PALS Updated Final Exam 2026–2027 Complete Practice Questions, Verified Answers & Study Guide

PALS Updated Final Exam 2026–2027 |
Complete Practice Questions, Verified Answers
& Study Guide
1. A 12-year-old child being evaluated in the pediatric intensive care unit dis-plays
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the following ECG waveform. The team interprets this as which arrhyth-mia?: second
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degree
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2. Laboratory tests are ordered for a child who has been vomiting for 3 days f f f f f f f f f f f f f




andisdiaphoretic,tachypneic,lethargicandpale.Whichtestwouldthe provider
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use to determine the adequacy of oxygen delivery?: Lactate
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3. A 9-year-old patient is presenting with decreased breath sounds, brady-
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cardia, slowed respiratory rate and a low O2 saturation level. The provider
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interpretsthesefindingsasindicatingwhichcondition?:Respiratoryfailure
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4. A 4-year-old child is brought to the emergency department by the parents.
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Assessment reveals that the child has only gasping respirations and the pulse rate is 65
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beats per minute. Which action would the provider initiate first?: De-liver 1 BVM ventilation
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every 3 to 5 seconds.
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5. A 15-year-old patient is being evaluated during a follow-up visit after being
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diagnosed with Lyme disease 2 months ago. A rhythm strip is obtained as shown
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below.Theproviderinterpretsthisrhythmasindicating whicharrhyth-mia?:First-degree
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atrioventricular(AV)block
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6. A child in cardiac arrest experiences return of spontaneous circulation but is
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fexhibiting signs of post-cardiac arrest syndrome (PCAS). The PALS resus-
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citation team determines that the child is experiencing a systemic response to
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fischemia/reperfusion. The team bases this determination on which find- f f f f f f f f




ing(s)?: Hypotension f




Fever

Hyperglycemia
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7. A 2-year-old child arrives at the emergency department with the parents.
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The child is unresponsive, is not breathing and has no pulse. Two emer-gency
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fdepartment providers begin high-quality CPR. Which action(s) by the providers f f f f f f f f f




demonstrates high-quality CPR?: Allowingthechesttorecoilfullyaftereachcom-pression
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1/7 f f

, Providing ventilations that last about 1 second each Compressing
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thechestabout2inches
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Giving2ventilationstoevery15compressions
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8. A PALS resuscitation team is preparing to defibrillate a child experiencing
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cardiacarrest.Forwhichrhythm(s)wouldthisactionbeappropriate?: VFandpVT are
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shockable cardiac arrest rhythms.
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9. A provider is assessing a child with suspected shock. Which statement cor-
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rectly describes hypotension and shock?: Hypotension is not a consistent feature of shock;
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10. A provider is caring for a 4-year-old child in the urgent care clinic. Primary
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assessment reveals difficulty breathing and an oxygen saturation of 91%. The
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provider administers oxygen by nasal cannula with the goal of improving the
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child'soxygensaturationabovewhatpercentage?:Supplementaloxygenshouldbe
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administered as needed to maintain an oxygen saturation above 94%.
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11. An 11-year-old soccer player is brought to the emergency department. After
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fa quick assessment, the team realizes this patient is experiencing a severe
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fasthma exacerbation. Which medication would the team administer first?: f f f f f f f f




Albuterol plus ipratropium bromid
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12. A child in the pediatric step-down unit is exhibiting signs of respiratory
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distress. When assessing this child, which circulation finding might be pre-
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sent?: Pallor is a circulation finding that may be seen in patients with respiratory distress.
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13. A healthcare provider is performing a primary assessment of a child in
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respiratory distress. The provider documents increased work of breathing when
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which findings are observed?: Nasalflaring,useofaccessorymusclestobreatheand intercostal, substernal
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or suprasternal retractions are all indicators of increased work or ettort of breathing. Grunting and inspiratory stridor are
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abnormal breath sounds.
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14. An 11-year-old child develops unstable wide-complex tachycardia. Assess-ment
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freveals signs of significant hemodynamic compromise, but the child has a pulse.
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ThePALSteamwouldpreparethechildforwhichintervention?: First-line treatment for unstable
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wide-complex tachycardias consists of synchronized electrical cardioversion, particularly when signs of hemodynamic
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compromise are apparent.
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