PALS PRETEST ACTUAL EXAM PAPER
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ A 12-year-old child being evaluated in the pediatric intensive care unit
displays the following ECG waveform. The team interprets this as which
arrhythmia?.
Answer: second degree
◍ what should the first rescuer arriving on the scene of an unresponsive infant
or child do?.
Answer: verify scene safety, check responsiveness, shout for help, activate
emergency response system
◍ How long should assessing for breathing and checking for a pulse take?.
Answer: No longer than 10 seconds
◍ Laboratory tests are ordered for a child who has been vomiting for 3 days
and is diaphoretic, tachypneic, lethargic and pale. Which test would the
provider use to determine the adequacy of oxygen delivery?.
Answer: Lactate
◍ If the AED indicates no shock advised, what should be the next action?.
Answer: Start chest compressions
◍ What is the compression-to-breath ratio for 1- and 2-rescuer CPR for
children and infants?.
Answer: 1-rescuer, 30:2; 2-rescuer, 15:2
◍ A 9-year-old patient is presenting with decreased breath sounds,
bradycardia, slowed respiratory rate and a low O2 saturation level. The
provider interprets these findings as indicating which condition?.
, Answer: Respiratory failure
◍ A 4-year-old child is brought to the emergency department by the parents.
Assessment reveals that the child has only gasping respirations and the pulse
rate is 65 beats per minute. Which action would the provider initiate first?.
Answer: Deliver 1 BVM ventilation every 3 to 5 seconds.
◍ Systematic Approach video 1: Blonde, 18-month-old child with pacifier.
Does this patient need immediate intervention?.
Answer: Yes
◍ Systematic Approach video 1: Blonde, 18-month-old child with pacifier.
What is the patient's appearance?.
Answer: Awake
◍ Systematic Approach video 1: Blonde, 18-month-old child with pacifier.
What is the patient's work of breathing?.
Answer: Increased work of breathing
◍ Systematic Approach video 1: Blonde, 18-month-old child with pacifier.
What is this patient's color?.
Answer: Pale
◍ A 15-year-old patient is being evaluated during a follow-up visit after being
diagnosed with Lyme disease 2 months ago. A rhythm strip is obtained as
shown below. The provider interprets this rhythm as indicating which
arrhythmia?.
Answer: First-degree atrioventricular (AV) block
◍ Systematic Approach video 2: 3-year-old child in yellow shirt. Does this
patient need immediate intervention?.
Answer: No
◍ 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
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ A 12-year-old child being evaluated in the pediatric intensive care unit
displays the following ECG waveform. The team interprets this as which
arrhythmia?.
Answer: second degree
◍ what should the first rescuer arriving on the scene of an unresponsive infant
or child do?.
Answer: verify scene safety, check responsiveness, shout for help, activate
emergency response system
◍ How long should assessing for breathing and checking for a pulse take?.
Answer: No longer than 10 seconds
◍ Laboratory tests are ordered for a child who has been vomiting for 3 days
and is diaphoretic, tachypneic, lethargic and pale. Which test would the
provider use to determine the adequacy of oxygen delivery?.
Answer: Lactate
◍ If the AED indicates no shock advised, what should be the next action?.
Answer: Start chest compressions
◍ What is the compression-to-breath ratio for 1- and 2-rescuer CPR for
children and infants?.
Answer: 1-rescuer, 30:2; 2-rescuer, 15:2
◍ A 9-year-old patient is presenting with decreased breath sounds,
bradycardia, slowed respiratory rate and a low O2 saturation level. The
provider interprets these findings as indicating which condition?.
, Answer: Respiratory failure
◍ A 4-year-old child is brought to the emergency department by the parents.
Assessment reveals that the child has only gasping respirations and the pulse
rate is 65 beats per minute. Which action would the provider initiate first?.
Answer: Deliver 1 BVM ventilation every 3 to 5 seconds.
◍ Systematic Approach video 1: Blonde, 18-month-old child with pacifier.
Does this patient need immediate intervention?.
Answer: Yes
◍ Systematic Approach video 1: Blonde, 18-month-old child with pacifier.
What is the patient's appearance?.
Answer: Awake
◍ Systematic Approach video 1: Blonde, 18-month-old child with pacifier.
What is the patient's work of breathing?.
Answer: Increased work of breathing
◍ Systematic Approach video 1: Blonde, 18-month-old child with pacifier.
What is this patient's color?.
Answer: Pale
◍ A 15-year-old patient is being evaluated during a follow-up visit after being
diagnosed with Lyme disease 2 months ago. A rhythm strip is obtained as
shown below. The provider interprets this rhythm as indicating which
arrhythmia?.
Answer: First-degree atrioventricular (AV) block
◍ Systematic Approach video 2: 3-year-old child in yellow shirt. Does this
patient need immediate intervention?.
Answer: No
◍ 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
