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PEDIATRIC ADVANCED LIFE SUPPORT (PALS) PRACTICE
EXAM 2026/2027 COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
(PALS)
Prepare for the Pediatric Advanced Life Support (PALS) Exam with a focused study
resource designed to reinforce essential pediatric emergency and resuscitation
concepts. It supports review of pediatric assessment, basic life support, respiratory
emergencies, shock, arrhythmias, cardiopulmonary arrest, treatment algorithms, and
effective team dynamics. Use the material to strengthen clinical decision-making,
improve prioritization, and build confidence when responding to pediatric emergency
scenarios. This resource is best suited for healthcare professionals, nursing students,
paramedics, and other providers preparing for a PALS examination or pediatric
emergency care training.
MULTIPLE CHOICE.
SECTION 1: SYSTEMATIC PEDIATRIC ASSESSMENT (Questions 1–10)
Question 1:
What are the three components of the Pediatric Assessment Triangle (PAT)
used during the initial impression of a pediatric patient? (Select all that apply)
A) Appearance
B) Work of Breathing
C) Circulation to Skin
D) Glasgow Coma Scale score
Answer: A, B, and C
Rationale: The Pediatric Assessment Triangle (PAT) consists of three
components: Appearance, Work of Breathing, and Circulation to Skin.
These are assessed visually within seconds of first contact, without
touching the child. The Glasgow Coma Scale (D) is part of the detailed
physical examination, not the PAT.
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Question 2:
In the primary assessment ABCDE framework, what is the correct sequential
order of evaluation?
A) Airway → Breathing → Circulation → Disability → Exposure
B) Airway → Breathing → Disability → Circulation → Exposure
C) Breathing → Airway → Circulation → Exposure → Disability
D) Disability → Airway → Breathing → Circulation → Exposure
Answer: A) Airway → Breathing → Circulation → Disability → Exposure
Rationale: The correct sequence for the primary assessment in PALS is
Airway, Breathing, Circulation, Disability, and Exposure (ABCDE). This
systematic approach ensures life-threatening conditions are identified
and addressed in order of priority.
Question 3:
A 4-year-old child presents to the emergency department. The team leader
asks you to perform the initial impression using the PAT. Which of the
following best describes the key difference between the PAT and the ABCDE
primary assessment?
A) The PAT involves hands-on measurement of vital signs, whereas the ABCDE
assessment is visual only
B) The PAT is a quick visual and auditory assessment from across the room,
whereas the ABCDE involves hands-on evaluation and interventions
C) The PAT is performed only on infants, whereas the ABCDE is performed on
children older than 1 year
D) The PAT and ABCDE are identical frameworks used interchangeably in
pediatric assessment
Answer: B) The PAT is a quick visual and auditory assessment from across
the room, whereas the ABCDE involves hands-on evaluation and
interventions
Rationale: The PAT is performed at a distance without touching the child
and provides an immediate impression of the child's overall physiologic
state. It takes only seconds. The ABCDE primary assessment follows the
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PAT and involves hands-on evaluation, vital sign measurement, and
potential interventions.
Question 4:
The primary assessment includes all of the following assessments EXCEPT:
A) Airway
B) Breathing
C) Choking
D) Exposure
Answer: C) Choking
Rationale: The primary assessment includes Airway, Breathing,
Circulation, Disability, and Exposure (ABCDE). Choking is not a separate
component—it is addressed within the airway assessment.
Question 5:
When obtaining a SAMPLE history from the parent of a pediatric patient, what
does the letter "S" represent?
A) Signs and symptoms
B) Severity
C) Situation
D) Safety
Answer: A) Signs and symptoms
Rationale: The SAMPLE mnemonic stands for: Signs and symptoms,
Allergies, Medications, Past medical history, Last meal, and Events
leading to the illness/injury.
Question 6:
The PALS systematic approach algorithm begins with the initial impression.
This is an assessment of which three characteristics?
A) Consciousness, Breathing, Color
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B) Airway, Breathing, Circulation
C) Appearance, Work of Breathing, Circulation to Skin
D) Heart rate, Respiratory rate, Oxygen saturation
Answer: C) Appearance, Work of Breathing, Circulation to Skin
Rationale: The PAT assesses Appearance, Work of Breathing, and
Circulation to Skin.
Question 7:
A 2-year-old child presents with lethargy, nasal flaring, and intercostal
retractions. Using the Pediatric Assessment Triangle (PAT), which component
is being assessed?
A) Appearance
B) Work of Breathing
C) Circulation to Skin
D) Disability
Answer: B) Work of Breathing
Rationale: Nasal flaring and intercostal retractions are signs of increased
work of breathing, which is one of the three components of the PAT.
Question 8:
After determining that a child has no pulse, what is the next immediate
action?
A) Start CPR
B) Give rescue breaths
C) Attach the AED/monitor
D) Establish vascular access
Answer: A) Start CPR
Rationale: High-quality CPR is the foundation of pediatric resuscitation. If
a child has no pulse, CPR should be started immediately.
PEDIATRIC ADVANCED LIFE SUPPORT (PALS) PRACTICE
EXAM 2026/2027 COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
(PALS)
Prepare for the Pediatric Advanced Life Support (PALS) Exam with a focused study
resource designed to reinforce essential pediatric emergency and resuscitation
concepts. It supports review of pediatric assessment, basic life support, respiratory
emergencies, shock, arrhythmias, cardiopulmonary arrest, treatment algorithms, and
effective team dynamics. Use the material to strengthen clinical decision-making,
improve prioritization, and build confidence when responding to pediatric emergency
scenarios. This resource is best suited for healthcare professionals, nursing students,
paramedics, and other providers preparing for a PALS examination or pediatric
emergency care training.
MULTIPLE CHOICE.
SECTION 1: SYSTEMATIC PEDIATRIC ASSESSMENT (Questions 1–10)
Question 1:
What are the three components of the Pediatric Assessment Triangle (PAT)
used during the initial impression of a pediatric patient? (Select all that apply)
A) Appearance
B) Work of Breathing
C) Circulation to Skin
D) Glasgow Coma Scale score
Answer: A, B, and C
Rationale: The Pediatric Assessment Triangle (PAT) consists of three
components: Appearance, Work of Breathing, and Circulation to Skin.
These are assessed visually within seconds of first contact, without
touching the child. The Glasgow Coma Scale (D) is part of the detailed
physical examination, not the PAT.
, Page 2 of 40
Question 2:
In the primary assessment ABCDE framework, what is the correct sequential
order of evaluation?
A) Airway → Breathing → Circulation → Disability → Exposure
B) Airway → Breathing → Disability → Circulation → Exposure
C) Breathing → Airway → Circulation → Exposure → Disability
D) Disability → Airway → Breathing → Circulation → Exposure
Answer: A) Airway → Breathing → Circulation → Disability → Exposure
Rationale: The correct sequence for the primary assessment in PALS is
Airway, Breathing, Circulation, Disability, and Exposure (ABCDE). This
systematic approach ensures life-threatening conditions are identified
and addressed in order of priority.
Question 3:
A 4-year-old child presents to the emergency department. The team leader
asks you to perform the initial impression using the PAT. Which of the
following best describes the key difference between the PAT and the ABCDE
primary assessment?
A) The PAT involves hands-on measurement of vital signs, whereas the ABCDE
assessment is visual only
B) The PAT is a quick visual and auditory assessment from across the room,
whereas the ABCDE involves hands-on evaluation and interventions
C) The PAT is performed only on infants, whereas the ABCDE is performed on
children older than 1 year
D) The PAT and ABCDE are identical frameworks used interchangeably in
pediatric assessment
Answer: B) The PAT is a quick visual and auditory assessment from across
the room, whereas the ABCDE involves hands-on evaluation and
interventions
Rationale: The PAT is performed at a distance without touching the child
and provides an immediate impression of the child's overall physiologic
state. It takes only seconds. The ABCDE primary assessment follows the
, Page 3 of 40
PAT and involves hands-on evaluation, vital sign measurement, and
potential interventions.
Question 4:
The primary assessment includes all of the following assessments EXCEPT:
A) Airway
B) Breathing
C) Choking
D) Exposure
Answer: C) Choking
Rationale: The primary assessment includes Airway, Breathing,
Circulation, Disability, and Exposure (ABCDE). Choking is not a separate
component—it is addressed within the airway assessment.
Question 5:
When obtaining a SAMPLE history from the parent of a pediatric patient, what
does the letter "S" represent?
A) Signs and symptoms
B) Severity
C) Situation
D) Safety
Answer: A) Signs and symptoms
Rationale: The SAMPLE mnemonic stands for: Signs and symptoms,
Allergies, Medications, Past medical history, Last meal, and Events
leading to the illness/injury.
Question 6:
The PALS systematic approach algorithm begins with the initial impression.
This is an assessment of which three characteristics?
A) Consciousness, Breathing, Color
, Page 4 of 40
B) Airway, Breathing, Circulation
C) Appearance, Work of Breathing, Circulation to Skin
D) Heart rate, Respiratory rate, Oxygen saturation
Answer: C) Appearance, Work of Breathing, Circulation to Skin
Rationale: The PAT assesses Appearance, Work of Breathing, and
Circulation to Skin.
Question 7:
A 2-year-old child presents with lethargy, nasal flaring, and intercostal
retractions. Using the Pediatric Assessment Triangle (PAT), which component
is being assessed?
A) Appearance
B) Work of Breathing
C) Circulation to Skin
D) Disability
Answer: B) Work of Breathing
Rationale: Nasal flaring and intercostal retractions are signs of increased
work of breathing, which is one of the three components of the PAT.
Question 8:
After determining that a child has no pulse, what is the next immediate
action?
A) Start CPR
B) Give rescue breaths
C) Attach the AED/monitor
D) Establish vascular access
Answer: A) Start CPR
Rationale: High-quality CPR is the foundation of pediatric resuscitation. If
a child has no pulse, CPR should be started immediately.
