PALS Exam 2026/2027 – Pediatric Advanced Life Support |
Latest Comprehensive Practice Exam | 200 Questions &
Answers with Rationales
PALS — Pediatric Advanced Life Support
Comprehensive Practice Examination — Questions 1–200
1. A child is unresponsive and not breathing normally. What is the priority action?
A. Obtain a blood pressure
B. Start an IV
C. Begin CPR and activate the emergency response system
D. Administer oxygen by nasal cannula
2. Which finding most strongly indicates respiratory failure in a child?
A. Mild tachypnea
B. Nasal congestion
C. Bradypnea with altered mental status
D. Mild cough
3. Which pulse is commonly assessed in an infant during CPR?
A. Radial
B. Carotid
,C. Brachial
D. Temporal
4. During pediatric CPR, which compression rate is recommended?
A. 60–80/min
B. 80–90/min
C. 100–120/min
D. 130–150/min
5. What is the recommended chest-compression depth for an infant?
A. 0.5 cm
B. 1 cm
C. About one-third of the chest depth, approximately 4 cm (1.5 in)
D. 6 cm
6. What is the recommended chest-compression depth for a child?
A. 1 cm
B. 2 cm
C. About one-third of the chest depth, approximately 5 cm (2 in)
D. 7 cm
7. For two rescuers performing CPR on an infant or child, what compression-to-ventilation
ratio is generally used?
A. 5:1
B. 15:1
C. 15:2
D. 30:1
,8. For a lone rescuer performing conventional CPR on a child, what compression-to-
ventilation ratio is used?
A. 5:1
B. 15:2
C. 30:2
D. 50:5
9. What is the first step in the pediatric systematic approach?
A. Detailed secondary assessment
B. Obtain laboratory tests
C. Initial assessment
D. Calculate drug doses
10. Which component belongs to the pediatric initial assessment?
A. SAMPLE history only
B. Appearance, breathing, and circulation
C. Chest radiography
D. Electrolyte analysis
11. A child with respiratory distress is sitting upright and using accessory muscles. What
does this finding suggest?
A. Normal breathing
B. Increased work of breathing
C. Cardiogenic shock only
D. Cardiac arrest
12. Which finding is most concerning for impending respiratory failure?
A. Strong cry
, B. Mild tachypnea
C. Decreasing respiratory effort with altered consciousness
D. Clear speech
13. Which assessment is part of the “B” component of the ABCDE approach?
A. Blood glucose
B. Pupillary response
C. Breathing and oxygenation
D. Peripheral pulses only
14. A child with severe respiratory distress becomes suddenly quiet and lethargic. What
should the clinician suspect?
A. Improvement
B. Anxiety resolution
C. Respiratory muscle fatigue and impending failure
D. Normal sleep
15. Which oxygen-delivery method can provide a high concentration of oxygen to a
spontaneously breathing child?
A. Room air
B. Low-flow nasal cannula only
C. Nonrebreather mask
D. Simple oral airway
16. What is the primary purpose of pulse oximetry?
A. Measure blood pressure
B. Measure cardiac output directly
Latest Comprehensive Practice Exam | 200 Questions &
Answers with Rationales
PALS — Pediatric Advanced Life Support
Comprehensive Practice Examination — Questions 1–200
1. A child is unresponsive and not breathing normally. What is the priority action?
A. Obtain a blood pressure
B. Start an IV
C. Begin CPR and activate the emergency response system
D. Administer oxygen by nasal cannula
2. Which finding most strongly indicates respiratory failure in a child?
A. Mild tachypnea
B. Nasal congestion
C. Bradypnea with altered mental status
D. Mild cough
3. Which pulse is commonly assessed in an infant during CPR?
A. Radial
B. Carotid
,C. Brachial
D. Temporal
4. During pediatric CPR, which compression rate is recommended?
A. 60–80/min
B. 80–90/min
C. 100–120/min
D. 130–150/min
5. What is the recommended chest-compression depth for an infant?
A. 0.5 cm
B. 1 cm
C. About one-third of the chest depth, approximately 4 cm (1.5 in)
D. 6 cm
6. What is the recommended chest-compression depth for a child?
A. 1 cm
B. 2 cm
C. About one-third of the chest depth, approximately 5 cm (2 in)
D. 7 cm
7. For two rescuers performing CPR on an infant or child, what compression-to-ventilation
ratio is generally used?
A. 5:1
B. 15:1
C. 15:2
D. 30:1
,8. For a lone rescuer performing conventional CPR on a child, what compression-to-
ventilation ratio is used?
A. 5:1
B. 15:2
C. 30:2
D. 50:5
9. What is the first step in the pediatric systematic approach?
A. Detailed secondary assessment
B. Obtain laboratory tests
C. Initial assessment
D. Calculate drug doses
10. Which component belongs to the pediatric initial assessment?
A. SAMPLE history only
B. Appearance, breathing, and circulation
C. Chest radiography
D. Electrolyte analysis
11. A child with respiratory distress is sitting upright and using accessory muscles. What
does this finding suggest?
A. Normal breathing
B. Increased work of breathing
C. Cardiogenic shock only
D. Cardiac arrest
12. Which finding is most concerning for impending respiratory failure?
A. Strong cry
, B. Mild tachypnea
C. Decreasing respiratory effort with altered consciousness
D. Clear speech
13. Which assessment is part of the “B” component of the ABCDE approach?
A. Blood glucose
B. Pupillary response
C. Breathing and oxygenation
D. Peripheral pulses only
14. A child with severe respiratory distress becomes suddenly quiet and lethargic. What
should the clinician suspect?
A. Improvement
B. Anxiety resolution
C. Respiratory muscle fatigue and impending failure
D. Normal sleep
15. Which oxygen-delivery method can provide a high concentration of oxygen to a
spontaneously breathing child?
A. Room air
B. Low-flow nasal cannula only
C. Nonrebreather mask
D. Simple oral airway
16. What is the primary purpose of pulse oximetry?
A. Measure blood pressure
B. Measure cardiac output directly
