ACLS Core Rhythms – 50 Comprehensive MCQs
This set of 50 ACLS-style multiple choice questions comprehensively covers the full content
of the 'ACLS Core Rhythms' training material. Each question targets a specific concept,
diagnostic criterion, or clinical decision aligned with ACLS protocols. Correct answers are
marked with an asterisk (*) for review.
1. 1. Which of the following is the correct next step after delivering a shock during ACLS?
a. Check pulse
*b. Resume chest compressions
c. Deliver another shock
d. Assess breathing
2. 2. The primary pacemaker of the heart is:
a. AV node
*b. SA node
c. Purkinje fibers
d. His bundle
3. 3. In normal sinus rhythm, what is the correct order of electrical conduction?
a. AV node → SA node → Purkinje fibers
*b. SA node → AV node → Bundle of His → Purkinje fibers
c. Bundle of His → SA node → AV node → Purkinje
d. SA node → Bundle of His → AV node → Purkinje
4. 4. What does the QRS complex represent on the ECG?
a. Atrial depolarization
b. Atrial repolarization
*c. Ventricular depolarization
d. Ventricular repolarization
5. 5. Which of the following rhythms is defined by no identifiable P, QRS, or T waves and a
chaotic baseline?
a. Asystole
*b. Ventricular fibrillation
c. Atrial flutter
d. SVT
6. 6. What rhythm has organized electrical activity but no palpable pulse?
a. Ventricular tachycardia
*b. Pulseless electrical activity (PEA)
c. Atrial fibrillation
d. Junctional rhythm
7. 7. What ECG rhythm has sawtooth flutter waves and a regular atrial rate between 220-
350 bpm?
a. Atrial fibrillation
*b. Atrial flutter
c. SVT
d. Sinus tachycardia
8. 8. What is the hallmark feature of atrial fibrillation on ECG?
a. Regular rhythm
b. Sawtooth pattern
*c. Irregularly irregular rhythm
d. Narrow P waves
9. 9. Which of the following ECG rhythms is most often caused by hypoxia or hypovolemia?
a. Monomorphic VT
*b. PEA
c. Atrial flutter
d. Sinus tachycardia
10. 10. A widened QRS complex (>0.12s) with a regular rhythm and constant shape is most
indicative of:
a. SVT with aberrancy
*b. Monomorphic VT
c. Torsades de pointes
d. Atrial fibrillation