AHA PALS Exam – Newest 2026/2027 Actual Exam Test Bank Actual Exam
2026/2027: Complete Exam-Style Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Time Limit: 90 minutes
1. During single-rescuer CPR for an infant, what is the recommended
compression-to-ventilation ratio?
A) 15 compressions to 2 breaths
B) 30 compressions to 2 breaths ✓
C) 15 compressions to 1 breath
D) 30 compressions to 1 breath
Correct Answer: B) 30 compressions to 2 breaths
Rationale: For single-rescuer CPR in infants and children, the AHA recommends a 30:2
compression-to-ventilation ratio to maximize the number of compressions delivered.
2. A 5-year-old child presents with lethargy. Using the systematic approach, which
assessment should be performed first?
A) Obtain a detailed history from the parents
B) Evaluate the child's airway and breathing ✓
C) Insert an intraosseous needle for fluid access
D) Check blood glucose level
Correct Answer: B) Evaluate the child's airway and breathing
Rationale: The systematic approach prioritizes the primary assessment of airway,
breathing, and circulation before any interventions or secondary assessments.
3. A 3-year-old with a barky cough, stridor at rest, and mild retractions is afebrile.
Which intervention is most appropriate initially?
A) Immediate intubation in the operating room
B) Nebulized racemic epinephrine and corticosteroids ✓
,C) Direct laryngoscopy in the emergency department
D) High-dose intravenous antibiotics
Correct Answer: B) Nebulized racemic epinephrine and corticosteroids
Rationale: The presentation is consistent with viral croup; nebulized epinephrine and
systemic steroids reduce airway edema and stridor. Intubation and laryngoscopy are
reserved for severe or atypical cases.
4. A 6-year-old with vomiting and diarrhea has tachycardia, prolonged capillary refill,
and normal blood pressure. What stage of shock is most likely?
A) Hypotensive shock
B) Compensated shock ✓
C) Irreversible shock
D) Neurogenic shock
Correct Answer: B) Compensated shock
Rationale: Compensated shock is characterized by tachycardia and poor perfusion with
maintained blood pressure due to compensatory vasoconstriction.
5. A 2-year-old in septic shock has received 60 mL/kg of isotonic crystalloid but
remains hypotensive and poorly perfused. What is the next best step?
A) Administer a fourth 20 mL/kg fluid bolus immediately
B) Begin epinephrine at 0.1 mcg/kg/min and obtain central access ✓
C) Start dopamine at 20 mcg/kg/min via peripheral IV
D) Administer hydrocortisone before any vasoactive medication
Correct Answer: B) Begin epinephrine at 0.1 mcg/kg/min and obtain central access
Rationale: After 40-60 mL/kg of fluid resuscitation in septic shock with persistent
hypotension, vasoactive support with epinephrine is indicated; excessive fluid beyond
60 mL/kg without inotropes increases cardiorespiratory compromise.
6. For 2-rescuer CPR in a child, what is the correct compression-to-ventilation ratio?
A) 30:2
B) 15:2 ✓
, C) 20:2
D) 15:1
Correct Answer: B) 15:2
Rationale: Two-rescuer CPR for infants and children uses a 15:2 ratio to provide more
frequent ventilations while maintaining adequate coronary perfusion.
7. A 4-month-old infant is irritable with a heart rate of 260 beats/min, narrow QRS
complexes, and poor feeding. The infant is stable. What is the first-line
treatment?
A) Immediate synchronized cardioversion at 1 J/kg
B) Adenosine 0.1 mg/kg rapid IV bolus followed by flush ✓
C) Amiodarone 5 mg/kg IV over 20 minutes
D) Vagal maneuvers including carotid sinus massage
Correct Answer: B) Adenosine 0.1 mg/kg rapid IV bolus followed by flush
Rationale: Stable supraventricular tachycardia in infants is treated with adenosine as the
first-line pharmacologic agent; vagal maneuvers are limited in infants and cardioversion
is for unstable patients.
8. Which statement correctly describes the pediatric dosing of amiodarone for
pulseless ventricular fibrillation?
A) 0.1 mg/kg IV push, may repeat once
B) 5 mg/kg IV/IO bolus, may repeat up to 2 times for refractory VF ✓
C) 0.5 mg/kg IV over 10 minutes, maximum single dose 50 mg
D) 1 mg/kg IV every 3 to 5 minutes until ROSC
Correct Answer: B) 5 mg/kg IV/IO bolus, may repeat up to 2 times for refractory VF
Rationale: Amiodarone is administered as 5 mg/kg IV/IO rapid bolus for VF/pulseless
VT and may be repeated for refractory shockable rhythms.
9. Which findings are consistent with impending respiratory failure in a pediatric
patient? (Select all that apply.)
A) Tachypnea with shallow respirations
2026/2027: Complete Exam-Style Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Time Limit: 90 minutes
1. During single-rescuer CPR for an infant, what is the recommended
compression-to-ventilation ratio?
A) 15 compressions to 2 breaths
B) 30 compressions to 2 breaths ✓
C) 15 compressions to 1 breath
D) 30 compressions to 1 breath
Correct Answer: B) 30 compressions to 2 breaths
Rationale: For single-rescuer CPR in infants and children, the AHA recommends a 30:2
compression-to-ventilation ratio to maximize the number of compressions delivered.
2. A 5-year-old child presents with lethargy. Using the systematic approach, which
assessment should be performed first?
A) Obtain a detailed history from the parents
B) Evaluate the child's airway and breathing ✓
C) Insert an intraosseous needle for fluid access
D) Check blood glucose level
Correct Answer: B) Evaluate the child's airway and breathing
Rationale: The systematic approach prioritizes the primary assessment of airway,
breathing, and circulation before any interventions or secondary assessments.
3. A 3-year-old with a barky cough, stridor at rest, and mild retractions is afebrile.
Which intervention is most appropriate initially?
A) Immediate intubation in the operating room
B) Nebulized racemic epinephrine and corticosteroids ✓
,C) Direct laryngoscopy in the emergency department
D) High-dose intravenous antibiotics
Correct Answer: B) Nebulized racemic epinephrine and corticosteroids
Rationale: The presentation is consistent with viral croup; nebulized epinephrine and
systemic steroids reduce airway edema and stridor. Intubation and laryngoscopy are
reserved for severe or atypical cases.
4. A 6-year-old with vomiting and diarrhea has tachycardia, prolonged capillary refill,
and normal blood pressure. What stage of shock is most likely?
A) Hypotensive shock
B) Compensated shock ✓
C) Irreversible shock
D) Neurogenic shock
Correct Answer: B) Compensated shock
Rationale: Compensated shock is characterized by tachycardia and poor perfusion with
maintained blood pressure due to compensatory vasoconstriction.
5. A 2-year-old in septic shock has received 60 mL/kg of isotonic crystalloid but
remains hypotensive and poorly perfused. What is the next best step?
A) Administer a fourth 20 mL/kg fluid bolus immediately
B) Begin epinephrine at 0.1 mcg/kg/min and obtain central access ✓
C) Start dopamine at 20 mcg/kg/min via peripheral IV
D) Administer hydrocortisone before any vasoactive medication
Correct Answer: B) Begin epinephrine at 0.1 mcg/kg/min and obtain central access
Rationale: After 40-60 mL/kg of fluid resuscitation in septic shock with persistent
hypotension, vasoactive support with epinephrine is indicated; excessive fluid beyond
60 mL/kg without inotropes increases cardiorespiratory compromise.
6. For 2-rescuer CPR in a child, what is the correct compression-to-ventilation ratio?
A) 30:2
B) 15:2 ✓
, C) 20:2
D) 15:1
Correct Answer: B) 15:2
Rationale: Two-rescuer CPR for infants and children uses a 15:2 ratio to provide more
frequent ventilations while maintaining adequate coronary perfusion.
7. A 4-month-old infant is irritable with a heart rate of 260 beats/min, narrow QRS
complexes, and poor feeding. The infant is stable. What is the first-line
treatment?
A) Immediate synchronized cardioversion at 1 J/kg
B) Adenosine 0.1 mg/kg rapid IV bolus followed by flush ✓
C) Amiodarone 5 mg/kg IV over 20 minutes
D) Vagal maneuvers including carotid sinus massage
Correct Answer: B) Adenosine 0.1 mg/kg rapid IV bolus followed by flush
Rationale: Stable supraventricular tachycardia in infants is treated with adenosine as the
first-line pharmacologic agent; vagal maneuvers are limited in infants and cardioversion
is for unstable patients.
8. Which statement correctly describes the pediatric dosing of amiodarone for
pulseless ventricular fibrillation?
A) 0.1 mg/kg IV push, may repeat once
B) 5 mg/kg IV/IO bolus, may repeat up to 2 times for refractory VF ✓
C) 0.5 mg/kg IV over 10 minutes, maximum single dose 50 mg
D) 1 mg/kg IV every 3 to 5 minutes until ROSC
Correct Answer: B) 5 mg/kg IV/IO bolus, may repeat up to 2 times for refractory VF
Rationale: Amiodarone is administered as 5 mg/kg IV/IO rapid bolus for VF/pulseless
VT and may be repeated for refractory shockable rhythms.
9. Which findings are consistent with impending respiratory failure in a pediatric
patient? (Select all that apply.)
A) Tachypnea with shallow respirations
