AHA Pediatric Advanced Life Support (PALS) Actual
Exam Questions and Verified Answers – Latest Updated
Edition- 2026 with Detailed Explanations (100% Pass
Guaranteed - Graded A+)
Question 1
A 5-year-old child has had severe respiratory distress for 2 days. During assessment the
child's heart rate decreases from 140/min to 90/min, and the child's respiratory rate
decreases from 66/min to 8/min. What intervention is most appropriate?
A. Provide rescue breaths at a rate of 12 to 20/min
B. Provide rescue breaths at a rate of 6 to 10/min
C. Initiate chest compressions at a rate of at least 100/min
D. Initiate chest compressions at a rate of 60/min
Answer: A
Rationale: The child is showing signs of impending respiratory failure with
bradycardia (heart rate dropping from 140 to 90) and severely decreased respiratory
rate (from 66 to 8). For a child with a pulse but inadequate breathing, rescue breaths
should be provided at 12-20/min.
Question 2
What is the recommended location to check for a pulse in a 3-month-old infant?
A. Carotid
B. Radial
C. Brachial
D. Cardiac apex
Answer: C
Rationale: For infants under 1 year of age, the brachial artery is the recommended site
for pulse check due to easier palpation and anatomical considerations. The carotid can
be used in older children.
Question 3
The initial impression of a 4-year-old child reveals a lethargic child who is diaphoretic,
with no increased work of breathing and pink color. Her heart rate is 220/min,
respiratory rate is 24/min, blood pressure is 84/46 mm Hg, and capillary refill time is 5
pg. 1
,seconds. IV access has been established. The rhythm below is seen on the cardiac
monitor. What is the most appropriate initial intervention?
A. Give adenosine 0.1 mg/kg rapid IV push
B. Perform carotid sinus massage
C. Perform synchronized cardioversion at 0.5 J/kg
D. Attempt defibrillation at 2 J/kg
Answer: A
Rationale: This presentation is consistent with SVT with poor perfusion (lethargy,
diaphoresis, weak pulses, prolonged capillary refill). Adenosine 0.1 mg/kg rapid IV push
is the first-line pharmacological treatment for SVT when IV access is available.
Question 4
An 8-month-old infant is being evaluated. The child's mother says the infant has not
been feeding well. The infant is alert with rapid but unlabored breathing, and the
infant's color is pale. A cardiac monitor is applied, and the rhythm below is noted. Distal
pulses are readily palpable. You give oxygen and establish IV access. What is the most
appropriate vagal maneuver?
A. Valsalva maneuver
B. Carotid massage
C. Ocular pressure
D. Ice to the face
Answer: D
Rationale: For infants with SVT and adequate perfusion, the preferred vagal maneuver
is applying ice to the face. Valsalva and carotid massage are more appropriate for older
children; ocular pressure is contraindicated due to retinal damage risk.
Question 5
A 7-year-old child presents in pulseless arrest. The child's ECG shows the rhythm below.
Which of the following describes the patient's condition?
A. Ventricular escape rhythm
B. Ventricular tachycardia
C. Pulseless electrical activity
D. Sinus bradycardia
Answer: C
Rationale: Pulseless electrical activity (PEA) is defined as organized electrical activity
on the ECG without a palpable pulse. The patient is in pulseless arrest with an organized
rhythm, which characterizes PEA rather than V-tach or bradycardia.
pg. 2
, Question 6
A 12-year-old child suddenly collapses while playing sports. He is unresponsive and not
breathing. Emergency response is activated. The child has no pulse, and CPR is
initiated. An AED arrives. What is the most appropriate next intervention?
A. Contact the child's family
B. Provide CPR for 2 minutes
C. Drive the child to the hospital
D. Use the AED
Answer: D
Rationale: In a witnessed sudden cardiac arrest, early defibrillation is critical for
survival. The AED should be used as soon as it arrives, according to the device prompts.
Question 7
A 6-year-old child is found unresponsive, not breathing, and pulseless. What is the
correct compression-to-ventilation ratio when 2 or more healthcare providers are
present to perform CPR?
A. 30:2
B. 15:2
C. 5:1
D. 3:1
Answer: B
Rationale: For pediatric CPR with 2 or more healthcare providers, the compression-to-
ventilation ratio is 15:2. This differs from single-provider CPR (30:2) and adult CPR to
optimize oxygenation and circulation in children.
Question 8
A 7-year-old child presents with a narrow-complex supraventricular tachycardia,
lethargy, and poor perfusion. Pulses are weak and thready. What is the most appropriate
intervention?
A. Provide synchronized cardioversion at 0.5 to 1 J/kg
B. Attempt vagal maneuvers
C. Administer adenosine 0.1 mg/kg rapid IV push
D. Administer amiodarone 5 mg/kg over 20 minutes
Answer: A
pg. 3
Exam Questions and Verified Answers – Latest Updated
Edition- 2026 with Detailed Explanations (100% Pass
Guaranteed - Graded A+)
Question 1
A 5-year-old child has had severe respiratory distress for 2 days. During assessment the
child's heart rate decreases from 140/min to 90/min, and the child's respiratory rate
decreases from 66/min to 8/min. What intervention is most appropriate?
A. Provide rescue breaths at a rate of 12 to 20/min
B. Provide rescue breaths at a rate of 6 to 10/min
C. Initiate chest compressions at a rate of at least 100/min
D. Initiate chest compressions at a rate of 60/min
Answer: A
Rationale: The child is showing signs of impending respiratory failure with
bradycardia (heart rate dropping from 140 to 90) and severely decreased respiratory
rate (from 66 to 8). For a child with a pulse but inadequate breathing, rescue breaths
should be provided at 12-20/min.
Question 2
What is the recommended location to check for a pulse in a 3-month-old infant?
A. Carotid
B. Radial
C. Brachial
D. Cardiac apex
Answer: C
Rationale: For infants under 1 year of age, the brachial artery is the recommended site
for pulse check due to easier palpation and anatomical considerations. The carotid can
be used in older children.
Question 3
The initial impression of a 4-year-old child reveals a lethargic child who is diaphoretic,
with no increased work of breathing and pink color. Her heart rate is 220/min,
respiratory rate is 24/min, blood pressure is 84/46 mm Hg, and capillary refill time is 5
pg. 1
,seconds. IV access has been established. The rhythm below is seen on the cardiac
monitor. What is the most appropriate initial intervention?
A. Give adenosine 0.1 mg/kg rapid IV push
B. Perform carotid sinus massage
C. Perform synchronized cardioversion at 0.5 J/kg
D. Attempt defibrillation at 2 J/kg
Answer: A
Rationale: This presentation is consistent with SVT with poor perfusion (lethargy,
diaphoresis, weak pulses, prolonged capillary refill). Adenosine 0.1 mg/kg rapid IV push
is the first-line pharmacological treatment for SVT when IV access is available.
Question 4
An 8-month-old infant is being evaluated. The child's mother says the infant has not
been feeding well. The infant is alert with rapid but unlabored breathing, and the
infant's color is pale. A cardiac monitor is applied, and the rhythm below is noted. Distal
pulses are readily palpable. You give oxygen and establish IV access. What is the most
appropriate vagal maneuver?
A. Valsalva maneuver
B. Carotid massage
C. Ocular pressure
D. Ice to the face
Answer: D
Rationale: For infants with SVT and adequate perfusion, the preferred vagal maneuver
is applying ice to the face. Valsalva and carotid massage are more appropriate for older
children; ocular pressure is contraindicated due to retinal damage risk.
Question 5
A 7-year-old child presents in pulseless arrest. The child's ECG shows the rhythm below.
Which of the following describes the patient's condition?
A. Ventricular escape rhythm
B. Ventricular tachycardia
C. Pulseless electrical activity
D. Sinus bradycardia
Answer: C
Rationale: Pulseless electrical activity (PEA) is defined as organized electrical activity
on the ECG without a palpable pulse. The patient is in pulseless arrest with an organized
rhythm, which characterizes PEA rather than V-tach or bradycardia.
pg. 2
, Question 6
A 12-year-old child suddenly collapses while playing sports. He is unresponsive and not
breathing. Emergency response is activated. The child has no pulse, and CPR is
initiated. An AED arrives. What is the most appropriate next intervention?
A. Contact the child's family
B. Provide CPR for 2 minutes
C. Drive the child to the hospital
D. Use the AED
Answer: D
Rationale: In a witnessed sudden cardiac arrest, early defibrillation is critical for
survival. The AED should be used as soon as it arrives, according to the device prompts.
Question 7
A 6-year-old child is found unresponsive, not breathing, and pulseless. What is the
correct compression-to-ventilation ratio when 2 or more healthcare providers are
present to perform CPR?
A. 30:2
B. 15:2
C. 5:1
D. 3:1
Answer: B
Rationale: For pediatric CPR with 2 or more healthcare providers, the compression-to-
ventilation ratio is 15:2. This differs from single-provider CPR (30:2) and adult CPR to
optimize oxygenation and circulation in children.
Question 8
A 7-year-old child presents with a narrow-complex supraventricular tachycardia,
lethargy, and poor perfusion. Pulses are weak and thready. What is the most appropriate
intervention?
A. Provide synchronized cardioversion at 0.5 to 1 J/kg
B. Attempt vagal maneuvers
C. Administer adenosine 0.1 mg/kg rapid IV push
D. Administer amiodarone 5 mg/kg over 20 minutes
Answer: A
pg. 3
