AHA PAL PRACTICE EXAM 2026 WITH ACTUAL CORRECT
QUESTIONS AND ANSWERS|CURRENTLY TESTING
VERSION|ALREADY GRADED A+|GUARANTEED PASS
1.A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few
minutes ago. Which of the following most likely to be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing
2. What abnormality is most likely to be present in children with acute respiratory distress caused
by lung tissue disease?
A. Decreased oxygen saturation
B. Stridor
C. Normal respiratory rate
D. Decreased respiratory effort
3. An alert 2-year-old child with an increased work of breathing and pink color is being
evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would best describe this
patient's condition?
A. Respiratory distress
B. Respiratory arrest
C. Respiratory failure
D. Disordered control of breathing
A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer. What is the
next most appropriate intervention?
A. Administer 0.1 mg/kg of adenosine
B. Obtain a blood sample to evaluate arterial or venous blood gases
C. Reassess breath sounds and clinical status
D. Repeat the albuterol treatment
2. The respiratory rate of a 1-year-old child with respiratory distress has decreased from 65/min
to 30/min. The child is more lethargic and continues to have subcostal retractions. What does this
change likely indicate?
A. Respiratory distress is unchanged
B. Progression toward respiratory failure
C. Improved respiratory status
D. Neurologic impairment
1
,3. What is the most likely cause of head bobbing in infants?
A. Increased respiratory effort
B. Improving respiratory status
C. Decompensated shock
D. Brain injury
4. Several healthcare providers are participating in an attempted resuscitation. Which of the
following is most consistent with the responsibilities of the team leader of the resuscitation?
A. Records medications and interventions
B. Assigns roles to team members
C. Administers defibrillation shocks
D. Provides compressions
5. Which of the following conditions is appropriate for use of an oropharyngeal airway?
A. Conscious with no gag reflex
B. Unconscious with a gag reflex
C. Unconscious with no gag reflex
D. Conscious with a gag reflex
6. A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10
minutes after eating peanuts. What is the most appropriate initial medication for this child?
A. Nebulized albuterol
B. Epinephrine IM
C. Isotonic crystalloid IV
D. Methylprednisolone IV
7. A mother brings her 7-year-old child to the emergency department. The mother states that the
child has had a fever for the past 4 days and has had little to eat or drink during the past 24 hours.
Your initial impression reveals a lethargic child with increased respiratory rate and pale color.
Heart rate is 160/min, respiratory rate is 38/min, and blood pressure is 86/48 mm Hg. Capillary
refill is 4 seconds. Which of the following is the most appropriate intervention for this child?
8. Fluid bolus of 10 mL/kg of isotonic crystalloid
B. Fluid bolus of 20 mL/kg of isotonic crystalloid
C. Maintenance fluid infusion of isotonic crystalloid at 10 mL/h
D. Maintenance fluid infusion of 5% dextrose and water at 20 mL/h
9. An intubated 5-year-old child who was in a motor vehicle collision becomes increasingly more
difficult to ventilate. The child has diminished breath sounds and chest expansion on the right
side of the chest, with audible breath sounds and visible chest expansion on the left. The
endotracheal tube insertion depth has not changed. What is the most appropriate intervention?
A. Deflate the cuff and pull the tube back
B. Perform needle decompression on the right chest
C. Perform needle decompression on the left chest D. Insert a gastric tube
2
, 10. A 2-year-old child with a 2-day history of a barking cough presents with audible stridor on
inspiration, intercostal retractions, and agitation. What is the most appropriate intervention for
this child?
A. Lay the child flat on a stretcher
B. Suction the mouth and nose
C. Administer nebulized epinephrine
D. Administer inhaled albuterol
11. Which of the following oxygen saturations indicates the need for additional intervention?
A. 96% on room air
B. 95% on room air
C. 93% on 4 L of oxygen
D. 97% on 50% oxygen
12. A 3-year-old child presents with a 2-day history of nausea and vomiting. She is alert, with no
increase in respiratory effort, and is pale in color. The child's heart rate is 160/min, respiratory
rate is 40/min, and blood pressure is 100/70 mm Hg. Her extremities are cool, with sluggish
capillary refill. Which term best describes this child's physiologic state?
A. Compensated shock
B. Cardiogenic shock
C. Hypotensive shock
D. Obstructive shock
13. A 3-year-old child presents with dehydration after a 2-day history of vomiting and diarrhea.
The child after has received 2 fluid boluses of 20 mL/ kg of normal saline. After the second
bolus, the child is alert and interacting. Her heart rate is 110/ min, respiratory rate is 30/min, and
blood pressure is 92/64 mm Hg. Her capillary refill time is 2 seconds, and oxygen saturation is
98%. What is the most appropriate next intervention for this child?
A. Administer another 20 mL/kg normal saline fluid bolus
B. Administer 10 mL/kg of packed red cells
C. Continue to monitor and reevaluate the child
D. Initiate a dopamine drip of 20 mcg/kg per minute
14. A 3-year-old child presents with a high fever and a petechial rash. The child is lethargic, has
no signs of increased work of breathing, and is pale in color. His heart rate is 180/min,
respiratory rate is 30/min, blood pressure is 80/68 mm Hg. Capillary refill time is 4 seconds, and
oxygen saturation is 88%. Airway and lungs are clear. Peripheral pulses are diminished. Which
of the following is the most appropriate initial intervention?
A. Provide 100% oxygen via a nonrebreathing mask
B. Obtain IV access
C. Administer dopamine
D. Administer an antibiotic
3
QUESTIONS AND ANSWERS|CURRENTLY TESTING
VERSION|ALREADY GRADED A+|GUARANTEED PASS
1.A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few
minutes ago. Which of the following most likely to be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing
2. What abnormality is most likely to be present in children with acute respiratory distress caused
by lung tissue disease?
A. Decreased oxygen saturation
B. Stridor
C. Normal respiratory rate
D. Decreased respiratory effort
3. An alert 2-year-old child with an increased work of breathing and pink color is being
evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would best describe this
patient's condition?
A. Respiratory distress
B. Respiratory arrest
C. Respiratory failure
D. Disordered control of breathing
A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer. What is the
next most appropriate intervention?
A. Administer 0.1 mg/kg of adenosine
B. Obtain a blood sample to evaluate arterial or venous blood gases
C. Reassess breath sounds and clinical status
D. Repeat the albuterol treatment
2. The respiratory rate of a 1-year-old child with respiratory distress has decreased from 65/min
to 30/min. The child is more lethargic and continues to have subcostal retractions. What does this
change likely indicate?
A. Respiratory distress is unchanged
B. Progression toward respiratory failure
C. Improved respiratory status
D. Neurologic impairment
1
,3. What is the most likely cause of head bobbing in infants?
A. Increased respiratory effort
B. Improving respiratory status
C. Decompensated shock
D. Brain injury
4. Several healthcare providers are participating in an attempted resuscitation. Which of the
following is most consistent with the responsibilities of the team leader of the resuscitation?
A. Records medications and interventions
B. Assigns roles to team members
C. Administers defibrillation shocks
D. Provides compressions
5. Which of the following conditions is appropriate for use of an oropharyngeal airway?
A. Conscious with no gag reflex
B. Unconscious with a gag reflex
C. Unconscious with no gag reflex
D. Conscious with a gag reflex
6. A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10
minutes after eating peanuts. What is the most appropriate initial medication for this child?
A. Nebulized albuterol
B. Epinephrine IM
C. Isotonic crystalloid IV
D. Methylprednisolone IV
7. A mother brings her 7-year-old child to the emergency department. The mother states that the
child has had a fever for the past 4 days and has had little to eat or drink during the past 24 hours.
Your initial impression reveals a lethargic child with increased respiratory rate and pale color.
Heart rate is 160/min, respiratory rate is 38/min, and blood pressure is 86/48 mm Hg. Capillary
refill is 4 seconds. Which of the following is the most appropriate intervention for this child?
8. Fluid bolus of 10 mL/kg of isotonic crystalloid
B. Fluid bolus of 20 mL/kg of isotonic crystalloid
C. Maintenance fluid infusion of isotonic crystalloid at 10 mL/h
D. Maintenance fluid infusion of 5% dextrose and water at 20 mL/h
9. An intubated 5-year-old child who was in a motor vehicle collision becomes increasingly more
difficult to ventilate. The child has diminished breath sounds and chest expansion on the right
side of the chest, with audible breath sounds and visible chest expansion on the left. The
endotracheal tube insertion depth has not changed. What is the most appropriate intervention?
A. Deflate the cuff and pull the tube back
B. Perform needle decompression on the right chest
C. Perform needle decompression on the left chest D. Insert a gastric tube
2
, 10. A 2-year-old child with a 2-day history of a barking cough presents with audible stridor on
inspiration, intercostal retractions, and agitation. What is the most appropriate intervention for
this child?
A. Lay the child flat on a stretcher
B. Suction the mouth and nose
C. Administer nebulized epinephrine
D. Administer inhaled albuterol
11. Which of the following oxygen saturations indicates the need for additional intervention?
A. 96% on room air
B. 95% on room air
C. 93% on 4 L of oxygen
D. 97% on 50% oxygen
12. A 3-year-old child presents with a 2-day history of nausea and vomiting. She is alert, with no
increase in respiratory effort, and is pale in color. The child's heart rate is 160/min, respiratory
rate is 40/min, and blood pressure is 100/70 mm Hg. Her extremities are cool, with sluggish
capillary refill. Which term best describes this child's physiologic state?
A. Compensated shock
B. Cardiogenic shock
C. Hypotensive shock
D. Obstructive shock
13. A 3-year-old child presents with dehydration after a 2-day history of vomiting and diarrhea.
The child after has received 2 fluid boluses of 20 mL/ kg of normal saline. After the second
bolus, the child is alert and interacting. Her heart rate is 110/ min, respiratory rate is 30/min, and
blood pressure is 92/64 mm Hg. Her capillary refill time is 2 seconds, and oxygen saturation is
98%. What is the most appropriate next intervention for this child?
A. Administer another 20 mL/kg normal saline fluid bolus
B. Administer 10 mL/kg of packed red cells
C. Continue to monitor and reevaluate the child
D. Initiate a dopamine drip of 20 mcg/kg per minute
14. A 3-year-old child presents with a high fever and a petechial rash. The child is lethargic, has
no signs of increased work of breathing, and is pale in color. His heart rate is 180/min,
respiratory rate is 30/min, blood pressure is 80/68 mm Hg. Capillary refill time is 4 seconds, and
oxygen saturation is 88%. Airway and lungs are clear. Peripheral pulses are diminished. Which
of the following is the most appropriate initial intervention?
A. Provide 100% oxygen via a nonrebreathing mask
B. Obtain IV access
C. Administer dopamine
D. Administer an antibiotic
3
