1
AHA PALS EXAM 2026/2027 Complete
Certification Exam | Actual Questions &
Verified Answers | Pediatric Advanced
Life Support | Pass Guarantee
Section 1: Pediatric Assessment – Evaluate-Identify-Intervene Sequence
Q1: A 3-year-old is brought to the ED listless and pale. Using the PALS evaluate-identify-
intervene sequence, the provider’s first “evaluate” step is to:
A. Obtain a full set of vital signs
B. Check for responsiveness and simultaneously assess breathing & pulse
C. Attach a cardiac monitor
D. Establish IV access
Answer: B
Verified Rationale: The PALS primary assessment begins with checking responsiveness while
simultaneously looking for breathing and a pulse to detect cardiopulmonary failure within 10 s.
Q2: During ongoing assessment of an intubated 6 kg infant, which finding best indicates
effective oxygenation?
A. HR 160/min
B. SpO₂ ≥ 94 % on 30 % FiO₂
C. BP 70/35 mmHg
D. Capillary refill 3 s
Answer: B
Verified Rationale: SpO₂ ≥ 94 % is the PALS target for effective oxygenation in an infant without
congenital heart disease.
Q3: A child in the “GREEN” Broselow zone (18–23 kg) has symptomatic bradycardia; the
recommended epinephrine dose (0.1 mg/mL) is:
A. 0.05 mg
B. 0.18 mg
C. 0.23 mg
D. 0.5 mg
,2
Answer: C
Verified Rationale: 0.01 mg/kg × 23 kg (upper Green) = 0.23 mg IV/IO.
Q4: Which component is assessed LAST in the PALS secondary assessment?
A. Disability (neuro)
B. Exposure (temperature, glucose)
C. Full vital signs
D. Family presence
Answer: D
Verified Rationale: Family presence is part of the overall plan, not the systematic secondary
assessment.
Q5: A 4-year-old with septic shock has cool extremities & weak pulses. The next “intervene”
action after fluid 20 mL/kg is to:
A. Start dopamine
B. Reassess airway & breathing
C. Give 40 mL/kg rapid crystalloid
D. Obtain CT scan
Answer: B
Verified Rationale: After each intervention the sequence returns to re-evaluation of airway &
breathing.
Q6: Capillary refill > 5 s in an infant most directly reflects:
A. Hypoxemia
B. Decreased systemic perfusion
C. Hypoglycemia
D. Increased ICP
Answer: B
Verified Rationale: Delayed capillary refill is a marker of poor systemic perfusion/shock.
Q7: The Broselow tape estimates weight by:
A. Age
B. Head circumference
C. Body length
D. Mid-arm circumference
Answer: C
Verified Rationale: The tape uses body length to select color-coded equipment & drug doses.
Q8: During primary assessment you note agonal gasps & no pulse in a 7-year-old; next action is:
A. 15:2 compressions-ventilations
B. 30:2 compressions-ventilations
, 3
C. Start compressions at 100–120/min
D. Give 2 rescue breaths first
Answer: C
Verified Rationale: Agonal gasps + no pulse = cardiac arrest; begin high-quality compressions
immediately.
Q9: A child’s mental status suddenly worsens after IV fluid bolus; most likely cause is:
A. Worsening sepsis
B. Iatrogenic fluid overload
C. Development of hyponatremic encephalopathy
D. Reversible cerebral vasoconstriction
Answer: C
Verified Rationale: Rapid hypotonic fluid can precipitate hyponatremic seizures.
Q10: Which vital sign change is the earliest indicator of compensated shock in infants?
A. Hypotension
B. Tachycardia
C. Bradypnea
D. Fever
Answer: B
Verified Rationale: Tachycardia is the first compensatory response to maintain cardiac output.
Section 2: Respiratory Emergencies
Q11: A 2-year-old with stridor at rest, drooling, and fever most likely has:
A. Bacterial tracheitis
B. Epiglottitis
C. Croup
D. Foreign body
Answer: B
Verified Rationale: Classic presentation of epiglottitis—high fever, toxic, tripod, drooling.
Q12: Recommended first-line medication for moderate croup is:
A. Epinephrine 1:1000 IM
B. Racemic epinephrine nebulized
C. Dexamethasone 0.6 mg/kg PO/IM
D. Albuterol nebulized
Answer: C
Verified Rationale: Dexamethasone reduces airway inflammation and is first-line for all but mild
croup.
AHA PALS EXAM 2026/2027 Complete
Certification Exam | Actual Questions &
Verified Answers | Pediatric Advanced
Life Support | Pass Guarantee
Section 1: Pediatric Assessment – Evaluate-Identify-Intervene Sequence
Q1: A 3-year-old is brought to the ED listless and pale. Using the PALS evaluate-identify-
intervene sequence, the provider’s first “evaluate” step is to:
A. Obtain a full set of vital signs
B. Check for responsiveness and simultaneously assess breathing & pulse
C. Attach a cardiac monitor
D. Establish IV access
Answer: B
Verified Rationale: The PALS primary assessment begins with checking responsiveness while
simultaneously looking for breathing and a pulse to detect cardiopulmonary failure within 10 s.
Q2: During ongoing assessment of an intubated 6 kg infant, which finding best indicates
effective oxygenation?
A. HR 160/min
B. SpO₂ ≥ 94 % on 30 % FiO₂
C. BP 70/35 mmHg
D. Capillary refill 3 s
Answer: B
Verified Rationale: SpO₂ ≥ 94 % is the PALS target for effective oxygenation in an infant without
congenital heart disease.
Q3: A child in the “GREEN” Broselow zone (18–23 kg) has symptomatic bradycardia; the
recommended epinephrine dose (0.1 mg/mL) is:
A. 0.05 mg
B. 0.18 mg
C. 0.23 mg
D. 0.5 mg
,2
Answer: C
Verified Rationale: 0.01 mg/kg × 23 kg (upper Green) = 0.23 mg IV/IO.
Q4: Which component is assessed LAST in the PALS secondary assessment?
A. Disability (neuro)
B. Exposure (temperature, glucose)
C. Full vital signs
D. Family presence
Answer: D
Verified Rationale: Family presence is part of the overall plan, not the systematic secondary
assessment.
Q5: A 4-year-old with septic shock has cool extremities & weak pulses. The next “intervene”
action after fluid 20 mL/kg is to:
A. Start dopamine
B. Reassess airway & breathing
C. Give 40 mL/kg rapid crystalloid
D. Obtain CT scan
Answer: B
Verified Rationale: After each intervention the sequence returns to re-evaluation of airway &
breathing.
Q6: Capillary refill > 5 s in an infant most directly reflects:
A. Hypoxemia
B. Decreased systemic perfusion
C. Hypoglycemia
D. Increased ICP
Answer: B
Verified Rationale: Delayed capillary refill is a marker of poor systemic perfusion/shock.
Q7: The Broselow tape estimates weight by:
A. Age
B. Head circumference
C. Body length
D. Mid-arm circumference
Answer: C
Verified Rationale: The tape uses body length to select color-coded equipment & drug doses.
Q8: During primary assessment you note agonal gasps & no pulse in a 7-year-old; next action is:
A. 15:2 compressions-ventilations
B. 30:2 compressions-ventilations
, 3
C. Start compressions at 100–120/min
D. Give 2 rescue breaths first
Answer: C
Verified Rationale: Agonal gasps + no pulse = cardiac arrest; begin high-quality compressions
immediately.
Q9: A child’s mental status suddenly worsens after IV fluid bolus; most likely cause is:
A. Worsening sepsis
B. Iatrogenic fluid overload
C. Development of hyponatremic encephalopathy
D. Reversible cerebral vasoconstriction
Answer: C
Verified Rationale: Rapid hypotonic fluid can precipitate hyponatremic seizures.
Q10: Which vital sign change is the earliest indicator of compensated shock in infants?
A. Hypotension
B. Tachycardia
C. Bradypnea
D. Fever
Answer: B
Verified Rationale: Tachycardia is the first compensatory response to maintain cardiac output.
Section 2: Respiratory Emergencies
Q11: A 2-year-old with stridor at rest, drooling, and fever most likely has:
A. Bacterial tracheitis
B. Epiglottitis
C. Croup
D. Foreign body
Answer: B
Verified Rationale: Classic presentation of epiglottitis—high fever, toxic, tripod, drooling.
Q12: Recommended first-line medication for moderate croup is:
A. Epinephrine 1:1000 IM
B. Racemic epinephrine nebulized
C. Dexamethasone 0.6 mg/kg PO/IM
D. Albuterol nebulized
Answer: C
Verified Rationale: Dexamethasone reduces airway inflammation and is first-line for all but mild
croup.
