AHA PALS Exam 2025/2026 | Verified Questions & Answers
American Heart Association (AHA) | Verified 100% Correct
| Pediatric Advanced Life Support Candidates
This comprehensive exam set contains exactly 100 original, verified questions
designed to assess the candidate's knowledge of Pediatric Advanced Life
Support (PALS) protocols and guidelines. The questions cover PALS Core
Concepts and Systematic Assessment, Respiratory Emergencies and Airway
Management, Shock and Circulatory Emergencies, Cardiac Arrest and
Arrhythmias, and Post-Resuscitation Care and Special Considerations.
Content is based on the most current AHA PALS guidelines and constructed
to promote critical thinking and accurate application of pediatric
resuscitation principles for Professional Healthcare Providers preparing for
the PALS certification examination.
DOMAIN 1: PALS CORE CONCEPTS AND SYSTEMATIC ASSESSMENT
(Questions 1-20)
1. A 5-year-old child presents with lethargy, increased work of breathing, and
pale color. The primary assessment reveals the airway is open, respiratory
rate is 30/min, and crackles are 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. On the basis of this information,
which of the following provides the best interpretation of the oxygen
saturation of 95% by pulse oximetry?
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: B
Rationale: The pulse oximetry reading of 95% is reliable (normal perfusion and
good waveform). However, the child has increased work of breathing, crackles,
,and is lethargic, indicating respiratory distress or failure. Oxygen should be
administered to maintain SpO2 ≥94% as per PALS guidelines, and further
respiratory assessment is needed.
2. A 3-year-old child was recently diagnosed with leukemia and has been
treated with chemotherapy. The child presents with lethargy and a high fever.
Heart rate is 195/min, respiratory rate is 36/min, blood pressure is 85/40 mm
Hg, and capillary refill time is less than 2 seconds. What is the child's most
likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock
Correct Answer: A
Rationale: The child is immunocompromised (leukemia, chemotherapy) with
fever, tachycardia, tachypnea, and lethargy, suggesting sepsis. The blood pressure
is low-normal, and capillary refill is less than 2 seconds (warm shock). Septic
shock is the most likely diagnosis, and fluid resuscitation and antibiotics are
needed.
3. A 2-week-old infant presents with irritability and a history of poor feeding.
Blood pressure is 55/40 mm Hg. What term describes this infant's blood
pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated
Correct Answer: B
Rationale: Normal blood pressure in a full-term newborn (0-28 days) is
approximately 65-85/45-55 mmHg. A systolic BP of 55 mmHg is at the lower end
of normal but not hypotensive. Hypotension in a neonate is defined as systolic BP
<60 mmHg. Clinical correlation with signs of shock is essential.
,4. During a resuscitation attempt, the team leader orders an initial dose of
epinephrine 0.1 mg/kg to be given 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 initial IV/IO dose of epinephrine in pediatric resuscitation
is 0.01 mg/kg (0.1 mL/kg of 1:10,000 solution). The ordered dose of 0.1 mg/kg is
ten times higher (0.1 mg/kg = 1 mL/kg of 1:10,000) and could cause harm. The
team member should respectfully clarify the dose. Closed-loop communication is
essential for patient safety.
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
Rationale: Respiratory failure is defined as inadequate oxygenation (hypoxemia)
and/or ventilation (hypercapnia). It is a clinical diagnosis based on assessment of
airway, breathing, and oxygenation. PALS emphasizes early recognition of
respiratory failure to prevent cardiac arrest.
6. Which of the following is most likely to produce a prolonged expiratory
phase and wheezing?
A. Disordered control of breathing
B. Lower airway obstruction (asthma, bronchiolitis)
C. Hypovolemic shock
D. Upper airway obstruction
Correct Answer: B
Rationale: Lower airway obstruction (asthma, bronchiolitis, foreign body)
, produces a prolonged expiratory phase and wheezing. The airway narrowing
causes turbulent airflow and prolonged expiration due to increased airway
resistance and air trapping.
7. The PALS systematic assessment approach follows which sequence?
A. Primary assessment (ABCDE) → Secondary assessment → Diagnostic tests
B. Secondary assessment → Primary assessment → Diagnostic tests
C. Diagnostic tests → Primary assessment → Secondary assessment
D. Primary assessment → Diagnostic tests → Secondary assessment
Correct Answer: A
Rationale: The PALS systematic assessment follows the sequence: Primary
Assessment (ABCDE: Airway, Breathing, Circulation, Disability, Exposure) →
Secondary Assessment (focused history, physical exam) → Diagnostic tests. This
ensures life threats are identified and managed first.
8. A child with a respiratory rate of 8/min and poor respiratory effort should
receive which intervention?
A. Supplemental oxygen only.
B. Bag-mask ventilation with 100% oxygen.
C. Oral airway insertion only.
D. Immediate intubation without ventilation.
Correct Answer: B
Rationale: A child with a respiratory rate of <12/min and poor respiratory effort is
in respiratory failure and requires immediate bag-mask ventilation with 100%
oxygen. Positive pressure ventilation is the priority. Intubation may be needed if
bag-mask ventilation is inadequate or prolonged.
9. What is the correct sequence for the Pediatric Assessment Triangle (PAT)?
A. Airway, Breathing, Circulation
B. Appearance, Work of breathing, Circulation to skin
C. Consciousness, Effort, Pulse
D. Airway, Disability, Exposure
American Heart Association (AHA) | Verified 100% Correct
| Pediatric Advanced Life Support Candidates
This comprehensive exam set contains exactly 100 original, verified questions
designed to assess the candidate's knowledge of Pediatric Advanced Life
Support (PALS) protocols and guidelines. The questions cover PALS Core
Concepts and Systematic Assessment, Respiratory Emergencies and Airway
Management, Shock and Circulatory Emergencies, Cardiac Arrest and
Arrhythmias, and Post-Resuscitation Care and Special Considerations.
Content is based on the most current AHA PALS guidelines and constructed
to promote critical thinking and accurate application of pediatric
resuscitation principles for Professional Healthcare Providers preparing for
the PALS certification examination.
DOMAIN 1: PALS CORE CONCEPTS AND SYSTEMATIC ASSESSMENT
(Questions 1-20)
1. A 5-year-old child presents with lethargy, increased work of breathing, and
pale color. The primary assessment reveals the airway is open, respiratory
rate is 30/min, and crackles are 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. On the basis of this information,
which of the following provides the best interpretation of the oxygen
saturation of 95% by pulse oximetry?
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: B
Rationale: The pulse oximetry reading of 95% is reliable (normal perfusion and
good waveform). However, the child has increased work of breathing, crackles,
,and is lethargic, indicating respiratory distress or failure. Oxygen should be
administered to maintain SpO2 ≥94% as per PALS guidelines, and further
respiratory assessment is needed.
2. A 3-year-old child was recently diagnosed with leukemia and has been
treated with chemotherapy. The child presents with lethargy and a high fever.
Heart rate is 195/min, respiratory rate is 36/min, blood pressure is 85/40 mm
Hg, and capillary refill time is less than 2 seconds. What is the child's most
likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock
Correct Answer: A
Rationale: The child is immunocompromised (leukemia, chemotherapy) with
fever, tachycardia, tachypnea, and lethargy, suggesting sepsis. The blood pressure
is low-normal, and capillary refill is less than 2 seconds (warm shock). Septic
shock is the most likely diagnosis, and fluid resuscitation and antibiotics are
needed.
3. A 2-week-old infant presents with irritability and a history of poor feeding.
Blood pressure is 55/40 mm Hg. What term describes this infant's blood
pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated
Correct Answer: B
Rationale: Normal blood pressure in a full-term newborn (0-28 days) is
approximately 65-85/45-55 mmHg. A systolic BP of 55 mmHg is at the lower end
of normal but not hypotensive. Hypotension in a neonate is defined as systolic BP
<60 mmHg. Clinical correlation with signs of shock is essential.
,4. During a resuscitation attempt, the team leader orders an initial dose of
epinephrine 0.1 mg/kg to be given 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 initial IV/IO dose of epinephrine in pediatric resuscitation
is 0.01 mg/kg (0.1 mL/kg of 1:10,000 solution). The ordered dose of 0.1 mg/kg is
ten times higher (0.1 mg/kg = 1 mL/kg of 1:10,000) and could cause harm. The
team member should respectfully clarify the dose. Closed-loop communication is
essential for patient safety.
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
Rationale: Respiratory failure is defined as inadequate oxygenation (hypoxemia)
and/or ventilation (hypercapnia). It is a clinical diagnosis based on assessment of
airway, breathing, and oxygenation. PALS emphasizes early recognition of
respiratory failure to prevent cardiac arrest.
6. Which of the following is most likely to produce a prolonged expiratory
phase and wheezing?
A. Disordered control of breathing
B. Lower airway obstruction (asthma, bronchiolitis)
C. Hypovolemic shock
D. Upper airway obstruction
Correct Answer: B
Rationale: Lower airway obstruction (asthma, bronchiolitis, foreign body)
, produces a prolonged expiratory phase and wheezing. The airway narrowing
causes turbulent airflow and prolonged expiration due to increased airway
resistance and air trapping.
7. The PALS systematic assessment approach follows which sequence?
A. Primary assessment (ABCDE) → Secondary assessment → Diagnostic tests
B. Secondary assessment → Primary assessment → Diagnostic tests
C. Diagnostic tests → Primary assessment → Secondary assessment
D. Primary assessment → Diagnostic tests → Secondary assessment
Correct Answer: A
Rationale: The PALS systematic assessment follows the sequence: Primary
Assessment (ABCDE: Airway, Breathing, Circulation, Disability, Exposure) →
Secondary Assessment (focused history, physical exam) → Diagnostic tests. This
ensures life threats are identified and managed first.
8. A child with a respiratory rate of 8/min and poor respiratory effort should
receive which intervention?
A. Supplemental oxygen only.
B. Bag-mask ventilation with 100% oxygen.
C. Oral airway insertion only.
D. Immediate intubation without ventilation.
Correct Answer: B
Rationale: A child with a respiratory rate of <12/min and poor respiratory effort is
in respiratory failure and requires immediate bag-mask ventilation with 100%
oxygen. Positive pressure ventilation is the priority. Intubation may be needed if
bag-mask ventilation is inadequate or prolonged.
9. What is the correct sequence for the Pediatric Assessment Triangle (PAT)?
A. Airway, Breathing, Circulation
B. Appearance, Work of breathing, Circulation to skin
C. Consciousness, Effort, Pulse
D. Airway, Disability, Exposure
