PEDIATRIC ADVANCED LIFE SUPPORT
(PALS) POST TEST 2026 QUESTIONS
AND ANSWERS
1. A 7-year-old child presents with a heart rate of 190 bpm, a narrow QRS complex, and no
visible P waves. The child is lethargic with a blood pressure of 70/40 mmHg. What is the most
appropriate initial intervention?
A. Vagal maneuvers
B. Adenosine 0.1 mg/kg rapid IV push
C. Synchronized cardioversion at 0.5 to 1 J/kg
D. Amiodarone 5 mg/kg IV over 20 minutes
Answer: C
Conceptual Explanation: The patient is symptomatic (hypotension, altered mental status)
with probable Supraventricular Tachycardia (SVT). According to PALS guidelines,
synchronized cardioversion is the immediate treatment for unstable SVT.
,2. During CPR on a 4-year-old child in cardiac arrest, the monitor shows a fine ventricular
fibrillation. After the first shock and 2 minutes of CPR, the rhythm persists. What is the next
drug and dose to be administered?
A. Amiodarone 5 mg/kg
B. Epinephrine 0.01 mg/kg
C. Lidocaine 1 mg/kg
D. Magnesium Sulfate 25-50 mg/kg
Answer: B
Conceptual Explanation: Epinephrine is the first drug given in pulseless arrest (VF, pVT,
PEA, or Asystole), typically after the second shock in shockable rhythms.
3. Which of the following is a sign of probable upper airway obstruction?
A. Inspiratory stridor
B. Expiratory wheezing
C. Grunting
D. Crackles on auscultation
Answer: A
Conceptual Explanation: Stridor is a high-pitched sound typically heard on inspiration
and is a hallmark sign of upper airway obstruction, such as croup or foreign body
aspiration.
, 4. An infant presents with a heart rate of 55 bpm and signs of poor perfusion despite
adequate oxygenation and ventilation. What is the first action to take?
A. Administer Epinephrine 0.01 mg/kg
B. Administer Atropine 0.02 mg/kg
C. Start chest compressions
D. Perform synchronized cardioversion
Answer: C
Conceptual Explanation: In PALS, if the heart rate is less than 60 bpm with signs of poor
perfusion despite oxygenation and ventilation, chest compressions must be initiated.
5. What is the correct energy dose for the initial defibrillation attempt in a pediatric patient
with ventricular fibrillation?
A. 1 J/kg
B. 2 J/kg
C. 4 J/kg
D. 10 J/kg
Answer: B
Conceptual Explanation: The initial defibrillation dose for VF or pulseless VT is 2 J/kg.
(PALS) POST TEST 2026 QUESTIONS
AND ANSWERS
1. A 7-year-old child presents with a heart rate of 190 bpm, a narrow QRS complex, and no
visible P waves. The child is lethargic with a blood pressure of 70/40 mmHg. What is the most
appropriate initial intervention?
A. Vagal maneuvers
B. Adenosine 0.1 mg/kg rapid IV push
C. Synchronized cardioversion at 0.5 to 1 J/kg
D. Amiodarone 5 mg/kg IV over 20 minutes
Answer: C
Conceptual Explanation: The patient is symptomatic (hypotension, altered mental status)
with probable Supraventricular Tachycardia (SVT). According to PALS guidelines,
synchronized cardioversion is the immediate treatment for unstable SVT.
,2. During CPR on a 4-year-old child in cardiac arrest, the monitor shows a fine ventricular
fibrillation. After the first shock and 2 minutes of CPR, the rhythm persists. What is the next
drug and dose to be administered?
A. Amiodarone 5 mg/kg
B. Epinephrine 0.01 mg/kg
C. Lidocaine 1 mg/kg
D. Magnesium Sulfate 25-50 mg/kg
Answer: B
Conceptual Explanation: Epinephrine is the first drug given in pulseless arrest (VF, pVT,
PEA, or Asystole), typically after the second shock in shockable rhythms.
3. Which of the following is a sign of probable upper airway obstruction?
A. Inspiratory stridor
B. Expiratory wheezing
C. Grunting
D. Crackles on auscultation
Answer: A
Conceptual Explanation: Stridor is a high-pitched sound typically heard on inspiration
and is a hallmark sign of upper airway obstruction, such as croup or foreign body
aspiration.
, 4. An infant presents with a heart rate of 55 bpm and signs of poor perfusion despite
adequate oxygenation and ventilation. What is the first action to take?
A. Administer Epinephrine 0.01 mg/kg
B. Administer Atropine 0.02 mg/kg
C. Start chest compressions
D. Perform synchronized cardioversion
Answer: C
Conceptual Explanation: In PALS, if the heart rate is less than 60 bpm with signs of poor
perfusion despite oxygenation and ventilation, chest compressions must be initiated.
5. What is the correct energy dose for the initial defibrillation attempt in a pediatric patient
with ventricular fibrillation?
A. 1 J/kg
B. 2 J/kg
C. 4 J/kg
D. 10 J/kg
Answer: B
Conceptual Explanation: The initial defibrillation dose for VF or pulseless VT is 2 J/kg.
