AHA PALS EXAM ACTUAL EXAM 2026-2027 COMPLETE
QUESTIONS AND CORRECT ANSWERS VERIFIED ANSWERS
JUST RELEASED UPDATED VERSION
Question 1
A 5-year-old child presents with lethargy, increased work of breathing, and pale color.
The primary assessment reveals that the airway is open and the respiratory rate is
30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 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 is indicated
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered
Question 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. Vital signs reveal:
Heart rate: 195/min
Respiratory rate: 36/min
Blood pressure: 85/40 mm Hg
Capillary refill time: Less than 2 seconds
What is the child's most likely condition?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Neurogenic shock
3. A 9-month-old infant in severe respiratory distress has a heart rate of 52/min.
After 1 minute of effective bag-mask ventilation with 100% oxygen, the heart rate
remains 54/min with poor perfusion. What is the immediate next step?
A. Administer IV/IO Atropine 0.02 mg/kg
B. Perform synchronized cardioversion at 0.5 J/kg
C. Administer an IV/IO fluid bolus of 20 mL/kg normal saline
D. Begin high-quality chest compressions at a ratio of 15:2
4. A 4-year-old child presents with high fever, barking cough, and severe
inspiratory stridor at rest. What is the priority first-line medication?
A. Albuterol nebulizer
B. Nebulized L-epinephrine (racemic epinephrine)
C. Intravenous amiodarone
D. Subcutaneous epinephrine
5. Which clinical sign provides the most reliable confirmation that an
endotracheal tube has been correctly placed in a pediatric patient during cardiac
arrest?
A. Condensation inside the endotracheal tube
B. Symmetrical chest expansion and equal breath sounds
C. Waveform capnography showing a persistent ETCO2 detection wave
D. Rapid improvement in the patient’s skin color
, 6. A 6-year-old child with severe status asthmaticus is unresponsive to
continuous albuterol and ipratropium bromide nebulizers. What is the next
standard medication?
A. Intravenous magnesium sulfate
B. Nebulized epinephrine
C. Intravenous adenosine
D. Intravenous atropine
7. While ventilating an intubated 2-year-old child, you notice a sudden drop in
heart rate and oxygen saturation. Which mnemonic should guide your immediate
assessment?
A. ABCDE
B. SAMPLE
C. DOPE (Displacement, Obstruction, Pneumothorax, Equipment)
D. AVPU
8. What is the primary respiratory rate threshold that defines bradypnea in an
infant under 1 year of age?
A. Less than 40 breaths per minute
B. Less than 30 breaths per minute
C. Less than 20 breaths per minute
D. Less than 15 breaths per minute
9. A 3-year-old child presents with sudden onset of choking, unilateral wheezing,
and decreased breath sounds on the right side. What is the suspected
pathology?
A. Acute bronchiolitis
B. Foreign body airway obstruction (FBAO)
C. Croup
D. Epiglottitis
10. What is the correct targeted oxygen saturation range for a pediatric patient
immediately after return of spontaneous circulation (ROSC)?
A. Always 100%
B. 94% to 99%
C. 90% to 95%
D. 88% to 92%
11. A 7-year-old child is breathing 8 times per minute, limp, and cyanotic. How
should you describe this condition?
A. Respiratory distress
B. Hyperventilation
C. Respiratory failure
D. Compensated shock
12. When selecting an uncuffed endotracheal tube for an 8-year-old child, what
formula calculates the internal diameter (ID)?
A. (Age in years / 4) + 3.5
QUESTIONS AND CORRECT ANSWERS VERIFIED ANSWERS
JUST RELEASED UPDATED VERSION
Question 1
A 5-year-old child presents with lethargy, increased work of breathing, and pale color.
The primary assessment reveals that the airway is open and the respiratory rate is
30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 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 is indicated
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered
Question 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. Vital signs reveal:
Heart rate: 195/min
Respiratory rate: 36/min
Blood pressure: 85/40 mm Hg
Capillary refill time: Less than 2 seconds
What is the child's most likely condition?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Neurogenic shock
3. A 9-month-old infant in severe respiratory distress has a heart rate of 52/min.
After 1 minute of effective bag-mask ventilation with 100% oxygen, the heart rate
remains 54/min with poor perfusion. What is the immediate next step?
A. Administer IV/IO Atropine 0.02 mg/kg
B. Perform synchronized cardioversion at 0.5 J/kg
C. Administer an IV/IO fluid bolus of 20 mL/kg normal saline
D. Begin high-quality chest compressions at a ratio of 15:2
4. A 4-year-old child presents with high fever, barking cough, and severe
inspiratory stridor at rest. What is the priority first-line medication?
A. Albuterol nebulizer
B. Nebulized L-epinephrine (racemic epinephrine)
C. Intravenous amiodarone
D. Subcutaneous epinephrine
5. Which clinical sign provides the most reliable confirmation that an
endotracheal tube has been correctly placed in a pediatric patient during cardiac
arrest?
A. Condensation inside the endotracheal tube
B. Symmetrical chest expansion and equal breath sounds
C. Waveform capnography showing a persistent ETCO2 detection wave
D. Rapid improvement in the patient’s skin color
, 6. A 6-year-old child with severe status asthmaticus is unresponsive to
continuous albuterol and ipratropium bromide nebulizers. What is the next
standard medication?
A. Intravenous magnesium sulfate
B. Nebulized epinephrine
C. Intravenous adenosine
D. Intravenous atropine
7. While ventilating an intubated 2-year-old child, you notice a sudden drop in
heart rate and oxygen saturation. Which mnemonic should guide your immediate
assessment?
A. ABCDE
B. SAMPLE
C. DOPE (Displacement, Obstruction, Pneumothorax, Equipment)
D. AVPU
8. What is the primary respiratory rate threshold that defines bradypnea in an
infant under 1 year of age?
A. Less than 40 breaths per minute
B. Less than 30 breaths per minute
C. Less than 20 breaths per minute
D. Less than 15 breaths per minute
9. A 3-year-old child presents with sudden onset of choking, unilateral wheezing,
and decreased breath sounds on the right side. What is the suspected
pathology?
A. Acute bronchiolitis
B. Foreign body airway obstruction (FBAO)
C. Croup
D. Epiglottitis
10. What is the correct targeted oxygen saturation range for a pediatric patient
immediately after return of spontaneous circulation (ROSC)?
A. Always 100%
B. 94% to 99%
C. 90% to 95%
D. 88% to 92%
11. A 7-year-old child is breathing 8 times per minute, limp, and cyanotic. How
should you describe this condition?
A. Respiratory distress
B. Hyperventilation
C. Respiratory failure
D. Compensated shock
12. When selecting an uncuffed endotracheal tube for an 8-year-old child, what
formula calculates the internal diameter (ID)?
A. (Age in years / 4) + 3.5
