AHA Pediatric Advanced Life Support (PALS) Exam 300+
Questions & Correct Answers with Rationales
1. A 6-year-old child is unresponsive and not breathing normally. What
should the nurse do first?
A. Obtain a blood pressure
B. Check for a pulse for 30 seconds
C. Activate the emergency response system and begin CPR as
appropriate
D. Administer oxygen by nasal cannula
Answer: C
Rationale: An unresponsive child with absent or abnormal breathing
requires immediate resuscitation. CPR and activation of emergency
assistance should not be delayed for nonessential assessments.
2. During pediatric cardiac arrest, what is the recommended chest-
compression rate?
A. 60–80/min
B. 80–100/min
C. 100–120/min
D. 130–150/min
Answer: C
Rationale: High-quality CPR uses chest compressions at 100–120/min.
3. What is the recommended compression depth for a child?
A. At least 1 cm
B. Approximately one-third the anterior-posterior diameter of the chest
C. One-half the chest diameter
D. Exactly 7 cm
,Answer: B
Rationale: Pediatric compressions should be approximately one-third of
the chest's anterior-posterior diameter, about 5 cm in many children.
4. What is the recommended compression depth for an infant?
A. Approximately one-third of the chest depth
B. 1 cm
C. 6 cm
D. Half the chest depth
Answer: A
Rationale: Infant chest compressions should be approximately one-
third of the anterior-posterior chest diameter, about 4 cm.
5. Two rescuers are performing CPR on a child without an advanced
airway. What compression-to-ventilation ratio should they use?
A. 15:2
B. 30:2
C. 5:1
D. 10:2
Answer: A
Rationale: With two rescuers, pediatric CPR generally uses 15
compressions followed by 2 breaths.
6. A single rescuer is performing CPR on a child. What ratio is used?
A. 15:2
B. 30:2
C. 5:1
D. 20:2
Answer: B
Rationale: A single rescuer uses a 30:2 compression-to-ventilation
ratio.
,7. Which characteristic best describes high-quality pediatric CPR?
A. Frequent interruptions
B. Slow compressions
C. Full chest recoil
D. Excessive ventilation
Answer: C
Rationale: High-quality CPR includes adequate rate and depth,
complete recoil, minimal interruptions, and appropriate ventilation.
8. During CPR, why should interruptions in compressions be minimized?
A. They increase oxygen consumption
B. They reduce coronary and cerebral perfusion
C. They increase body temperature
D. They prevent defibrillation
Answer: B
Rationale: Interruptions reduce blood flow generated by compressions
and can decrease the likelihood of successful resuscitation.
9. A child has a pulse but is not breathing adequately. What is the
priority?
A. Chest compressions immediately
B. Rescue breathing with appropriate ventilation
C. Defibrillation
D. Oral fluids
Answer: B
Rationale: Respiratory arrest with a pulse requires ventilation and
ongoing reassessment rather than immediate chest compressions.
10. What pulse rate should generally prompt chest compressions in a
child with signs of poor perfusion despite adequate oxygenation and
ventilation?
, A. Less than 60/min
B. Less than 100/min
C. Less than 120/min
D. Less than 140/min
Answer: A
Rationale: In pediatric resuscitation, a heart rate below 60/min with
signs of poor perfusion despite adequate oxygenation and ventilation is
an indication to begin CPR.
11. Which rhythm is shockable?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Answer: C
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia
are shockable cardiac-arrest rhythms.
12. Which rhythm is nonshockable?
A. Ventricular fibrillation
B. Pulseless ventricular tachycardia
C. Asystole
D. Torsades de pointes with no pulse
Answer: C
Rationale: Asystole is treated with high-quality CPR, epinephrine, and
correction of reversible causes rather than defibrillation.
13. A child in cardiac arrest has pulseless ventricular tachycardia. What
is the priority treatment?
A. Defibrillation
B. Atropine
Questions & Correct Answers with Rationales
1. A 6-year-old child is unresponsive and not breathing normally. What
should the nurse do first?
A. Obtain a blood pressure
B. Check for a pulse for 30 seconds
C. Activate the emergency response system and begin CPR as
appropriate
D. Administer oxygen by nasal cannula
Answer: C
Rationale: An unresponsive child with absent or abnormal breathing
requires immediate resuscitation. CPR and activation of emergency
assistance should not be delayed for nonessential assessments.
2. During pediatric cardiac arrest, what is the recommended chest-
compression rate?
A. 60–80/min
B. 80–100/min
C. 100–120/min
D. 130–150/min
Answer: C
Rationale: High-quality CPR uses chest compressions at 100–120/min.
3. What is the recommended compression depth for a child?
A. At least 1 cm
B. Approximately one-third the anterior-posterior diameter of the chest
C. One-half the chest diameter
D. Exactly 7 cm
,Answer: B
Rationale: Pediatric compressions should be approximately one-third of
the chest's anterior-posterior diameter, about 5 cm in many children.
4. What is the recommended compression depth for an infant?
A. Approximately one-third of the chest depth
B. 1 cm
C. 6 cm
D. Half the chest depth
Answer: A
Rationale: Infant chest compressions should be approximately one-
third of the anterior-posterior chest diameter, about 4 cm.
5. Two rescuers are performing CPR on a child without an advanced
airway. What compression-to-ventilation ratio should they use?
A. 15:2
B. 30:2
C. 5:1
D. 10:2
Answer: A
Rationale: With two rescuers, pediatric CPR generally uses 15
compressions followed by 2 breaths.
6. A single rescuer is performing CPR on a child. What ratio is used?
A. 15:2
B. 30:2
C. 5:1
D. 20:2
Answer: B
Rationale: A single rescuer uses a 30:2 compression-to-ventilation
ratio.
,7. Which characteristic best describes high-quality pediatric CPR?
A. Frequent interruptions
B. Slow compressions
C. Full chest recoil
D. Excessive ventilation
Answer: C
Rationale: High-quality CPR includes adequate rate and depth,
complete recoil, minimal interruptions, and appropriate ventilation.
8. During CPR, why should interruptions in compressions be minimized?
A. They increase oxygen consumption
B. They reduce coronary and cerebral perfusion
C. They increase body temperature
D. They prevent defibrillation
Answer: B
Rationale: Interruptions reduce blood flow generated by compressions
and can decrease the likelihood of successful resuscitation.
9. A child has a pulse but is not breathing adequately. What is the
priority?
A. Chest compressions immediately
B. Rescue breathing with appropriate ventilation
C. Defibrillation
D. Oral fluids
Answer: B
Rationale: Respiratory arrest with a pulse requires ventilation and
ongoing reassessment rather than immediate chest compressions.
10. What pulse rate should generally prompt chest compressions in a
child with signs of poor perfusion despite adequate oxygenation and
ventilation?
, A. Less than 60/min
B. Less than 100/min
C. Less than 120/min
D. Less than 140/min
Answer: A
Rationale: In pediatric resuscitation, a heart rate below 60/min with
signs of poor perfusion despite adequate oxygenation and ventilation is
an indication to begin CPR.
11. Which rhythm is shockable?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Answer: C
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia
are shockable cardiac-arrest rhythms.
12. Which rhythm is nonshockable?
A. Ventricular fibrillation
B. Pulseless ventricular tachycardia
C. Asystole
D. Torsades de pointes with no pulse
Answer: C
Rationale: Asystole is treated with high-quality CPR, epinephrine, and
correction of reversible causes rather than defibrillation.
13. A child in cardiac arrest has pulseless ventricular tachycardia. What
is the priority treatment?
A. Defibrillation
B. Atropine
