PALS FINAL EXAM 300 MULTIPLE
CHOICE QUESTIONS AND ANSWERS
WITH DETAILED RATIONALES LATEST
UPDATE 2026
SECTION 1: PEDIATRIC ASSESSMENT & INITIAL EVALUATION
(Questions 125)
Question 1
A 4yearold child is brought to the emergency department unresponsive with
gasping respirations and pallor. What is the priority action?
A) Check for a pulse for 10 seconds
B) Begin CPR with 30:2 compressionstoventilations
C) Give two rescue breaths immediately
D) Obtain a 12lead ECG
Correct Answer: B
Rationale: Unresponsiveness with abnormal gasping breathing indicates cardiac
arrest. The lone rescuer should initiate CPR immediately with a 30:2
compressiontoventilation ratio for a child, beginning with chest compressions.
Checking for a pulse should take no more than 10 seconds, but the priority in
suspected cardiac arrest is to start CPR immediately.
,Question 2
An 8yearold child has a palpable pulse but is not breathing adequately. What is the
appropriate ventilation rate?
A) 1 breath every 23 seconds
B) 1 breath every 35 seconds
C) 2 breaths every 5 seconds
D) 10 breaths per minute
Correct Answer: B
Rationale: For a child with a pulse but inadequate breathing, provide rescue
breathing at a rate of 1 breath every 35 seconds (1220 breaths per minute),
ensuring visible chest rise with each breath. This rate provides adequate
oxygenation while avoiding gastric insufflation.
Question 3
What is the correct chest compression depth for an infant during CPR?
A) At least 1 inch (2.5 cm)
B) At least 1.5 inches (4 cm)
C) At least 2 inches (5 cm)
D) At least 2.4 inches (6 cm)
Correct Answer: B
,Rationale: For infant CPR, the recommended compression depth is at least one
third the anteriorposterior diameter of the chest, which is approximately 1.5 inches
(4 cm). This depth ensures adequate cardiac output while minimizing the risk of
injury.
Question 4
What is the recommended chest compression rate for pediatric CPR?
A) 80100 compressions per minute
B) 100120 compressions per minute
C) 120140 compressions per minute
D) 6080 compressions per minute
Correct Answer: B
Rationale: High quality CPR requires a compression rate of 100120 per minute for
all age groups. This rate optimizes coronary perfusion pressure and has been
associated with improved outcomes in cardiac arrest.
Question 5
A 5yearold is unresponsive with no pulse. The cardiac monitor reveals ventricular
fibrillation. What is the first recommended shock dose?
A) 1 J/kg
, B) 2 J/kg
C) 4 J/kg
D) 5 J/kg
Correct Answer: B
Rationale: The initial defibrillation dose for pediatric pulseless ventricular
tachycardia (pVT) and ventricular fibrillation (VF) is 2 J/kg. If the initial shock is
unsuccessful, subsequent shocks may be increased to 4 J/kg. This energy level is
effective while minimizing myocardial damage.
Question 6
A 6yearold child presents with respiratory distress, stridor, and drooling. What is
the priority action?
A) Obtain a chest Xray
B) Administer nebulized epinephrine
C) Perform a rapid sequence intubation
D) Prepare for immediate airway intervention with minimal agitation
Correct Answer: D
Rationale: Stridor and drooling in a child suggest an upper airway obstruction,
possibly epiglottitis. The priority is to prepare for immediate airway intervention
while minimizing agitation, as excessive manipulation or crying can precipitate
complete airway obstruction. Do not perform a throat examination or obtain Xrays
if epiglottitis is suspected.
CHOICE QUESTIONS AND ANSWERS
WITH DETAILED RATIONALES LATEST
UPDATE 2026
SECTION 1: PEDIATRIC ASSESSMENT & INITIAL EVALUATION
(Questions 125)
Question 1
A 4yearold child is brought to the emergency department unresponsive with
gasping respirations and pallor. What is the priority action?
A) Check for a pulse for 10 seconds
B) Begin CPR with 30:2 compressionstoventilations
C) Give two rescue breaths immediately
D) Obtain a 12lead ECG
Correct Answer: B
Rationale: Unresponsiveness with abnormal gasping breathing indicates cardiac
arrest. The lone rescuer should initiate CPR immediately with a 30:2
compressiontoventilation ratio for a child, beginning with chest compressions.
Checking for a pulse should take no more than 10 seconds, but the priority in
suspected cardiac arrest is to start CPR immediately.
,Question 2
An 8yearold child has a palpable pulse but is not breathing adequately. What is the
appropriate ventilation rate?
A) 1 breath every 23 seconds
B) 1 breath every 35 seconds
C) 2 breaths every 5 seconds
D) 10 breaths per minute
Correct Answer: B
Rationale: For a child with a pulse but inadequate breathing, provide rescue
breathing at a rate of 1 breath every 35 seconds (1220 breaths per minute),
ensuring visible chest rise with each breath. This rate provides adequate
oxygenation while avoiding gastric insufflation.
Question 3
What is the correct chest compression depth for an infant during CPR?
A) At least 1 inch (2.5 cm)
B) At least 1.5 inches (4 cm)
C) At least 2 inches (5 cm)
D) At least 2.4 inches (6 cm)
Correct Answer: B
,Rationale: For infant CPR, the recommended compression depth is at least one
third the anteriorposterior diameter of the chest, which is approximately 1.5 inches
(4 cm). This depth ensures adequate cardiac output while minimizing the risk of
injury.
Question 4
What is the recommended chest compression rate for pediatric CPR?
A) 80100 compressions per minute
B) 100120 compressions per minute
C) 120140 compressions per minute
D) 6080 compressions per minute
Correct Answer: B
Rationale: High quality CPR requires a compression rate of 100120 per minute for
all age groups. This rate optimizes coronary perfusion pressure and has been
associated with improved outcomes in cardiac arrest.
Question 5
A 5yearold is unresponsive with no pulse. The cardiac monitor reveals ventricular
fibrillation. What is the first recommended shock dose?
A) 1 J/kg
, B) 2 J/kg
C) 4 J/kg
D) 5 J/kg
Correct Answer: B
Rationale: The initial defibrillation dose for pediatric pulseless ventricular
tachycardia (pVT) and ventricular fibrillation (VF) is 2 J/kg. If the initial shock is
unsuccessful, subsequent shocks may be increased to 4 J/kg. This energy level is
effective while minimizing myocardial damage.
Question 6
A 6yearold child presents with respiratory distress, stridor, and drooling. What is
the priority action?
A) Obtain a chest Xray
B) Administer nebulized epinephrine
C) Perform a rapid sequence intubation
D) Prepare for immediate airway intervention with minimal agitation
Correct Answer: D
Rationale: Stridor and drooling in a child suggest an upper airway obstruction,
possibly epiglottitis. The priority is to prepare for immediate airway intervention
while minimizing agitation, as excessive manipulation or crying can precipitate
complete airway obstruction. Do not perform a throat examination or obtain Xrays
if epiglottitis is suspected.
