AHA Pediatrics Advanced Life Support PALS Exam 2026: 280
Practice Questions and Correct Answers
Question 1.
What oxygen delivery system most reliably delivers a high (90% of greater) concentration
of inspired oxygen to a 7-year-old child? -
Correct Answer: Nonrebreathing face mask
Question 2.
You are called to help treat an infant with severe symptomatic bradycardia (heart rate
66/min) associated with respiratory distress. Bradycardia persists despite establishment of
an effective airway, oxygenation, and ventilation. There is no heart block present. What
first drug should you administer?
Correct Answer: *Epinephrine*
Question 3.
You are part of a team attempting to resuscitate a child with ventricular fibrillation cardiac
arrest. You deliver 2 unsynchronized shocks. A team member established IO access, so
you give a dose of epinephrine, 0.01 mg/kg IO. At next rhythm check, persistent
ventricular fibrillation is present. You administer a 4-J/kg shock and resume CPR. What
drug and dose should be administered next?
Correct Answer: *Amiodarone 5 mg/kg IO* - can be used for shock-refractory VF
or pVT
Question 4.
Initial impression of a 2-year-old girl shows her to be alert with mild breathing difficulty
during inspiration and pale skin color. On primary assessment, she makes high-pitched
inspiratory sounds (mild stridor) when agitated; otherwise, her breathing is quiet. Her
SpO2 is 92% on room air, and she has mild inspiratory intercostal retractions. Lung
auscultation reveals tr
Correct Answer: mitted upper airway sounds with adequate distal breath
sounds bilaterally. Most appropriate initial intervention for this child?
-✓✓*Humidified oxygen as tolerated*
Question 5.
7-year-old boy found unresponsive, apneic, and pulseless. CPR is ongoing. Child is
intubated, and vascular access is established. ECG monitor shows organized rhythm with
heart rate of 45/min, but a pulse check reveals no palpable pulses. High-quality CPR is
resumed, and an initial IV dose of epinephrine is administered. What intervention should
you perform next?
Correct Answer: *Identify and treat reversible causes*
,Question 6.
You are caring for a 6-year-old patient who is receiving positive- pressure mechanical
ventilation via an endotracheal tube. Child begins to move his head and suddenly
becomes cyanotic, and his heart rate decreases. His SpO2 is 65%. You remove child from
mechanical ventilator and begin to provide manual ventilation with a bag via endotracheal
tube. During manual ventilation with 100% oxygen, child's color and heart rate improve
slightly and his BP remains adequate. Breath sounds and chest exp
Correct Answer: ion are present and adequate on right side and are present but
consistently diminished on left side. Trachea not deviated, and neck veins are
not distended. Suction catheter passes easily beyond tip of the endotracheal
tube. Most likely cause of this child's acute deterioration? -✓✓*Tracheal tube
displacement into right main bronchus*
Question 7.
You are giving chest compressions for a child in cardiac arrest. What is the proper depth
of compressions for a child?
Correct Answer: *Compress the chest at least one third the depth of the chest,
about 2 inches (5 cm)*
Question 8.
During PALS, you and another rescuers begin CPR. Your colleague begins compressions,
and you noticed that the compression rate is too slow. What should you say to offer
constructive feedback?
Correct Answer: *You need to compress at a rate of 100 to 120 per minute*
Question 9.
You are preparing to use a manual defibrillator in the pediatric setting. What best
describes when it is appropriate to use the smaller pediatric- sized paddles?
Correct Answer: *If the child weighs less than 10 kg or is less than 1 year old*
Question 10.
You need to provide rescue breaths to a child victim with a pulse. What is the appropriate
rate for delivering breaths?
Correct Answer: *1 breath every 3 to 5 seconds*
Question 11.
You find an infant who is unresponsive, is not breathing, and does not have a pulse. You
shout for nearby help, but no one arrives. What action should you take next?
Correct Answer: *Provide CPR for about 2 minutes before leaving to activate the
emergency response system*
,Question 12.
3 yo boy presents with multiple-system trauma. Child was an unrestrained passenger in a
high-speed MVC. On primary assessment, he is unresponsive to voice or painful
stimulation. His RR is 5/min, HR and pulses are 170/min, systolic BC is 60 mmHg, capillary
refill is 5 seconds, and SpO2 is 75% on room air. What action should you take first?
Correct Answer: *While a colleague provides spinal motion restriction, open the
airway with a jaw thrust and provide bag-mask ventilation*
Question 13.
You are assisting in the elective intubation of an average-sized 4 yo child with respiratory
failure. Colleague is retrieving the color-coded length-based tape from the resuscitation
chart. What is likely to be the estimated size of the uncuffed endotracheal tube for this
child?
Correct Answer: *5- mm tube*
Question 14.
You find a 10 yo boy to be unresponsive. You shout for help, and after finding that he is
not breathing and has no pulse, you and a colleague begin CPR. Another colleague
activates the emergency response system, brings the emergency equipment, and places
the child on a cardiac monitor/defibrillator, which reveals ventricular tachycardia. You
attempt defib at 2 J/kg and give 2 minutes of CPR. The rhythm persists at the second
rhythm check, at which point you attempt defibrillation with 4 J/kg. A fourth colleague
arrives, starts an IV, and administers 1 dose of epinephrine 0.01 mg/kg. If v fib or
pulseless ventricular tachycardia persists after 2 minutes of CPR, you will administer
another shock. What drug and dose should be administered?
Correct Answer: *Lidocaine 1 mg/kg IV*
Question 15.
During bag-mask ventilation, how should you hold the mask to make an effective seal
between the child's face and the mask?
Correct Answer: *Position your fingers using the E-C clamp technique*
Question 16.
Age of infants
Correct Answer: <1 yo (excluding the newly born)
Question 17.
Age of children
Correct Answer: from 1 year of age to puberty
, Question 18.
To perform a pulse check in an infant, palpate a
Correct Answer: brachial pulse - if you don't definitely feel a pulse within 10
seconds, starts CPR, beginning with chest compressions
Question 19.
To perform a pulse check in a child, palpate a
Correct Answer: carotid or femoral pulse - if you don't definitely feel a pulse
within 10 seconds, starts CPR, beginning with chest compressions
Question 20.
Compression depth in infants
Correct Answer: at least 1/3 the AP diameter of the chest or about 1 1/2 inches
(4 cm)
Question 21.
If a head or neck injury is suspected, use what to open the airway? -
Correct Answer: jaw-thrust maneuver - if jaw thrust does not open the airway,
use the head tilt-chin lift
Question 22.
The primary assessment (primary survey) uses a hands-on ABCDE approach and includes
assessment of the patient's vital signs .. what does ABCDE stand for?
Correct Answer: Airway Breathing Circulation Disability Exposure
Question 23.
During PALS, determine the respiratory rate by ...
Correct Answer: counting the number of times the chest rises in 30 seconds and
multiply by 2
Question 24.
Rectractions accompanied by stridor or inspiratory snoring suggest -
Correct Answer: upper airway obstruction - seesaw respirations also usually
indicated upper airway obstruction + may also be observed in severe lower
airway obstruction
Practice Questions and Correct Answers
Question 1.
What oxygen delivery system most reliably delivers a high (90% of greater) concentration
of inspired oxygen to a 7-year-old child? -
Correct Answer: Nonrebreathing face mask
Question 2.
You are called to help treat an infant with severe symptomatic bradycardia (heart rate
66/min) associated with respiratory distress. Bradycardia persists despite establishment of
an effective airway, oxygenation, and ventilation. There is no heart block present. What
first drug should you administer?
Correct Answer: *Epinephrine*
Question 3.
You are part of a team attempting to resuscitate a child with ventricular fibrillation cardiac
arrest. You deliver 2 unsynchronized shocks. A team member established IO access, so
you give a dose of epinephrine, 0.01 mg/kg IO. At next rhythm check, persistent
ventricular fibrillation is present. You administer a 4-J/kg shock and resume CPR. What
drug and dose should be administered next?
Correct Answer: *Amiodarone 5 mg/kg IO* - can be used for shock-refractory VF
or pVT
Question 4.
Initial impression of a 2-year-old girl shows her to be alert with mild breathing difficulty
during inspiration and pale skin color. On primary assessment, she makes high-pitched
inspiratory sounds (mild stridor) when agitated; otherwise, her breathing is quiet. Her
SpO2 is 92% on room air, and she has mild inspiratory intercostal retractions. Lung
auscultation reveals tr
Correct Answer: mitted upper airway sounds with adequate distal breath
sounds bilaterally. Most appropriate initial intervention for this child?
-✓✓*Humidified oxygen as tolerated*
Question 5.
7-year-old boy found unresponsive, apneic, and pulseless. CPR is ongoing. Child is
intubated, and vascular access is established. ECG monitor shows organized rhythm with
heart rate of 45/min, but a pulse check reveals no palpable pulses. High-quality CPR is
resumed, and an initial IV dose of epinephrine is administered. What intervention should
you perform next?
Correct Answer: *Identify and treat reversible causes*
,Question 6.
You are caring for a 6-year-old patient who is receiving positive- pressure mechanical
ventilation via an endotracheal tube. Child begins to move his head and suddenly
becomes cyanotic, and his heart rate decreases. His SpO2 is 65%. You remove child from
mechanical ventilator and begin to provide manual ventilation with a bag via endotracheal
tube. During manual ventilation with 100% oxygen, child's color and heart rate improve
slightly and his BP remains adequate. Breath sounds and chest exp
Correct Answer: ion are present and adequate on right side and are present but
consistently diminished on left side. Trachea not deviated, and neck veins are
not distended. Suction catheter passes easily beyond tip of the endotracheal
tube. Most likely cause of this child's acute deterioration? -✓✓*Tracheal tube
displacement into right main bronchus*
Question 7.
You are giving chest compressions for a child in cardiac arrest. What is the proper depth
of compressions for a child?
Correct Answer: *Compress the chest at least one third the depth of the chest,
about 2 inches (5 cm)*
Question 8.
During PALS, you and another rescuers begin CPR. Your colleague begins compressions,
and you noticed that the compression rate is too slow. What should you say to offer
constructive feedback?
Correct Answer: *You need to compress at a rate of 100 to 120 per minute*
Question 9.
You are preparing to use a manual defibrillator in the pediatric setting. What best
describes when it is appropriate to use the smaller pediatric- sized paddles?
Correct Answer: *If the child weighs less than 10 kg or is less than 1 year old*
Question 10.
You need to provide rescue breaths to a child victim with a pulse. What is the appropriate
rate for delivering breaths?
Correct Answer: *1 breath every 3 to 5 seconds*
Question 11.
You find an infant who is unresponsive, is not breathing, and does not have a pulse. You
shout for nearby help, but no one arrives. What action should you take next?
Correct Answer: *Provide CPR for about 2 minutes before leaving to activate the
emergency response system*
,Question 12.
3 yo boy presents with multiple-system trauma. Child was an unrestrained passenger in a
high-speed MVC. On primary assessment, he is unresponsive to voice or painful
stimulation. His RR is 5/min, HR and pulses are 170/min, systolic BC is 60 mmHg, capillary
refill is 5 seconds, and SpO2 is 75% on room air. What action should you take first?
Correct Answer: *While a colleague provides spinal motion restriction, open the
airway with a jaw thrust and provide bag-mask ventilation*
Question 13.
You are assisting in the elective intubation of an average-sized 4 yo child with respiratory
failure. Colleague is retrieving the color-coded length-based tape from the resuscitation
chart. What is likely to be the estimated size of the uncuffed endotracheal tube for this
child?
Correct Answer: *5- mm tube*
Question 14.
You find a 10 yo boy to be unresponsive. You shout for help, and after finding that he is
not breathing and has no pulse, you and a colleague begin CPR. Another colleague
activates the emergency response system, brings the emergency equipment, and places
the child on a cardiac monitor/defibrillator, which reveals ventricular tachycardia. You
attempt defib at 2 J/kg and give 2 minutes of CPR. The rhythm persists at the second
rhythm check, at which point you attempt defibrillation with 4 J/kg. A fourth colleague
arrives, starts an IV, and administers 1 dose of epinephrine 0.01 mg/kg. If v fib or
pulseless ventricular tachycardia persists after 2 minutes of CPR, you will administer
another shock. What drug and dose should be administered?
Correct Answer: *Lidocaine 1 mg/kg IV*
Question 15.
During bag-mask ventilation, how should you hold the mask to make an effective seal
between the child's face and the mask?
Correct Answer: *Position your fingers using the E-C clamp technique*
Question 16.
Age of infants
Correct Answer: <1 yo (excluding the newly born)
Question 17.
Age of children
Correct Answer: from 1 year of age to puberty
, Question 18.
To perform a pulse check in an infant, palpate a
Correct Answer: brachial pulse - if you don't definitely feel a pulse within 10
seconds, starts CPR, beginning with chest compressions
Question 19.
To perform a pulse check in a child, palpate a
Correct Answer: carotid or femoral pulse - if you don't definitely feel a pulse
within 10 seconds, starts CPR, beginning with chest compressions
Question 20.
Compression depth in infants
Correct Answer: at least 1/3 the AP diameter of the chest or about 1 1/2 inches
(4 cm)
Question 21.
If a head or neck injury is suspected, use what to open the airway? -
Correct Answer: jaw-thrust maneuver - if jaw thrust does not open the airway,
use the head tilt-chin lift
Question 22.
The primary assessment (primary survey) uses a hands-on ABCDE approach and includes
assessment of the patient's vital signs .. what does ABCDE stand for?
Correct Answer: Airway Breathing Circulation Disability Exposure
Question 23.
During PALS, determine the respiratory rate by ...
Correct Answer: counting the number of times the chest rises in 30 seconds and
multiply by 2
Question 24.
Rectractions accompanied by stridor or inspiratory snoring suggest -
Correct Answer: upper airway obstruction - seesaw respirations also usually
indicated upper airway obstruction + may also be observed in severe lower
airway obstruction
