AHA PALS
Pediatric Advanced Life Support
Provider Certification Examination
EXAMINATION (ANSWERED)
Aligned with current AHA Guidelines for Pediatric Advanced Life Support
Comprehensive 100-Question Written Examination
Includes Detailed Rationales and AHA Algorithm Citations
Total Questions 100 MCQs (4 options, one correct)
Sections 8 integrated PALS content domains
Cognitive Mix 35% recall / 45% application / 20% analysis
Format 65% scenario-based / 35% direct recall
Rationale Depth 2-4 sentences with AHA Guidelines citations
AHA PALS | Pediatric Advanced Life Support | Z.ai Academic Series Confidential - Educational Use
,AHA PALS 2026/2027 - Pediatric Advanced Life Support Provider Exam Latest 2026/2027 (Answered)
Examination Overview
Purpose: This comprehensive 100-question examination assesses Pediatric Advanced Life
Support (PALS) knowledge aligned with the 2026/2027 American Heart Association (AHA) PALS
Provider Manual and current Guidelines for Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care. The examination covers the eight PALS written exam content domains:
(1) Systems of Care, (2) Pediatric Assessment, (3) Respiratory Emergencies, (4) Shock, (5)
Cardiac Emergencies, (6) BLS and High-Quality CPR, (7) Algorithms and Pharmacology, and (8)
Post-Cardiac Arrest Care and Special Situations. Each question includes a detailed rationale
with AHA Guidelines citations, drug dose specificity, and algorithm decision reasoning to
support remediation and certification preparation.
How to use this document: Attempt all 100 questions across 8 sections. Verify each answer
against the rationale. Pay special attention to algorithm sequence questions, drug dose recall
(epinephrine, amiodarone, lidocaine, atropine, adenosine), energy levels for defibrillation and
cardioversion, and recognition of respiratory failure versus shock versus cardiac arrest — the
highest-yield content domains on the AHA PALS written exam.
Section Title Q Range # Qs
Section 1 PALS Overview and Systems of Care Q1-Q10 10
Section 2 Pediatric Assessment Q11-Q22 12
Section 3 Recognition and Management of Respiratory Emergencies Q23-Q36 14
Section 4 Recognition and Management of Shock Q37-Q50 14
Section 5 Recognition and Management of Cardiac Emergencies Q51-Q64 14
Section 6 Pediatric BLS and High-Quality CPR Q65-Q76 12
Section 7 PALS Algorithms and Pharmacology Q77-Q90 14
Section 8 Post-Cardiac Arrest Care and Special Situations Q91-Q100 10
TOTAL 100
Section 1: PALS Overview and Systems of Care
Chain of Survival, Team Dynamics, & Pediatric Assessment
Q1. A 6-year-old child collapses in the waiting room of an outpatient clinic. The first
staff member to arrive confirms unresponsiveness, no breathing, and no pulse. Which
sequence BEST reflects the Pediatric Chain of Survival the team should execute?
A. Begin CPR, then call for help, then deliver a shock, then give epinephrine
B. Activate emergency response, begin high-quality CPR, use an AED, provide advanced
life support, and coordinate post-cardiac arrest care [CORRECT]
C. Establish IV access first, then begin CPR, then activate the emergency response
AHA PALS Final Exam Page 2 100 Questions
, D. Provide rescue breaths only and wait for the parents to consent to treatment
Correct Answer: B
Rationale: The Pediatric Chain of Survival (AHA 2020/2025 updates) consists of five interlinked
links: (1) prevention of arrest, (2) activation of emergency response, (3) high-quality CPR, (4)
advanced resuscitation (including defibrillation when indicated), and (5) coordinated
post-cardiac arrest care. For a witnessed collapse in a clinical setting, activating the response
and initiating immediate high-quality CPR with early AED use is the correct sequence.
Delaying CPR for IV access or breaths-only rescue is inappropriate.
Q2. During a pediatric code, the team leader assigns roles before the patient arrives.
Which assignment BEST reflects AHA-recommended team structure?
A. Single clinician performing all roles to avoid communication errors
B. Compressor, Airway/Ventilator, Monitor/Defibrillator operator, IV/IO access,
Medication administrator, Recorder, and Team Leader [CORRECT]
C. Two compressors only, with all other tasks deferred until arrival
D. Team Leader only, who will assign roles after rhythm is identified
Correct Answer: B
Rationale: The AHA PALS course specifies predefined team roles for resuscitation: Team
Leader, Compressor, Airway/Ventilator, Monitor/Defibrillator operator, IV/IO access,
Medication administrator, and Recorder. Role preassignment before patient arrival enables
parallel-task execution, minimizes critical delays, and supports closed-loop communication. A
single rescuer cannot deliver high-quality CPR and manage all roles simultaneously. Roles are
dynamic and may shift, but they must be assigned at the start.
Q3. A team member calls out 'Epinephrine 0.01 mg per kg IV push.' The team leader
should respond using which closed-loop communication technique?
A. Nod silently and proceed with the next task
B. Say 'OK' without confirming dose or route
C. Wait for the medication nurse to verbally confirm independently
D. Repeat 'Epinephrine 0.01 mg per kg IV push, given' after the medication is
administered, confirm dose and route, and verify the time [CORRECT]
Correct Answer: D
Rationale: Closed-loop communication requires the receiver to repeat back the order (drug,
dose, route) BEFORE administration, then the leader confirms. After administration, the
administrator states the drug, dose, route, and time given. The team leader verifies and
documents. This prevents medication errors common in PALS (e.g., confusing 0.01 mg/kg
IV/IO push with the 0.1 mg/kg endotracheal dose — a 10× dosing error). Silent
acknowledgment or unconfirmed 'OK' responses are not closed-loop.
, Q4. Which of the following statements BEST reflects a system-of-care principle
emphasized in the 2025 AHA Guidelines Update for pediatric resuscitation?
A. Implementation of pediatric medical emergency teams (MET) / rapid response teams
(RRT) and early-warning scores can prevent in-hospital cardiac arrest [CORRECT]
B. Pediatric resuscitation outcomes depend primarily on individual clinician skill rather
than system factors
C. Family presence during resuscitation is contraindicated in pediatric arrests
D. Pediatric-specific equipment is unnecessary because adult equipment is acceptable in
children >5 years
Correct Answer: A
Rationale: AHA Guidelines emphasize that pediatric cardiac arrest is often the terminal event
of progressive respiratory failure or shock. Implementation of pediatric MET/RRT systems,
validated early-warning scores (e.g., PEWS), and standardized handoffs have been shown to
reduce in-hospital cardiac arrest. Family presence during resuscitation is supported by AHA
when a dedicated family facilitator is present. Pediatric-specific weight-based dosing and
equipment are required for all pediatric arrests.
Q5. An 8-year-old is being evaluated in the emergency department. The nurse notes
the child is alert, has normal color, no increased work of breathing, and is speaking
in full sentences. Using the Pediatric Assessment Triangle (PAT), how should this
child be categorized?
A. Sick — needs immediate resuscitation
B. Unstable — requires intubation
C. Stable — not sick, can wait for evaluation [CORRECT]
D. Compensated shock — needs fluid bolus
Correct Answer: C
Rationale: The Pediatric Assessment Triangle (PAT) uses Appearance, Work of Breathing, and
Circulation to skin to rapidly categorize the child as 'sick' or 'not sick' and identify the
physiologic problem. This child has normal Appearance (alert, interactive, speaking), normal
Work of Breathing (no distress), and normal Circulation (normal color). PAT categorization is
'not sick / stable.' The child can be triaged to evaluation but does not require immediate
resuscitation.
Q6. A 3-year-old is brought to the ED with lethargy, marked retractions, and pale,
mottled skin. The PAT categorization is 'sick.' Which component of the PAT suggests
the MOST severe, immediate problem?
A. Appearance — lethargy indicates impending respiratory failure or shock
B. Work of Breathing — retractions indicate upper airway obstruction
C. Circulation to skin — pale, mottled skin indicates poor perfusion and possible shock
[CORRECT]
D. All three are equally weighted and provide no specific diagnosis
Correct Answer: C
Pediatric Advanced Life Support
Provider Certification Examination
EXAMINATION (ANSWERED)
Aligned with current AHA Guidelines for Pediatric Advanced Life Support
Comprehensive 100-Question Written Examination
Includes Detailed Rationales and AHA Algorithm Citations
Total Questions 100 MCQs (4 options, one correct)
Sections 8 integrated PALS content domains
Cognitive Mix 35% recall / 45% application / 20% analysis
Format 65% scenario-based / 35% direct recall
Rationale Depth 2-4 sentences with AHA Guidelines citations
AHA PALS | Pediatric Advanced Life Support | Z.ai Academic Series Confidential - Educational Use
,AHA PALS 2026/2027 - Pediatric Advanced Life Support Provider Exam Latest 2026/2027 (Answered)
Examination Overview
Purpose: This comprehensive 100-question examination assesses Pediatric Advanced Life
Support (PALS) knowledge aligned with the 2026/2027 American Heart Association (AHA) PALS
Provider Manual and current Guidelines for Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care. The examination covers the eight PALS written exam content domains:
(1) Systems of Care, (2) Pediatric Assessment, (3) Respiratory Emergencies, (4) Shock, (5)
Cardiac Emergencies, (6) BLS and High-Quality CPR, (7) Algorithms and Pharmacology, and (8)
Post-Cardiac Arrest Care and Special Situations. Each question includes a detailed rationale
with AHA Guidelines citations, drug dose specificity, and algorithm decision reasoning to
support remediation and certification preparation.
How to use this document: Attempt all 100 questions across 8 sections. Verify each answer
against the rationale. Pay special attention to algorithm sequence questions, drug dose recall
(epinephrine, amiodarone, lidocaine, atropine, adenosine), energy levels for defibrillation and
cardioversion, and recognition of respiratory failure versus shock versus cardiac arrest — the
highest-yield content domains on the AHA PALS written exam.
Section Title Q Range # Qs
Section 1 PALS Overview and Systems of Care Q1-Q10 10
Section 2 Pediatric Assessment Q11-Q22 12
Section 3 Recognition and Management of Respiratory Emergencies Q23-Q36 14
Section 4 Recognition and Management of Shock Q37-Q50 14
Section 5 Recognition and Management of Cardiac Emergencies Q51-Q64 14
Section 6 Pediatric BLS and High-Quality CPR Q65-Q76 12
Section 7 PALS Algorithms and Pharmacology Q77-Q90 14
Section 8 Post-Cardiac Arrest Care and Special Situations Q91-Q100 10
TOTAL 100
Section 1: PALS Overview and Systems of Care
Chain of Survival, Team Dynamics, & Pediatric Assessment
Q1. A 6-year-old child collapses in the waiting room of an outpatient clinic. The first
staff member to arrive confirms unresponsiveness, no breathing, and no pulse. Which
sequence BEST reflects the Pediatric Chain of Survival the team should execute?
A. Begin CPR, then call for help, then deliver a shock, then give epinephrine
B. Activate emergency response, begin high-quality CPR, use an AED, provide advanced
life support, and coordinate post-cardiac arrest care [CORRECT]
C. Establish IV access first, then begin CPR, then activate the emergency response
AHA PALS Final Exam Page 2 100 Questions
, D. Provide rescue breaths only and wait for the parents to consent to treatment
Correct Answer: B
Rationale: The Pediatric Chain of Survival (AHA 2020/2025 updates) consists of five interlinked
links: (1) prevention of arrest, (2) activation of emergency response, (3) high-quality CPR, (4)
advanced resuscitation (including defibrillation when indicated), and (5) coordinated
post-cardiac arrest care. For a witnessed collapse in a clinical setting, activating the response
and initiating immediate high-quality CPR with early AED use is the correct sequence.
Delaying CPR for IV access or breaths-only rescue is inappropriate.
Q2. During a pediatric code, the team leader assigns roles before the patient arrives.
Which assignment BEST reflects AHA-recommended team structure?
A. Single clinician performing all roles to avoid communication errors
B. Compressor, Airway/Ventilator, Monitor/Defibrillator operator, IV/IO access,
Medication administrator, Recorder, and Team Leader [CORRECT]
C. Two compressors only, with all other tasks deferred until arrival
D. Team Leader only, who will assign roles after rhythm is identified
Correct Answer: B
Rationale: The AHA PALS course specifies predefined team roles for resuscitation: Team
Leader, Compressor, Airway/Ventilator, Monitor/Defibrillator operator, IV/IO access,
Medication administrator, and Recorder. Role preassignment before patient arrival enables
parallel-task execution, minimizes critical delays, and supports closed-loop communication. A
single rescuer cannot deliver high-quality CPR and manage all roles simultaneously. Roles are
dynamic and may shift, but they must be assigned at the start.
Q3. A team member calls out 'Epinephrine 0.01 mg per kg IV push.' The team leader
should respond using which closed-loop communication technique?
A. Nod silently and proceed with the next task
B. Say 'OK' without confirming dose or route
C. Wait for the medication nurse to verbally confirm independently
D. Repeat 'Epinephrine 0.01 mg per kg IV push, given' after the medication is
administered, confirm dose and route, and verify the time [CORRECT]
Correct Answer: D
Rationale: Closed-loop communication requires the receiver to repeat back the order (drug,
dose, route) BEFORE administration, then the leader confirms. After administration, the
administrator states the drug, dose, route, and time given. The team leader verifies and
documents. This prevents medication errors common in PALS (e.g., confusing 0.01 mg/kg
IV/IO push with the 0.1 mg/kg endotracheal dose — a 10× dosing error). Silent
acknowledgment or unconfirmed 'OK' responses are not closed-loop.
, Q4. Which of the following statements BEST reflects a system-of-care principle
emphasized in the 2025 AHA Guidelines Update for pediatric resuscitation?
A. Implementation of pediatric medical emergency teams (MET) / rapid response teams
(RRT) and early-warning scores can prevent in-hospital cardiac arrest [CORRECT]
B. Pediatric resuscitation outcomes depend primarily on individual clinician skill rather
than system factors
C. Family presence during resuscitation is contraindicated in pediatric arrests
D. Pediatric-specific equipment is unnecessary because adult equipment is acceptable in
children >5 years
Correct Answer: A
Rationale: AHA Guidelines emphasize that pediatric cardiac arrest is often the terminal event
of progressive respiratory failure or shock. Implementation of pediatric MET/RRT systems,
validated early-warning scores (e.g., PEWS), and standardized handoffs have been shown to
reduce in-hospital cardiac arrest. Family presence during resuscitation is supported by AHA
when a dedicated family facilitator is present. Pediatric-specific weight-based dosing and
equipment are required for all pediatric arrests.
Q5. An 8-year-old is being evaluated in the emergency department. The nurse notes
the child is alert, has normal color, no increased work of breathing, and is speaking
in full sentences. Using the Pediatric Assessment Triangle (PAT), how should this
child be categorized?
A. Sick — needs immediate resuscitation
B. Unstable — requires intubation
C. Stable — not sick, can wait for evaluation [CORRECT]
D. Compensated shock — needs fluid bolus
Correct Answer: C
Rationale: The Pediatric Assessment Triangle (PAT) uses Appearance, Work of Breathing, and
Circulation to skin to rapidly categorize the child as 'sick' or 'not sick' and identify the
physiologic problem. This child has normal Appearance (alert, interactive, speaking), normal
Work of Breathing (no distress), and normal Circulation (normal color). PAT categorization is
'not sick / stable.' The child can be triaged to evaluation but does not require immediate
resuscitation.
Q6. A 3-year-old is brought to the ED with lethargy, marked retractions, and pale,
mottled skin. The PAT categorization is 'sick.' Which component of the PAT suggests
the MOST severe, immediate problem?
A. Appearance — lethargy indicates impending respiratory failure or shock
B. Work of Breathing — retractions indicate upper airway obstruction
C. Circulation to skin — pale, mottled skin indicates poor perfusion and possible shock
[CORRECT]
D. All three are equally weighted and provide no specific diagnosis
Correct Answer: C
