AHA PALS Practice Exam Questions and Answers Updated 2026/2027 Version | Verified Answers

AHA PALS Practice Exam Questions and Answers Updated 2026/2027 Version | Verified Answers 1. A mother brings her 7-year-old child to the emergency department. The mother states that the child has had a fever for the past 4 days and has had little to eat or drink during the past 24 hours. Your initial impression reveals a lethargic child with increased respiratory rate and pale color. Heart rate is 160/min, respiratory rate is 38/min, and blood pressure is 86/48 mm Hg. Capillary refill is 4 seconds. Which of the following is the most appropriate intervention for this child? A. Fluid bolus of 10 mL/kg of isotonic crystalloid B. Fluid bolus of 20 mL/kg of isotonic crystalloid C. Maintenance fluid infusion of isotonic crystalloid at 10 mL/h D. Maintenance fluid infusion of 5% dextrose and water at 20 mL/h - ANSWER Fluid bolus of 20 mL/kg of isotonic crystalloid 2. . An intubated 5-year-old child who was in a motor vehicle collision becomes increasingly more difficult to ventilate. The child has diminished breath sounds and chest expansion on the right side of the chest, with audible breath sounds and visible chest expansion on the left. The endotracheal tube insertion depth has not changed. What is the most appropriate intervention? A. Deflate the cuff and pull the tube back B. Perform needle decompression on the right chest C. Perform needle decompression on the left chest D. Insert a gastric tube - ANSWER Perform needle decompression on the right chest 3. . A 2-year-old child with a 2-day history of a barking cough presents with audible stridor on inspiration, intercostal retractions, and agitation. What is the most appropriate intervention for this child? A. Lay the child flat on a stretcher B. Suction the mouth and nose C. Administer nebulized epinephrine D. Administer inhaled albuterol - ANSWER Administer nebulized epinephrine 4. Which of the following oxygen saturations indicates the need for additional intervention? A. 96% on room air B. 95% on room air C. 93% on 4 L of oxygen D. 97% on 50% oxygen - ANSWER 93% on 4 L of oxygen 5. A 3-year-old child presents with a 2-day history of nausea and vomiting. She is alert, with no increase in respiratory effort, and is pale in color. The child's heart rate is 160/min, respiratory rate is 40/min, and blood pressure is 100/70 mm Hg. Her extremities are cool, with sluggish capillary refill. Which term best describes this child's physiologic state? A. Compensated shock B. Cardiogenic shock C. Hypotensive shock D. Obstructive shock - ANSWER Compensated shock 6. A 3-year-old child presents with dehydration after a 2-day history of vomiting and diarrhea. The child after has received 2 fluid boluses of 20 mL/ kg of normal saline. After the second bolus, the child is alert and interacting. Her heart rate is 110/ min, respiratory rate is 30/min, and blood pressure is 92/64 mm Hg. Her capillary refill time is 2 seconds, and oxygen saturation is 98%. What is the most appropriate next intervention for this child? A. Administer another 20 mL/kg normal saline fluid bolus B. Administer 10 mL/kg of packed red cells C. Continue to monitor and reevaluate the child D. Initiate a dopamine drip of 20 mcg/kg per minute - ANSWER Continue to monitor and reevaluate the child 7. A 3-year-old child presents with a high fever and a petechial rash. The child is lethargic, has no signs of increased work of breathing, and is pale in color. His heart rate is 180/min, respiratory rate is 30/min, blood pressure is 80/68 mm Hg. Capillary refill time is 4 seconds, and oxygen saturation is 88%. Airway and lungs are clear. Peripheral pulses are diminished. Which of the following is the most appropriate initial intervention? A. Provide 100% oxygen via a nonrebreathing mask B. Obtain IV access B. Administer dopamine C. Administer an antibiotic - ANSWER Provide 100% oxygen via a nonrebreathing mask 8. An alert toddler presents with a barking cough, moderate stridor, and moderate retractions. The child's color is pink. What is the most appropriate initial intervention? A. Obtain a chest radiograph B. Administer nebulized epinephrine C. Prepare for a surgical airway D. Use an epinephrine autoinjector - ANSWER Administer nebulized epinephrine 9. The initial impression of a 4-year-old child reveals a lethargic child who is diaphoretic, with no increased work of breathing and pink color. Her heart rate is 220/min, respiratory rate is 24/min, blood pressure is 84/46 mm Hg, and capillary refill time is 5 seconds. IV access has been established. The rhythm below is seen on the cardiac monitor. What is the most appropriate initial intervention? A. Give adenosine 0.1 mg/kg rapid IV push B. Perform carotid sinus massage C. Perform synchronized cardioversion at 0.5 J/kg D. Attempt defibrillation at 2 J/kg - ANSWER Give adenosine 0.1 mg/kg rapid IV push 10. An 8-month-old infant is being evaluated. The child's mother says the infant has not been feeding well. The infant is alert with rapid but unlabored breathing, and the infant's color is pale. A cardiac monitor is applied, and the rhythm below is noted. Distal pulses are readily palpable. You give oxygen and establish IV access. What is the most appropriate vagal maneuver? A. Valsalva maneuver B. Carotid massage C. Ocular pressure D. Ice to the face - ANSWER Ice to the face 11. A 7-year-old child presents with a narrow-complex supraventricular tachycardia, lethargy, and poor perfusion. Pulses are weak and thready. Vascular access cannot be established. What is the most appropriate intervention? A. Unsynchronized shock with 0.5 to 1 J/kg B. Synchronized shock with 0.5 to 1 J/kg C. Unsynchronized shock with 2 J/kg D. Synchronized shock with 2 J/kg - ANSWER Synchronized shock with 0.5 to 1 J/kg 12. . A 3-month-old infant presents with lethargy and a 3-day history of vomiting, diarrhea, and poor feeding. The initial impression reveals lethargy, increased respiratory effort with retractions, and pale, mottled skin color. Vital signs are as follows: heart rate 210/min, respiratory rate 60/min, and blood pressure 60/40 mm Hg. Peripheral pulses are thready, and capillary refill time is 4 seconds. The cardiac monitor displays the rhythm below. After administration of oxygen and establishment of vascular access, what is the most appropriate intervention? A. Adenosine O.1 mg/kg IV rapid push B. Vagal maneuvers C. Synchronized shock at 0.5 to 1 J/kg D. IV fluid bolus of 20 mL/kg normal saline - ANSWER IV fluid bolus of 20 mL/kg normal saline