PALS ACTUAL FINAL EXAM 2026
ACCURATE Practice Exam 2026| Most
Tested Questions Collection & Verified
Detailed Answers | Tutor Verified
Success Exam) Graded A+
1.
A 6-year-old child is lethargic, pale, and breathing rapidly. Which
assessment should the nurse perform first?
A. Obtain a complete medication history
B. Assess airway patency and breathing
C. Obtain a temperature
D. Ask about immunization history
Answer: B. Assess airway patency and breathing
Airway and breathing are immediate priorities because inadequate
oxygenation or ventilation can rapidly become life-threatening.
2.
Which finding is most concerning for impending respiratory failure in
a child?
A. Mild tachypnea
B. Nasal congestion
C. Decreasing respiratory effort with altered mental status
D. Occasional cough
Answer: C. Decreasing respiratory effort with altered mental status
Children may initially compensate for respiratory distress with
increased effort. Decreasing effort accompanied by altered
consciousness suggests fatigue and impending respiratory failure.
,3.
Which assessment is part of the pediatric primary assessment?
A. SAMPLE history
B. Disability/neurologic status
C. Family medical history
D. Dietary history
Answer: B. Disability/neurologic status
The primary assessment includes airway, breathing, circulation,
disability, and exposure.
4.
A child has severe respiratory distress and cyanosis. What is the
priority?
A. Obtain a chest x-ray
B. Establish an IV before treatment
C. Support oxygenation and ventilation
D. Obtain a detailed history
Answer: C. Support oxygenation and ventilation
Immediate support of oxygenation and ventilation takes priority over
diagnostic procedures.
5.
Which finding indicates respiratory distress rather than respiratory
failure?
A. Apnea
B. Bradycardia caused by hypoxia
C. Increased work of breathing with adequate mental status
D. Absent respiratory effort
Answer: C. Increased work of breathing with adequate mental
status
,Respiratory distress is characterized by increased effort while the
child is still maintaining adequate oxygenation and ventilation.
6.
A child is unresponsive and not breathing normally. What should be
assessed immediately?
A. Blood pressure
B. Pulse
C. Temperature
D. Pupillary response
Answer: B. Pulse
For an unresponsive child who is not breathing normally, a healthcare
professional should assess for a pulse while simultaneously initiating
appropriate resuscitation actions.
7.
Which pulse is commonly assessed in an infant during cardiac arrest?
A. Carotid
B. Radial
C. Brachial
D. Temporal
Answer: C. Brachial
The brachial pulse is commonly used in infants because it is accessible
and reliable.
8.
Which pulse is commonly assessed in an older child?
A. Carotid or femoral
B. Brachial only
C. Dorsalis pedis only
D. Radial only
, Answer: A. Carotid or femoral
Central pulses such as carotid or femoral are appropriate for
assessing circulation in older children.
9.
A child has a heart rate of 55/min with poor perfusion despite
oxygenation and ventilation. What should the team anticipate?
A. Observation only
B. CPR
C. Oral fluids
D. Discharge
Answer: B. CPR
Severe bradycardia with poor perfusion despite effective oxygenation
and ventilation is an indication for chest compressions.
10.
Which finding is a sign of poor systemic perfusion?
A. Warm extremities and brisk capillary refill
B. Strong peripheral pulses
C. Altered mental status and weak pulses
D. Normal urine output
Answer: C. Altered mental status and weak pulses
Altered consciousness and weak pulses can indicate inadequate
cardiac output and systemic perfusion.
Section 2: Airway and Breathing
11.
A child with respiratory distress has audible stridor. Which condition
is most associated with this finding?
ACCURATE Practice Exam 2026| Most
Tested Questions Collection & Verified
Detailed Answers | Tutor Verified
Success Exam) Graded A+
1.
A 6-year-old child is lethargic, pale, and breathing rapidly. Which
assessment should the nurse perform first?
A. Obtain a complete medication history
B. Assess airway patency and breathing
C. Obtain a temperature
D. Ask about immunization history
Answer: B. Assess airway patency and breathing
Airway and breathing are immediate priorities because inadequate
oxygenation or ventilation can rapidly become life-threatening.
2.
Which finding is most concerning for impending respiratory failure in
a child?
A. Mild tachypnea
B. Nasal congestion
C. Decreasing respiratory effort with altered mental status
D. Occasional cough
Answer: C. Decreasing respiratory effort with altered mental status
Children may initially compensate for respiratory distress with
increased effort. Decreasing effort accompanied by altered
consciousness suggests fatigue and impending respiratory failure.
,3.
Which assessment is part of the pediatric primary assessment?
A. SAMPLE history
B. Disability/neurologic status
C. Family medical history
D. Dietary history
Answer: B. Disability/neurologic status
The primary assessment includes airway, breathing, circulation,
disability, and exposure.
4.
A child has severe respiratory distress and cyanosis. What is the
priority?
A. Obtain a chest x-ray
B. Establish an IV before treatment
C. Support oxygenation and ventilation
D. Obtain a detailed history
Answer: C. Support oxygenation and ventilation
Immediate support of oxygenation and ventilation takes priority over
diagnostic procedures.
5.
Which finding indicates respiratory distress rather than respiratory
failure?
A. Apnea
B. Bradycardia caused by hypoxia
C. Increased work of breathing with adequate mental status
D. Absent respiratory effort
Answer: C. Increased work of breathing with adequate mental
status
,Respiratory distress is characterized by increased effort while the
child is still maintaining adequate oxygenation and ventilation.
6.
A child is unresponsive and not breathing normally. What should be
assessed immediately?
A. Blood pressure
B. Pulse
C. Temperature
D. Pupillary response
Answer: B. Pulse
For an unresponsive child who is not breathing normally, a healthcare
professional should assess for a pulse while simultaneously initiating
appropriate resuscitation actions.
7.
Which pulse is commonly assessed in an infant during cardiac arrest?
A. Carotid
B. Radial
C. Brachial
D. Temporal
Answer: C. Brachial
The brachial pulse is commonly used in infants because it is accessible
and reliable.
8.
Which pulse is commonly assessed in an older child?
A. Carotid or femoral
B. Brachial only
C. Dorsalis pedis only
D. Radial only
, Answer: A. Carotid or femoral
Central pulses such as carotid or femoral are appropriate for
assessing circulation in older children.
9.
A child has a heart rate of 55/min with poor perfusion despite
oxygenation and ventilation. What should the team anticipate?
A. Observation only
B. CPR
C. Oral fluids
D. Discharge
Answer: B. CPR
Severe bradycardia with poor perfusion despite effective oxygenation
and ventilation is an indication for chest compressions.
10.
Which finding is a sign of poor systemic perfusion?
A. Warm extremities and brisk capillary refill
B. Strong peripheral pulses
C. Altered mental status and weak pulses
D. Normal urine output
Answer: C. Altered mental status and weak pulses
Altered consciousness and weak pulses can indicate inadequate
cardiac output and systemic perfusion.
Section 2: Airway and Breathing
11.
A child with respiratory distress has audible stridor. Which condition
is most associated with this finding?
