The ACLS exam is more than a test—it’s proof you can handle life-threatening emergencies with confidence. But between the written exam and the megacode skills test, many healthcare providers feel nervous.
This guide will give you practical tips, study resources, and preparation strategies so you can walk into your ACLS exam calm, confident, and ready to pass on your first try.
Usually 50 multiple-choice questions.
Passing score: 84% or higher (varies by training center).
Topics include:
ECG rhythm recognition
Pharmacology (drugs like epinephrine, amiodarone, atropine)
BLS fundamentals
ACLS algorithms
Simulated patient scenario with cardiac arrest or arrhythmia.
You’ll lead a resuscitation team and apply ACLS protocols.
Skills tested:
Team leadership
Chest compressions & airway management
Using AED/defibrillator
Administering drugs correctly
Following ACLS algorithms
If your BLS skills are weak, ACLS will feel overwhelming. Review:
High-quality CPR (rate, depth, recoil).
AED usage.
2-rescuer team coordination.
👉 Learn more about BLS vs ACLS here.
The exam is algorithm-heavy. Focus on:
Cardiac arrest (VF/pulseless VT, PEA/asystole).
Bradycardia and tachycardia.
Post-cardiac arrest care.
💡 Tip: Print out the AHA algorithm charts and practice until you can recall them from memory.
You must identify rhythms quickly during the test. Focus on:
Ventricular fibrillation (VF).
Ventricular tachycardia (VT).
Asystole.
Pulseless electrical activity (PEA).
Supraventricular tachycardia (SVT).
Heart blocks.
Learn the “big five” ACLS drugs:
Epinephrine – cardiac arrest.
Amiodarone – VF/pulseless VT.
Atropine – bradycardia.
Adenosine – supraventricular tachycardia.
Lidocaine – alternative antiarrhythmic.
Pro tip: Study dosage, indications, and routes of administration.
Use flashcards for drug dosages and rhythms.
Take practice tests online to simulate real questions.
Join study groups or online ACLS prep forums.
Speak clearly when giving commands.
Don’t panic if you forget—focus on the algorithm.
Use closed-loop communication with your “team.”
Always prioritize CPR and early defibrillation.
Get enough sleep the night before.
Stay hydrated.
Arrive early to reduce stress.
Remember: instructors want you to succeed.
Confusing drug dosages.
Forgetting to check for pulse before shocking.
Skipping high-quality CPR in favor of drugs.
Overthinking rhythms instead of following algorithms.
Ready to ace your ACLS exam? Start preparing today with a structured ACLS prep course and practice until the algorithms become second nature.
It can be challenging due to ECG interpretation and algorithms, but with practice, most providers pass on the first try.
Most centers require 84% on the written exam plus a successful megacode performance.
Yes, but you usually get a chance to retake the test after remediation.
Yes. They are central to both the written test and the megacode.
You’ll receive feedback, review weak areas, and typically retest the same day or later.
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+91 - 8466 000 108
+91 - 7997 000 108
1800 8899 108
support@pionovaiq.plus
The AHA strongly promotes knowledge and proficiency in all AHA courses and has developed instructional materials for this purpose. Use of these materials in an educational course does not represent course sponsorship by the AHA. Any fees charged for such a course, except for a portion of fees needed for AHA course materials, do not represent income to the AHA.
