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 5-year-old child presents with lethargy, increased work of
breathing, and pale color. The primary assessment reveals that the
airway is open and the respiratory rate is 30/min, with crackles heard
on auscultation. The cardiac monitor shows sinus tachycardia at a
rate of 165/min. The pulse oximeter displays an oxygen saturation of
95% and a pulse rate of 93/min. On the basis of this information,
which of the following provides the best interpretation of the oxygen
saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated
B. Reliable; supplementary oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered
Correct Answer: B. Reliable; supplementary oxygen should be
administered
EXPERT LOGIC>>:
The child has signs of respiratory distress (increased work of breathing,
crackles, lethargy). Although pulse oximetry demonstrates 95%, which is
borderline hypoxemia, the clinical picture suggests early respiratory
compromise. Oxygen saturation readings above 94% are generally
acceptable; however, in children with respiratory distress and abnormal
lung findings, oxygen supplementation is indicated to prevent deterioration.
The discrepancy between heart rate and pulse oximeter pulse rate likely
indicates peripheral perfusion issues but does not invalidate the oxygen
saturation. Thus, the 95% reading should be considered reliable enough to
justify oxygen therapy.
---
### 2. A 3-year-old child was recently diagnosed with leukemia and
has been treated with chemotherapy. The child presents with lethargy
and a high fever. Heart rate is 195/min, respiratory rate is 36/min,
,blood pressure is 85/40 mm Hg, and capillary refill time is less than 2
seconds. What is the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock
Correct Answer: A. Septic shock
EXPERT LOGIC>>:
Leukemia and chemotherapy cause immunosuppression, predisposing to
infections and sepsis. The child is tachycardic with hypotension and a high
fever, consistent with septic shock. Capillary refill under 2 seconds
indicates adequate perfusion despite hypotension, suggesting a
compensated shock state. The tachycardia and fever align with a
hyperdynamic, distributive shock picture typical of sepsis rather than
hypovolemic or cardiogenic shock.
---
### 3. A 2-week-old infant presents with irritability and a history of
poor feeding.
Blood pressure is 55/40 mm Hg. What term describes this infant's
blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated
, Correct Answer: A. Hypotensive
EXPERT LOGIC>>:
Normal blood pressure in neonates and infants is age-dependent and
generally higher than 60/40 mm Hg at 2 weeks of age. A blood pressure of
55/40 mm Hg is below the 5th percentile for this age and is considered
hypotensive, which may indicate shock or cardiovascular compromise.
---
### 4. During a resuscitation attempt, the team leader orders an initial
dose of epinephrine at 0.1 mg/kg to be given. What should the team
member do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug
Correct Answer: C. Respectfully ask the team leader to clarify the dose
EXPERT LOGIC>>:
The AHA PALS guideline recommends an initial epinephrine dose of 0.01
mg/kg IV/IO during cardiac arrest, not 0.1 mg/kg (which is 10 times higher
and potentially harmful). The team member should seek clarification to
prevent overdose, showing respectful communication and patient safety
awareness.
---
### 5. Which of the following is a characteristic of respiratory failure?
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 5-year-old child presents with lethargy, increased work of
breathing, and pale color. The primary assessment reveals that the
airway is open and the respiratory rate is 30/min, with crackles heard
on auscultation. The cardiac monitor shows sinus tachycardia at a
rate of 165/min. The pulse oximeter displays an oxygen saturation of
95% and a pulse rate of 93/min. On the basis of this information,
which of the following provides the best interpretation of the oxygen
saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated
B. Reliable; supplementary oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered
Correct Answer: B. Reliable; supplementary oxygen should be
administered
EXPERT LOGIC>>:
The child has signs of respiratory distress (increased work of breathing,
crackles, lethargy). Although pulse oximetry demonstrates 95%, which is
borderline hypoxemia, the clinical picture suggests early respiratory
compromise. Oxygen saturation readings above 94% are generally
acceptable; however, in children with respiratory distress and abnormal
lung findings, oxygen supplementation is indicated to prevent deterioration.
The discrepancy between heart rate and pulse oximeter pulse rate likely
indicates peripheral perfusion issues but does not invalidate the oxygen
saturation. Thus, the 95% reading should be considered reliable enough to
justify oxygen therapy.
---
### 2. A 3-year-old child was recently diagnosed with leukemia and
has been treated with chemotherapy. The child presents with lethargy
and a high fever. Heart rate is 195/min, respiratory rate is 36/min,
,blood pressure is 85/40 mm Hg, and capillary refill time is less than 2
seconds. What is the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock
Correct Answer: A. Septic shock
EXPERT LOGIC>>:
Leukemia and chemotherapy cause immunosuppression, predisposing to
infections and sepsis. The child is tachycardic with hypotension and a high
fever, consistent with septic shock. Capillary refill under 2 seconds
indicates adequate perfusion despite hypotension, suggesting a
compensated shock state. The tachycardia and fever align with a
hyperdynamic, distributive shock picture typical of sepsis rather than
hypovolemic or cardiogenic shock.
---
### 3. A 2-week-old infant presents with irritability and a history of
poor feeding.
Blood pressure is 55/40 mm Hg. What term describes this infant's
blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated
, Correct Answer: A. Hypotensive
EXPERT LOGIC>>:
Normal blood pressure in neonates and infants is age-dependent and
generally higher than 60/40 mm Hg at 2 weeks of age. A blood pressure of
55/40 mm Hg is below the 5th percentile for this age and is considered
hypotensive, which may indicate shock or cardiovascular compromise.
---
### 4. During a resuscitation attempt, the team leader orders an initial
dose of epinephrine at 0.1 mg/kg to be given. What should the team
member do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug
Correct Answer: C. Respectfully ask the team leader to clarify the dose
EXPERT LOGIC>>:
The AHA PALS guideline recommends an initial epinephrine dose of 0.01
mg/kg IV/IO during cardiac arrest, not 0.1 mg/kg (which is 10 times higher
and potentially harmful). The team member should seek clarification to
prevent overdose, showing respectful communication and patient safety
awareness.
---
### 5. Which of the following is a characteristic of respiratory failure?
