AHA PEDIATRIC ADVANCED LIFE
SUPPORT PALS CERTIFICATION PRACTICE
EXAM 2026 COMPREHENSIVE PRACTICE
QUESTIONS WITH CORRECT ANSWERS
AND DETAILED RATIONALES PROVIDER
COURSE STUDY GUIDE
4. Several healthcare providers are participating in an attempted
resuscitation. Which of the following is most consistent with the
responsibilities of the team leader of the resuscitation?
A. Records medications and interventions
B. Assigns roles to team members
C. Administers defibrillation shocks
D. Provides compressions - CORRECT ANSWER -Assigns roles to team
members
5. Which of the following conditions is appropriate for use of an
oropharyngeal airway?
A. Conscious with no gag reflex
B. Unconscious with a gag reflex
C. Unconscious with no gag reflex
D. Conscious with a gag reflex - CORRECT ANSWER -Unconscious with no
gag reflex
,7. A child presents with severe respiratory distress, urticaria, stridor, and
tachycardia about 10 minutes after eating peanuts. What is the most
appropriate initial medication for this child?
A. Nebulized albuterol
B. Epinephrine IM
C. Isotonic crystalloid IV
D. Methylprednisolone IV - CORRECT ANSWER -Epinephrine IM
8. A mother brings her 7-year-old child to the emergency department. The
mother states that the child has had a fever for the past 4 days and has had
little to eat or drink during the past 24 hours. Your initial impression
reveals a lethargic child with increased respiratory rate and pale color.
Heart rate is 160/min, respiratory rate is 38/min, and blood pressure is
86/48 mm Hg. Capillary refill is 4 seconds. Which of the following is the
most appropriate intervention for this child?
A. Fluid bolus of 10 mL/kg of isotonic crystalloid
B. Fluid bolus of 20 mL/kg of isotonic crystalloid
C. Maintenance fluid infusion of isotonic crystalloid at 10 mL/h
D. Maintenance fluid infusion of 5% dextrose and water at 20 mL/h -
CORRECT ANSWER -Fluid bolus of 20 mL/kg of isotonic crystalloid
9. An intubated 5-year-old child who was in a motor vehicle collision
becomes increasingly more difficult to ventilate. The child has diminished
breath sounds and chest expansion on the right side of the chest, with
audible breath sounds and visible chest expansion on the left. The
endotracheal tube insertion depth has not changed. What is the most
appropriate intervention?
A. Deflate the cuff and pull the tube back
, B. Perform needle decompression on the right chest
C. Perform needle decompression on the left chest D. Insert a gastric tube -
CORRECT ANSWER -Perform needle decompression on the right chest
10. A 2-year-old child with a 2-day history of a barking cough presents with
audible stridor on inspiration, intercostal retractions, and agitation. What
is the most appropriate intervention for this child?
A. Lay the child flat on a stretcher
B. Suction the mouth and nose
C. Administer nebulized epinephrine
D. Administer inhaled albuterol - CORRECT ANSWER -Administer nebulized
epinephrine
11. Which of the following oxygen saturations indicates the need for
additional intervention?
A. 96% on room air
B. 95% on room air
C. 93% on 4 L of oxygen
D. 97% on 50% oxygen - CORRECT ANSWER -93% on 4 L of oxygen
12. A 3-year-old child presents with a 2-day history of nausea and vomiting.
She is alert, with no increase in respiratory effort, and is pale in color. The
child's heart rate is 160/min, respiratory rate is 40/min, and blood pressure
is 100/70 mm Hg. Her extremities are cool, with sluggish capillary refill.
Which term best describes this child's physiologic state?
A. Compensated shock
B. Cardiogenic shock
SUPPORT PALS CERTIFICATION PRACTICE
EXAM 2026 COMPREHENSIVE PRACTICE
QUESTIONS WITH CORRECT ANSWERS
AND DETAILED RATIONALES PROVIDER
COURSE STUDY GUIDE
4. Several healthcare providers are participating in an attempted
resuscitation. Which of the following is most consistent with the
responsibilities of the team leader of the resuscitation?
A. Records medications and interventions
B. Assigns roles to team members
C. Administers defibrillation shocks
D. Provides compressions - CORRECT ANSWER -Assigns roles to team
members
5. Which of the following conditions is appropriate for use of an
oropharyngeal airway?
A. Conscious with no gag reflex
B. Unconscious with a gag reflex
C. Unconscious with no gag reflex
D. Conscious with a gag reflex - CORRECT ANSWER -Unconscious with no
gag reflex
,7. A child presents with severe respiratory distress, urticaria, stridor, and
tachycardia about 10 minutes after eating peanuts. What is the most
appropriate initial medication for this child?
A. Nebulized albuterol
B. Epinephrine IM
C. Isotonic crystalloid IV
D. Methylprednisolone IV - CORRECT ANSWER -Epinephrine IM
8. A mother brings her 7-year-old child to the emergency department. The
mother states that the child has had a fever for the past 4 days and has had
little to eat or drink during the past 24 hours. Your initial impression
reveals a lethargic child with increased respiratory rate and pale color.
Heart rate is 160/min, respiratory rate is 38/min, and blood pressure is
86/48 mm Hg. Capillary refill is 4 seconds. Which of the following is the
most appropriate intervention for this child?
A. Fluid bolus of 10 mL/kg of isotonic crystalloid
B. Fluid bolus of 20 mL/kg of isotonic crystalloid
C. Maintenance fluid infusion of isotonic crystalloid at 10 mL/h
D. Maintenance fluid infusion of 5% dextrose and water at 20 mL/h -
CORRECT ANSWER -Fluid bolus of 20 mL/kg of isotonic crystalloid
9. An intubated 5-year-old child who was in a motor vehicle collision
becomes increasingly more difficult to ventilate. The child has diminished
breath sounds and chest expansion on the right side of the chest, with
audible breath sounds and visible chest expansion on the left. The
endotracheal tube insertion depth has not changed. What is the most
appropriate intervention?
A. Deflate the cuff and pull the tube back
, B. Perform needle decompression on the right chest
C. Perform needle decompression on the left chest D. Insert a gastric tube -
CORRECT ANSWER -Perform needle decompression on the right chest
10. A 2-year-old child with a 2-day history of a barking cough presents with
audible stridor on inspiration, intercostal retractions, and agitation. What
is the most appropriate intervention for this child?
A. Lay the child flat on a stretcher
B. Suction the mouth and nose
C. Administer nebulized epinephrine
D. Administer inhaled albuterol - CORRECT ANSWER -Administer nebulized
epinephrine
11. Which of the following oxygen saturations indicates the need for
additional intervention?
A. 96% on room air
B. 95% on room air
C. 93% on 4 L of oxygen
D. 97% on 50% oxygen - CORRECT ANSWER -93% on 4 L of oxygen
12. A 3-year-old child presents with a 2-day history of nausea and vomiting.
She is alert, with no increase in respiratory effort, and is pale in color. The
child's heart rate is 160/min, respiratory rate is 40/min, and blood pressure
is 100/70 mm Hg. Her extremities are cool, with sluggish capillary refill.
Which term best describes this child's physiologic state?
A. Compensated shock
B. Cardiogenic shock
