ARC PALS FINAL EXAM: (LATEST 2026–2027
UPDATE), WITH CORRECT/ACCURATE
ANSWERS
QUESTIONS 1–50
AMERICAN RED CROSS (ARC) PALS FINAL EXAM
Question 1
A healthcare provider is performing a primary assessment of a child in respiratory distress. Which findings
indicate increased work of breathing?
A. Sternal retractions
B. Nasal flaring
C. Accessory muscle use
D. Bradycardia
Correct Answers: A, B, C
Rationale 1:
Increased work of breathing is reflected by visible signs of increased effort, including retractions, nasal
flaring, and accessory muscle use. Bradycardia is a late and ominous sign.
Question 2
A 12-year-old child displays an ECG rhythm with progressively lengthening PR intervals followed by a
dropped QRS complex. Which arrhythmia is present?
A. First-degree AV block
B. Second-degree AV block, Type I
C. Second-degree AV block, Type II
D. Third-degree AV block
Correct Answer: B
Rationale 2:
Mobitz Type I (Wenckebach) shows gradual PR prolongation until a beat is dropped.
,Question 3
An 11-year-old develops unstable wide-complex tachycardia with a pulse and signs of poor perfusion. What
intervention is indicated?
A. Defibrillation
B. Vagal maneuvers
C. Synchronized cardioversion
D. Adenosine infusion
Correct Answer: C
Rationale 3:
Unstable tachycardia with a pulse requires synchronized cardioversion to restore perfusing rhythm.
Question 4
A 4-year-old has tachycardia, weak pulses, cold extremities, hepatomegaly, and jugular venous distention.
What type of shock is suspected?
A. Hypovolemic
B. Distributive
C. Cardiogenic
D. Septic
Correct Answer: C
Rationale 4:
Signs of fluid overload and poor cardiac output indicate cardiogenic shock.
Question 5
A 9-year-old presents with bradycardia, decreased breath sounds, hypoxia, and slow respirations. What
condition is most likely?
A. Upper airway obstruction
B. Respiratory failure
C. Compensated shock
D. Asthma exacerbation
Correct Answer: B
,Rationale 5:
Bradycardia with hypoxia and hypoventilation indicates impending or actual respiratory failure.
Question 6
Which intervention helps manage increased intracranial pressure (ICP) in a pediatric patient?
A. Trendelenburg positioning
B. Flat supine position
C. Head midline with 30° elevation
D. Hyperventilation routinely
Correct Answer: C
Rationale 6:
Elevating the head promotes venous drainage and reduces ICP.
Question 7
Which circulation finding may be present in a child with respiratory distress?
A. Bounding pulses
B. Pallor
C. Hypertension
D. Warm extremities
Correct Answer: B
Rationale 7:
Hypoxia and increased work of breathing can reduce perfusion, causing pallor.
Question 8
Which findings suggest impending cardiac arrest in a child with shock?
A. Hypotension
B. Diminished central pulses
C. Bradycardia
D. Tachycardia
Correct Answers: A, B, C
, Rationale 8:
Bradycardia with hypotension and weak pulses signals decompensated shock and imminent arrest.
Question 9
A child with fever, vomiting, and diarrhea has an ECG showing a regular rhythm with narrow QRS
complexes and elevated rate. What rhythm is this?
A. SVT
B. Sinus tachycardia
C. Atrial flutter
D. Ventricular tachycardia
Correct Answer: B
Rationale 9:
Sinus tachycardia is appropriate in dehydration, fever, and hypovolemia.
Question 10
A 4-year-old suddenly collapses. A provider witnesses the event. What assessment is performed FIRST?
A. Secondary assessment
B. Focused history
C. Rapid assessment
D. Detailed neurologic exam
Correct Answer: C
Rationale 10:
Rapid assessment identifies life-threatening conditions immediately.
Question 11
Which actions demonstrate high-quality CPR in a 2-year-old?
A. Compressing the chest about 2 inches
B. Ventilations lasting 1 second
C. 2 ventilations to every 15 compressions
D. Allowing full chest recoil
Correct Answers: A, B, C, D
UPDATE), WITH CORRECT/ACCURATE
ANSWERS
QUESTIONS 1–50
AMERICAN RED CROSS (ARC) PALS FINAL EXAM
Question 1
A healthcare provider is performing a primary assessment of a child in respiratory distress. Which findings
indicate increased work of breathing?
A. Sternal retractions
B. Nasal flaring
C. Accessory muscle use
D. Bradycardia
Correct Answers: A, B, C
Rationale 1:
Increased work of breathing is reflected by visible signs of increased effort, including retractions, nasal
flaring, and accessory muscle use. Bradycardia is a late and ominous sign.
Question 2
A 12-year-old child displays an ECG rhythm with progressively lengthening PR intervals followed by a
dropped QRS complex. Which arrhythmia is present?
A. First-degree AV block
B. Second-degree AV block, Type I
C. Second-degree AV block, Type II
D. Third-degree AV block
Correct Answer: B
Rationale 2:
Mobitz Type I (Wenckebach) shows gradual PR prolongation until a beat is dropped.
,Question 3
An 11-year-old develops unstable wide-complex tachycardia with a pulse and signs of poor perfusion. What
intervention is indicated?
A. Defibrillation
B. Vagal maneuvers
C. Synchronized cardioversion
D. Adenosine infusion
Correct Answer: C
Rationale 3:
Unstable tachycardia with a pulse requires synchronized cardioversion to restore perfusing rhythm.
Question 4
A 4-year-old has tachycardia, weak pulses, cold extremities, hepatomegaly, and jugular venous distention.
What type of shock is suspected?
A. Hypovolemic
B. Distributive
C. Cardiogenic
D. Septic
Correct Answer: C
Rationale 4:
Signs of fluid overload and poor cardiac output indicate cardiogenic shock.
Question 5
A 9-year-old presents with bradycardia, decreased breath sounds, hypoxia, and slow respirations. What
condition is most likely?
A. Upper airway obstruction
B. Respiratory failure
C. Compensated shock
D. Asthma exacerbation
Correct Answer: B
,Rationale 5:
Bradycardia with hypoxia and hypoventilation indicates impending or actual respiratory failure.
Question 6
Which intervention helps manage increased intracranial pressure (ICP) in a pediatric patient?
A. Trendelenburg positioning
B. Flat supine position
C. Head midline with 30° elevation
D. Hyperventilation routinely
Correct Answer: C
Rationale 6:
Elevating the head promotes venous drainage and reduces ICP.
Question 7
Which circulation finding may be present in a child with respiratory distress?
A. Bounding pulses
B. Pallor
C. Hypertension
D. Warm extremities
Correct Answer: B
Rationale 7:
Hypoxia and increased work of breathing can reduce perfusion, causing pallor.
Question 8
Which findings suggest impending cardiac arrest in a child with shock?
A. Hypotension
B. Diminished central pulses
C. Bradycardia
D. Tachycardia
Correct Answers: A, B, C
, Rationale 8:
Bradycardia with hypotension and weak pulses signals decompensated shock and imminent arrest.
Question 9
A child with fever, vomiting, and diarrhea has an ECG showing a regular rhythm with narrow QRS
complexes and elevated rate. What rhythm is this?
A. SVT
B. Sinus tachycardia
C. Atrial flutter
D. Ventricular tachycardia
Correct Answer: B
Rationale 9:
Sinus tachycardia is appropriate in dehydration, fever, and hypovolemia.
Question 10
A 4-year-old suddenly collapses. A provider witnesses the event. What assessment is performed FIRST?
A. Secondary assessment
B. Focused history
C. Rapid assessment
D. Detailed neurologic exam
Correct Answer: C
Rationale 10:
Rapid assessment identifies life-threatening conditions immediately.
Question 11
Which actions demonstrate high-quality CPR in a 2-year-old?
A. Compressing the chest about 2 inches
B. Ventilations lasting 1 second
C. 2 ventilations to every 15 compressions
D. Allowing full chest recoil
Correct Answers: A, B, C, D
