AHA PALS Exam 2026: Actual Questions with Answers,
Rationales, and High-Yield Content Review – Complete Study
Guide for Pediatric Advanced Life Support Certification LATEST
UPDATE THIS YEAR
Exam Overview
Feature Details
Certification Pediatric Advanced Life Support (PALS)
Administering American Heart Association (AHA)
Body
Guidelines 2026 AHA Guidelines for CPR and ECC
Format Multiple Choice, Scenario-Based
Key Domains Systematic Approach, Respiratory Distress/Failure, Shock Recognition,
Cardiac Arrhythmias, Pharmacology, Post-Cardiac Arrest Care, Team
Dynamics
How to Use This Guide
This exam mirrors the structure and content of the AHA PALS Exam. Each question
includes the correct answer and a detailed rationale to help you understand the "why"
behind the clinical decision. Use this guide to test your knowledge, identify weak areas, and
build confidence for the actual exam.
SECTION 1: SYSTEMATIC APPROACH & INITIAL ASSESSMENT (Questions 1-30)
,1. What is the first step in the systematic approach to assessing a seriously ill or
injured child?
A) Begin CPR immediately
B) Assess the child's level of consciousness
C) Perform the initial impression (look, listen, and feel)
D) Check for a pulse
Answer: C. The systematic approach begins with the initial impression, using look, listen,
and feel to form a general sense of the child's condition before proceeding to a more
detailed assessment.
2. The Pediatric Assessment Triangle (PAT) evaluates which three components?
A) Heart rate, respiratory rate, and blood pressure
B) Appearance, work of breathing, and circulation
C) Mental status, oxygen saturation, and capillary refill
D) Pupils, lung sounds, and skin temperature
Answer: B. The PAT evaluates appearance (level of consciousness, muscle tone), work of
breathing (respiratory effort, retractions, abnormal sounds), and circulation (skin color,
pallor, cyanosis).
,3. According to the PALS systematic approach, after completing the initial
impression, what is the next step?
A) Obtain a full medical history
B) Determine the child's weight
C) Perform the primary assessment (ABCDE)
D) Administer oxygen
Answer: C. After the initial impression, the primary assessment (Airway, Breathing,
Circulation, Disability, Exposure) is performed.
4. A 4-year-old child presents with lethargy, increased work of breathing, and pale
color. The primary assessment reveals the airway is open and the respiratory rate is
30/min with crackles on auscultation. The cardiac monitor shows sinus tachycardia
at 165/min. The pulse oximeter displays 95% with a pulse rate of 93/min. How should
the nurse interpret the oxygen saturation?
A) Reliable; no supplementary oxygen is indicated
B) Reliable; supplementary oxygen should be administered
C) Unreliable; no supplementary oxygen is indicated
D) Unreliable; supplementary oxygen should be administered
, Answer: D. The pulse oximeter reading is unreliable because it does not match the cardiac
monitor rate (93 vs. 165). The child shows signs of respiratory distress and should receive
supplementary oxygen regardless of the unreliable reading.
5. The PALS systematic approach algorithm begins with which of the following?
A) Secondary assessment
B) Initial impression
C) Laboratory testing
D) Intravenous access
Answer: B. The PALS systematic approach begins with the initial impression—a rapid,
visual assessment of consciousness, breathing, and color.
6. During the primary assessment, which of the following is evaluated first?
A) Circulation
B) Disability
C) Airway
D) Breathing
Answer: C. The primary assessment follows the ABCDE sequence: Airway, Breathing,
Circulation, Disability, Exposure.
Rationales, and High-Yield Content Review – Complete Study
Guide for Pediatric Advanced Life Support Certification LATEST
UPDATE THIS YEAR
Exam Overview
Feature Details
Certification Pediatric Advanced Life Support (PALS)
Administering American Heart Association (AHA)
Body
Guidelines 2026 AHA Guidelines for CPR and ECC
Format Multiple Choice, Scenario-Based
Key Domains Systematic Approach, Respiratory Distress/Failure, Shock Recognition,
Cardiac Arrhythmias, Pharmacology, Post-Cardiac Arrest Care, Team
Dynamics
How to Use This Guide
This exam mirrors the structure and content of the AHA PALS Exam. Each question
includes the correct answer and a detailed rationale to help you understand the "why"
behind the clinical decision. Use this guide to test your knowledge, identify weak areas, and
build confidence for the actual exam.
SECTION 1: SYSTEMATIC APPROACH & INITIAL ASSESSMENT (Questions 1-30)
,1. What is the first step in the systematic approach to assessing a seriously ill or
injured child?
A) Begin CPR immediately
B) Assess the child's level of consciousness
C) Perform the initial impression (look, listen, and feel)
D) Check for a pulse
Answer: C. The systematic approach begins with the initial impression, using look, listen,
and feel to form a general sense of the child's condition before proceeding to a more
detailed assessment.
2. The Pediatric Assessment Triangle (PAT) evaluates which three components?
A) Heart rate, respiratory rate, and blood pressure
B) Appearance, work of breathing, and circulation
C) Mental status, oxygen saturation, and capillary refill
D) Pupils, lung sounds, and skin temperature
Answer: B. The PAT evaluates appearance (level of consciousness, muscle tone), work of
breathing (respiratory effort, retractions, abnormal sounds), and circulation (skin color,
pallor, cyanosis).
,3. According to the PALS systematic approach, after completing the initial
impression, what is the next step?
A) Obtain a full medical history
B) Determine the child's weight
C) Perform the primary assessment (ABCDE)
D) Administer oxygen
Answer: C. After the initial impression, the primary assessment (Airway, Breathing,
Circulation, Disability, Exposure) is performed.
4. A 4-year-old child presents with lethargy, increased work of breathing, and pale
color. The primary assessment reveals the airway is open and the respiratory rate is
30/min with crackles on auscultation. The cardiac monitor shows sinus tachycardia
at 165/min. The pulse oximeter displays 95% with a pulse rate of 93/min. How should
the nurse interpret the oxygen saturation?
A) Reliable; no supplementary oxygen is indicated
B) Reliable; supplementary oxygen should be administered
C) Unreliable; no supplementary oxygen is indicated
D) Unreliable; supplementary oxygen should be administered
, Answer: D. The pulse oximeter reading is unreliable because it does not match the cardiac
monitor rate (93 vs. 165). The child shows signs of respiratory distress and should receive
supplementary oxygen regardless of the unreliable reading.
5. The PALS systematic approach algorithm begins with which of the following?
A) Secondary assessment
B) Initial impression
C) Laboratory testing
D) Intravenous access
Answer: B. The PALS systematic approach begins with the initial impression—a rapid,
visual assessment of consciousness, breathing, and color.
6. During the primary assessment, which of the following is evaluated first?
A) Circulation
B) Disability
C) Airway
D) Breathing
Answer: C. The primary assessment follows the ABCDE sequence: Airway, Breathing,
Circulation, Disability, Exposure.
