ACLS Precourse Self-Assessment Answers 2026–2026 — Complete Guide

What Is the ACLS Precourse Self-Assessment?

The AHA ACLS Precourse Self-Assessment is a web-based evaluation tool accessed through the AHA website (heart.org) or your training center's learning management system. It is assigned to candidates before every ACLS provider course and ACLS recertification course. The assessment is not timed in a traditional sense — you complete it at your own pace — but your results are required before you attend the in-person or blended learning ACLS course.

Purpose of the precourse assessment: The precourse self-assessment is designed to ensure that ACLS candidates arrive at the course with sufficient foundational knowledge to benefit from the training. ACLS courses are intensive — they assume you already know basic rhythm interpretation, core drug knowledge, and BLS technique. Without this foundation, you will struggle to keep up during the course's hands-on megacode and algorithm practice. The precourse assessment helps you identify where you need to study before course day.

Is the precourse assessment graded? The precourse assessment is not pass/fail in the traditional sense. You receive a summary of your performance identifying areas of strength and areas needing review. Some training centers require a minimum percentage correct in each module before they allow you to attend. Check with your specific training center — requirements vary.

The 3 modules:

• ECG Rhythm Identification: Identify cardiac rhythms from rhythm strips. Approximately 20–30 questions.
• Pharmacology: Knowledge of ACLS drugs — doses, indications, contraindications, and mechanisms. Approximately 20–30 questions.
• Practical Application (BLS Skills): CPR technique, AED use, rescue breathing, and team dynamics. Approximately 10–15 questions.

ECG Rhythm Identification Module — Key Rhythms and Answers

The ECG module tests your ability to identify 12–15 core cardiac rhythms from rhythm strips. These are the same rhythms you will need to recognize instantly during the ACLS megacode. Below are the most commonly tested rhythms and their identifying characteristics.

Ventricular Fibrillation (VF): Chaotic, disorganized waveform with no identifiable P waves, QRS, or T waves. No regular rate — just a wavy/coarse baseline. Treatment: immediate defibrillation. This is the most important rhythm to recognize — it is the most treatable form of cardiac arrest.

Pulseless Ventricular Tachycardia (pVT): Wide QRS complexes (> 0.12 sec), regular rate typically 150–250 bpm, no identifiable P waves. Monomorphic pVT has uniform QRS morphology; Polymorphic pVT (Torsades de Pointes) has varying QRS morphology. Treatment: defibrillation (same protocol as VF).

Asystole: Flat line — no electrical activity. Confirm in 2 leads before treating as asystole. Treatment: CPR + epinephrine. Do NOT shock asystole.

Pulseless Electrical Activity (PEA): Any organized rhythm (sinus, junctional, etc.) without a palpable pulse. The key: PEA is a clinical diagnosis combining rhythm AND pulse check. Treatment: CPR + epinephrine + treat reversible causes (H's and T's).

Sinus Bradycardia: Regular P-QRS-T, rate below 60 bpm. Treat only if symptomatic (unstable bradycardia). First-line: atropine 0.5mg IV.

3rd Degree Heart Block (Complete Heart Block): P waves and QRS complexes are completely dissociated — they march out at their own independent rates. P rate faster than QRS rate. No consistent PR interval. Treatment: atropine (may not work), transcutaneous pacing, then transvenous pacing.

Atrial Fibrillation (Afib): Irregularly irregular rhythm, no distinct P waves (replaced by fibrillatory baseline), normal QRS (unless aberrant conduction). Rate control or rhythm conversion depending on stability.

SVT (Supraventricular Tachycardia): Regular narrow-complex tachycardia > 150 bpm, P waves may be absent or hidden in the T wave. Treatment: vagal maneuvers → adenosine 6mg → adenosine 12mg.

BLS Skills Module — CPR and AED Review

The BLS practical application module covers the core CPR technique and AED use that form the foundation of all ACLS resuscitation efforts. High-quality CPR is the single most important intervention in cardiac arrest — even the best ACLS algorithms fail without excellent CPR.

Adult CPR key facts (AHA 2026 Guidelines):

• Compression rate: 100–120 compressions per minute (too slow or too fast both reduce survival)
• Compression depth: At least 2 inches (5 cm) for adults; no more than 2.4 inches to avoid injury
• Hand position: Heel of one hand on center of chest (lower half of sternum); other hand on top, fingers interlaced and off the chest
• Compression-to-ventilation ratio: 30:2 for 1 or 2 rescuers without advanced airway; with advanced airway in place, continuous compressions at 100–120/min + 1 breath every 6 seconds
• Allow full chest recoil: Lean fully off the chest between compressions — incomplete recoil reduces venous return
• Minimize interruptions: Limit all CPR pauses to less than 10 seconds; pause only to deliver shocks or check rhythm

AED use sequence: Power on → Apply pads (right of sternum below clavicle, and left lateral chest at level of axilla) → Analyze rhythm (clear the patient) → Shock if advised → Immediately resume CPR → Repeat 2-minute CPR cycles.

Team dynamics questions: The precourse assessment also tests ACLS team roles — closed-loop communication, role assignment (compressor, airway, recorder, team leader), and how to provide constructive feedback during resuscitation. Know the difference between the team leader's responsibilities (directs, monitors, delegates) vs team member responsibilities (executes assigned tasks, communicates clearly, monitors fatigue).

Reinforce your knowledge with our full ACLS Advanced Cardiovascular Life Support study guide and take our ACLS practice test to test your algorithm and pharmacology knowledge. Review our ACLS video questions and answers for worked clinical scenarios, and our ACLS algorithm guide for the complete cardiac arrest, bradycardia, and tachycardia pathways.