PALS Red Cross Final Exam 2026/2027 |
Verified Questions & Answers | A+ Study
Guide | Just Released This Year PDF |
Updated This Year
• This study guide contains 200 verified PALS exam questions from the Red Cross
2026/2027 curriculum—use these to master every topic on the certification test
through consistent practice and detailed explanations.
• Study strategically by reviewing each rationale thoroughly, identifying weak areas,
and retesting those sections until you achieve 90%+ accuracy across all pediatric
emergency scenarios.
1. When performing chest compressions on an infant (less than 1 year old),
you should compress the chest at a depth of approximately:
A) 1 inch (2.5 cm)
B) 1.5 inches (4 cm)
C) 2 inches (5 cm)
D) 2.5 inches (6 cm)
E) 3 inches (7.5 cm)
B) 1.5 inches (4 cm)
Rationale: For infants less than 1 year old, chest compression depth should be
approximately 1.5 inches or about 4 centimeters, which represents about one-third
the depth of the chest. This depth is sufficient to generate adequate cardiac output
without causing rib fractures or internal injuries. Compressions that are too shallow
will not produce adequate perfusion, while compressions that are too deep can
cause serious internal injuries in the smaller infant thorax.
2. What is the correct compression-to-ventilation ratio for single-rescuer CPR
in children?
A) 100:2
,B) 30:2
C) 15:2
D) 5:1
E) 3:1
B) 30:2
Rationale: The current recommendation for single-rescuer CPR in children is a
compression-to-ventilation ratio of 30:2. This ratio prioritizes high-quality chest
compressions while maintaining adequate ventilation. The 30:2 ratio applies to
children from 1 year old through puberty when a single rescuer is performing CPR
without an advanced airway in place.
3. Which of the following is the most appropriate initial action when
encountering an unresponsive child with no breathing and no pulse?
A) Obtain a detailed history from bystanders
B) Immediately initiate CPR and call for emergency services
C) Wait 30 seconds to see if spontaneous breathing returns
D) Perform a full physical examination
E) Place the child in the recovery position
B) Immediately initiate CPR and call for emergency services
Rationale: Time is critical in cardiac arrest. When an unresponsive child has no
breathing and no pulse, CPR must be initiated immediately to maintain cerebral
and coronary perfusion. Emergency services should be activated simultaneously (or
a bystander should be directed to call). Delays in initiating CPR significantly reduce
survival chances. In a single-rescuer scenario, initiate CPR first, then call for help.
4. What is the correct hand position for performing chest compressions on a
school-age child (approximately 8-12 years old)?
,A) Two fingers on the lower third of the sternum
B) Heel of one hand on the lower half of the sternum
C) Heel of two hands on the lower half of the sternum
D) Palm of hand directly over the xiphoid process
E) Fingertips placed on the ribs
B) Heel of one hand on the lower half of the sternum
Rationale: For a school-age child, the heel of one hand placed on the lower half of
the sternum is the appropriate technique. This single-hand technique provides
adequate compression depth (approximately 2 inches) without causing excessive
trauma. Two-handed compression may be used if the rescuer is particularly strong
or the child is very large, but one hand is standard for this age group. The lower half
of the sternum ensures compression of the heart without injury to the xiphoid
process.
5. Which drug should be the first medication administered during pediatric
cardiac arrest?
A) Amiodarone
B) Epinephrine (Adrenaline)
C) Atropine
D) Sodium bicarbonate
E) Calcium chloride
B) Epinephrine (Adrenaline)
Rationale: Epinephrine is the first medication administered during pediatric
cardiac arrest. The recommended IV/IO dose is 0.01 mg/kg of 1:10,000 solution (or
0.1 mL/kg), with subsequent doses being 0.1 mg/kg of 1:1,000 solution if IV/IO
access is used. Epinephrine increases coronary and cerebral perfusion pressures,
improving outcomes in cardiac arrest. It should be given every 3-5 minutes during
ongoing resuscitation.
, 6. What is the correct compression rate for pediatric CPR?
A) 80-100 compressions per minute
B) 100-120 compressions per minute
C) 120-140 compressions per minute
D) 140-160 compressions per minute
E) 160-180 compressions per minute
B) 100-120 compressions per minute
Rationale: The recommended compression rate for pediatric CPR is 100-120
compressions per minute. This rate applies to both infants and children.
Compressions at this rate optimize the balance between adequate coronary and
cerebral perfusion and minimize myocardial oxygen consumption. Many rescuers
use the rhythm of the song "Stayin' Alive" to maintain proper rate during CPR.
7. When should defibrillation be attempted in a pediatric cardiac arrest
patient?
A) Never in children under 12 years old
B) Only if the child is over 14 years old
C) For any child with a shockable rhythm (VF or pulseless VT)
D) Only as a last resort after 10 minutes of CPR
E) Only if an AED designed for children is available
C) For any child with a shockable rhythm (VF or pulseless VT)
Rationale: Defibrillation should be attempted for any pediatric patient in
ventricular fibrillation (VF) or pulseless ventricular tachycardia (pulseless VT),
regardless of age. Most children who are in VF have had a primary cardiac event
(such as myocarditis or long QT syndrome) and defibrillation offers the best chance
Verified Questions & Answers | A+ Study
Guide | Just Released This Year PDF |
Updated This Year
• This study guide contains 200 verified PALS exam questions from the Red Cross
2026/2027 curriculum—use these to master every topic on the certification test
through consistent practice and detailed explanations.
• Study strategically by reviewing each rationale thoroughly, identifying weak areas,
and retesting those sections until you achieve 90%+ accuracy across all pediatric
emergency scenarios.
1. When performing chest compressions on an infant (less than 1 year old),
you should compress the chest at a depth of approximately:
A) 1 inch (2.5 cm)
B) 1.5 inches (4 cm)
C) 2 inches (5 cm)
D) 2.5 inches (6 cm)
E) 3 inches (7.5 cm)
B) 1.5 inches (4 cm)
Rationale: For infants less than 1 year old, chest compression depth should be
approximately 1.5 inches or about 4 centimeters, which represents about one-third
the depth of the chest. This depth is sufficient to generate adequate cardiac output
without causing rib fractures or internal injuries. Compressions that are too shallow
will not produce adequate perfusion, while compressions that are too deep can
cause serious internal injuries in the smaller infant thorax.
2. What is the correct compression-to-ventilation ratio for single-rescuer CPR
in children?
A) 100:2
,B) 30:2
C) 15:2
D) 5:1
E) 3:1
B) 30:2
Rationale: The current recommendation for single-rescuer CPR in children is a
compression-to-ventilation ratio of 30:2. This ratio prioritizes high-quality chest
compressions while maintaining adequate ventilation. The 30:2 ratio applies to
children from 1 year old through puberty when a single rescuer is performing CPR
without an advanced airway in place.
3. Which of the following is the most appropriate initial action when
encountering an unresponsive child with no breathing and no pulse?
A) Obtain a detailed history from bystanders
B) Immediately initiate CPR and call for emergency services
C) Wait 30 seconds to see if spontaneous breathing returns
D) Perform a full physical examination
E) Place the child in the recovery position
B) Immediately initiate CPR and call for emergency services
Rationale: Time is critical in cardiac arrest. When an unresponsive child has no
breathing and no pulse, CPR must be initiated immediately to maintain cerebral
and coronary perfusion. Emergency services should be activated simultaneously (or
a bystander should be directed to call). Delays in initiating CPR significantly reduce
survival chances. In a single-rescuer scenario, initiate CPR first, then call for help.
4. What is the correct hand position for performing chest compressions on a
school-age child (approximately 8-12 years old)?
,A) Two fingers on the lower third of the sternum
B) Heel of one hand on the lower half of the sternum
C) Heel of two hands on the lower half of the sternum
D) Palm of hand directly over the xiphoid process
E) Fingertips placed on the ribs
B) Heel of one hand on the lower half of the sternum
Rationale: For a school-age child, the heel of one hand placed on the lower half of
the sternum is the appropriate technique. This single-hand technique provides
adequate compression depth (approximately 2 inches) without causing excessive
trauma. Two-handed compression may be used if the rescuer is particularly strong
or the child is very large, but one hand is standard for this age group. The lower half
of the sternum ensures compression of the heart without injury to the xiphoid
process.
5. Which drug should be the first medication administered during pediatric
cardiac arrest?
A) Amiodarone
B) Epinephrine (Adrenaline)
C) Atropine
D) Sodium bicarbonate
E) Calcium chloride
B) Epinephrine (Adrenaline)
Rationale: Epinephrine is the first medication administered during pediatric
cardiac arrest. The recommended IV/IO dose is 0.01 mg/kg of 1:10,000 solution (or
0.1 mL/kg), with subsequent doses being 0.1 mg/kg of 1:1,000 solution if IV/IO
access is used. Epinephrine increases coronary and cerebral perfusion pressures,
improving outcomes in cardiac arrest. It should be given every 3-5 minutes during
ongoing resuscitation.
, 6. What is the correct compression rate for pediatric CPR?
A) 80-100 compressions per minute
B) 100-120 compressions per minute
C) 120-140 compressions per minute
D) 140-160 compressions per minute
E) 160-180 compressions per minute
B) 100-120 compressions per minute
Rationale: The recommended compression rate for pediatric CPR is 100-120
compressions per minute. This rate applies to both infants and children.
Compressions at this rate optimize the balance between adequate coronary and
cerebral perfusion and minimize myocardial oxygen consumption. Many rescuers
use the rhythm of the song "Stayin' Alive" to maintain proper rate during CPR.
7. When should defibrillation be attempted in a pediatric cardiac arrest
patient?
A) Never in children under 12 years old
B) Only if the child is over 14 years old
C) For any child with a shockable rhythm (VF or pulseless VT)
D) Only as a last resort after 10 minutes of CPR
E) Only if an AED designed for children is available
C) For any child with a shockable rhythm (VF or pulseless VT)
Rationale: Defibrillation should be attempted for any pediatric patient in
ventricular fibrillation (VF) or pulseless ventricular tachycardia (pulseless VT),
regardless of age. Most children who are in VF have had a primary cardiac event
(such as myocarditis or long QT syndrome) and defibrillation offers the best chance
