PALS CERTIFICATION EXAM
PRACTICE TEST QUESTIONS WITH
CORRECT ANSWERS PLUS
RATIONALES 2026/2027 EDITION
WITH INSTANT PDF DOWNLOAD
A 6-year-old child suddenly becomes unresponsive and is not
breathing normally. You cannot detect a pulse within 10 seconds.
What is the most appropriate immediate action?
A. Administer oxygen and reassess in 5 minutes
B. Obtain a blood pressure measurement
C. Begin high-quality CPR
D. Give a fluid bolus
Rationale: When a child is unresponsive, not breathing normally,
and no definite pulse is detected within 10 seconds, CPR should
be initiated immediately. High-quality chest compressions and
appropriate ventilation are essential components of pediatric
cardiac arrest management.
Question 2
During pediatric CPR, what is the recommended chest
compression rate?
A. 60–80 compressions/minute
B. 80–100 compressions/minute
C. 100–120 compressions/minute
D. 130–150 compressions/minute
,Rationale: High-quality pediatric CPR requires a compression rate
of 100–120 compressions per minute. Maintaining this rate while
allowing complete chest recoil helps provide adequate coronary
and cerebral perfusion.
Question 3
What is the recommended compression depth for a child during
CPR?
A. Approximately 1 cm
B. Approximately 2 cm
C. At least one-third of the anterior-posterior diameter of the
chest, approximately 5 cm
D. Approximately 7 cm
Rationale: Pediatric chest compressions should be deep enough
to produce effective blood flow while avoiding excessive force.
The target is at least one-third of the chest's anterior-posterior
diameter, approximately 5 cm in a child.
Question 4
A child in cardiac arrest has an advanced airway in place. How
should ventilation be provided during continuous chest
compressions?
A. 1 breath every 30 seconds
B. 1 breath every 10 seconds
C. 1 breath every 2–3 seconds
D. 2 breaths after every 30 compressions
Rationale: Once an advanced airway is established during
pediatric cardiac arrest, continuous chest compressions are
performed while ventilations are delivered at approximately 20–30
breaths per minute, or one breath every 2–3 seconds.
,Question 5
A 4-year-old child has a heart rate of 45/min with poor perfusion
despite adequate oxygenation and ventilation. What is the next
appropriate intervention?
A. Observe for another 10 minutes
B. Administer oral fluids
C. Begin CPR
D. Perform synchronized cardioversion
Rationale: Severe bradycardia with a heart rate below 60/min and
signs of poor perfusion despite adequate oxygenation and
ventilation is treated with CPR. Bradycardia in children can rapidly
progress to cardiac arrest.
Question 6
Which medication is recommended for pediatric symptomatic
bradycardia associated with increased vagal tone or primary AV
block?
A. Adenosine
B. Amiodarone
C. Atropine
D. Calcium chloride
Rationale: Atropine is used for symptomatic pediatric bradycardia
when increased vagal tone or primary AV block is suspected. It
may improve heart rate by reducing parasympathetic influence on
the cardiac conduction system.
Question 7
What is the recommended initial IV/IO dose of epinephrine during
pediatric cardiac arrest?
, A. 0.001 mg/kg
B. 0.01 mg/kg of the 0.1 mg/mL concentration
C. 0.1 mg/kg
D. 1 mg/kg
Rationale: The recommended IV/IO epinephrine dose during
pediatric cardiac arrest is 0.01 mg/kg using the 0.1 mg/mL
concentration. Epinephrine should be administered as soon as
possible during cardiac arrest.
Question 8
A child has a shockable rhythm during cardiac arrest. What is the
recommended initial defibrillation energy?
A. 0.5 J/kg
B. 2 J/kg
C. 5 J/kg
D. 10 J/kg
Rationale: For pediatric ventricular fibrillation or pulseless
ventricular tachycardia, the initial defibrillation dose is 2 J/kg. If
additional shocks are required, subsequent doses may be
increased according to pediatric resuscitation protocols.
Question 9
Which rhythm is classified as shockable during pediatric cardiac
arrest?
A. Asystole
B. Pulseless electrical activity
C. Sinus bradycardia
D. Ventricular fibrillation
PRACTICE TEST QUESTIONS WITH
CORRECT ANSWERS PLUS
RATIONALES 2026/2027 EDITION
WITH INSTANT PDF DOWNLOAD
A 6-year-old child suddenly becomes unresponsive and is not
breathing normally. You cannot detect a pulse within 10 seconds.
What is the most appropriate immediate action?
A. Administer oxygen and reassess in 5 minutes
B. Obtain a blood pressure measurement
C. Begin high-quality CPR
D. Give a fluid bolus
Rationale: When a child is unresponsive, not breathing normally,
and no definite pulse is detected within 10 seconds, CPR should
be initiated immediately. High-quality chest compressions and
appropriate ventilation are essential components of pediatric
cardiac arrest management.
Question 2
During pediatric CPR, what is the recommended chest
compression rate?
A. 60–80 compressions/minute
B. 80–100 compressions/minute
C. 100–120 compressions/minute
D. 130–150 compressions/minute
,Rationale: High-quality pediatric CPR requires a compression rate
of 100–120 compressions per minute. Maintaining this rate while
allowing complete chest recoil helps provide adequate coronary
and cerebral perfusion.
Question 3
What is the recommended compression depth for a child during
CPR?
A. Approximately 1 cm
B. Approximately 2 cm
C. At least one-third of the anterior-posterior diameter of the
chest, approximately 5 cm
D. Approximately 7 cm
Rationale: Pediatric chest compressions should be deep enough
to produce effective blood flow while avoiding excessive force.
The target is at least one-third of the chest's anterior-posterior
diameter, approximately 5 cm in a child.
Question 4
A child in cardiac arrest has an advanced airway in place. How
should ventilation be provided during continuous chest
compressions?
A. 1 breath every 30 seconds
B. 1 breath every 10 seconds
C. 1 breath every 2–3 seconds
D. 2 breaths after every 30 compressions
Rationale: Once an advanced airway is established during
pediatric cardiac arrest, continuous chest compressions are
performed while ventilations are delivered at approximately 20–30
breaths per minute, or one breath every 2–3 seconds.
,Question 5
A 4-year-old child has a heart rate of 45/min with poor perfusion
despite adequate oxygenation and ventilation. What is the next
appropriate intervention?
A. Observe for another 10 minutes
B. Administer oral fluids
C. Begin CPR
D. Perform synchronized cardioversion
Rationale: Severe bradycardia with a heart rate below 60/min and
signs of poor perfusion despite adequate oxygenation and
ventilation is treated with CPR. Bradycardia in children can rapidly
progress to cardiac arrest.
Question 6
Which medication is recommended for pediatric symptomatic
bradycardia associated with increased vagal tone or primary AV
block?
A. Adenosine
B. Amiodarone
C. Atropine
D. Calcium chloride
Rationale: Atropine is used for symptomatic pediatric bradycardia
when increased vagal tone or primary AV block is suspected. It
may improve heart rate by reducing parasympathetic influence on
the cardiac conduction system.
Question 7
What is the recommended initial IV/IO dose of epinephrine during
pediatric cardiac arrest?
, A. 0.001 mg/kg
B. 0.01 mg/kg of the 0.1 mg/mL concentration
C. 0.1 mg/kg
D. 1 mg/kg
Rationale: The recommended IV/IO epinephrine dose during
pediatric cardiac arrest is 0.01 mg/kg using the 0.1 mg/mL
concentration. Epinephrine should be administered as soon as
possible during cardiac arrest.
Question 8
A child has a shockable rhythm during cardiac arrest. What is the
recommended initial defibrillation energy?
A. 0.5 J/kg
B. 2 J/kg
C. 5 J/kg
D. 10 J/kg
Rationale: For pediatric ventricular fibrillation or pulseless
ventricular tachycardia, the initial defibrillation dose is 2 J/kg. If
additional shocks are required, subsequent doses may be
increased according to pediatric resuscitation protocols.
Question 9
Which rhythm is classified as shockable during pediatric cardiac
arrest?
A. Asystole
B. Pulseless electrical activity
C. Sinus bradycardia
D. Ventricular fibrillation
