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AHA PALS Exam 2025/2026 – Actual
Test Bank with 230 Scenario-Based
Questions and Correct Answers |
Verified & A+ Graded
Pediatric Resuscitation (Questions 1–46)
1. A 3-year-old is found unresponsive in a park with no pulse. You confirm
unresponsiveness and call for help. What is the next step in pediatric resuscitation?
A) Administer epinephrine immediately
B) Begin high-quality chest compressions
C) Apply an AED without compressions
D) Provide rescue breaths only
Rationale: Per AHA PALS, high-quality chest compressions are initiated immediately
after confirming unresponsiveness and absence of pulse in pediatric cardiac arrest to
restore circulation.
2. During CPR on a 5-year-old, the team ensures chest compression depth is adequate.
What is the appropriate depth for a child this age?
A) 1 inch
B) About 2 inches or one-third the chest diameter
C) 3 inches
D) Half the chest diameter
Rationale: AHA PALS guidelines recommend a compression depth of about one-third
the anterior-posterior chest diameter, approximately 2 inches in a child.
3. A 2-year-old in cardiac arrest receives CPR by two rescuers. What is the correct
compression-to-ventilation ratio?
A) 30:2
B) 15:2
C) 5:1
D) 3:1
Rationale: For two-rescuer CPR in children, the AHA PALS algorithm specifies a 15:2
compression-to-ventilation ratio to optimize coordination and oxygenation.
4. A 6-year-old collapses during a soccer game. You begin CPR and attach an AED.
The AED advises a shock. What is the initial energy dose for defibrillation?
A) 0.5 J/kg
B) 2 J/kg
C) 4 J/kg
D) 10 J/kg
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Rationale: AHA PALS recommends an initial defibrillation dose of 2 J/kg for ventricular
fibrillation (VF) or pulseless ventricular tachycardia (pVT).
5. A 4-year-old is in cardiac arrest. After two minutes of CPR, the rhythm is asystole.
What is the next action?
A) Defibrillate at 4 J/kg
B) Continue CPR and administer epinephrine
C) Administer amiodarone
D) Perform synchronized cardioversion
Rationale: Asystole is a non-shockable rhythm. AHA PALS directs to continue CPR and
administer epinephrine 0.01 mg/kg IV/IO every 3–5 minutes.
6. During resuscitation of an 8-month-old, the team notices poor chest rise with bag-
mask ventilation. What should the team do first?
A) Increase ventilation pressure
B) Reposition the airway
C) Administer oxygen at a higher flow rate
D) Intubate immediately
Rationale: Poor chest rise often indicates airway obstruction or improper positioning.
Repositioning the airway is the first step per AHA PALS.
7. A 7-year-old in cardiac arrest achieves return of spontaneous circulation (ROSC).
What is the priority in post-resuscitation care?
A) Administer a sedative
B) Optimize oxygenation and ventilation
C) Begin rewarming
D) Restrict fluids
Rationale: Post-ROSC care prioritizes optimizing oxygenation and ventilation to
stabilize the patient, per AHA PALS guidelines.
8. A 1-year-old is unresponsive with gasping respirations. The pulse is absent. What is
the compression rate for CPR?
A) 60–80 per minute
B) 100–120 per minute
C) 140–160 per minute
D) 80–100 per minute
Rationale: AHA PALS recommends a compression rate of 100–120 per minute for
pediatric CPR to ensure adequate circulation.
9. A 5-year-old in cardiac arrest is intubated. How often should ventilations be
provided during CPR?
A) Every 2 seconds
B) Every 6–8 seconds
C) Every 10 seconds
D) Every 12 seconds
Rationale: For intubated children, AHA PALS recommends 1 ventilation every 6–8
seconds (8–10 breaths per minute) to avoid hyperventilation.
10. A 3-year-old in cardiac arrest receives epinephrine. What is the correct IV/IO dose?
A) 0.1 mg/kg
B) 0.01 mg/kg
C) 0.001 mg/kg
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D) 1 mg/kg
Rationale: AHA PALS specifies epinephrine 0.01 mg/kg IV/IO (1:10,000 solution)
every 3–5 minutes for cardiac arrest.
11. A 6-year-old is in pulseless ventricular tachycardia. After defibrillation, what
medication should be administered?
A) Atropine
B) Amiodarone
C) Adenosine
D) Lidocaine
Rationale: Amiodarone is the preferred antiarrhythmic for shockable rhythms (VF/pVT)
in pediatric cardiac arrest per AHA PALS.
12. A 2-year-old is receiving CPR. The team suspects hypovolemia as a cause. What
intervention is appropriate?
A) Administer atropine
B) Give a fluid bolus of 20 mL/kg
C) Perform synchronized cardioversion
D) Administer amiodarone
Rationale: Hypovolemia, a reversible cause (H’s and T’s), is treated with a 20 mL/kg
fluid bolus per AHA PALS.
13. A 4-year-old in cardiac arrest has an intraosseous (IO) line placed. What is a key
nursing responsibility?
A) Limit fluid administration
B) Confirm IO placement and patency
C) Avoid medication administration
D) Remove the IO line after 5 minutes
Rationale: Confirming IO placement and patency ensures effective medication and fluid
delivery during resuscitation.
14. A 9-month-old in cardiac arrest is defibrillated at 2 J/kg. The rhythm remains VF.
What is the next defibrillation dose?
A) 2 J/kg
B) 4 J/kg
C) 0.5 J/kg
D) 10 J/kg
Rationale: AHA PALS recommends escalating to 4 J/kg for subsequent defibrillation
attempts in persistent VF/pVT.
15. A 5-year-old receives CPR for asystole. After epinephrine, the rhythm remains
unchanged. What is the next action?
A) Defibrillate at 4 J/kg
B) Continue CPR and reassess rhythm
C) Administer adenosine
D) Perform synchronized cardioversion
Rationale: Asystole is non-shockable; AHA PALS directs to continue CPR, reassess
rhythm, and address reversible causes.
16. A 3-year-old in cardiac arrest has a pulse restored after CPR. The child is
hypotensive. What is the first intervention?
A) Administer atropine
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B) Give a fluid bolus of 20 mL/kg
C) Start amiodarone infusion
D) Perform cardioversion
Rationale: Hypotension post-ROSC is treated with a 20 mL/kg fluid bolus to improve
perfusion, per AHA PALS.
17. During CPR on a 6-year-old, the team notices the compression rate is too slow.
What is the target rate?
A) 80–100 per minute
B) 100–120 per minute
C) 60–80 per minute
D) 140–160 per minute
Rationale: AHA PALS specifies a compression rate of 100–120 per minute for effective
pediatric CPR.
18. A 1-year-old in cardiac arrest is ventilated via bag-mask. What is the correct
ventilation volume?
A) Full chest expansion
B) Just enough to see chest rise
C) No chest movement
D) Half the chest diameter
Rationale: AHA PALS recommends ventilations that produce visible chest rise to avoid
overinflation and barotrauma.
19. A 7-year-old in cardiac arrest is intubated. The team confirms placement. What is
the best method to verify?
A) Auscultate the abdomen
B) Use capnography
C) Check pulse oximetry
D) Observe chest rise only
Rationale: Capnography is the most reliable method to confirm endotracheal tube
placement per AHA PALS.
20. A 2-year-old in cardiac arrest receives epinephrine via ET tube. What is the correct
dose?
A) 0.01 mg/kg
B) 0.1 mg/kg
C) 0.001 mg/kg
D) 1 mg/kg
Rationale: For endotracheal administration, AHA PALS recommends epinephrine 0.1
mg/kg (1:1,000 solution) every 3–5 minutes.
21. A 4-year-old in cardiac arrest has a shockable rhythm. After defibrillation, what
should the team do next?
A) Pause CPR for pulse check
B) Resume CPR immediately
C) Administer atropine
D) Wait for rhythm analysis
Rationale: AHA PALS directs to resume CPR immediately after defibrillation to
minimize interruptions.
AHA PALS Exam 2025/2026 – Actual
Test Bank with 230 Scenario-Based
Questions and Correct Answers |
Verified & A+ Graded
Pediatric Resuscitation (Questions 1–46)
1. A 3-year-old is found unresponsive in a park with no pulse. You confirm
unresponsiveness and call for help. What is the next step in pediatric resuscitation?
A) Administer epinephrine immediately
B) Begin high-quality chest compressions
C) Apply an AED without compressions
D) Provide rescue breaths only
Rationale: Per AHA PALS, high-quality chest compressions are initiated immediately
after confirming unresponsiveness and absence of pulse in pediatric cardiac arrest to
restore circulation.
2. During CPR on a 5-year-old, the team ensures chest compression depth is adequate.
What is the appropriate depth for a child this age?
A) 1 inch
B) About 2 inches or one-third the chest diameter
C) 3 inches
D) Half the chest diameter
Rationale: AHA PALS guidelines recommend a compression depth of about one-third
the anterior-posterior chest diameter, approximately 2 inches in a child.
3. A 2-year-old in cardiac arrest receives CPR by two rescuers. What is the correct
compression-to-ventilation ratio?
A) 30:2
B) 15:2
C) 5:1
D) 3:1
Rationale: For two-rescuer CPR in children, the AHA PALS algorithm specifies a 15:2
compression-to-ventilation ratio to optimize coordination and oxygenation.
4. A 6-year-old collapses during a soccer game. You begin CPR and attach an AED.
The AED advises a shock. What is the initial energy dose for defibrillation?
A) 0.5 J/kg
B) 2 J/kg
C) 4 J/kg
D) 10 J/kg
, 2
Rationale: AHA PALS recommends an initial defibrillation dose of 2 J/kg for ventricular
fibrillation (VF) or pulseless ventricular tachycardia (pVT).
5. A 4-year-old is in cardiac arrest. After two minutes of CPR, the rhythm is asystole.
What is the next action?
A) Defibrillate at 4 J/kg
B) Continue CPR and administer epinephrine
C) Administer amiodarone
D) Perform synchronized cardioversion
Rationale: Asystole is a non-shockable rhythm. AHA PALS directs to continue CPR and
administer epinephrine 0.01 mg/kg IV/IO every 3–5 minutes.
6. During resuscitation of an 8-month-old, the team notices poor chest rise with bag-
mask ventilation. What should the team do first?
A) Increase ventilation pressure
B) Reposition the airway
C) Administer oxygen at a higher flow rate
D) Intubate immediately
Rationale: Poor chest rise often indicates airway obstruction or improper positioning.
Repositioning the airway is the first step per AHA PALS.
7. A 7-year-old in cardiac arrest achieves return of spontaneous circulation (ROSC).
What is the priority in post-resuscitation care?
A) Administer a sedative
B) Optimize oxygenation and ventilation
C) Begin rewarming
D) Restrict fluids
Rationale: Post-ROSC care prioritizes optimizing oxygenation and ventilation to
stabilize the patient, per AHA PALS guidelines.
8. A 1-year-old is unresponsive with gasping respirations. The pulse is absent. What is
the compression rate for CPR?
A) 60–80 per minute
B) 100–120 per minute
C) 140–160 per minute
D) 80–100 per minute
Rationale: AHA PALS recommends a compression rate of 100–120 per minute for
pediatric CPR to ensure adequate circulation.
9. A 5-year-old in cardiac arrest is intubated. How often should ventilations be
provided during CPR?
A) Every 2 seconds
B) Every 6–8 seconds
C) Every 10 seconds
D) Every 12 seconds
Rationale: For intubated children, AHA PALS recommends 1 ventilation every 6–8
seconds (8–10 breaths per minute) to avoid hyperventilation.
10. A 3-year-old in cardiac arrest receives epinephrine. What is the correct IV/IO dose?
A) 0.1 mg/kg
B) 0.01 mg/kg
C) 0.001 mg/kg
, 3
D) 1 mg/kg
Rationale: AHA PALS specifies epinephrine 0.01 mg/kg IV/IO (1:10,000 solution)
every 3–5 minutes for cardiac arrest.
11. A 6-year-old is in pulseless ventricular tachycardia. After defibrillation, what
medication should be administered?
A) Atropine
B) Amiodarone
C) Adenosine
D) Lidocaine
Rationale: Amiodarone is the preferred antiarrhythmic for shockable rhythms (VF/pVT)
in pediatric cardiac arrest per AHA PALS.
12. A 2-year-old is receiving CPR. The team suspects hypovolemia as a cause. What
intervention is appropriate?
A) Administer atropine
B) Give a fluid bolus of 20 mL/kg
C) Perform synchronized cardioversion
D) Administer amiodarone
Rationale: Hypovolemia, a reversible cause (H’s and T’s), is treated with a 20 mL/kg
fluid bolus per AHA PALS.
13. A 4-year-old in cardiac arrest has an intraosseous (IO) line placed. What is a key
nursing responsibility?
A) Limit fluid administration
B) Confirm IO placement and patency
C) Avoid medication administration
D) Remove the IO line after 5 minutes
Rationale: Confirming IO placement and patency ensures effective medication and fluid
delivery during resuscitation.
14. A 9-month-old in cardiac arrest is defibrillated at 2 J/kg. The rhythm remains VF.
What is the next defibrillation dose?
A) 2 J/kg
B) 4 J/kg
C) 0.5 J/kg
D) 10 J/kg
Rationale: AHA PALS recommends escalating to 4 J/kg for subsequent defibrillation
attempts in persistent VF/pVT.
15. A 5-year-old receives CPR for asystole. After epinephrine, the rhythm remains
unchanged. What is the next action?
A) Defibrillate at 4 J/kg
B) Continue CPR and reassess rhythm
C) Administer adenosine
D) Perform synchronized cardioversion
Rationale: Asystole is non-shockable; AHA PALS directs to continue CPR, reassess
rhythm, and address reversible causes.
16. A 3-year-old in cardiac arrest has a pulse restored after CPR. The child is
hypotensive. What is the first intervention?
A) Administer atropine
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B) Give a fluid bolus of 20 mL/kg
C) Start amiodarone infusion
D) Perform cardioversion
Rationale: Hypotension post-ROSC is treated with a 20 mL/kg fluid bolus to improve
perfusion, per AHA PALS.
17. During CPR on a 6-year-old, the team notices the compression rate is too slow.
What is the target rate?
A) 80–100 per minute
B) 100–120 per minute
C) 60–80 per minute
D) 140–160 per minute
Rationale: AHA PALS specifies a compression rate of 100–120 per minute for effective
pediatric CPR.
18. A 1-year-old in cardiac arrest is ventilated via bag-mask. What is the correct
ventilation volume?
A) Full chest expansion
B) Just enough to see chest rise
C) No chest movement
D) Half the chest diameter
Rationale: AHA PALS recommends ventilations that produce visible chest rise to avoid
overinflation and barotrauma.
19. A 7-year-old in cardiac arrest is intubated. The team confirms placement. What is
the best method to verify?
A) Auscultate the abdomen
B) Use capnography
C) Check pulse oximetry
D) Observe chest rise only
Rationale: Capnography is the most reliable method to confirm endotracheal tube
placement per AHA PALS.
20. A 2-year-old in cardiac arrest receives epinephrine via ET tube. What is the correct
dose?
A) 0.01 mg/kg
B) 0.1 mg/kg
C) 0.001 mg/kg
D) 1 mg/kg
Rationale: For endotracheal administration, AHA PALS recommends epinephrine 0.1
mg/kg (1:1,000 solution) every 3–5 minutes.
21. A 4-year-old in cardiac arrest has a shockable rhythm. After defibrillation, what
should the team do next?
A) Pause CPR for pulse check
B) Resume CPR immediately
C) Administer atropine
D) Wait for rhythm analysis
Rationale: AHA PALS directs to resume CPR immediately after defibrillation to
minimize interruptions.
