BLS Certification Exam
Complete this form to participate in the Basic Life Support Certification Exam. Please answer all questions and follow instructions carefully.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Exam
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Exam Instructions
What is the correct compression to ventilation ratio for an adult during single-rescuer CPR?
*
30:2
15:2
5:1
Other
When should an AED be used during a cardiac arrest scenario?
*
As soon as it is available
After 5 cycles of CPR
Only if the victim is breathing
Other
Which of the following is the first step in the BLS assessment?
*
Check responsiveness
Start chest compressions
Call for help
Other
Scenario: You find an unresponsive adult in a public place. Describe your initial actions.
*
BLS Skills Evaluation
*
Rows
Skill Performed
Needs Improvement
Satisfactory
Excellent
Chest Compressions
1
2
3
4
Ventilations
5
6
7
8
AED Use
9
10
11
12
Scene Safety
13
14
15
16
Calling for Help
17
18
19
20
Additional Comments (optional)
Submit Exam
Should be Empty: