AHA PALS EXAM 2026 ACTUAL EXAM| QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
(100% VERIFIED ANSWERS) |ALREADY GRADED
A+|LATEST 2026 VERSION!!!
1. A 2-year-old child presents with a 4-day history of vomiting. The
initial impression reveals an unresponsive child with intermittent
apnea and mottled color. Heart rate is 166/min, respiratory rate is now
being supported with bag-mask ventilation, capillary refill time is 5 to
6 seconds, and temperature is 102°F (38.9°C). What is the best
method of establishing immediate vascular access? A. Two providers
may attempt peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line
Place an intraosseous line
2. What is the appropriate fluid bolus to administer for a child with
hypovolemic shock with adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's
20 mL/kg normal saline
3. An alert toddler presents with a barking cough, moderate stridor,
and moderate retractions. The child's color is pink. What is the most
appropriate initial intervention?
A. Obtain a chest radiograph
pg. 1
,B. Administer nebulized epinephrine
C. Prepare for a surgical airway
D. Use an epinephrine autoinjector
Administer nebulized epinephrine
4. An 8-year-old child presents with a history of vomiting and
diarrhea. The child has the following vital signs: heart rate 168/min,
respiratory rate 15/min, blood pressure 9060 mm Hg, and temperature
98.6°F (37°C). The child's capillary refill time is 4 seconds. After 2 IV
boluses of normal saline (20 mL/kg each), the child's vital signs are
now as follows: heart rate 130/min, respiratory rate 16/min, blood
pressure 94/62 mm Hg, capillary refill 2 seconds, and temperature
98.6°F (37°C). The child's urine output is 1 to 2 mL/kg in the past
hour. The child is still lethargic. What diagnostic tests or information
should be obtained first?
A. Arterial blood gas
B. Serum potassium concentration
C. Glucose
D. A 12-lead ECG
Glucose
5. A 15-year-old boy presents with acute onset of severe respiratory
distress, with retractions and an oxygen saturation of 85%. His
trachea is deviated to the right, and there are no breath sounds on the
left. His heart rate is 140/min, his blood pressure is 84/60 mm Hg, and
his capillary refill time is 3 seconds. What is the most appropriate
intervention?
A. Obtain a chest x-ray
pg. 2
,B. Perform needle decompression on the left chest C. Insert a chest
tube on the left side
D. Insert an IV and administer 20 mL/kg of normal saline
Perform needle decompression on the left chest
6. A 4-year-old is being treated for hypovolemic shock and has
received a single fluid bolus of 20 mL/kg of normal saline. On
reevaluation the child remains anxious, with a heart rate of 140/min, a
blood pressure of 84/54 mm Hg, and a capillary refill time of 4
seconds. What describes this patient's condition?
A. Hypotensive shock
B. Compensated shock
C. No longer in shock
D. Cardiogenic shock
Compensated shock
7. An 8-year-old child had a sudden onset of palpitations and light-
headedness. At the time of evaluation the child is alert. His respiratory
rate is 26/ min, and his blood pressure is 104/70 mm Hg. A cardiac
monitor is applied, and the rhythm below is noted. What is the most
appropriate initial intervention?
A. Provide synchronized cardioversion at 0.5 to 1 J/kg
B. Attempt vagal maneuvers
C. Administer adenosine 0.1 mg/kg over 5 minutes D. Administer
amiodarone 5 mg/kg over 20 minutes
Attempt vagal maneuvers
pg. 3
, 8. A 10-year-old child had a sudden witnessed cardiac arrest and
received immediate bystander CPR and defibrillation within 3
minutes. He had a return of spontaneous circulation. The child
remains unresponsive and has an advanced airway in place. There is
no history of trauma or signs of shock. What is the target range for
oxygen saturation for this child?
A. 92% to 100%
B. 92% to 99%
C. 94% to 99%
D. 94% to 100%
94% to 99%
9. A 3-month-old infant with bronchiolitis is suctioned to remove
upper airway secretions. The infant's heart rate decreases from
155/min to 65/min as shown below. The infant remains alert, with
easily palpable pulses. Capillary refill time is 1 second. What is the
most appropriate initial intervention?
A. Administer oxygen and ensure adequate ventilation; be prepared to
intervene further if heart rate does not increase
B. Establish IV/IO access and administer epinephrine 0.01 mg/kg IV
C. Establish IV/IO access and administer atropine 0.02 mg/kg IV
D. Call for help and prepare to provide transthoracic
pacing/transvenous pacing
Administer oxygen and ensure adequate ventilation; be prepared to
intervene further if heart rate
10. A 3-month-old infant with bronchiolitis is intubated for
management of respiratory failure. During transport, the infant
develops bradycardia with a heart rate of 60/min, and the infant's
pg. 4
CORRECT DETAILED ANSWERS WITH RATIONALES
(100% VERIFIED ANSWERS) |ALREADY GRADED
A+|LATEST 2026 VERSION!!!
1. A 2-year-old child presents with a 4-day history of vomiting. The
initial impression reveals an unresponsive child with intermittent
apnea and mottled color. Heart rate is 166/min, respiratory rate is now
being supported with bag-mask ventilation, capillary refill time is 5 to
6 seconds, and temperature is 102°F (38.9°C). What is the best
method of establishing immediate vascular access? A. Two providers
may attempt peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line
Place an intraosseous line
2. What is the appropriate fluid bolus to administer for a child with
hypovolemic shock with adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's
20 mL/kg normal saline
3. An alert toddler presents with a barking cough, moderate stridor,
and moderate retractions. The child's color is pink. What is the most
appropriate initial intervention?
A. Obtain a chest radiograph
pg. 1
,B. Administer nebulized epinephrine
C. Prepare for a surgical airway
D. Use an epinephrine autoinjector
Administer nebulized epinephrine
4. An 8-year-old child presents with a history of vomiting and
diarrhea. The child has the following vital signs: heart rate 168/min,
respiratory rate 15/min, blood pressure 9060 mm Hg, and temperature
98.6°F (37°C). The child's capillary refill time is 4 seconds. After 2 IV
boluses of normal saline (20 mL/kg each), the child's vital signs are
now as follows: heart rate 130/min, respiratory rate 16/min, blood
pressure 94/62 mm Hg, capillary refill 2 seconds, and temperature
98.6°F (37°C). The child's urine output is 1 to 2 mL/kg in the past
hour. The child is still lethargic. What diagnostic tests or information
should be obtained first?
A. Arterial blood gas
B. Serum potassium concentration
C. Glucose
D. A 12-lead ECG
Glucose
5. A 15-year-old boy presents with acute onset of severe respiratory
distress, with retractions and an oxygen saturation of 85%. His
trachea is deviated to the right, and there are no breath sounds on the
left. His heart rate is 140/min, his blood pressure is 84/60 mm Hg, and
his capillary refill time is 3 seconds. What is the most appropriate
intervention?
A. Obtain a chest x-ray
pg. 2
,B. Perform needle decompression on the left chest C. Insert a chest
tube on the left side
D. Insert an IV and administer 20 mL/kg of normal saline
Perform needle decompression on the left chest
6. A 4-year-old is being treated for hypovolemic shock and has
received a single fluid bolus of 20 mL/kg of normal saline. On
reevaluation the child remains anxious, with a heart rate of 140/min, a
blood pressure of 84/54 mm Hg, and a capillary refill time of 4
seconds. What describes this patient's condition?
A. Hypotensive shock
B. Compensated shock
C. No longer in shock
D. Cardiogenic shock
Compensated shock
7. An 8-year-old child had a sudden onset of palpitations and light-
headedness. At the time of evaluation the child is alert. His respiratory
rate is 26/ min, and his blood pressure is 104/70 mm Hg. A cardiac
monitor is applied, and the rhythm below is noted. What is the most
appropriate initial intervention?
A. Provide synchronized cardioversion at 0.5 to 1 J/kg
B. Attempt vagal maneuvers
C. Administer adenosine 0.1 mg/kg over 5 minutes D. Administer
amiodarone 5 mg/kg over 20 minutes
Attempt vagal maneuvers
pg. 3
, 8. A 10-year-old child had a sudden witnessed cardiac arrest and
received immediate bystander CPR and defibrillation within 3
minutes. He had a return of spontaneous circulation. The child
remains unresponsive and has an advanced airway in place. There is
no history of trauma or signs of shock. What is the target range for
oxygen saturation for this child?
A. 92% to 100%
B. 92% to 99%
C. 94% to 99%
D. 94% to 100%
94% to 99%
9. A 3-month-old infant with bronchiolitis is suctioned to remove
upper airway secretions. The infant's heart rate decreases from
155/min to 65/min as shown below. The infant remains alert, with
easily palpable pulses. Capillary refill time is 1 second. What is the
most appropriate initial intervention?
A. Administer oxygen and ensure adequate ventilation; be prepared to
intervene further if heart rate does not increase
B. Establish IV/IO access and administer epinephrine 0.01 mg/kg IV
C. Establish IV/IO access and administer atropine 0.02 mg/kg IV
D. Call for help and prepare to provide transthoracic
pacing/transvenous pacing
Administer oxygen and ensure adequate ventilation; be prepared to
intervene further if heart rate
10. A 3-month-old infant with bronchiolitis is intubated for
management of respiratory failure. During transport, the infant
develops bradycardia with a heart rate of 60/min, and the infant's
pg. 4
