2026AHA PALS
FINAL EXAM
Actual Questions and Revised Answers
Expert
-Verified Explanation
Inside you will get:
exam consists of 50 multiple
-choice questions and answers with
explanations.
questions that are derived from the American Red Cross and
American Heart Association Pediatric Advanced Life Support
(PALS) provider handbooks and adhere to the latest AHA, ILCOR and ECC
guidelines.
,### 1. A child experiencing bradycardia with inadequate perfusion
despite supporting oxygenation and ventilation is receiving
compressions. Despite these efforts, the child's status remains
unchanged. Which medication would the emergency response team
expect to administer next?
A. Atropine
B. Adenosine
C.Epinephrine
D.Amiodarone
CORRECT ANSWER>>: C. Epinephrine
EXPERT LOGIC>>:
For pediatric bradycardia with poor perfusion that is unresponsive to
oxygenation, ventilation, and compressions, epinephrine is the first-line
medication. It acts on alpha- and beta-adrenergic receptors to increase
heart rate, improve myocardial contractility, and cause peripheral
vasoconstriction, which improves coronary and cerebral perfusion. Atropine
is rarely the first choice in bradycardia except for suspected vagal-
mediated or cholinergic causes. Adenosine is indicated primarily for
supraventricular tachycardias, and amiodarone is used for refractory
ventricular arrhythmias.
---
### 2. A 12-year-old is being treated in the urgent care clinic. The
mother reports that the child came home from school yesterday with
a high fever, vomiting and multiple episodes of watery diarrhea. The
healthcare provider obtains a rhythm strip and notes the following
waveform. The provider interprets this as which type of arrhythmia?
A. Atrial fibrillation
B. Ventricular tachycardia
C.Sinus tachycardia
,D.Junctional rhythm
CORRECT ANSWER>>: C. Sinus tachycardia
EXPERT LOGIC>>:
Sinus tachycardia is the most common arrhythmia in children and often
represents a physiologic response to fever, dehydration, or systemic
illness. Fever and hypovolemia from vomiting and diarrhea increase
metabolic demand and sympathetic tone, resulting in a compensatory
increase in heart rate. This rhythm maintains normal P wave morphology
before each QRS complex. Other arrhythmias would show abnormal P
waves or QRS morphology.
---
### 3. After ROSC, a child is experiencing post-cardiac arrest
hypoperfusion. The PALS resuscitation team would administer which
element to restore intravascular volume and optimize preload?
A. Isotonic fluid boluses
B. Diuretics
C. Vasopressors
D. Calcium channel blockers
CORRECT ANSWER>>: A. Isotonic fluid boluses
EXPERT LOGIC>>:
Post-resuscitation hypoperfusion often results from relative hypovolemia
caused by vasodilation and capillary leak. Isotonic fluids (normal saline or
lactated Ringer’s) are administered to restore intravascular volume and
improve cardiac preload, optimizing cardiac output. Use of vasopressors or
calcium channel blockers needs to be judicious and after volume status is
optimized. Diuretics would worsen hypovolemia.
, ---
### 4. A 30-month old child has been diagnosed with moderate croup.
Which medication(s) would the provider administer?
A. Oral antibiotics
B. Nebulized epinephrine and corticosteroids
C.Bronchodilators alone
D.Intravenous fluids only
CORRECT ANSWER>>: B. Nebulized epinephrine and corticosteroids
EXPERT LOGIC>>:
Moderate croup is characterized by inspiratory stridor at rest and increased
work of breathing. Corticosteroids provide sustained anti-inflammatory
effects while nebulized epinephrine rapidly decreases airway edema via
vasoconstriction. Antibiotics are not indicated as croup is viral.
Bronchodilators have minimal effect, and IV fluids support hydration but do
not treat airway obstruction.
---
### 5. A 2-year-old child is brought to the pediatric urgent care clinic
by the parent who says that the child has had a barking cough for two
days. During the rapid assessment of the child, the provider hears
audible inspiratory stridor. Which common cause of partial upper
airway obstruction in children would the provider most likely
suspect?
A. Epiglottitis
B. Foreign body aspiration
C. Croup
D. Bacterial tracheitis
FINAL EXAM
Actual Questions and Revised Answers
Expert
-Verified Explanation
Inside you will get:
exam consists of 50 multiple
-choice questions and answers with
explanations.
questions that are derived from the American Red Cross and
American Heart Association Pediatric Advanced Life Support
(PALS) provider handbooks and adhere to the latest AHA, ILCOR and ECC
guidelines.
,### 1. A child experiencing bradycardia with inadequate perfusion
despite supporting oxygenation and ventilation is receiving
compressions. Despite these efforts, the child's status remains
unchanged. Which medication would the emergency response team
expect to administer next?
A. Atropine
B. Adenosine
C.Epinephrine
D.Amiodarone
CORRECT ANSWER>>: C. Epinephrine
EXPERT LOGIC>>:
For pediatric bradycardia with poor perfusion that is unresponsive to
oxygenation, ventilation, and compressions, epinephrine is the first-line
medication. It acts on alpha- and beta-adrenergic receptors to increase
heart rate, improve myocardial contractility, and cause peripheral
vasoconstriction, which improves coronary and cerebral perfusion. Atropine
is rarely the first choice in bradycardia except for suspected vagal-
mediated or cholinergic causes. Adenosine is indicated primarily for
supraventricular tachycardias, and amiodarone is used for refractory
ventricular arrhythmias.
---
### 2. A 12-year-old is being treated in the urgent care clinic. The
mother reports that the child came home from school yesterday with
a high fever, vomiting and multiple episodes of watery diarrhea. The
healthcare provider obtains a rhythm strip and notes the following
waveform. The provider interprets this as which type of arrhythmia?
A. Atrial fibrillation
B. Ventricular tachycardia
C.Sinus tachycardia
,D.Junctional rhythm
CORRECT ANSWER>>: C. Sinus tachycardia
EXPERT LOGIC>>:
Sinus tachycardia is the most common arrhythmia in children and often
represents a physiologic response to fever, dehydration, or systemic
illness. Fever and hypovolemia from vomiting and diarrhea increase
metabolic demand and sympathetic tone, resulting in a compensatory
increase in heart rate. This rhythm maintains normal P wave morphology
before each QRS complex. Other arrhythmias would show abnormal P
waves or QRS morphology.
---
### 3. After ROSC, a child is experiencing post-cardiac arrest
hypoperfusion. The PALS resuscitation team would administer which
element to restore intravascular volume and optimize preload?
A. Isotonic fluid boluses
B. Diuretics
C. Vasopressors
D. Calcium channel blockers
CORRECT ANSWER>>: A. Isotonic fluid boluses
EXPERT LOGIC>>:
Post-resuscitation hypoperfusion often results from relative hypovolemia
caused by vasodilation and capillary leak. Isotonic fluids (normal saline or
lactated Ringer’s) are administered to restore intravascular volume and
improve cardiac preload, optimizing cardiac output. Use of vasopressors or
calcium channel blockers needs to be judicious and after volume status is
optimized. Diuretics would worsen hypovolemia.
, ---
### 4. A 30-month old child has been diagnosed with moderate croup.
Which medication(s) would the provider administer?
A. Oral antibiotics
B. Nebulized epinephrine and corticosteroids
C.Bronchodilators alone
D.Intravenous fluids only
CORRECT ANSWER>>: B. Nebulized epinephrine and corticosteroids
EXPERT LOGIC>>:
Moderate croup is characterized by inspiratory stridor at rest and increased
work of breathing. Corticosteroids provide sustained anti-inflammatory
effects while nebulized epinephrine rapidly decreases airway edema via
vasoconstriction. Antibiotics are not indicated as croup is viral.
Bronchodilators have minimal effect, and IV fluids support hydration but do
not treat airway obstruction.
---
### 5. A 2-year-old child is brought to the pediatric urgent care clinic
by the parent who says that the child has had a barking cough for two
days. During the rapid assessment of the child, the provider hears
audible inspiratory stridor. Which common cause of partial upper
airway obstruction in children would the provider most likely
suspect?
A. Epiglottitis
B. Foreign body aspiration
C. Croup
D. Bacterial tracheitis
