AHA PALS Exam – Complete Practice Test
(2025/2026 Guidelines)
Course: Pediatric Advanced Life Support (PALS) – American Heart
Association
2025/2026 Guidelines Update: Reflects new science from the 2025 AHA
Guidelines for CPR and ECC
Verification Period: 2 years
Format: Multiple Choice
Total Questions: 50
Focus: Systematic assessment, respiratory emergencies, shock
management, cardiac arrhythmias, pharmacology, and team dynamics
EXAM OVERVIEW
The PALS Provider Course is designed for healthcare professionals who
direct or participate in the management of respiratory and/or
cardiovascular emergencies and cardiopulmonary arrest in infants and
children . The 2025 Guidelines represent the most comprehensive update
since 2020, with major changes in epinephrine use, early defibrillation,
temperature control, and hemodynamic targets during CPR and post-
cardiac arrest care
SECTION 1: Systematic Approach & Primary Assessment
Q1. What are the key elements to observe during the initial "doorway
assessment" of a pediatric patient?
• A) Airway, Breathing, Circulation
• B) Appearance, Breathing, and Circulation (skin color)
• C) Level of consciousness and pupil response
• D) Heart rate and blood pressure only
Answer: B – The initial doorway assessment evaluates Appearance (level of
alertness and responsiveness), Breathing (signs of increased effort, no
,respiratory effort, or abnormal sounds), and Circulation (skin color—pallor,
mottling, or cyanosis). The 2025 guidelines emphasize this rapid visual
assessment as the first step in identifying life-threatening conditions .
Q2. What are the five components of the primary assessment in
pediatric emergencies?
• A) Airway, Breathing, Circulation, Disability, Exposure
• B) Airway, Breathing, Circulation, Defibrillation, Evaluation
• C) Appearance, Breathing, Circulation, Disability, Exposure
• D) Airway, Breathing, Circulation, Disability, Extrication
Answer: A – The primary assessment follows the ABCDE approach: Airway,
Breathing, Circulation, Disability (neurologic status), and Exposure (visual
inspection and temperature check). The PALS systematic approach
includes both the initial impression and the primary ABCDE assessment .
Q3. A 3-year-old boy is brought to the ED lethargic with retractions and
nasal flaring. He has a respiratory rate of 70/min, warm extremities,
and brisk capillary refill. To which life-threatening condition could this
child's condition most likely progress if left untreated?
• A) Cardiogenic shock
• B) Hypovolemic shock
• C) Respiratory distress
• D) Respiratory failure
Answer: D – Signs of increased work of breathing (retractions, nasal flaring,
tachypnea) with altered mental status (lethargy) indicate the child is at risk
for progressing from respiratory distress to respiratory failure. The 2025
guidelines emphasize that respiratory failure is a life-threatening condition
requiring immediate intervention .
, Q4. A 6-year-old boy is being evaluated for difficulty breathing. Which
finding would suggest this child has respiratory distress rather than
respiratory failure?
• A) Audible inspiratory stridor
• B) Decreased respiratory effort
• C) Oxygen saturation of 88% on room air
• D) Respiratory rate of 8/min
Answer: A – Audible inspiratory stridor indicates upper airway obstruction
and increased work of breathing, which is a sign of respiratory distress.
Decreased respiratory effort, bradycardia, and hypoxia with poor response
to oxygen suggest progression to respiratory failure .
Q5. What is the recommended timeframe for a healthcare provider to
check for a pulse in a pediatric patient during the primary assessment?
• A) 5 seconds
• B) 10 seconds
• C) 15 seconds
• D) 30 seconds
Answer: B – According to the 2025 PALS guidelines, it is reasonable for
healthcare professionals to check the pulse for up to 10 seconds and begin
chest compressions unless a definite pulse is felt .
Q6. What is the normal heart rate range for a 2-week-old infant?
• A) 60-90 beats/min
• B) 80-130 beats/min
• C) 100-160 beats/min
• D) 120-180 beats/min
(2025/2026 Guidelines)
Course: Pediatric Advanced Life Support (PALS) – American Heart
Association
2025/2026 Guidelines Update: Reflects new science from the 2025 AHA
Guidelines for CPR and ECC
Verification Period: 2 years
Format: Multiple Choice
Total Questions: 50
Focus: Systematic assessment, respiratory emergencies, shock
management, cardiac arrhythmias, pharmacology, and team dynamics
EXAM OVERVIEW
The PALS Provider Course is designed for healthcare professionals who
direct or participate in the management of respiratory and/or
cardiovascular emergencies and cardiopulmonary arrest in infants and
children . The 2025 Guidelines represent the most comprehensive update
since 2020, with major changes in epinephrine use, early defibrillation,
temperature control, and hemodynamic targets during CPR and post-
cardiac arrest care
SECTION 1: Systematic Approach & Primary Assessment
Q1. What are the key elements to observe during the initial "doorway
assessment" of a pediatric patient?
• A) Airway, Breathing, Circulation
• B) Appearance, Breathing, and Circulation (skin color)
• C) Level of consciousness and pupil response
• D) Heart rate and blood pressure only
Answer: B – The initial doorway assessment evaluates Appearance (level of
alertness and responsiveness), Breathing (signs of increased effort, no
,respiratory effort, or abnormal sounds), and Circulation (skin color—pallor,
mottling, or cyanosis). The 2025 guidelines emphasize this rapid visual
assessment as the first step in identifying life-threatening conditions .
Q2. What are the five components of the primary assessment in
pediatric emergencies?
• A) Airway, Breathing, Circulation, Disability, Exposure
• B) Airway, Breathing, Circulation, Defibrillation, Evaluation
• C) Appearance, Breathing, Circulation, Disability, Exposure
• D) Airway, Breathing, Circulation, Disability, Extrication
Answer: A – The primary assessment follows the ABCDE approach: Airway,
Breathing, Circulation, Disability (neurologic status), and Exposure (visual
inspection and temperature check). The PALS systematic approach
includes both the initial impression and the primary ABCDE assessment .
Q3. A 3-year-old boy is brought to the ED lethargic with retractions and
nasal flaring. He has a respiratory rate of 70/min, warm extremities,
and brisk capillary refill. To which life-threatening condition could this
child's condition most likely progress if left untreated?
• A) Cardiogenic shock
• B) Hypovolemic shock
• C) Respiratory distress
• D) Respiratory failure
Answer: D – Signs of increased work of breathing (retractions, nasal flaring,
tachypnea) with altered mental status (lethargy) indicate the child is at risk
for progressing from respiratory distress to respiratory failure. The 2025
guidelines emphasize that respiratory failure is a life-threatening condition
requiring immediate intervention .
, Q4. A 6-year-old boy is being evaluated for difficulty breathing. Which
finding would suggest this child has respiratory distress rather than
respiratory failure?
• A) Audible inspiratory stridor
• B) Decreased respiratory effort
• C) Oxygen saturation of 88% on room air
• D) Respiratory rate of 8/min
Answer: A – Audible inspiratory stridor indicates upper airway obstruction
and increased work of breathing, which is a sign of respiratory distress.
Decreased respiratory effort, bradycardia, and hypoxia with poor response
to oxygen suggest progression to respiratory failure .
Q5. What is the recommended timeframe for a healthcare provider to
check for a pulse in a pediatric patient during the primary assessment?
• A) 5 seconds
• B) 10 seconds
• C) 15 seconds
• D) 30 seconds
Answer: B – According to the 2025 PALS guidelines, it is reasonable for
healthcare professionals to check the pulse for up to 10 seconds and begin
chest compressions unless a definite pulse is felt .
Q6. What is the normal heart rate range for a 2-week-old infant?
• A) 60-90 beats/min
• B) 80-130 beats/min
• C) 100-160 beats/min
• D) 120-180 beats/min
