AHA PALS EXAM QUESTIONS & ANSWERS 2025/2026 300
MULTIPLE CHOICE QUESTIONS WITH CORRECT ANSWERS
AND RATIONALES
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Section 1: Systematic Approach and Primary Assessment (Questions 1-25)
Question 1
A 5-year-old child presents with lethargy, increased work of breathing, and pale
color. The primary assessment reveals the airway is open and the respiratory rate
is 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 pulse oximetry
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
Rationale: The pulse oximeter shows a pulse rate of 93/min while the monitor
shows 165/min, indicating a mismatch. This suggests the pulse oximetry reading is
unreliable. When there is a discrepancy between the oximeter pulse rate and the
,actual heart rate, the SpO2 reading should not be trusted, and supplementary
oxygen should be administered based on clinical presentation .
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Question 2
The PALS systematic approach algorithm begins with the initial impression. Which
three characteristics are assessed during the initial impression?
A) Airway, Breathing, Circulation
B) Consciousness, Breathing, Color
C) Appearance, Work of Breathing, Circulation
D) Responsiveness, Airway, Pulse
Correct Answer: B
Rationale: The initial impression in the PALS systematic approach algorithm
assesses three characteristics: consciousness (appearance/mental status),
breathing (respiratory effort), and color (skin perfusion). This rapid visual
assessment helps determine the severity of the child's condition and guides the
next steps in the evaluation process .
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Question 3
,A child is unresponsive and not breathing. Emergency response was activated. The
pulse check reveals the child has a pulse. What should you do next?
A) Perform a brief head-to-toe assessment
B) Place the child in the recovery position
C) Give epinephrine 1 mg IV push
D) Open the airway and provide ventilations and oxygen
Correct Answer: D
Rationale: When a child is unresponsive, not breathing, but has a pulse, the
priority is to open the airway and provide ventilations with oxygen. Respiratory
arrest with a pulse requires immediate ventilatory support to prevent progression
to cardiac arrest .
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Question 4
During a resuscitation attempt, the team leader orders an initial dose of
epinephrine at 0.1 mg/kg IV. 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
, Correct Answer: C
Rationale: The correct IV/IO dose of epinephrine for pediatric cardiac arrest is 0.01
mg/kg (0.1 mL/kg of the 1:10,000 concentration). An order for 0.1 mg/kg is ten
times the correct dose. Team members should respectfully question orders they
believe may be incorrect to prevent medication errors .
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Question 5
Which statement best describes the evaluate-identify-intervene sequence?
A) It is performed only during the initial assessment
B) It is used before and after each intervention until the child is stable
C) It is performed only by the team leader
D) It replaces the primary assessment
Correct Answer: B
Rationale: The evaluate-identify-intervene sequence is a continuous process used
throughout the resuscitation. After each intervention, the team reevaluates the
patient, identifies any changes or ongoing problems, and intervenes as needed.
This cycle continues until the child is stabilized .
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Question 6
MULTIPLE CHOICE QUESTIONS WITH CORRECT ANSWERS
AND RATIONALES
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Section 1: Systematic Approach and Primary Assessment (Questions 1-25)
Question 1
A 5-year-old child presents with lethargy, increased work of breathing, and pale
color. The primary assessment reveals the airway is open and the respiratory rate
is 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 pulse oximetry
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
Rationale: The pulse oximeter shows a pulse rate of 93/min while the monitor
shows 165/min, indicating a mismatch. This suggests the pulse oximetry reading is
unreliable. When there is a discrepancy between the oximeter pulse rate and the
,actual heart rate, the SpO2 reading should not be trusted, and supplementary
oxygen should be administered based on clinical presentation .
---
Question 2
The PALS systematic approach algorithm begins with the initial impression. Which
three characteristics are assessed during the initial impression?
A) Airway, Breathing, Circulation
B) Consciousness, Breathing, Color
C) Appearance, Work of Breathing, Circulation
D) Responsiveness, Airway, Pulse
Correct Answer: B
Rationale: The initial impression in the PALS systematic approach algorithm
assesses three characteristics: consciousness (appearance/mental status),
breathing (respiratory effort), and color (skin perfusion). This rapid visual
assessment helps determine the severity of the child's condition and guides the
next steps in the evaluation process .
---
Question 3
,A child is unresponsive and not breathing. Emergency response was activated. The
pulse check reveals the child has a pulse. What should you do next?
A) Perform a brief head-to-toe assessment
B) Place the child in the recovery position
C) Give epinephrine 1 mg IV push
D) Open the airway and provide ventilations and oxygen
Correct Answer: D
Rationale: When a child is unresponsive, not breathing, but has a pulse, the
priority is to open the airway and provide ventilations with oxygen. Respiratory
arrest with a pulse requires immediate ventilatory support to prevent progression
to cardiac arrest .
---
Question 4
During a resuscitation attempt, the team leader orders an initial dose of
epinephrine at 0.1 mg/kg IV. 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
, Correct Answer: C
Rationale: The correct IV/IO dose of epinephrine for pediatric cardiac arrest is 0.01
mg/kg (0.1 mL/kg of the 1:10,000 concentration). An order for 0.1 mg/kg is ten
times the correct dose. Team members should respectfully question orders they
believe may be incorrect to prevent medication errors .
---
Question 5
Which statement best describes the evaluate-identify-intervene sequence?
A) It is performed only during the initial assessment
B) It is used before and after each intervention until the child is stable
C) It is performed only by the team leader
D) It replaces the primary assessment
Correct Answer: B
Rationale: The evaluate-identify-intervene sequence is a continuous process used
throughout the resuscitation. After each intervention, the team reevaluates the
patient, identifies any changes or ongoing problems, and intervenes as needed.
This cycle continues until the child is stabilized .
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Question 6
