Ohio Pediatric Advanced Life Support (PALS) Instructor Practice Exam (2025–2026) – Practice Questions, Verified Answers, and Rationales

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
highquality 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
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B. 10–20 J/kg, then 30–40 J/kg for subsequent shocks
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C. 2–4 J/kg, then escalate if needed
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D. 5–10 J/kg repeated
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Rationale: Pediatric defibrillation dosing commonly recommended:
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7. In a pediatric patient with pulseless arrest, how frequently
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A. Every 2 minutes m m m




B. Every 30 seconds m m m




C. Every 3–5 minutes m m m




D. Only once during arrest
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Rationale: Epinephrine is typically given every 3–5 minutes during
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8. Which rhythm is most likely to respond to synchronized
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A. Asystole m




B. Pulseless VF m m