PALS FINAL EXAM QUESTIONS AND
ANSWERS 2026 QUESTIONS AND
ANSWERS
1. A 6-month-old infant is brought to the emergency department with respiratory distress.
The Pediatric Assessment Triangle (PAT) reveals a normal appearance, increased work of
breathing, and normal circulation. How would you categorize this patient’s status?
A. Respiratory failure
B. Upper airway obstruction
C. Cardiopulmonary failure
D. Respiratory distress
Answer: D
Conceptual Explanation: Respiratory distress is characterized by increased work of
breathing while maintaining relatively normal appearance (mental status) and circulation.
If appearance or circulation were compromised, it would suggest respiratory failure.
,2. During a resuscitation attempt for a child in cardiac arrest, the team leader orders a dose of
Epinephrine. What is the standard intravenous/intraosseous dose?
A. 0.1 mg/kg (0.1 mL/kg of 1:1,000)
B. 0.02 mg/kg (0.2 mL/kg of 1:10,000)
C. 0.01 mg/kg (0.1 mL/kg of 1:10,000)
D. 1 mg/kg (1.0 mL/kg of 1:1,000)
Answer: C
Conceptual Explanation: The standard IV/IO dose for Epinephrine in pediatric cardiac
arrest is 0.01 mg/kg using the 0.1 mg/mL (1:10,000) concentration.
3. A 4-year-old child presents with a heart rate of 55 bpm, poor perfusion, and altered mental
status despite adequate oxygenation and ventilation. What is the immediate next step in
management?
A. Begin high-quality CPR
B. Synchronized cardioversion at 0.5 J/kg
C. Administer Atropine 0.02 mg/kg
D. Establish IV access and give a fluid bolus
Answer: A
Conceptual Explanation: In pediatrics, if the heart rate is less than 60 bpm with signs of
poor perfusion despite adequate oxygenation and ventilation, CPR should be initiated.
, 4. A child with suspected hypovolemic shock is being treated. What is the recommended
volume for an initial isotonic crystalloid fluid bolus?
A. 10 mL/kg over 20 minutes
B. 20 mL/kg over 5 to 20 minutes
C. 5 mL/kg over 30 minutes
D. 50 mL/kg as a rapid push
Answer: B
Conceptual Explanation: For hypovolemic and septic shock, the standard bolus is 20
mL/kg of isotonic crystalloid (NS or LR) administered over 5 to 20 minutes.
5. Which of the following ECG rhythms is considered ‘shockable’ in the PALS pediatric cardiac
arrest algorithm?
A. Pulseless Ventricular Tachycardia
B. Pulseless Electrical Activity (PEA)
C. Asystole
D. Sinus Bradycardia
Answer: A
Conceptual Explanation: The shockable rhythms in pediatric cardiac arrest are
Ventricular Fibrillation (VF) and Pulseless Ventricular Tachycardia (pVT). Asystole and
PEA are non-shockable.
ANSWERS 2026 QUESTIONS AND
ANSWERS
1. A 6-month-old infant is brought to the emergency department with respiratory distress.
The Pediatric Assessment Triangle (PAT) reveals a normal appearance, increased work of
breathing, and normal circulation. How would you categorize this patient’s status?
A. Respiratory failure
B. Upper airway obstruction
C. Cardiopulmonary failure
D. Respiratory distress
Answer: D
Conceptual Explanation: Respiratory distress is characterized by increased work of
breathing while maintaining relatively normal appearance (mental status) and circulation.
If appearance or circulation were compromised, it would suggest respiratory failure.
,2. During a resuscitation attempt for a child in cardiac arrest, the team leader orders a dose of
Epinephrine. What is the standard intravenous/intraosseous dose?
A. 0.1 mg/kg (0.1 mL/kg of 1:1,000)
B. 0.02 mg/kg (0.2 mL/kg of 1:10,000)
C. 0.01 mg/kg (0.1 mL/kg of 1:10,000)
D. 1 mg/kg (1.0 mL/kg of 1:1,000)
Answer: C
Conceptual Explanation: The standard IV/IO dose for Epinephrine in pediatric cardiac
arrest is 0.01 mg/kg using the 0.1 mg/mL (1:10,000) concentration.
3. A 4-year-old child presents with a heart rate of 55 bpm, poor perfusion, and altered mental
status despite adequate oxygenation and ventilation. What is the immediate next step in
management?
A. Begin high-quality CPR
B. Synchronized cardioversion at 0.5 J/kg
C. Administer Atropine 0.02 mg/kg
D. Establish IV access and give a fluid bolus
Answer: A
Conceptual Explanation: In pediatrics, if the heart rate is less than 60 bpm with signs of
poor perfusion despite adequate oxygenation and ventilation, CPR should be initiated.
, 4. A child with suspected hypovolemic shock is being treated. What is the recommended
volume for an initial isotonic crystalloid fluid bolus?
A. 10 mL/kg over 20 minutes
B. 20 mL/kg over 5 to 20 minutes
C. 5 mL/kg over 30 minutes
D. 50 mL/kg as a rapid push
Answer: B
Conceptual Explanation: For hypovolemic and septic shock, the standard bolus is 20
mL/kg of isotonic crystalloid (NS or LR) administered over 5 to 20 minutes.
5. Which of the following ECG rhythms is considered ‘shockable’ in the PALS pediatric cardiac
arrest algorithm?
A. Pulseless Ventricular Tachycardia
B. Pulseless Electrical Activity (PEA)
C. Asystole
D. Sinus Bradycardia
Answer: A
Conceptual Explanation: The shockable rhythms in pediatric cardiac arrest are
Ventricular Fibrillation (VF) and Pulseless Ventricular Tachycardia (pVT). Asystole and
PEA are non-shockable.
