PALS NEWEST 2026
ACCURATE ACTUAL EXAM
WITH FREQUENTLY
TESTED QUESTIONS AND
STUDY GUIDE\EXPERT
VERIFIED FOR
GUARANTEED
PASS\ALREADY GRADED A+
A 10-month-old infant boy is brought to the emergency department. Your initial assessment reveals a
lethargic, pale infant with slow respirations and slow, weak central pulses. One team member begins
ventilation with a BVM with 100% O2. A second team member attaches the monitor/defibrillator and
obtains vital signs while a third team member attempts to establish IV/IO access. The patient's HR is
38/min with the rhythm (bradycardia) on the monitor. The infant's BP is 58/38 mmHg, and capillary
refill is 4 seconds. His central pulses remain weak, and distal pulses cannot be palpated. Chest
compressions are started and IO access is obtained. Which medication do you anticipate will be given
next?
epinephrine 0.01 mg/kg IV/IO
You are caring for a 6-year old patient who is receiving positive-pressure mechanical ventilation via
ETT. The child begins to move his head and suddenly become cyanotic, and his HR decreases. His SPO2
is 65%. You remove the child from the mechanical ventilator and begin to provide manual ventilation
with a bag via the ETT. During manual ventilation with 100% O2, the child's color and HR improved
slightly and his BP remains adequate. Breath sounds and chest expansion are present and adequate
on the right side and are present but consistently diminished on the left side. The trachea is not
, deviated, and the neck veins are not distended. A suction catheter passes easily beyond the tip of the
ETT. Which of the following is the most likely cause of this child's acute deterioration?
Tracheal tube displacement into the right main bronchus.
You are alone and witness a child suddenly collapse. There is no suspected head or neck injury. A
colleague responded to your shout for help and is activating the emergency response system and is
retrieving the resuscitation equipment, including a defibrillator. After delivering 30 compressions,
what would be your next action?
Open the airway with a head tilt-chin lift maneuver and give 2 breaths
You find a 10 yo boy to be unresponsive. You shout for help, and after finding that he is not breathing
and has no pulse, you and a colleague begin CPR. Another colleague activates the emergency response
system, brings the emergency equipment, and places the child on a cardiac monitor/defibrillator,
which reveals the rhythm shown here (Vtach). You attempt defibrillation at 2 J/kg and give 2 minutes
of CPR. The rhythm persists at the second rhythm check, at which point you attempt defibrillation
with 4 J/kg. A fourth colleague arrives, starts an IV, and administers 1 dose of epinephrine 0.01 mg/kg.
If ventricular fibrillation or pulseless ventricular tachycardia persists after 2 minutes of CPR, you will
administer another shock. Which drug and dose should be administered next?
Lidocaine 1mg/kg IV
A 1-year-old boy is brought to the emergency department for evaluation of poor feeding, irritability,
and sweating. The child is lethargic but arousable. He has labored breathing, very rapid pulses, and
dusky color. His RR is 68/min, HR 300/min, and BP 70/45 mmHg. He has weak brachial pulses and
absent radial pulses, a capillary refill of 6 seconds, SPO2 85% on RA, and good bilateral BS. You
administer high-flow O2 and place the child on a cardiac monitor and see the rhythm (SVT). The child
has no history of congenital heart disease IV access has beeb established. Which therapy is most
appropriate for this child?
Adenosine 0.1 mg/kg IV rapid push
You are preparing to use a manual defibrillator in the pediatric setting. Which best describes when it
is appropriate to use the smaller, pediatric-sized paddles?
If the child weighs less than 10 kg or is less than 1 year old
A pale and very sleepy but arousable 3-year old child with a history of diarrhea is brought to the
hospital. Primary assessment reveals a respiratory rate of 45/min with good breath sounds bilaterally.
HR is 150/min, BP is 90/64, and SPO2 is 92% on RA. Capillary refill is 5 seconds, and peripheral pulses
are weak. After placing the child on a NRB with 100% O2 and obtaining vascular access, which is the
most appropriate immediate treatment for this child?
administer a bolus of 20 ml/kg isotonic crystalloid
A 3-year old boy presents with multiple-system trauma. The child was an unrestrained passenger in a
high-speed motor vehicle crash. On primary assessment, he is unresponsive to voice or painful
stimulation. His respiratory rate is 5/min, HR and pulses are 170/min, systolic BP is 60 mmHg, capillary
refill is 5 seconds, and SPO2 is 75% on RA. Which action should you take first?
ACCURATE ACTUAL EXAM
WITH FREQUENTLY
TESTED QUESTIONS AND
STUDY GUIDE\EXPERT
VERIFIED FOR
GUARANTEED
PASS\ALREADY GRADED A+
A 10-month-old infant boy is brought to the emergency department. Your initial assessment reveals a
lethargic, pale infant with slow respirations and slow, weak central pulses. One team member begins
ventilation with a BVM with 100% O2. A second team member attaches the monitor/defibrillator and
obtains vital signs while a third team member attempts to establish IV/IO access. The patient's HR is
38/min with the rhythm (bradycardia) on the monitor. The infant's BP is 58/38 mmHg, and capillary
refill is 4 seconds. His central pulses remain weak, and distal pulses cannot be palpated. Chest
compressions are started and IO access is obtained. Which medication do you anticipate will be given
next?
epinephrine 0.01 mg/kg IV/IO
You are caring for a 6-year old patient who is receiving positive-pressure mechanical ventilation via
ETT. The child begins to move his head and suddenly become cyanotic, and his HR decreases. His SPO2
is 65%. You remove the child from the mechanical ventilator and begin to provide manual ventilation
with a bag via the ETT. During manual ventilation with 100% O2, the child's color and HR improved
slightly and his BP remains adequate. Breath sounds and chest expansion are present and adequate
on the right side and are present but consistently diminished on the left side. The trachea is not
, deviated, and the neck veins are not distended. A suction catheter passes easily beyond the tip of the
ETT. Which of the following is the most likely cause of this child's acute deterioration?
Tracheal tube displacement into the right main bronchus.
You are alone and witness a child suddenly collapse. There is no suspected head or neck injury. A
colleague responded to your shout for help and is activating the emergency response system and is
retrieving the resuscitation equipment, including a defibrillator. After delivering 30 compressions,
what would be your next action?
Open the airway with a head tilt-chin lift maneuver and give 2 breaths
You find a 10 yo boy to be unresponsive. You shout for help, and after finding that he is not breathing
and has no pulse, you and a colleague begin CPR. Another colleague activates the emergency response
system, brings the emergency equipment, and places the child on a cardiac monitor/defibrillator,
which reveals the rhythm shown here (Vtach). You attempt defibrillation at 2 J/kg and give 2 minutes
of CPR. The rhythm persists at the second rhythm check, at which point you attempt defibrillation
with 4 J/kg. A fourth colleague arrives, starts an IV, and administers 1 dose of epinephrine 0.01 mg/kg.
If ventricular fibrillation or pulseless ventricular tachycardia persists after 2 minutes of CPR, you will
administer another shock. Which drug and dose should be administered next?
Lidocaine 1mg/kg IV
A 1-year-old boy is brought to the emergency department for evaluation of poor feeding, irritability,
and sweating. The child is lethargic but arousable. He has labored breathing, very rapid pulses, and
dusky color. His RR is 68/min, HR 300/min, and BP 70/45 mmHg. He has weak brachial pulses and
absent radial pulses, a capillary refill of 6 seconds, SPO2 85% on RA, and good bilateral BS. You
administer high-flow O2 and place the child on a cardiac monitor and see the rhythm (SVT). The child
has no history of congenital heart disease IV access has beeb established. Which therapy is most
appropriate for this child?
Adenosine 0.1 mg/kg IV rapid push
You are preparing to use a manual defibrillator in the pediatric setting. Which best describes when it
is appropriate to use the smaller, pediatric-sized paddles?
If the child weighs less than 10 kg or is less than 1 year old
A pale and very sleepy but arousable 3-year old child with a history of diarrhea is brought to the
hospital. Primary assessment reveals a respiratory rate of 45/min with good breath sounds bilaterally.
HR is 150/min, BP is 90/64, and SPO2 is 92% on RA. Capillary refill is 5 seconds, and peripheral pulses
are weak. After placing the child on a NRB with 100% O2 and obtaining vascular access, which is the
most appropriate immediate treatment for this child?
administer a bolus of 20 ml/kg isotonic crystalloid
A 3-year old boy presents with multiple-system trauma. The child was an unrestrained passenger in a
high-speed motor vehicle crash. On primary assessment, he is unresponsive to voice or painful
stimulation. His respiratory rate is 5/min, HR and pulses are 170/min, systolic BP is 60 mmHg, capillary
refill is 5 seconds, and SPO2 is 75% on RA. Which action should you take first?
