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PALS All Questions 2026.
You are caring for a child who was resuscitated after a Epinephrine IV
drowning event. The child is intubated and ventilated
with 100% oxygen with equal breath sounds and
exhaled CO2 detected. The heart rate is slow and the
monitor shows sinus bradycardia. The skin is cool,
mottled, and moist; distal pulses are not palpable and
the central pulses are weak. Intravenous access has
been established. The core temperature is 37.3oC.
Based on the PALS bradycardia algorithm, which of
the following should be provided first?
Epinephrine IV
Transcutaneous pacing
Atropine IV
Dobutamine IV infusion
3/21/2026, 8:55:01 PM 3/21/2026, 8:55:03 PM 3/21/2026, 8:54:57 PM
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
,PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions 2026.
You are caring for a 5-year-old patient with Provide synchronized cardioversion at 0.5 to 1 J/kg
supraventricular tachycardia (heart rate = 220/min). The
child is lethargic. The skin is pale and cool with
delayed capillary refill. Distal pulses are not palpable.
Which of the following would be the best treatment to
provide without delay?
Place cold packs on the distal upper and lower
extremities
Ask the child to blow through a small straw
Exert light pressure on the eyes bilaterally
Provide synchronized cardioversion at 0.5 to 1 J/kg
3/21/2026, 8:55:01 PM 3/21/2026, 8:55:03 PM 3/21/2026, 8:54:57 PM
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
,PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions 2026.
You are initiating treatment for a child with septic Administer repeated fluid boluses of isotonic crystalloid
shock and hypotension. While administering high-flow
oxygen you determine that the child's respirations are
adequate and SpO2 is 100%. You have just established
vascular access and obtained blood samples. Which
of the following is the next most appropriate therapy
to support systemic perfusion?
Administer repeated fluid boluses of isotonic colloid
Administer repeated fluid boluses of isotonic
crystalloid
Begin immediate dopamine infusion
Begin immediate dobutamine infusion
3/21/2026, 8:55:01 PM 3/21/2026, 8:55:03 PM 3/21/2026, 8:54:57 PM
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
, PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions 2026.
You are treating an 8-year-old with ventricular Consider possible metabolic and toxicologic causes
tachycardia with pulses and adequate perfusion. You
attempted synchronized cardioversion without
success. While seeking expert consultation, it would
be most appropriate to:
Administer a loading dose of milrinone
Consider possible metabolic and toxicologic causes
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock
You are caring for a 2-year-old unconscious patient Using a resuscitation bag provide manual ventilation with 100% oxygen
who is intubated and receiving mechanical ventilation.
The child's heart rate suddenly drops to 40/min and his
color becomes mottled. You should respond to these
changes by:
Increasing the ventilator rate
Increasing tidal volume
Increasing positive end-expiratory pressure (PEEP)
Using a resuscitation bag provide manual ventilation
with 100% oxygen
3/21/2026, 8:55:01 PM 3/21/2026, 8:55:03 PM 3/21/2026, 8:54:57 PM
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions 2026.
You are caring for a child who was resuscitated after a Epinephrine IV
drowning event. The child is intubated and ventilated
with 100% oxygen with equal breath sounds and
exhaled CO2 detected. The heart rate is slow and the
monitor shows sinus bradycardia. The skin is cool,
mottled, and moist; distal pulses are not palpable and
the central pulses are weak. Intravenous access has
been established. The core temperature is 37.3oC.
Based on the PALS bradycardia algorithm, which of
the following should be provided first?
Epinephrine IV
Transcutaneous pacing
Atropine IV
Dobutamine IV infusion
3/21/2026, 8:55:01 PM 3/21/2026, 8:55:03 PM 3/21/2026, 8:54:57 PM
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
,PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions 2026.
You are caring for a 5-year-old patient with Provide synchronized cardioversion at 0.5 to 1 J/kg
supraventricular tachycardia (heart rate = 220/min). The
child is lethargic. The skin is pale and cool with
delayed capillary refill. Distal pulses are not palpable.
Which of the following would be the best treatment to
provide without delay?
Place cold packs on the distal upper and lower
extremities
Ask the child to blow through a small straw
Exert light pressure on the eyes bilaterally
Provide synchronized cardioversion at 0.5 to 1 J/kg
3/21/2026, 8:55:01 PM 3/21/2026, 8:55:03 PM 3/21/2026, 8:54:57 PM
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
,PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions 2026.
You are initiating treatment for a child with septic Administer repeated fluid boluses of isotonic crystalloid
shock and hypotension. While administering high-flow
oxygen you determine that the child's respirations are
adequate and SpO2 is 100%. You have just established
vascular access and obtained blood samples. Which
of the following is the next most appropriate therapy
to support systemic perfusion?
Administer repeated fluid boluses of isotonic colloid
Administer repeated fluid boluses of isotonic
crystalloid
Begin immediate dopamine infusion
Begin immediate dobutamine infusion
3/21/2026, 8:55:01 PM 3/21/2026, 8:55:03 PM 3/21/2026, 8:54:57 PM
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
, PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions 2026.
You are treating an 8-year-old with ventricular Consider possible metabolic and toxicologic causes
tachycardia with pulses and adequate perfusion. You
attempted synchronized cardioversion without
success. While seeking expert consultation, it would
be most appropriate to:
Administer a loading dose of milrinone
Consider possible metabolic and toxicologic causes
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock
You are caring for a 2-year-old unconscious patient Using a resuscitation bag provide manual ventilation with 100% oxygen
who is intubated and receiving mechanical ventilation.
The child's heart rate suddenly drops to 40/min and his
color becomes mottled. You should respond to these
changes by:
Increasing the ventilator rate
Increasing tidal volume
Increasing positive end-expiratory pressure (PEEP)
Using a resuscitation bag provide manual ventilation
with 100% oxygen
3/21/2026, 8:55:01 PM 3/21/2026, 8:55:03 PM 3/21/2026, 8:54:57 PM
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
PALS All Questions (5 files merged).pdf!@@@@@@@@!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
