PALS UPDATED 2026 FINAL
EXAM(Answered;graded A+)
Course
PALS
1. A 6-year-old child is unresponsive and not breathing normally. A healthcare provider
checks for a pulse and finds no definite pulse within 10 seconds. What should be done
next?
A. Give oxygen and reassess in 2 minutes
B. Begin CPR immediately
C. Obtain vascular access before compressions
D. Give a fluid bolus
Correct Answer: B. Begin CPR immediately
Rationale: When a child is unresponsive, not breathing normally, and no definite pulse is
identified within 10 seconds, CPR should be initiated promptly.
2. During pediatric CPR, what compression rate should rescuers use?
A. 60–80/min
B. 80–100/min
C. 100–120/min
D. 130–150/min
Correct Answer: C. 100–120/min
Rationale: High-quality CPR uses a compression rate of 100–120 compressions per minute.
3. What is the recommended chest-compression depth for a child during CPR?
A. Approximately 1 cm
B. At least one-third of the anterior-posterior diameter of the chest, about 5 cm
C. Approximately 7 cm
D. One-half of the chest depth
Correct Answer: B. At least one-third of the anterior-posterior diameter of the chest, about
5 cm
Rationale: Pediatric chest compressions should be approximately one-third of the chest's
anterior-posterior diameter, roughly 5 cm in a child.
4. A healthcare provider is performing two-rescuer CPR on a child. What compression-to-
ventilation ratio should be used?
,A. 15:2
B. 30:1
C. 5:1
D. 10:2
Correct Answer: A. 15:2
Rationale: For pediatric two-rescuer CPR, the compression-to-ventilation ratio is 15:2.
5. A child has a heart rate of 45/min with signs of poor perfusion despite adequate
oxygenation and ventilation. What is the appropriate intervention?
A. Observe only
B. Begin CPR
C. Give oral fluids
D. Perform synchronized cardioversion
Correct Answer: B. Begin CPR
Rationale: Bradycardia with a heart rate below 60/min accompanied by signs of poor perfusion
despite adequate oxygenation and ventilation requires CPR.
6. Which finding is most consistent with compensated shock in a child?
A. Normal blood pressure with tachycardia and prolonged capillary refill
B. Severe hypotension with no pulse
C. Complete absence of respirations
D. Fixed dilated pupils only
Correct Answer: A. Normal blood pressure with tachycardia and prolonged capillary refill
Rationale: Children can maintain blood pressure during early shock through compensatory
mechanisms. Tachycardia, cool extremities, prolonged capillary refill, and altered mental status
can occur before hypotension.
7. Which finding is characteristic of hypotensive or decompensated shock?
A. Normal perfusion
B. Low blood pressure
C. Warm extremities with normal capillary refill
D. Normal mental status and urine output
Correct Answer: B. Low blood pressure
Rationale: Hypotension is a late and serious sign of shock in children because compensatory
mechanisms can maintain blood pressure until significant circulatory compromise occurs.
, 8. A child with septic shock has poor perfusion despite initial fluid therapy. Which
medication is commonly used as a vasoactive infusion?
A. Epinephrine
B. Acetaminophen
C. Diphenhydramine
D. Adenosine
Correct Answer: A. Epinephrine
Rationale: Epinephrine is one of the vasoactive medications used in pediatric shock when
perfusion remains inadequate after appropriate initial management.
9. Which rhythm is considered shockable during pediatric cardiac arrest?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Correct Answer: C. Ventricular fibrillation
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are shockable rhythms.
Asystole and PEA are treated with CPR and medications rather than defibrillation.
10. What is the initial defibrillation energy recommended for pediatric ventricular fibrillation
or pulseless ventricular tachycardia?
A. 0.5 J/kg
B. 2 J/kg
C. 10 J/kg
D. 20 J/kg
Correct Answer: B. 2 J/kg
Rationale: The initial pediatric defibrillation dose is 2 J/kg. Subsequent shocks may be
increased according to the resuscitation algorithm.
11. A child remains in ventricular fibrillation after the initial defibrillation attempt. What is
the priority immediately after the shock?
A. Stop CPR for several minutes
B. Resume CPR immediately
C. Give oral medication
D. Wait for spontaneous movement
Correct Answer: B. Resume CPR immediately
EXAM(Answered;graded A+)
Course
PALS
1. A 6-year-old child is unresponsive and not breathing normally. A healthcare provider
checks for a pulse and finds no definite pulse within 10 seconds. What should be done
next?
A. Give oxygen and reassess in 2 minutes
B. Begin CPR immediately
C. Obtain vascular access before compressions
D. Give a fluid bolus
Correct Answer: B. Begin CPR immediately
Rationale: When a child is unresponsive, not breathing normally, and no definite pulse is
identified within 10 seconds, CPR should be initiated promptly.
2. During pediatric CPR, what compression rate should rescuers use?
A. 60–80/min
B. 80–100/min
C. 100–120/min
D. 130–150/min
Correct Answer: C. 100–120/min
Rationale: High-quality CPR uses a compression rate of 100–120 compressions per minute.
3. What is the recommended chest-compression depth for a child during CPR?
A. Approximately 1 cm
B. At least one-third of the anterior-posterior diameter of the chest, about 5 cm
C. Approximately 7 cm
D. One-half of the chest depth
Correct Answer: B. At least one-third of the anterior-posterior diameter of the chest, about
5 cm
Rationale: Pediatric chest compressions should be approximately one-third of the chest's
anterior-posterior diameter, roughly 5 cm in a child.
4. A healthcare provider is performing two-rescuer CPR on a child. What compression-to-
ventilation ratio should be used?
,A. 15:2
B. 30:1
C. 5:1
D. 10:2
Correct Answer: A. 15:2
Rationale: For pediatric two-rescuer CPR, the compression-to-ventilation ratio is 15:2.
5. A child has a heart rate of 45/min with signs of poor perfusion despite adequate
oxygenation and ventilation. What is the appropriate intervention?
A. Observe only
B. Begin CPR
C. Give oral fluids
D. Perform synchronized cardioversion
Correct Answer: B. Begin CPR
Rationale: Bradycardia with a heart rate below 60/min accompanied by signs of poor perfusion
despite adequate oxygenation and ventilation requires CPR.
6. Which finding is most consistent with compensated shock in a child?
A. Normal blood pressure with tachycardia and prolonged capillary refill
B. Severe hypotension with no pulse
C. Complete absence of respirations
D. Fixed dilated pupils only
Correct Answer: A. Normal blood pressure with tachycardia and prolonged capillary refill
Rationale: Children can maintain blood pressure during early shock through compensatory
mechanisms. Tachycardia, cool extremities, prolonged capillary refill, and altered mental status
can occur before hypotension.
7. Which finding is characteristic of hypotensive or decompensated shock?
A. Normal perfusion
B. Low blood pressure
C. Warm extremities with normal capillary refill
D. Normal mental status and urine output
Correct Answer: B. Low blood pressure
Rationale: Hypotension is a late and serious sign of shock in children because compensatory
mechanisms can maintain blood pressure until significant circulatory compromise occurs.
, 8. A child with septic shock has poor perfusion despite initial fluid therapy. Which
medication is commonly used as a vasoactive infusion?
A. Epinephrine
B. Acetaminophen
C. Diphenhydramine
D. Adenosine
Correct Answer: A. Epinephrine
Rationale: Epinephrine is one of the vasoactive medications used in pediatric shock when
perfusion remains inadequate after appropriate initial management.
9. Which rhythm is considered shockable during pediatric cardiac arrest?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Correct Answer: C. Ventricular fibrillation
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are shockable rhythms.
Asystole and PEA are treated with CPR and medications rather than defibrillation.
10. What is the initial defibrillation energy recommended for pediatric ventricular fibrillation
or pulseless ventricular tachycardia?
A. 0.5 J/kg
B. 2 J/kg
C. 10 J/kg
D. 20 J/kg
Correct Answer: B. 2 J/kg
Rationale: The initial pediatric defibrillation dose is 2 J/kg. Subsequent shocks may be
increased according to the resuscitation algorithm.
11. A child remains in ventricular fibrillation after the initial defibrillation attempt. What is
the priority immediately after the shock?
A. Stop CPR for several minutes
B. Resume CPR immediately
C. Give oral medication
D. Wait for spontaneous movement
Correct Answer: B. Resume CPR immediately
