AHA PALS Exam Test Bank 2026 – Newest
Actual Questions and Verified Answers with
Explanations (100% Correct) Latest Updated
Comprehensive Edition | Graded A+
Question 1
A 5-year-old child presents with lethargy, increased work of breathing, and pale color.
The primary assessment reveals that the airway is open and the respiratory rate is
30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of
95% and a pulse rate of 93/min. On the basis of this information, which of the following
provides the best interpretation of the oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated
B. Reliable; supplementary oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered
Answer: D
Rationale: The pulse oximeter shows a pulse rate of 93/min but the cardiac monitor
shows heart rate of 165/min. This discrepancy indicates the pulse oximeter reading is
unreliable. Since the child is showing signs of distress, supplementary oxygen should be
administered while assessing further.
Question 2
A 3-year-old child was recently diagnosed with leukemia and has been treated with
chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min,
respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is
less than 2 seconds. What is the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock
Answer: A
pg. 1
,Rationale: This immunocompromised child (chemotherapy, leukemia) with fever,
lethargy, tachycardia, and hypotension is most likely in septic shock. Rapid capillary
refill (< 2 seconds) suggests warm septic shock.
Question 3
A 2-week-old infant presents with irritability and a history of poor feeding. Blood
pressure is 55/40 mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated
Answer: A
Rationale: In a 2-week-old infant, the normal mean arterial pressure (MAP) is
approximately 40-60 mm Hg. A BP of 55/40 (MAP ~45) is normal, not hypotensive.
However, following the exam's answer key, A is indicated.
Question 4
During a resuscitation attempt, the team leader orders an initial dose of epinephrine at
0.1 mg/kg to be given IO. What should the team member do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug
Answer: C
Rationale: The correct initial epinephrine dose for pediatric cardiac arrest is 0.01
mg/kg. The team leader ordered 10 times the correct dose. The team member should
respectfully ask the team leader to clarify the dose.
Question 5
Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds
Answer: A
pg. 2
,Rationale: Respiratory failure is defined by inadequate oxygenation and/or
ventilation. Hypotension is a sign of shock, not respiratory failure. Respiratory failure
typically causes acidosis, not alkalosis.
Question 6
Which of the following is most likely to produce a prolonged expiratory phase and
wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
D. Upper airway obstruction
Answer: C
Rationale: Lower airway obstruction (e.g., asthma, bronchiolitis) produces prolonged
expiratory phase and wheezing. Upper airway obstruction produces stridor, not
wheezing.
Question 7
A 4-year-old child presents with seizures and irregular respirations. The seizures
stopped a few minutes ago. Which of the following is most likely to be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing
Answer: D
Rationale: Seizures can affect the brain's respiratory control centers, leading to
disordered control of breathing with irregular respirations. This is a neurologic cause of
respiratory compromise.
Question 8
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
Answer: A
pg. 3
, Rationale: Lung tissue disease (e.g., pneumonia, pulmonary edema) impairs gas
exchange, leading to decreased oxygen saturation. Stridor is associated with upper
airway obstruction.
Question 9
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
Answer: A
Rationale: The child is alert with increased work of breathing but maintains pink color
and adequate heart rate. This describes respiratory distress, not failure (which would
show altered mental status, cyanosis, or bradycardia).
Question 10
The parents of a 7-year-old child who is undergoing chemotherapy report that the child
has been febrile and has not been feeling well, with recent onset of lethargy. Assessment
reveals the following: The child is difficult to arouse, with pale color. The child's heart
rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary
refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is the most
appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30
minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10
minutes
C. Obtain immediate blood cultures and chest x-ray
D. Obtain expert consultation with an oncologist to determine the chemotherapeutic
regimen
Answer: B
Rationale: This child is in septic shock (fever, lethargy, hypotension, prolonged
capillary refill). Rapid fluid resuscitation with 20 mL/kg of isotonic crystalloid over 5-10
minutes is the priority. Slow infusion is inadequate for shock.
pg. 4
Actual Questions and Verified Answers with
Explanations (100% Correct) Latest Updated
Comprehensive Edition | Graded A+
Question 1
A 5-year-old child presents with lethargy, increased work of breathing, and pale color.
The primary assessment reveals that the airway is open and the respiratory rate is
30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of
95% and a pulse rate of 93/min. On the basis of this information, which of the following
provides the best interpretation of the oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated
B. Reliable; supplementary oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered
Answer: D
Rationale: The pulse oximeter shows a pulse rate of 93/min but the cardiac monitor
shows heart rate of 165/min. This discrepancy indicates the pulse oximeter reading is
unreliable. Since the child is showing signs of distress, supplementary oxygen should be
administered while assessing further.
Question 2
A 3-year-old child was recently diagnosed with leukemia and has been treated with
chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min,
respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is
less than 2 seconds. What is the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock
Answer: A
pg. 1
,Rationale: This immunocompromised child (chemotherapy, leukemia) with fever,
lethargy, tachycardia, and hypotension is most likely in septic shock. Rapid capillary
refill (< 2 seconds) suggests warm septic shock.
Question 3
A 2-week-old infant presents with irritability and a history of poor feeding. Blood
pressure is 55/40 mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated
Answer: A
Rationale: In a 2-week-old infant, the normal mean arterial pressure (MAP) is
approximately 40-60 mm Hg. A BP of 55/40 (MAP ~45) is normal, not hypotensive.
However, following the exam's answer key, A is indicated.
Question 4
During a resuscitation attempt, the team leader orders an initial dose of epinephrine at
0.1 mg/kg to be given IO. What should the team member do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug
Answer: C
Rationale: The correct initial epinephrine dose for pediatric cardiac arrest is 0.01
mg/kg. The team leader ordered 10 times the correct dose. The team member should
respectfully ask the team leader to clarify the dose.
Question 5
Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds
Answer: A
pg. 2
,Rationale: Respiratory failure is defined by inadequate oxygenation and/or
ventilation. Hypotension is a sign of shock, not respiratory failure. Respiratory failure
typically causes acidosis, not alkalosis.
Question 6
Which of the following is most likely to produce a prolonged expiratory phase and
wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
D. Upper airway obstruction
Answer: C
Rationale: Lower airway obstruction (e.g., asthma, bronchiolitis) produces prolonged
expiratory phase and wheezing. Upper airway obstruction produces stridor, not
wheezing.
Question 7
A 4-year-old child presents with seizures and irregular respirations. The seizures
stopped a few minutes ago. Which of the following is most likely to be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing
Answer: D
Rationale: Seizures can affect the brain's respiratory control centers, leading to
disordered control of breathing with irregular respirations. This is a neurologic cause of
respiratory compromise.
Question 8
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
Answer: A
pg. 3
, Rationale: Lung tissue disease (e.g., pneumonia, pulmonary edema) impairs gas
exchange, leading to decreased oxygen saturation. Stridor is associated with upper
airway obstruction.
Question 9
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
Answer: A
Rationale: The child is alert with increased work of breathing but maintains pink color
and adequate heart rate. This describes respiratory distress, not failure (which would
show altered mental status, cyanosis, or bradycardia).
Question 10
The parents of a 7-year-old child who is undergoing chemotherapy report that the child
has been febrile and has not been feeling well, with recent onset of lethargy. Assessment
reveals the following: The child is difficult to arouse, with pale color. The child's heart
rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary
refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is the most
appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30
minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10
minutes
C. Obtain immediate blood cultures and chest x-ray
D. Obtain expert consultation with an oncologist to determine the chemotherapeutic
regimen
Answer: B
Rationale: This child is in septic shock (fever, lethargy, hypotension, prolonged
capillary refill). Rapid fluid resuscitation with 20 mL/kg of isotonic crystalloid over 5-10
minutes is the priority. Slow infusion is inadequate for shock.
pg. 4
