PALS POST TEST 2026/2027 ADVANCED
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. What is the recommended initial energy dose for manual defibrillation in pediatric cardiac
arrest?
A. 2 J/kg
B. 1 J/kg
C. 4 J/kg
D. 10 J/kg
Answer: A
Conceptual Explanation: The initial energy dose for manual defibrillation is 2 J/kg.
Subsequent doses should be at least 4 J/kg, and higher levels may be considered, not to
exceed 10 J/kg or the adult dose.
2. In a child with septic shock, what is the recommended volume for the initial fluid bolus?
A. 5 mL/kg
B. 10 mL/kg
,C. 20 mL/kg
D. 50 mL/kg
Answer: C
Conceptual Explanation: For children in shock, the standard initial bolus is 20 mL/kg of
isotonic crystalloid (e.g., Normal Saline or Lactated Ringer’s) over 5 to 20 minutes.
3. Which of the following is a late and concerning sign of shock in a pediatric patient?
A. Hypotension
B. Delayed capillary refill
C. Tachycardia
D. Irritability
Answer: A
Conceptual Explanation: Hypotension is a late sign of shock in children, indicating that
compensatory mechanisms (like tachycardia and peripheral vasoconstriction) have failed.
This is termed ‘hypotensive shock’.
4. What is the correct compression-to-ventilation ratio for 2-rescuer CPR in an infant?
A. 30:2
B. 15:2
C. 3:1
, D. 15:1
Answer: B
Conceptual Explanation: For 2-rescuer healthcare provider CPR in infants and children
(before puberty), the ratio is 15:2. For single rescuers, the ratio remains 30:2.
5. A 4-year-old child is in cardiac arrest. After high-quality CPR and one dose of Epinephrine,
the rhythm shows Ventricular Fibrillation. What is the next drug to consider if VF persists
after the second shock?
A. Atropine
B. Magnesium Sulfate
C. Adenosine
D. Amiodarone
Answer: D
Conceptual Explanation: For refractory VF or pulseless VT, Amiodarone (5 mg/kg) or
Lidocaine (1 mg/kg) may be administered after the second shock and subsequent CPR.
6. What is the maximum dose of Adenosine for a pediatric patient weighing 35 kg during the
first administration for SVT?
A. 6 mg
B. 3 mg
C. 12 mg
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. What is the recommended initial energy dose for manual defibrillation in pediatric cardiac
arrest?
A. 2 J/kg
B. 1 J/kg
C. 4 J/kg
D. 10 J/kg
Answer: A
Conceptual Explanation: The initial energy dose for manual defibrillation is 2 J/kg.
Subsequent doses should be at least 4 J/kg, and higher levels may be considered, not to
exceed 10 J/kg or the adult dose.
2. In a child with septic shock, what is the recommended volume for the initial fluid bolus?
A. 5 mL/kg
B. 10 mL/kg
,C. 20 mL/kg
D. 50 mL/kg
Answer: C
Conceptual Explanation: For children in shock, the standard initial bolus is 20 mL/kg of
isotonic crystalloid (e.g., Normal Saline or Lactated Ringer’s) over 5 to 20 minutes.
3. Which of the following is a late and concerning sign of shock in a pediatric patient?
A. Hypotension
B. Delayed capillary refill
C. Tachycardia
D. Irritability
Answer: A
Conceptual Explanation: Hypotension is a late sign of shock in children, indicating that
compensatory mechanisms (like tachycardia and peripheral vasoconstriction) have failed.
This is termed ‘hypotensive shock’.
4. What is the correct compression-to-ventilation ratio for 2-rescuer CPR in an infant?
A. 30:2
B. 15:2
C. 3:1
, D. 15:1
Answer: B
Conceptual Explanation: For 2-rescuer healthcare provider CPR in infants and children
(before puberty), the ratio is 15:2. For single rescuers, the ratio remains 30:2.
5. A 4-year-old child is in cardiac arrest. After high-quality CPR and one dose of Epinephrine,
the rhythm shows Ventricular Fibrillation. What is the next drug to consider if VF persists
after the second shock?
A. Atropine
B. Magnesium Sulfate
C. Adenosine
D. Amiodarone
Answer: D
Conceptual Explanation: For refractory VF or pulseless VT, Amiodarone (5 mg/kg) or
Lidocaine (1 mg/kg) may be administered after the second shock and subsequent CPR.
6. What is the maximum dose of Adenosine for a pediatric patient weighing 35 kg during the
first administration for SVT?
A. 6 mg
B. 3 mg
C. 12 mg
