PALS POST TEST 2026/2027 QUESTIONS
AND ANSWERS
1. A 7-year-old child presents with a heart rate of 195 bpm, narrow QRS complexes, and a
history of sudden onset. The patient is stable but complains of chest palpitations. Which is
the most appropriate initial intervention?
A. Immediate synchronized cardioversion at 0.5 J/kg
B. Vagal maneuvers such as blowing through a straw or ice to the face
C. Adenosine 0.1 mg/kg rapid IV bolus
D. Amiodarone 5 mg/kg infusion over 20 minutes
Answer: B
Conceptual Explanation: For stable SVT, vagal maneuvers should be attempted first. If
unsuccessful or if the patient is unstable, pharmacological or electrical interventions are
indicated.
2. During CPR of an intubated 4-year-old, the capnography reading suddenly jumps from 15
mmHg to 45 mmHg. What does this most likely indicate?
A. Return of spontaneous circulation (ROSC)
,B. The endotracheal tube has become dislodged
C. Improved chest compression quality
D. Severe metabolic acidosis
Answer: A
Conceptual Explanation: An abrupt, sustained increase in PETCO2 is a reliable indicator
of ROSC during resuscitation.
3. In a child with septic shock, which vasoactive agent is preferred if the patient remains
hypotensive despite adequate fluid resuscitation and exhibits ‘cold’ shock (low cardiac
output, high systemic vascular resistance)?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Vasopressin
Answer: B
Conceptual Explanation: Current PALS guidelines suggest Epinephrine for cold shock and
Norepinephrine for warm shock (vasodilation/low SVR).
4. A 6-month-old infant is in cardiac arrest. After 2 minutes of CPR and one dose of
Epinephrine, the rhythm check shows Ventricular Fibrillation. What is the next priority?
A. Administer Amiodarone 5 mg/kg
, B. Deliver a shock at 4 J/kg
C. Provide a second dose of Epinephrine
D. Deliver a shock at 2 J/kg
Answer: B
Conceptual Explanation: For VF/pVT, the initial shock is 2 J/kg, and subsequent shocks
should be at least 4 J/kg.
5. What is the correct compression-to-ventilation ratio for two-rescuer CPR in an infant when
an advanced airway is NOT in place?
A. 30:2
B. Continuous compressions with 1 breath every 2-3 seconds
C. 15:1
D. 15:2
Answer: D
Conceptual Explanation: Two-rescuer pediatric CPR uses a 15:2 ratio to maintain higher
minute ventilation.
6. Which sign is part of the ‘Appearance’ component of the Pediatric Assessment Triangle
(PAT)?
A. Nasal flaring
B. Skin mottling
AND ANSWERS
1. A 7-year-old child presents with a heart rate of 195 bpm, narrow QRS complexes, and a
history of sudden onset. The patient is stable but complains of chest palpitations. Which is
the most appropriate initial intervention?
A. Immediate synchronized cardioversion at 0.5 J/kg
B. Vagal maneuvers such as blowing through a straw or ice to the face
C. Adenosine 0.1 mg/kg rapid IV bolus
D. Amiodarone 5 mg/kg infusion over 20 minutes
Answer: B
Conceptual Explanation: For stable SVT, vagal maneuvers should be attempted first. If
unsuccessful or if the patient is unstable, pharmacological or electrical interventions are
indicated.
2. During CPR of an intubated 4-year-old, the capnography reading suddenly jumps from 15
mmHg to 45 mmHg. What does this most likely indicate?
A. Return of spontaneous circulation (ROSC)
,B. The endotracheal tube has become dislodged
C. Improved chest compression quality
D. Severe metabolic acidosis
Answer: A
Conceptual Explanation: An abrupt, sustained increase in PETCO2 is a reliable indicator
of ROSC during resuscitation.
3. In a child with septic shock, which vasoactive agent is preferred if the patient remains
hypotensive despite adequate fluid resuscitation and exhibits ‘cold’ shock (low cardiac
output, high systemic vascular resistance)?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Vasopressin
Answer: B
Conceptual Explanation: Current PALS guidelines suggest Epinephrine for cold shock and
Norepinephrine for warm shock (vasodilation/low SVR).
4. A 6-month-old infant is in cardiac arrest. After 2 minutes of CPR and one dose of
Epinephrine, the rhythm check shows Ventricular Fibrillation. What is the next priority?
A. Administer Amiodarone 5 mg/kg
, B. Deliver a shock at 4 J/kg
C. Provide a second dose of Epinephrine
D. Deliver a shock at 2 J/kg
Answer: B
Conceptual Explanation: For VF/pVT, the initial shock is 2 J/kg, and subsequent shocks
should be at least 4 J/kg.
5. What is the correct compression-to-ventilation ratio for two-rescuer CPR in an infant when
an advanced airway is NOT in place?
A. 30:2
B. Continuous compressions with 1 breath every 2-3 seconds
C. 15:1
D. 15:2
Answer: D
Conceptual Explanation: Two-rescuer pediatric CPR uses a 15:2 ratio to maintain higher
minute ventilation.
6. Which sign is part of the ‘Appearance’ component of the Pediatric Assessment Triangle
(PAT)?
A. Nasal flaring
B. Skin mottling
