PALS (PEDIATRIC ADVANCED LIFE
SUPPORT) CERTIFICATION EXAM
PRACTICE QUESTIONS WITH CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
1. A 4-year-old child is unresponsive, apneic, and pulseless. What is the nurse's
first action?
A. Begin high-quality CPR immediately.
B. Obtain a 12-lead ECG.
C. Administer epinephrine.
D. Check blood glucose.
CORRECT ANSWER: A — Begin high-quality CPR immediately.
RATIONALE: Immediate, high-quality CPR is the first priority for pediatric cardiac arrest.
2. Which rhythm is considered shockable in pediatric cardiac arrest?
A. Ventricular fibrillation (VF).
B. Asystole.
C. Pulseless electrical activity (PEA).
D. Sinus bradycardia.
CORRECT ANSWER: A — Ventricular fibrillation (VF).
RATIONALE: VF and pulseless ventricular tachycardia are the only shockable rhythms in PALS.
3. What is the recommended chest compression rate for infants and children?
A. 100–120 compressions/minute.
B. 60–80 compressions/minute.
,C. 80–90 compressions/minute.
D. 130–150 compressions/minute.
CORRECT ANSWER: A — 100–120 compressions/minute.
RATIONALE: PALS recommends a compression rate of 100–120/min for high-quality CPR.
4. Which medication is administered during pediatric cardiac arrest every 3–5
minutes?
A. Epinephrine.
B. Atropine.
C. Adenosine.
D. Dopamine.
CORRECT ANSWER: A — Epinephrine.
RATIONALE: Epinephrine is the primary medication administered during pediatric cardiac
arrest.
5. Which finding indicates poor perfusion in a child?
A. Delayed capillary refill and weak pulses.
B. Warm extremities.
C. Strong peripheral pulses.
D. Normal mental status.
CORRECT ANSWER: A — Delayed capillary refill and weak pulses.
RATIONALE: Poor perfusion commonly presents with delayed capillary refill, cool skin, and
weak pulses.
6. A child has symptomatic bradycardia despite adequate oxygenation and
ventilation. Heart rate is 50/min with poor perfusion. What is the next
intervention?
A. Begin chest compressions.
B. Observe for improvement.
, C. Administer adenosine.
D. Perform synchronized cardioversion.
CORRECT ANSWER: A — Begin chest compressions.
RATIONALE: In children, CPR should begin when the heart rate is less than 60/min with signs
of poor perfusion despite adequate oxygenation.
7. Which rhythm requires immediate defibrillation?
A. Pulseless ventricular tachycardia.
B. Asystole.
C. PEA.
D. Sinus rhythm.
CORRECT ANSWER: A — Pulseless ventricular tachycardia.
RATIONALE: Pulseless VT is a shockable rhythm.
8. What is the first-line medication for stable supraventricular tachycardia
(SVT) that does not respond to vagal maneuvers?
A. Adenosine.
B. Epinephrine.
C. Atropine.
D. Amiodarone.
CORRECT ANSWER: A — Adenosine.
RATIONALE: Adenosine is recommended for stable regular narrow-complex SVT after
unsuccessful vagal maneuvers.
9. Which intervention has the greatest impact on survival from pediatric cardiac
arrest?
A. Early high-quality CPR.
B. Delayed rhythm assessment.
C. Routine antibiotic therapy.
D. Blood glucose monitoring.
SUPPORT) CERTIFICATION EXAM
PRACTICE QUESTIONS WITH CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
1. A 4-year-old child is unresponsive, apneic, and pulseless. What is the nurse's
first action?
A. Begin high-quality CPR immediately.
B. Obtain a 12-lead ECG.
C. Administer epinephrine.
D. Check blood glucose.
CORRECT ANSWER: A — Begin high-quality CPR immediately.
RATIONALE: Immediate, high-quality CPR is the first priority for pediatric cardiac arrest.
2. Which rhythm is considered shockable in pediatric cardiac arrest?
A. Ventricular fibrillation (VF).
B. Asystole.
C. Pulseless electrical activity (PEA).
D. Sinus bradycardia.
CORRECT ANSWER: A — Ventricular fibrillation (VF).
RATIONALE: VF and pulseless ventricular tachycardia are the only shockable rhythms in PALS.
3. What is the recommended chest compression rate for infants and children?
A. 100–120 compressions/minute.
B. 60–80 compressions/minute.
,C. 80–90 compressions/minute.
D. 130–150 compressions/minute.
CORRECT ANSWER: A — 100–120 compressions/minute.
RATIONALE: PALS recommends a compression rate of 100–120/min for high-quality CPR.
4. Which medication is administered during pediatric cardiac arrest every 3–5
minutes?
A. Epinephrine.
B. Atropine.
C. Adenosine.
D. Dopamine.
CORRECT ANSWER: A — Epinephrine.
RATIONALE: Epinephrine is the primary medication administered during pediatric cardiac
arrest.
5. Which finding indicates poor perfusion in a child?
A. Delayed capillary refill and weak pulses.
B. Warm extremities.
C. Strong peripheral pulses.
D. Normal mental status.
CORRECT ANSWER: A — Delayed capillary refill and weak pulses.
RATIONALE: Poor perfusion commonly presents with delayed capillary refill, cool skin, and
weak pulses.
6. A child has symptomatic bradycardia despite adequate oxygenation and
ventilation. Heart rate is 50/min with poor perfusion. What is the next
intervention?
A. Begin chest compressions.
B. Observe for improvement.
, C. Administer adenosine.
D. Perform synchronized cardioversion.
CORRECT ANSWER: A — Begin chest compressions.
RATIONALE: In children, CPR should begin when the heart rate is less than 60/min with signs
of poor perfusion despite adequate oxygenation.
7. Which rhythm requires immediate defibrillation?
A. Pulseless ventricular tachycardia.
B. Asystole.
C. PEA.
D. Sinus rhythm.
CORRECT ANSWER: A — Pulseless ventricular tachycardia.
RATIONALE: Pulseless VT is a shockable rhythm.
8. What is the first-line medication for stable supraventricular tachycardia
(SVT) that does not respond to vagal maneuvers?
A. Adenosine.
B. Epinephrine.
C. Atropine.
D. Amiodarone.
CORRECT ANSWER: A — Adenosine.
RATIONALE: Adenosine is recommended for stable regular narrow-complex SVT after
unsuccessful vagal maneuvers.
9. Which intervention has the greatest impact on survival from pediatric cardiac
arrest?
A. Early high-quality CPR.
B. Delayed rhythm assessment.
C. Routine antibiotic therapy.
D. Blood glucose monitoring.
