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PALS Updated Final Exam 2026 | Latest Update Exam Prep | High-Yield Review Guide | Pediatric Advanced Life Support Key Concepts, Algorithms, Drug Doses & Practice Questions

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This 2026 PALS final exam review guide is built for fast, high-yield revision. It focuses on the topics tested most: pediatric assessment (the primary and secondary survey), respiratory distress vs. failure, shock types, bradycardia and tachycardia algorithms, cardiac arrest management, defibrillation and drug dosing, post-ROSC care, and team communication. Use it for a last-minute review before your PALS certification or recertification exam. It suits nurses, paramedics, physicians, and other healthcare providers.

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PALS Updated Final Exam Latest Update 2026 | Exam
Prep | High-Yield Review Guide
1. What is the primary focus of the PALS team leader during a debriefing
session?

Clinical findings and appropriate medical responses

Medication administration techniques

Patient history and family dynamics

Nutritional needs of pediatric patients

2. Describe the role of dexamethasone in the treatment of moderate croup in
pediatric patients.

Dexamethasone is used to treat bacterial infections in children.

Dexamethasone increases mucus production to soothe the throat.

Dexamethasone acts as a bronchodilator to open airways.

Dexamethasone reduces inflammation in the airways, alleviating
symptoms of croup.

3. What is the common arrhythmia associated with Lyme disease that may be
identified on an ECG?

Atrial fibrillation

Sinus bradycardia

Heart block

Ventricular tachycardia

,4. What is a key intervention in airway management for a child with respiratory
distress?

Nebulized bronchodilators

Endotracheal intubation

Chest physiotherapy

Intravenous fluids

5. Describe how respiratory distress can affect a child's circulation status.

Respiratory distress has no effect on circulation status.

Respiratory distress causes bradycardia due to increased carbon
dioxide levels.

Respiratory distress can lead to tachycardia as the body
compensates for decreased oxygen levels.

Respiratory distress results in hypotension due to fluid loss.

6. Chest compressions are indicated when a pediatric patient presents with:

a pulse rate slower than 100 beats per minute that is not increasing in
response to supplemental oxygenation and assisted ventilation.

wide-complex tachycardia unresponsive to cardioversion.

a pulse rate slower than 60 beats per minute with signs of shock or
poor peripheral perfusion despite oxygenation and ventilation.

a pulse rate slower than 80 beats per minute with signs of shock or
poor peripheral perfusion.

7. Which of the following lab tests would be most helpful in the diagnosis of
septic shock?

, BNP

procalcitonin

lactate

D-dimer

8. What is the primary method used to confirm the correct placement of an
advanced airway in pediatric patients?

Blood gas analysis

Capnography

Chest X-ray

Pulse oximetry

9. Describe the significance of sinus tachycardia in a pediatric patient with
symptoms of dehydration.

Sinus tachycardia indicates the heart's response to decreased blood
volume and compensatory mechanisms due to dehydration.

Sinus tachycardia shows that the heart is functioning normally under
stress.

Sinus tachycardia is a sign of heart failure in children.

Sinus tachycardia is unrelated to dehydration symptoms.

10. An 11-year-old soccer player is brought to the emergency department. After
a quick assessment, the team realizes this patient is experiencing a severe
asthma exacerbation. Which medication would the team administer
immediately?

Prednisone

Magnesium sulfate

, Albuterol with or without ipratropium bromide

Terbutaline


11. What is the correct placement location for the red electrode in a three-
electrode system for cardiac monitoring in a pediatric patient?

Left upper chest

Right upper chest

Right lower chest

Left lower chest

12. In a scenario where a child presents with a rapid heart rate and the ECG
shows ventricular tachycardia, what should be the immediate action taken by
the healthcare provider?

Administer synchronized cardioversion

Provide supplemental oxygen

Perform a thorough physical examination

Initiate CPR immediately

13. What laboratory test is commonly used to assess the adequacy of oxygen
delivery in pediatric patients?

Complete blood count (CBC)

Liver function tests

Electrolyte panel

Arterial blood gas (ABG)

Document information

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October 1, 2026
Number of pages
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Written in
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