PALS Final Exam Practice Test Questions with Answers and Detailed Rationales
Based on AHA 2025/2026 Guidelines
Topic Distribution
Topic Area
Pediatric Assessment (PAT, Primary/Secondary Survey)
Airway & Ventilation Management
Cardiac Arrest Rhythms & Algorithms
Shock Recognition & Management
Bradycardia & Tachycardia Management
Pharmacology (Drug Dosing & Administration)
Post–Cardiac Arrest Care
Respiratory Distress/Failure
Team Dynamics & Resuscitation
Questions
, 1. A child in cardiac arrest experiences return of spontaneous circulation but is
exhibiting signs of post-cardiac arrest syndrome (PCAS). The PALS resuscitation
team determines that the child is experiencing a systemic response to
ischemia/reperfusion. The team bases this determination on which finding(s)?
A) Hypotension alone
B) Fever alone
C) Hyperglycemia alone
D) Hypotension, fever, and hyperglycemia
Answer: D
Rationale: Post-cardiac arrest syndrome (PCAS) is a systemic response to
ischemia/reperfusion that includes:
Hypotension from myocardial dysfunction and vasodilation
Fever from systemic inflammatory response syndrome (SIRS)
Hyperglycemia from stress response and insulin resistance
All three findings indicate the systemic nature of PCAS and require targeted
management .
2. The PALS team is providing post-cardiac arrest care to an 8-year-old child in
the pediatric intensive care unit. Which intervention would the team implement
to achieve the primary goal of post-cardiac arrest care, after assuring adequate
oxygenation and ventilation?
A) Maintain strict normothermia (36-37.5°C)
B) Ensure adequate mean arterial pressure
C) Administer prophylactic anticonvulsants
D) Maintain serum glucose between 150-180 mg/dL
Answer: B
Rationale: After adequate oxygenation and ventilation, the primary goal of post-
, cardiac arrest care is to maintain adequate mean arterial pressure (MAP) to
ensure cerebral and coronary perfusion . Hypotension in the post-arrest period is
associated with worse neurologic outcomes. MAP targets vary by age but
generally should be ≥ age-appropriate 5th percentile for blood pressure.
3. An advanced airway was placed in a 5-year-old child. Which action(s) would
be most appropriate for the team to take to confirm correct placement?
A) Auscultate over the lungs and epigastrium for air movement
B) Observe for bilateral chest rise
C) Evaluate results of capnography
D) All of the above
Answer: D
Rationale: Confirmation of advanced airway placement requires multiple
methods :
Auscultation over lungs (breath sounds) and epigastrium (no gurgling)
Observation of bilateral chest rise with each ventilation
Capnography (continuous waveform capnography is the most reliable method to
confirm and monitor ET tube placement)
All three should be used in conjunction.
4. A provider is forming an initial impression of a child using the Pediatric
Assessment Triangle (PAT). For which part of the PAT may the provider use the
mnemonic TICLS to assess the patient?
A) Appearance
B) Breathing
Based on AHA 2025/2026 Guidelines
Topic Distribution
Topic Area
Pediatric Assessment (PAT, Primary/Secondary Survey)
Airway & Ventilation Management
Cardiac Arrest Rhythms & Algorithms
Shock Recognition & Management
Bradycardia & Tachycardia Management
Pharmacology (Drug Dosing & Administration)
Post–Cardiac Arrest Care
Respiratory Distress/Failure
Team Dynamics & Resuscitation
Questions
, 1. A child in cardiac arrest experiences return of spontaneous circulation but is
exhibiting signs of post-cardiac arrest syndrome (PCAS). The PALS resuscitation
team determines that the child is experiencing a systemic response to
ischemia/reperfusion. The team bases this determination on which finding(s)?
A) Hypotension alone
B) Fever alone
C) Hyperglycemia alone
D) Hypotension, fever, and hyperglycemia
Answer: D
Rationale: Post-cardiac arrest syndrome (PCAS) is a systemic response to
ischemia/reperfusion that includes:
Hypotension from myocardial dysfunction and vasodilation
Fever from systemic inflammatory response syndrome (SIRS)
Hyperglycemia from stress response and insulin resistance
All three findings indicate the systemic nature of PCAS and require targeted
management .
2. The PALS team is providing post-cardiac arrest care to an 8-year-old child in
the pediatric intensive care unit. Which intervention would the team implement
to achieve the primary goal of post-cardiac arrest care, after assuring adequate
oxygenation and ventilation?
A) Maintain strict normothermia (36-37.5°C)
B) Ensure adequate mean arterial pressure
C) Administer prophylactic anticonvulsants
D) Maintain serum glucose between 150-180 mg/dL
Answer: B
Rationale: After adequate oxygenation and ventilation, the primary goal of post-
, cardiac arrest care is to maintain adequate mean arterial pressure (MAP) to
ensure cerebral and coronary perfusion . Hypotension in the post-arrest period is
associated with worse neurologic outcomes. MAP targets vary by age but
generally should be ≥ age-appropriate 5th percentile for blood pressure.
3. An advanced airway was placed in a 5-year-old child. Which action(s) would
be most appropriate for the team to take to confirm correct placement?
A) Auscultate over the lungs and epigastrium for air movement
B) Observe for bilateral chest rise
C) Evaluate results of capnography
D) All of the above
Answer: D
Rationale: Confirmation of advanced airway placement requires multiple
methods :
Auscultation over lungs (breath sounds) and epigastrium (no gurgling)
Observation of bilateral chest rise with each ventilation
Capnography (continuous waveform capnography is the most reliable method to
confirm and monitor ET tube placement)
All three should be used in conjunction.
4. A provider is forming an initial impression of a child using the Pediatric
Assessment Triangle (PAT). For which part of the PAT may the provider use the
mnemonic TICLS to assess the patient?
A) Appearance
B) Breathing
