PEDIATRIC ADVANCED LIFE SUPPORT (PALS) EXAM
2025/2026 WITH 100% ACCURATE ANSWERS
1. The primary assessment mnemonic ABCDE, used to determine what life-
threatening conditions may exist, stands for:
Airway, Breathing, Circulation, Disability, Exposure
Awareness, Breathing, Color, Disability, Exposure
Airway, Breathing, Color, Disability, Edema
Airway, Breathing, Circulation, Disability, Edema
2. A 4-year-old child presents with a respiratory rate of 40 breaths per
minute. What should be your immediate concern based on the normal
respiratory rate for this age group?
Increased physical activity
Normal respiratory function
Dehydration
Potential respiratory distress
3. A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is
ongoing. The child is intubated and vascular access is established. The
ECG monitor reveals an organized rhythm, but a pulse check reveals no
palpable pulses. Effective ventilations and compressions are resumed,
and an initial IV dose of epinephrine is administered. Which of the
following therapies should you perform next?
Attempt defibrillation at 4 J/kg
Administer epinephrine 0.1 mg/kg IV (0.1 mL/kg of 1:1,000)
Attempt to identify and treat reversible causes (using the H's
,and T's as a memory aid)
Administer synchronized cardioversion at 1 J/kg
,4. What is the primary indication for administering vasopressors in septic
shock management?
When the person is severely hypotensive despite proper fluid
management
When the person is responding to fluid resuscitation
Always indicated as soon as IV access is obtained
Vasopressors are never used for septic shock
5. Which type of shock occurs mainly from allergic reactions?
Hypovolemic Shock
Distributive Shock
Anaphylactic Shock
Septic Shock
Cardiogenic Shock
6. In a scenario where a child is found unresponsive and unable to
maintain their airway, what steps should be taken following the decision
to perform endotracheal intubation?
Perform the head tilt-chin lift maneuver to open the airway.
Prepare the intubation equipment and ensure proper
positioning of the patient.
Administer CPR immediately without checking the airway.
Use a nasopharyngeal airway to assist breathing.
7. Describe the significance of the rescue breath rate for a child with a
pulse during CPR.
The breath rate can be adjusted based on the rescuer's comfort
, level.
The breath rate should be faster to quickly restore
consciousness.
The rescue breath rate of 1 breath every 3 to 5 seconds ensures
adequate oxygenation without causing hyperventilation.
The rescue breath rate is less important than chest compressions.
8. A 2-year-old was seen to be unresponsive. He was gasping and upon
checking for the pulse, it was not felt within 10 seconds. What is the next
step in management?
Hook to cardiac monitor and pulse oximeter
Activate emergency response system and get the AED
Perform cardiopulmonary resuscitation (CPR)
Do rescue breathing
9. You are preparing to use a manual defibrillator and paddles in the
pediatric setting. When would it be most appropriate to use the smaller
"pediatric" sized paddles for shock delivery?
If the patient weighs less than approximately 10 kg or is less
than 1 year of age.
Whenever you can compress the victim's chest using only the
heel of one hand
If the patient weighs less than approximately 25 kg, or is less than
8 years of age.
To attempt synchronized cardioversion but not defibrillation
10. _______________ is the drug of choice for patients in anaphylactic shock
pseudoephrine
2025/2026 WITH 100% ACCURATE ANSWERS
1. The primary assessment mnemonic ABCDE, used to determine what life-
threatening conditions may exist, stands for:
Airway, Breathing, Circulation, Disability, Exposure
Awareness, Breathing, Color, Disability, Exposure
Airway, Breathing, Color, Disability, Edema
Airway, Breathing, Circulation, Disability, Edema
2. A 4-year-old child presents with a respiratory rate of 40 breaths per
minute. What should be your immediate concern based on the normal
respiratory rate for this age group?
Increased physical activity
Normal respiratory function
Dehydration
Potential respiratory distress
3. A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is
ongoing. The child is intubated and vascular access is established. The
ECG monitor reveals an organized rhythm, but a pulse check reveals no
palpable pulses. Effective ventilations and compressions are resumed,
and an initial IV dose of epinephrine is administered. Which of the
following therapies should you perform next?
Attempt defibrillation at 4 J/kg
Administer epinephrine 0.1 mg/kg IV (0.1 mL/kg of 1:1,000)
Attempt to identify and treat reversible causes (using the H's
,and T's as a memory aid)
Administer synchronized cardioversion at 1 J/kg
,4. What is the primary indication for administering vasopressors in septic
shock management?
When the person is severely hypotensive despite proper fluid
management
When the person is responding to fluid resuscitation
Always indicated as soon as IV access is obtained
Vasopressors are never used for septic shock
5. Which type of shock occurs mainly from allergic reactions?
Hypovolemic Shock
Distributive Shock
Anaphylactic Shock
Septic Shock
Cardiogenic Shock
6. In a scenario where a child is found unresponsive and unable to
maintain their airway, what steps should be taken following the decision
to perform endotracheal intubation?
Perform the head tilt-chin lift maneuver to open the airway.
Prepare the intubation equipment and ensure proper
positioning of the patient.
Administer CPR immediately without checking the airway.
Use a nasopharyngeal airway to assist breathing.
7. Describe the significance of the rescue breath rate for a child with a
pulse during CPR.
The breath rate can be adjusted based on the rescuer's comfort
, level.
The breath rate should be faster to quickly restore
consciousness.
The rescue breath rate of 1 breath every 3 to 5 seconds ensures
adequate oxygenation without causing hyperventilation.
The rescue breath rate is less important than chest compressions.
8. A 2-year-old was seen to be unresponsive. He was gasping and upon
checking for the pulse, it was not felt within 10 seconds. What is the next
step in management?
Hook to cardiac monitor and pulse oximeter
Activate emergency response system and get the AED
Perform cardiopulmonary resuscitation (CPR)
Do rescue breathing
9. You are preparing to use a manual defibrillator and paddles in the
pediatric setting. When would it be most appropriate to use the smaller
"pediatric" sized paddles for shock delivery?
If the patient weighs less than approximately 10 kg or is less
than 1 year of age.
Whenever you can compress the victim's chest using only the
heel of one hand
If the patient weighs less than approximately 25 kg, or is less than
8 years of age.
To attempt synchronized cardioversion but not defibrillation
10. _______________ is the drug of choice for patients in anaphylactic shock
pseudoephrine
