AHA PALS (Pediatric Advanced Life Support) 2025 Exam
Prep Test Bank – 100 NCLEX-Style Questions with Answers
and Rationales (Pediatric Emergencies, CPR, Algorithms,
Rhythms)
This AHA PALS 2025 Exam Prep Test Bank includes 150 NCLEX-style multiple-choice
questions covering pediatric assessment, respiratory and cardiac emergencies, shock,
arrhythmia management, and resuscitation algorithms. Each question includes clear, 6–9
line rationales explaining AHA guidelines and clinical reasoning. Perfect for nursing students,
EMTs, paramedics, and pediatric care providers preparing for the AHA PALS certification
or renewal exam. Fully formatted for self-study, tutoring, or group review.
Part 1: Pediatric Assessment, BLS &
Respiratory Emergencies (Q1–50)
1. What is the first step in the PALS pediatric assessment triangle?
A. Circulation
B. Disability
C. Appearance
D. Airway
Rationale: The Pediatric Assessment Triangle (PAT) assesses Appearance, Work of
Breathing, and Circulation to Skin. Appearance is evaluated first to quickly determine the
child’s overall neurological and physiological status without touching them.
2. Which pulse should be checked in an unresponsive infant?
A. Radial pulse
B. Brachial pulse
C. Carotid pulse
D. Femoral pulse
Rationale: For infants (<1 year), the brachial pulse is most accessible. It’s located on the
inside of the upper arm between the shoulder and elbow.
,3. What is the correct compression-to-ventilation ratio for 1 rescuer performing infant CPR?
A. 15:2
B. 30:2
C. 10:1
D. 20:2
Rationale: A 30:2 ratio is used for single rescuers performing CPR on infants and children,
matching adult BLS guidelines. With two rescuers, the ratio changes to 15:2.
4. Which sign indicates respiratory distress in a child?
A. Warm extremities
B. Quiet breathing
C. Nasal flaring and retractions
D. Bradycardia
Rationale: Nasal flaring, intercostal retractions, and grunting indicate increased work of
breathing and possible airway obstruction or hypoxemia.
5. Which condition is the most common cause of cardiac arrest in children?
A. Arrhythmia
B. Hypoxia from respiratory failure
C. Myocardial infarction
D. Tension pneumothorax
Rationale: Pediatric cardiac arrest is usually secondary to respiratory failure or shock, not
primary cardiac causes. Early airway management and oxygenation are vital.
6. For a child in bradycardia with poor perfusion, what is the first intervention?
A. Epinephrine
B. Support airway and give oxygen
C. Defibrillate
D. Atropine
Rationale: Bradycardia in children is often hypoxia-induced. Ensure adequate oxygenation
and ventilation before medications or pacing.
7. What is the correct compression depth for infants during CPR?
A. 1 inch
B. 1.5 inches (4 cm)
C. 2 inches
D. 3 inches
, Rationale: For infants, compress the chest 1.5 inches (about one-third the anterior-posterior
diameter) at a rate of 100–120/min.
8. Which statement best describes the two-thumb encircling technique?
A. Used by single rescuers
B. Preferred for 2-rescuer infant CPR
C. Ineffective for deep compressions
D. Used for older children only
Rationale: In 2-rescuer infant CPR, both thumbs compress the sternum while hands encircle
the torso — providing consistent depth and recoil.
9. What is the recommended defibrillation dose for the first shock in pediatric cardiac arrest?
A. 1 J/kg
B. 2 J/kg
C. 3 J/kg
D. 5 J/kg
Rationale: The initial shock dose is 2 J/kg, followed by 4 J/kg for subsequent shocks. Use
pediatric pads and ensure good skin contact.
10. What is the correct ventilation rate for a child with a pulse but inadequate respirations?
A. 1 breath every 3–5 seconds
B. 1 breath every 2–3 seconds
C. 1 breath every 6–8 seconds
D. Continuous compressions only
Rationale: Provide 1 breath every 2–3 seconds (20–30 breaths/min) in children with pulse but
poor respirations to avoid hypoventilation or hyperinflation.
11. Which finding indicates impending respiratory failure in a child?
A. Tachypnea
B. Retractions
C. Decreased respiratory effort and bradypnea
D. Crying and agitation
Rationale: Falling respiratory rate, poor chest rise, and decreased effort signal fatigue and
impending arrest. Immediate assisted ventilation is required.
Prep Test Bank – 100 NCLEX-Style Questions with Answers
and Rationales (Pediatric Emergencies, CPR, Algorithms,
Rhythms)
This AHA PALS 2025 Exam Prep Test Bank includes 150 NCLEX-style multiple-choice
questions covering pediatric assessment, respiratory and cardiac emergencies, shock,
arrhythmia management, and resuscitation algorithms. Each question includes clear, 6–9
line rationales explaining AHA guidelines and clinical reasoning. Perfect for nursing students,
EMTs, paramedics, and pediatric care providers preparing for the AHA PALS certification
or renewal exam. Fully formatted for self-study, tutoring, or group review.
Part 1: Pediatric Assessment, BLS &
Respiratory Emergencies (Q1–50)
1. What is the first step in the PALS pediatric assessment triangle?
A. Circulation
B. Disability
C. Appearance
D. Airway
Rationale: The Pediatric Assessment Triangle (PAT) assesses Appearance, Work of
Breathing, and Circulation to Skin. Appearance is evaluated first to quickly determine the
child’s overall neurological and physiological status without touching them.
2. Which pulse should be checked in an unresponsive infant?
A. Radial pulse
B. Brachial pulse
C. Carotid pulse
D. Femoral pulse
Rationale: For infants (<1 year), the brachial pulse is most accessible. It’s located on the
inside of the upper arm between the shoulder and elbow.
,3. What is the correct compression-to-ventilation ratio for 1 rescuer performing infant CPR?
A. 15:2
B. 30:2
C. 10:1
D. 20:2
Rationale: A 30:2 ratio is used for single rescuers performing CPR on infants and children,
matching adult BLS guidelines. With two rescuers, the ratio changes to 15:2.
4. Which sign indicates respiratory distress in a child?
A. Warm extremities
B. Quiet breathing
C. Nasal flaring and retractions
D. Bradycardia
Rationale: Nasal flaring, intercostal retractions, and grunting indicate increased work of
breathing and possible airway obstruction or hypoxemia.
5. Which condition is the most common cause of cardiac arrest in children?
A. Arrhythmia
B. Hypoxia from respiratory failure
C. Myocardial infarction
D. Tension pneumothorax
Rationale: Pediatric cardiac arrest is usually secondary to respiratory failure or shock, not
primary cardiac causes. Early airway management and oxygenation are vital.
6. For a child in bradycardia with poor perfusion, what is the first intervention?
A. Epinephrine
B. Support airway and give oxygen
C. Defibrillate
D. Atropine
Rationale: Bradycardia in children is often hypoxia-induced. Ensure adequate oxygenation
and ventilation before medications or pacing.
7. What is the correct compression depth for infants during CPR?
A. 1 inch
B. 1.5 inches (4 cm)
C. 2 inches
D. 3 inches
, Rationale: For infants, compress the chest 1.5 inches (about one-third the anterior-posterior
diameter) at a rate of 100–120/min.
8. Which statement best describes the two-thumb encircling technique?
A. Used by single rescuers
B. Preferred for 2-rescuer infant CPR
C. Ineffective for deep compressions
D. Used for older children only
Rationale: In 2-rescuer infant CPR, both thumbs compress the sternum while hands encircle
the torso — providing consistent depth and recoil.
9. What is the recommended defibrillation dose for the first shock in pediatric cardiac arrest?
A. 1 J/kg
B. 2 J/kg
C. 3 J/kg
D. 5 J/kg
Rationale: The initial shock dose is 2 J/kg, followed by 4 J/kg for subsequent shocks. Use
pediatric pads and ensure good skin contact.
10. What is the correct ventilation rate for a child with a pulse but inadequate respirations?
A. 1 breath every 3–5 seconds
B. 1 breath every 2–3 seconds
C. 1 breath every 6–8 seconds
D. Continuous compressions only
Rationale: Provide 1 breath every 2–3 seconds (20–30 breaths/min) in children with pulse but
poor respirations to avoid hypoventilation or hyperinflation.
11. Which finding indicates impending respiratory failure in a child?
A. Tachypnea
B. Retractions
C. Decreased respiratory effort and bradypnea
D. Crying and agitation
Rationale: Falling respiratory rate, poor chest rise, and decreased effort signal fatigue and
impending arrest. Immediate assisted ventilation is required.
