GAHA PALS EXAM NEWEST 2025/2026 -
PRACTICE QUESTIONS AND ANSWERS
SECTION 1: PEDIATRIC ASSESSMENT AND
RESPIRATORY EMERGENCIES
Question 1
A 5-year-old child presents with lethargy, increased work of
breathing, and pale color. The primary assessment reveals an
open airway and respiratory rate of 30/min with crackles
heard on auscultation. The cardiac monitor shows sinus
tachycardia at 165/min. The pulse oximeter displays an oxygen
saturation of 95% and a pulse rate of 93/min. What is the
best interpretation of the oxygen saturation reading?
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
Correct Answer: D) Unreliable; supplementary oxygen
should be administered
,Rationale: The pulse oximeter reading is unreliable because
the displayed pulse rate (93/min) does not match the heart
rate on the cardiac monitor (165/min). The child is in
respiratory distress with increased work of breathing and
crackles, indicating the need for supplemental oxygen despite
the questionable reading. Always verify pulse oximetry
readings correlate with the actual heart rate before making
clinical decisions.
Question 2
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
Correct Answer: D) Control of breathing
Rationale: Seizures can affect the central nervous system's
control of breathing. The respiratory center in the brainstem
may be impacted by seizure activity, leading to irregular
respiratory patterns. This is a classic presentation of
,disordered control of breathing, which is one of the four
categories of respiratory failure in children.
Question 3
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
Correct Answer: C) Lower airway obstruction
Rationale: Lower airway obstruction (such as asthma or
bronchiolitis) causes air trapping and prolonged expiration.
Wheezing is the hallmark sound of lower airway obstruction.
Upper airway obstruction typically produces stridor, while
disordered control of breathing results in irregular
respiratory patterns without characteristic airway sounds.
Question 4
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) Increased tidal volume
Correct Answer: A) Decreased oxygen saturation
Rationale: Lung tissue diseases (such as pneumonia, pulmonary
edema, or acute respiratory distress syndrome) impair gas
exchange at the alveolar-capillary membrane level. This
results in V/Q mismatch and shunting, leading to decreased
oxygen saturation (hypoxemia) that is often refractory to
supplemental oxygen.
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
Correct Answer: A) Inadequate oxygenation and/or
ventilation
PRACTICE QUESTIONS AND ANSWERS
SECTION 1: PEDIATRIC ASSESSMENT AND
RESPIRATORY EMERGENCIES
Question 1
A 5-year-old child presents with lethargy, increased work of
breathing, and pale color. The primary assessment reveals an
open airway and respiratory rate of 30/min with crackles
heard on auscultation. The cardiac monitor shows sinus
tachycardia at 165/min. The pulse oximeter displays an oxygen
saturation of 95% and a pulse rate of 93/min. What is the
best interpretation of the oxygen saturation reading?
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
Correct Answer: D) Unreliable; supplementary oxygen
should be administered
,Rationale: The pulse oximeter reading is unreliable because
the displayed pulse rate (93/min) does not match the heart
rate on the cardiac monitor (165/min). The child is in
respiratory distress with increased work of breathing and
crackles, indicating the need for supplemental oxygen despite
the questionable reading. Always verify pulse oximetry
readings correlate with the actual heart rate before making
clinical decisions.
Question 2
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
Correct Answer: D) Control of breathing
Rationale: Seizures can affect the central nervous system's
control of breathing. The respiratory center in the brainstem
may be impacted by seizure activity, leading to irregular
respiratory patterns. This is a classic presentation of
,disordered control of breathing, which is one of the four
categories of respiratory failure in children.
Question 3
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
Correct Answer: C) Lower airway obstruction
Rationale: Lower airway obstruction (such as asthma or
bronchiolitis) causes air trapping and prolonged expiration.
Wheezing is the hallmark sound of lower airway obstruction.
Upper airway obstruction typically produces stridor, while
disordered control of breathing results in irregular
respiratory patterns without characteristic airway sounds.
Question 4
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) Increased tidal volume
Correct Answer: A) Decreased oxygen saturation
Rationale: Lung tissue diseases (such as pneumonia, pulmonary
edema, or acute respiratory distress syndrome) impair gas
exchange at the alveolar-capillary membrane level. This
results in V/Q mismatch and shunting, leading to decreased
oxygen saturation (hypoxemia) that is often refractory to
supplemental oxygen.
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
Correct Answer: A) Inadequate oxygenation and/or
ventilation
