Pediatric Advanced Life Support (PALS) Exit Exam – 250 Practice Questions &
Verified Answers with Rationales (2026 Latest Update)
Questions 1–250
1. A 3-year-old child is brought to the emergency department with stridor,
barking cough, and respiratory distress. Which condition is most likely?
A) Asthma
B) Bronchiolitis
C) Croup
D) Epiglottitis
Answer C: Croup
Rationale: Stridor and barking cough are classic signs of croup
(laryngotracheobronchitis).
2. What is the most common cause of cardiac arrest in pediatric patients?
,A) Congenital heart disease
B) Respiratory failure
C) Ventricular fibrillation
D) Sepsis
Answer B: Respiratory failure
Rationale: Respiratory failure is the most common cause of cardiac arrest in
children.
3. A 4-year-old child has only gasping respirations and a pulse of 65 beats
per minute. Which action should the provider initiate first?
A) Start chest compressions
B) Deliver 1 BVM ventilation every 3-5 seconds
C) Administer epinephrine IV
D) Place an advanced airway
Answer B: Deliver 1 BVM ventilation every 3-5 seconds
Rationale: Gasping respirations with bradycardia indicate respiratory failure;
provide bag-mask ventilation at 12-20 breaths/min.
4. A 5-year-old child with a history of asthma is in severe respiratory
distress. The child has decreased air movement, prolonged expiratory time,
,and wheezing. SpO₂ is 92% on a non-rebreather mask. Which medication
should be administered first?
A) Epinephrine
B) Albuterol
C) Ipratropium bromide
D) Methylprednisolone
Answer B: Albuterol
Rationale: Albuterol is the first-line bronchodilator for acute asthma
exacerbation.
5. What ratio of compressions to breaths should be used for 1-rescuer child
CPR?
A) 15:2
B) 30:2
C) 100:0
D) 50:2
Answer B: 30:2
Rationale: For 1-rescuer child CPR, the compression-to-ventilation ratio is
30:2.
, 6. What ratio of compressions to breaths should be used for 2-rescuer infant
CPR?
A) 15:2
B) 30:2
C) 20:2
D) 5:1
Answer A: 15:2
Rationale: For 2-rescuer infant CPR, the compression-to-ventilation ratio is
15:2.
7. The proper 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 one fourth the depth of the chest, approximately 1.5 inches (4 cm)
C) At least two thirds the depth of the chest, approximately 4 inches (10 cm)
D) At least one half the depth of the chest, approximately 3 inches (8 cm)
Answer A: At least one third the depth of the chest, approximately 2 inches
(5 cm)
Rationale: Child CPR compression depth is at least 2 inches (5 cm).
8. What is the proper depth of chest compressions for an infant?
A) At least one third the depth of the chest, approximately 1.5 inches (4 cm)
Verified Answers with Rationales (2026 Latest Update)
Questions 1–250
1. A 3-year-old child is brought to the emergency department with stridor,
barking cough, and respiratory distress. Which condition is most likely?
A) Asthma
B) Bronchiolitis
C) Croup
D) Epiglottitis
Answer C: Croup
Rationale: Stridor and barking cough are classic signs of croup
(laryngotracheobronchitis).
2. What is the most common cause of cardiac arrest in pediatric patients?
,A) Congenital heart disease
B) Respiratory failure
C) Ventricular fibrillation
D) Sepsis
Answer B: Respiratory failure
Rationale: Respiratory failure is the most common cause of cardiac arrest in
children.
3. A 4-year-old child has only gasping respirations and a pulse of 65 beats
per minute. Which action should the provider initiate first?
A) Start chest compressions
B) Deliver 1 BVM ventilation every 3-5 seconds
C) Administer epinephrine IV
D) Place an advanced airway
Answer B: Deliver 1 BVM ventilation every 3-5 seconds
Rationale: Gasping respirations with bradycardia indicate respiratory failure;
provide bag-mask ventilation at 12-20 breaths/min.
4. A 5-year-old child with a history of asthma is in severe respiratory
distress. The child has decreased air movement, prolonged expiratory time,
,and wheezing. SpO₂ is 92% on a non-rebreather mask. Which medication
should be administered first?
A) Epinephrine
B) Albuterol
C) Ipratropium bromide
D) Methylprednisolone
Answer B: Albuterol
Rationale: Albuterol is the first-line bronchodilator for acute asthma
exacerbation.
5. What ratio of compressions to breaths should be used for 1-rescuer child
CPR?
A) 15:2
B) 30:2
C) 100:0
D) 50:2
Answer B: 30:2
Rationale: For 1-rescuer child CPR, the compression-to-ventilation ratio is
30:2.
, 6. What ratio of compressions to breaths should be used for 2-rescuer infant
CPR?
A) 15:2
B) 30:2
C) 20:2
D) 5:1
Answer A: 15:2
Rationale: For 2-rescuer infant CPR, the compression-to-ventilation ratio is
15:2.
7. The proper 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 one fourth the depth of the chest, approximately 1.5 inches (4 cm)
C) At least two thirds the depth of the chest, approximately 4 inches (10 cm)
D) At least one half the depth of the chest, approximately 3 inches (8 cm)
Answer A: At least one third the depth of the chest, approximately 2 inches
(5 cm)
Rationale: Child CPR compression depth is at least 2 inches (5 cm).
8. What is the proper depth of chest compressions for an infant?
A) At least one third the depth of the chest, approximately 1.5 inches (4 cm)
