cardiac arrest.
Correct answer: After initial shocks if shockable, and early if non-shockable.
Epinephrine 1 mg IV/IO every 3-5 minutes is given after the initial defibrillation attempts in shockable rhythms (VF/pVT) and as soon as possible in non-shockable rhythms (asystole/PEA).
Which statement is true regarding interruptions in chest compressions during a code?
- A Pausing compressions for 30 seconds to assess rhythm is acceptable.
- B Interruptions must be minimized because coronary perfusion pressure falls when compressions stop.
- C Pauses do not matter as long as ventilations are delivered.
- D Compressions may be stopped at any time once a monitor is attached.
Correct answer: Interruptions must be minimized because coronary perfusion pressure falls when compressions stop.
Coronary perfusion pressure drops almost immediately when compressions stop and takes time to rebuild, so guidelines stress minimizing interruptions, especially around defibrillation.
What is the recommended compression-to-ventilation ratio in adult BLS without an advanced airway?
- A 15 compressions : 2 ventilations.
- B 30 compressions : 2 ventilations.
- C 10 compressions : 1 ventilation.
- D Continuous compressions with no ventilations.
Correct answer: 30 compressions : 2 ventilations.
Until an advanced airway is placed, the standard ratio for adult CPR is 30:2 to balance compressions and ventilations.
What is the recommended depth of chest compressions for an adult in cardiac arrest?
- A At least 4 cm (1.5 in) but less than 5 cm.
- B At least 5 cm (2 in) but not more than 6 cm.
- C Exactly 3 cm for all adults.
- D Depth is not important as long as you compress.
Correct answer: At least 5 cm (2 in) but not more than 6 cm.
Guidelines specify at least 5 cm but no more than 6 cm for adult chest compressions to ensure effective perfusion without causing injury.
After return of spontaneous circulation (ROSC), what is an important component of post-cardiac arrest care per ACLS?
- A Discontinue monitoring once a pulse returns.
- B Maintain SpO2 92-98%, support hemodynamics, obtain a 12-lead ECG, consider targeted temperature management.
- C Stop supplemental oxygen therapy after ROSC.
- D Transfer the patient immediately without stabilization.
Correct answer: Maintain SpO2 92-98%, support hemodynamics, obtain a 12-lead ECG, consider targeted temperature management.
Post-ROSC care includes airway and ventilation management with targeted oxygenation (SpO2 92-98%), hemodynamic support, a 12-lead ECG to identify treatable causes, and targeted temperature management if the patient remains comatose.
Which medication is considered an anti-arrhythmic option after the second defibrillation attempt in adult VF/pVT?
- A Amiodarone or lidocaine
- B Atropine
- C Adenosine
- D Phenylephrine
Correct answer: Amiodarone or lidocaine
After the second shock in refractory VF/pVT, an anti-arrhythmic is indicated: amiodarone (300 mg) first-line, with lidocaine as an alternative. Atropine, adenosine, and phenylephrine have no role in this setting.
In CPR quality, why is it recommended to switch compressors every ~2 minutes?
- A It creates time for documentation by the team.
- B Rescuer fatigue reduces compression depth and quality.
- C It allows the patient a brief rest from compressions.
- D It lets the team rotate equipment between rescuers.
Correct answer: Rescuer fatigue reduces compression depth and quality.
Rescuer fatigue sets in within about two minutes and degrades compression depth and rate, so switching compressors maintains high-quality CPR.
Which is the correct order of steps in the ACLS adult cardiac arrest algorithm for a shockable rhythm?
- A Give epinephrine first, then start CPR, then defibrillate.
- B Start CPR, defibrillate, resume CPR, gain IV/IO access, give epinephrine, then consider an anti-arrhythmic.
- C Defibrillate before starting any chest compressions.
- D Administer amiodarone before delivering the first shock.
Correct answer: Start CPR, defibrillate, resume CPR, gain IV/IO access, give epinephrine, then consider an anti-arrhythmic.
For VF/pVT: begin CPR, shock as soon as the defibrillator is ready, immediately resume CPR, obtain IV/IO access, give epinephrine every 3-5 minutes, and add an anti-arrhythmic after the second shock.