PALS EXAM (50 QUESTIONS) STUDY GUIDE 2026
COMPLETE QUESTIONS WITH CORRECT DETAILED
ANSWERS || 100% GUARANTEED PASS <RECENT
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Part 1: Systematic Approach, BLS, and Respiratory Emergencies (Questions 1-25)
1. What is the first step in the Pediatric Assessment Triangle (PAT)?
A. Assessing circulation
B. Forming a general impression
C. Checking for responsiveness
D. Opening the airway
Answer: B. The PAT is a rapid, 30-second tool that begins with forming a general
impression from the doorway (across the room) to identify the child's status as
stable, unstable, or in cardiorespiratory failure.
2. The "Appearance" component of the PAT is best assessed using:
A. Capillary refill time
B. Blood pressure
C. TICLS (Tone, Interactiveness, Consolability, Look/Gaze, Speech/Cry)
D. Heart rate and respiratory rate
Answer: C. TICLS is the mnemonic for quickly evaluating a child's appearance,
which reflects the adequacy of ventilation, oxygenation, and brain perfusion.
3. A 4-year-old child is found unresponsive. You shout their name and gently
shake their shoulder, but they do not respond. What is your next immediate
action?
A. Check for a pulse.
B. Deliver 2 rescue breaths.
C. Activate the emergency response system.
D. Check for breathing and a pulse simultaneously.
,Answer: D. For an unresponsive child, after verifying unresponsiveness, you
should simultaneously check for breathing and a pulse (for no more than 10
seconds) to determine if CPR is needed.
4. The correct compression-to-ventilation ratio for a child in cardiac arrest with a
single rescuer is:
A. 15:2
B. 30:2
C. 15:1
D. 30:1
Answer: B. For a single rescuer, the ratio is 30:2 for infants, children, and adults.
For two rescuers, the ratio for a child is 15:2.
5. The correct depth of chest compressions for a child is:
A. At least one-third the depth of the chest, approximately 2 inches (5 cm)
B. At least 2.4 inches (6 cm)
C. 1.5 inches (4 cm)
D. 2 inches (5 cm) for infants and 2.4 inches (6 cm) for children
Answer: A. For all children (infants to puberty), the compression depth is at least
one-third the anterior-posterior diameter of the chest, which is approximately 2
inches (5 cm).
6. A 6-month-old infant has a strong central pulse but is apneic. What is the
appropriate action?
A. Begin chest compressions.
B. Provide rescue breathing at 1 breath every 2-3 seconds (20-30 breaths/min).
C. Provide rescue breathing at 1 breath every 5-6 seconds (10-12 breaths/min).
D. Administer high-flow oxygen via non-rebreather mask.
Answer: B. If a patient has a pulse but is not breathing (respiratory arrest), rescue
breathing is required. For a child/infant, the rate is 1 breath every 2-3 seconds.
7. Signs of respiratory distress include all of the following EXCEPT:
A. Tachypnea
, B. Stridor
C. Bradycardia
D. Nasal flaring
Answer: C. Bradycardia is a sign of respiratory failure or impending cardiac arrest,
not early respiratory distress. Tachypnea, stridor, and nasal flaring are classic signs
of distress.
8. A 2-year-old with croup presents with stridor at rest, tachypnea, and mild
retractions. According to the PAT, which triangle component is primarily
affected?
A. Appearance
B. Work of Breathing
C. Circulation to Skin
D. Mental Status
Answer: B. Stridor and retractions are direct indicators of increased work of
breathing.
9. The primary medication for treating moderate to severe croup is:
A. Albuterol
B. Epinephrine (racemic or standard)
C. Dexamethasone
D. Ipratropium bromide
Answer: B. Nebulized epinephrine is used for acute, moderate-to-severe upper
airway obstruction from croup. Dexamethasone is also given but its effect is not
immediate.
10. For a child in status asthmaticus who is not responding to initial
bronchodilator therapy, what is the next recommended medication?
A. Ipratropium bromide
B. Epinephrine IM
C. Dexamethasone
D. Magnesium sulfate
Answer: A. The typical sequence for status asthmaticus is: 1) Short-acting beta-
agonist (Albuterol), 2) Add Ipratropium bromide, 3) Consider systemic
COMPLETE QUESTIONS WITH CORRECT DETAILED
ANSWERS || 100% GUARANTEED PASS <RECENT
VERSION>
Part 1: Systematic Approach, BLS, and Respiratory Emergencies (Questions 1-25)
1. What is the first step in the Pediatric Assessment Triangle (PAT)?
A. Assessing circulation
B. Forming a general impression
C. Checking for responsiveness
D. Opening the airway
Answer: B. The PAT is a rapid, 30-second tool that begins with forming a general
impression from the doorway (across the room) to identify the child's status as
stable, unstable, or in cardiorespiratory failure.
2. The "Appearance" component of the PAT is best assessed using:
A. Capillary refill time
B. Blood pressure
C. TICLS (Tone, Interactiveness, Consolability, Look/Gaze, Speech/Cry)
D. Heart rate and respiratory rate
Answer: C. TICLS is the mnemonic for quickly evaluating a child's appearance,
which reflects the adequacy of ventilation, oxygenation, and brain perfusion.
3. A 4-year-old child is found unresponsive. You shout their name and gently
shake their shoulder, but they do not respond. What is your next immediate
action?
A. Check for a pulse.
B. Deliver 2 rescue breaths.
C. Activate the emergency response system.
D. Check for breathing and a pulse simultaneously.
,Answer: D. For an unresponsive child, after verifying unresponsiveness, you
should simultaneously check for breathing and a pulse (for no more than 10
seconds) to determine if CPR is needed.
4. The correct compression-to-ventilation ratio for a child in cardiac arrest with a
single rescuer is:
A. 15:2
B. 30:2
C. 15:1
D. 30:1
Answer: B. For a single rescuer, the ratio is 30:2 for infants, children, and adults.
For two rescuers, the ratio for a child is 15:2.
5. The correct depth of chest compressions for a child is:
A. At least one-third the depth of the chest, approximately 2 inches (5 cm)
B. At least 2.4 inches (6 cm)
C. 1.5 inches (4 cm)
D. 2 inches (5 cm) for infants and 2.4 inches (6 cm) for children
Answer: A. For all children (infants to puberty), the compression depth is at least
one-third the anterior-posterior diameter of the chest, which is approximately 2
inches (5 cm).
6. A 6-month-old infant has a strong central pulse but is apneic. What is the
appropriate action?
A. Begin chest compressions.
B. Provide rescue breathing at 1 breath every 2-3 seconds (20-30 breaths/min).
C. Provide rescue breathing at 1 breath every 5-6 seconds (10-12 breaths/min).
D. Administer high-flow oxygen via non-rebreather mask.
Answer: B. If a patient has a pulse but is not breathing (respiratory arrest), rescue
breathing is required. For a child/infant, the rate is 1 breath every 2-3 seconds.
7. Signs of respiratory distress include all of the following EXCEPT:
A. Tachypnea
, B. Stridor
C. Bradycardia
D. Nasal flaring
Answer: C. Bradycardia is a sign of respiratory failure or impending cardiac arrest,
not early respiratory distress. Tachypnea, stridor, and nasal flaring are classic signs
of distress.
8. A 2-year-old with croup presents with stridor at rest, tachypnea, and mild
retractions. According to the PAT, which triangle component is primarily
affected?
A. Appearance
B. Work of Breathing
C. Circulation to Skin
D. Mental Status
Answer: B. Stridor and retractions are direct indicators of increased work of
breathing.
9. The primary medication for treating moderate to severe croup is:
A. Albuterol
B. Epinephrine (racemic or standard)
C. Dexamethasone
D. Ipratropium bromide
Answer: B. Nebulized epinephrine is used for acute, moderate-to-severe upper
airway obstruction from croup. Dexamethasone is also given but its effect is not
immediate.
10. For a child in status asthmaticus who is not responding to initial
bronchodilator therapy, what is the next recommended medication?
A. Ipratropium bromide
B. Epinephrine IM
C. Dexamethasone
D. Magnesium sulfate
Answer: A. The typical sequence for status asthmaticus is: 1) Short-acting beta-
agonist (Albuterol), 2) Add Ipratropium bromide, 3) Consider systemic
