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Ohio Pediatric Advanced Life Support (PALS) Instructor Practice Exam – Complete Q&A with 300+ Verified Questions & Detailed Rationales | AHA 2025/2026 Guidelines | A+ Graded

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This comprehensive practice exam is designed for healthcare professionals, instructors, and certification candidates preparing for the Ohio Pediatric Advanced Life Support (PALS) Instructor Practice Exam and the AHA PALS Provider/Instructor Certification Exam. Updated for the 2025/2026 testing cycle, this A+ graded resource features 300+ exam-style questions with verified correct answers and detailed rationales covering all key content areas required for PALS certification and instructor eligibility. Exam Context: The Ohio PALS Instructor Practice Exam is aligned with the latest American Heart Association (AHA) guidelines. The PALS Instructor course is designed to teach instructor candidates how to effectively teach the PALS Provider course. This exam tests knowledge of the systematic approach to pediatric assessment, recognition and management of respiratory distress/failure and shock, cardiac arrhythmias, BLS/CPR techniques, post-resuscitation care, team dynamics, pharmacology (epinephrine, amiodarone, adenosine), and special resuscitation situations. Key topics covered include: Systematic Approach to Pediatric Assessment: The PALS systematic approach algorithm begins with the initial impression – an assessment of consciousness, breathing, and color. Respiratory Emergencies: Recognition and management of respiratory distress and respiratory failure. Shock Management: Recognition and management of hypovolemic, distributive, cardiogenic, and obstructive shock. Cardiac Arrhythmias: Recognition and management of bradyarrhythmias, tachyarrhythmias, and pulseless arrest. Pharmacology: Appropriate use of emergency medications including epinephrine, amiodarone, adenosine, and atropine. Post-Resuscitation Care: Management of the pediatric patient after return of spontaneous circulation (ROSC). Team Dynamics: Effective communication and leadership during pediatric resuscitation. Instructor-Level Concepts: Teaching strategies, course administration, and evaluation techniques. Instructor Eligibility: To become a PALS Instructor, candidates must have a current, non-expired PALS Provider course completion card, be proficient in all PALS skills, and successfully complete the PALS Instructor Course. The AHA instructor card is valid for two years in Ohio. Each question includes the correct answer and a detailed rationale. Ideal for healthcare professionals, PALS instructors, and certification candidates preparing for PALS provider and instructor exams. A+ Graded | 2025/2026 Updated

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Ohio Pediatric Advanced Life Support
(PALS) Instructor Practice Exam Questions
And Correct Answers (Verified Answers)
Plus Rationales 2025|2026 Q&A | Instant
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1. A 6-month-old infant is unresponsive and not breathing normally.
After calling for help, what is the next best action for a lone rescuer
trained in PALS?
A. Attach AED
B. Begin CPR with 30 compressions and 2 breaths
C. Deliver 5 rescue breaths then start compressions
D. Place the infant in recovery position
Rationale: For an unresponsive infant who is not breathing normally,
start high-quality CPR immediately. For lone rescuers of
infants/children, current guidance recommends starting CPR

, (compressions and breaths) and activating emergency response as
soon as possible.

2. During pediatric chest compressions, what is the recommended
compression depth for an infant?
A. At least 2.5 inches (6 cm)
B. 1.5 inches (4 cm)
C. About one third the anterior–posterior chest depth (~1.5 inches /
4 cm)
D. At least 3 inches (8 cm)
Rationale: Recommended compression depth for infants is about one
third of the chest depth (~4 cm). Avoid excessively deep
compressions.

3. Which compression-to-ventilation ratio is correct for a 2-rescuer
pediatric BLS scenario without an advanced airway?
A. 30:2 for all rescuers
B. 15:2
C. 3:1
D. 5:1
Rationale: In 2-rescuer pediatric BLS (infant/child), the recommended
compression-to-ventilation ratio is 15:2 to provide more frequent
ventilations given likely respiratory causes of arrest.

4. For a child with bradycardia and poor perfusion despite adequate
oxygenation and ventilation, what is the immediate medication to

, consider?
A. Atropine only
B. Epinephrine
C. Adenosine
D. Amiodarone
Rationale: If bradycardia with poor perfusion persists despite
oxygenation and ventilation, give epinephrine and consider pacing;
atropine is less favored as first-line in PALS for unstable bradycardia.

5. When managing a pediatric patient in pulseless ventricular fibrillation
(VF), what is the correct immediate action?
A. Give atropine
B. Start IV fluids
C. Immediate high-quality CPR and defibrillation (shock) as soon as
possible
D. Give adenosine
Rationale: For shockable rhythms (VF/pulseless VT), immediate high-
quality CPR and prompt defibrillation are priorities, with epinephrine
and antiarrhythmics given per algorithm.

6. Appropriate energy dose for pediatric defibrillation (first shock) using
biphasic defibrillator is:
A. 10 J/kg only
B. 10–20 J/kg, then 30–40 J/kg for subsequent shocks
C. 2–4 J/kg, then escalate if needed

, D. 5–10 J/kg repeated
Rationale: Pediatric defibrillation dosing commonly recommended:
first shock 2–4 J/kg for manual defibrillation (some resources list 2–4
J/kg). If using biphasic and local protocols allow, initial doses often
start at 2 J/kg and may be increased. Follow local device guidance.

7. In a pediatric patient with pulseless arrest, how frequently should
epinephrine be administered?
A. Every 2 minutes
B. Every 30 seconds
C. Every 3–5 minutes
D. Only once during arrest
Rationale: Epinephrine is typically given every 3–5 minutes during
cardiac arrest (after initial actions and per algorithm) to support
circulation.

8. Which rhythm is most likely to respond to synchronized cardioversion
in a child with unstable tachycardia?
A. Asystole
B. Pulseless VF
C. Monomorphic supraventricular tachycardia (SVT) with signs of
poor perfusion
D. Torsades de pointes without pulse
Rationale: Unstable SVT or other organized tachycardias with poor

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