AHA PALS PEDIATRIC ADVANCED LIFE
SUPPORT EXAM: (LATEST 2026/2027
UPDATE) QUESTIONS & ANSWERS | 100%
CORRECT | GRADE A
AHA PALS PEDIATRIC ADVANCED LIFE
SUPPORT
AHA PALS Exam Questions & Answers 2026/2027
Verified 100% Correct | Pediatric Advanced Life Support
Question 1. Oxygen Saturation Interpretation
A 6-year-old child undergoing chemotherapy presents with lethargy, pale skin, sinus
tachycardia, crackles on lung auscultation, and a pulse oximetry reading of 95%. What
is the most appropriate interpretation of this oxygen saturation reading?
A. Normal; no intervention is required
B. Indicates mild hypoxemia; observe closely
C. Accurate but delayed due to anemia
D. Unreliable; supplementary oxygen should be administered
Correct Answer: D
Rationale:
Pulse oximetry can be unreliable in states of poor perfusion, such as shock, anemia, or
vasoconstriction. Despite a reading of 95%, the child’s clinical signs—including
lethargy, pallor, tachycardia, and crackles—suggest impaired oxygen delivery. PALS
emphasizes treating the patient, not the monitor. Supplemental oxygen should be
administered promptly based on clinical assessment rather than numerical values
alone.
,Question 2. Identification of Shock Type
A 5-year-old child receiving chemotherapy presents with fever, heart rate of 195/min,
respiratory rate of 36/min, blood pressure of 85/40 mm Hg, and capillary refill of less
than 2 seconds. Which condition is most likely?
A. Septic shock
B. Hypovolemic shock
C. Cardiogenic shock
D. Anaphylactic shock
Correct Answer: A
Rationale:
This child exhibits classic signs of septic shock, including fever, tachycardia,
tachypnea, and hypotension. Children receiving chemotherapy are
immunocompromised and at high risk for sepsis. Early septic shock may present with
warm extremities and brisk capillary refill (warm shock). Prompt recognition is critical
because early fluid resuscitation and antibiotics significantly improve outcomes.
Question 3. Blood Pressure Interpretation in a Neonate
A 2-week-old infant presents with a systolic blood pressure of 55 mm Hg. How should
this blood pressure be classified?
A. Hypotensive
B. Normal for age
C. Borderline low
D. Elevated
Correct Answer: A
Rationale:
Normal systolic blood pressure for a term neonate is typically greater than 60 mm Hg.
A systolic pressure of 55 mm Hg indicates hypotension and may reflect shock or
cardiovascular compromise. Neonates can deteriorate rapidly, so early identification of
hypotension is essential. PALS guidelines stress age-specific vital sign interpretation to
guide timely intervention.
,Question 4. Medication Safety During Resuscitation
During pediatric cardiac arrest, the team leader orders epinephrine 0.1 mg/kg IV. What
is the most appropriate action by the nurse?
A. Administer the medication as ordered
B. Reduce the dose by half and administer
C. Hold the medication and continue CPR
D. Respectfully ask the team leader to clarify the dose
Correct Answer: D
Rationale:
The correct IV/IO dose of epinephrine during pediatric cardiac arrest is 0.01 mg/kg. An
order for 0.1 mg/kg represents a tenfold overdose and could cause severe
hypertension, arrhythmias, or myocardial injury. PALS emphasizes closed-loop
communication and medication safety. Clarifying the order protects the patient and
supports effective team dynamics.
Question 5. Definition of Respiratory Failure
Which finding best defines respiratory failure in a pediatric patient?
A. Inadequate oxygenation and/or ventilation
B. Increased respiratory rate only
C. Use of accessory muscles
D. Presence of wheezing
Correct Answer: A
Rationale:
Respiratory failure occurs when the respiratory system cannot maintain adequate gas
exchange. This may involve hypoxemia, hypercapnia, or both. While signs such as
tachypnea, accessory muscle use, and wheezing indicate respiratory distress, they do
, not alone define failure. PALS distinguishes respiratory distress from respiratory failure
to guide escalation of care.
Question 6. Cause of Prolonged Expiratory Phase
A child presents with wheezing and a prolonged expiratory phase. Which underlying
mechanism is the most likely cause?
A. Upper airway obstruction
B. Lower airway obstruction
C. Disordered control of breathing
D. Neuromuscular weakness
Correct Answer: B
Rationale:
A prolonged expiratory phase and wheezing are hallmark signs of lower airway
obstruction. Conditions such as asthma, bronchiolitis, and reactive airway disease
cause narrowing of the bronchioles, making exhalation difficult. Disordered control of
breathing typically results in irregular respiratory patterns rather than wheezing.
Identifying the mechanism guides appropriate interventions such as bronchodilators.
Question 7. First Action in Pediatric Respiratory Distress
A 3-year-old child presents with nasal flaring, intercostal retractions, and tachypnea.
Oxygen saturation is 89% on room air. What is the priority initial intervention?
A. Obtain arterial blood gases
B. Begin chest compressions
C. Administer supplemental oxygen
D. Prepare for intubation
Correct Answer: C
SUPPORT EXAM: (LATEST 2026/2027
UPDATE) QUESTIONS & ANSWERS | 100%
CORRECT | GRADE A
AHA PALS PEDIATRIC ADVANCED LIFE
SUPPORT
AHA PALS Exam Questions & Answers 2026/2027
Verified 100% Correct | Pediatric Advanced Life Support
Question 1. Oxygen Saturation Interpretation
A 6-year-old child undergoing chemotherapy presents with lethargy, pale skin, sinus
tachycardia, crackles on lung auscultation, and a pulse oximetry reading of 95%. What
is the most appropriate interpretation of this oxygen saturation reading?
A. Normal; no intervention is required
B. Indicates mild hypoxemia; observe closely
C. Accurate but delayed due to anemia
D. Unreliable; supplementary oxygen should be administered
Correct Answer: D
Rationale:
Pulse oximetry can be unreliable in states of poor perfusion, such as shock, anemia, or
vasoconstriction. Despite a reading of 95%, the child’s clinical signs—including
lethargy, pallor, tachycardia, and crackles—suggest impaired oxygen delivery. PALS
emphasizes treating the patient, not the monitor. Supplemental oxygen should be
administered promptly based on clinical assessment rather than numerical values
alone.
,Question 2. Identification of Shock Type
A 5-year-old child receiving chemotherapy presents with fever, heart rate of 195/min,
respiratory rate of 36/min, blood pressure of 85/40 mm Hg, and capillary refill of less
than 2 seconds. Which condition is most likely?
A. Septic shock
B. Hypovolemic shock
C. Cardiogenic shock
D. Anaphylactic shock
Correct Answer: A
Rationale:
This child exhibits classic signs of septic shock, including fever, tachycardia,
tachypnea, and hypotension. Children receiving chemotherapy are
immunocompromised and at high risk for sepsis. Early septic shock may present with
warm extremities and brisk capillary refill (warm shock). Prompt recognition is critical
because early fluid resuscitation and antibiotics significantly improve outcomes.
Question 3. Blood Pressure Interpretation in a Neonate
A 2-week-old infant presents with a systolic blood pressure of 55 mm Hg. How should
this blood pressure be classified?
A. Hypotensive
B. Normal for age
C. Borderline low
D. Elevated
Correct Answer: A
Rationale:
Normal systolic blood pressure for a term neonate is typically greater than 60 mm Hg.
A systolic pressure of 55 mm Hg indicates hypotension and may reflect shock or
cardiovascular compromise. Neonates can deteriorate rapidly, so early identification of
hypotension is essential. PALS guidelines stress age-specific vital sign interpretation to
guide timely intervention.
,Question 4. Medication Safety During Resuscitation
During pediatric cardiac arrest, the team leader orders epinephrine 0.1 mg/kg IV. What
is the most appropriate action by the nurse?
A. Administer the medication as ordered
B. Reduce the dose by half and administer
C. Hold the medication and continue CPR
D. Respectfully ask the team leader to clarify the dose
Correct Answer: D
Rationale:
The correct IV/IO dose of epinephrine during pediatric cardiac arrest is 0.01 mg/kg. An
order for 0.1 mg/kg represents a tenfold overdose and could cause severe
hypertension, arrhythmias, or myocardial injury. PALS emphasizes closed-loop
communication and medication safety. Clarifying the order protects the patient and
supports effective team dynamics.
Question 5. Definition of Respiratory Failure
Which finding best defines respiratory failure in a pediatric patient?
A. Inadequate oxygenation and/or ventilation
B. Increased respiratory rate only
C. Use of accessory muscles
D. Presence of wheezing
Correct Answer: A
Rationale:
Respiratory failure occurs when the respiratory system cannot maintain adequate gas
exchange. This may involve hypoxemia, hypercapnia, or both. While signs such as
tachypnea, accessory muscle use, and wheezing indicate respiratory distress, they do
, not alone define failure. PALS distinguishes respiratory distress from respiratory failure
to guide escalation of care.
Question 6. Cause of Prolonged Expiratory Phase
A child presents with wheezing and a prolonged expiratory phase. Which underlying
mechanism is the most likely cause?
A. Upper airway obstruction
B. Lower airway obstruction
C. Disordered control of breathing
D. Neuromuscular weakness
Correct Answer: B
Rationale:
A prolonged expiratory phase and wheezing are hallmark signs of lower airway
obstruction. Conditions such as asthma, bronchiolitis, and reactive airway disease
cause narrowing of the bronchioles, making exhalation difficult. Disordered control of
breathing typically results in irregular respiratory patterns rather than wheezing.
Identifying the mechanism guides appropriate interventions such as bronchodilators.
Question 7. First Action in Pediatric Respiratory Distress
A 3-year-old child presents with nasal flaring, intercostal retractions, and tachypnea.
Oxygen saturation is 89% on room air. What is the priority initial intervention?
A. Obtain arterial blood gases
B. Begin chest compressions
C. Administer supplemental oxygen
D. Prepare for intubation
Correct Answer: C
