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AHA PALS EXAM 2025 ACTUAL EXAM TEST
BANK 230 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION
1. A 5-year-old child presents with lethargy, increased work of breathing,
and pale color. The primary assessment reveals that the airway is open and
the respiratory rate is 30/min, with crackles heard on auscultation. The
cardiac monitor shows sinus tachycardia at a rate of 165/min. The pulse
oximeter displays an oxygen saturation of 95% and a pulse rate of 93/min.
On the basis of this information, which of the following provides the best
interpretation of the oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable;
supplementary oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered - CORRECT
ANSWER✔✔ Unreliable; supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been
treated with chemotherapy. The child presents with lethargy and a high
fever. Heart rate is 195/min, respiratory rate is 36/min, blood pressure is
85/40 mm Hg, and capillary refill time is less than 2 seconds. What is the
child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock - CORRECT ANSWER✔✔ Septic shock
3. A 2-week-old infant presents with irritability and a history of poor
feeding. Blood pressure is 55/40 mm Hg. What term describes this infant's
blood pressure?
A. Hypotensive
ANSWERSHEET
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B. Normal
C. Hypertensive
D. Compensated - CORRECT ANSWER✔✔ Hypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of
epinephrine at 0.1 mg/kg to be given 10. What should the team member
do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug - CORRECT ANSWER✔✔ Respectfully ask
the team leader to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds - CORRECT ANSWER✔✔ Inadequate
oxygenation and/or ventilation
6. Which of the following is most likely to produce a prolonged expiratory
phase and wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
D. Upper airway obstruction - CORRECT ANSWER✔✔ Lower airway
obstruction
7. A 4-year-old child presents with seizures and irregular respirations. The
seizures stopped a few minutes ago. Which of the following most likely to
be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing - CORRECT ANSWER✔✔ Control of breathing
ANSWERSHEET
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8. What abnormality is most likely to be present in children with acute
respiratory distress caused by lung tissue disease?
A. Decreased oxygen saturation
B. Stridor
C. Normal respiratory rate
D. Decreased respiratory effort - CORRECT ANSWER✔✔ Decreased oxygen
saturation
9. An alert 2-year-old child with an increased work of breathing and pink
color is being evaluated. Heart rate is 110/min, and respiratory rate is
30/min. What would best describe this patient's condition? A. Respiratory
distress
B. Respiratory arrest
C. Respiratory failure
D. Disordered control of breathing - CORRECT ANSWER✔✔ Respiratory
distress
10. The parents of a 7-year-old child who is undergoing chemotherapy
report that the child has been febrile and has not been feeling well, with
recent onset of lethargy. Assessment reveals the following: The child is
difficult to arouse, with pale color. The child's heart rate is 160/min,
respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill
time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is the most
appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid
over 30 minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid
over 5 to 10 minutes
C. Obtain immediate blood cultures and chest x-ray D. Obtain expert
consultation with an oncologist to determine the chemotherapeutic
regimen - CORRECT ANSWER✔✔ Obtain vascular access and administer 20
mL/kg of isotonic crystalloid over 5 to 10 minutes
11. A 2-year-old child presents with a 4-day history of vomiting. The initial
impression reveals an unresponsive child with intermittent apnea and
ANSWERSHEET
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mottled color. Heart rate is 166/min, respiratory rate is now being
supported with bag-mask ventilation, capillary refill time is 5 to 6 seconds,
and temperature is 102°F (38.9°C). What is the best method of establishing
immediate vascular access? A. Two providers may attempt peripheral
vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line - CORRECT ANSWER✔✔ Place an intraosseous
line
12. What is the appropriate fluid bolus to administer for a child with
hypovolemic shock with adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's - CORRECT ANSWER✔✔ 20 mL/kg normal
saline
13. An alert toddler presents with a barking cough, moderate stridor, and
moderate retractions. The child's color is pink. What is the most
appropriate initial intervention?
A. Obtain a chest radiograph
B. Administer nebulized epinephrine
C. Prepare for a surgical airway
D. Use an epinephrine autoinjector - CORRECT ANSWER✔✔ Administer
nebulized epinephrine
14. An 8-year-old child presents with a history of vomiting and diarrhea.
The child has the following vital signs: heart rate 168/min, respiratory rate
15/min, blood pressure 9060 mm Hg, and temperature 98.6°F (37°C). The
child's capillary refill time is 4 seconds. After 2 IV boluses of normal saline
(20 mL/kg each), the child's vital signs are now as follows: heart rate
130/min, respiratory rate 16/min, blood pressure 94/62 mm Hg, capillary
refill 2 seconds, and temperature 98.6°F (37°C). The child's urine output is 1
to 2 mL/kg in the past hour. The child is still lethargic. What diagnostic tests
or information should be obtained first?
ANSWERSHEET
AHA PALS EXAM 2025 ACTUAL EXAM TEST
BANK 230 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION
1. A 5-year-old child presents with lethargy, increased work of breathing,
and pale color. The primary assessment reveals that the airway is open and
the respiratory rate is 30/min, with crackles heard on auscultation. The
cardiac monitor shows sinus tachycardia at a rate of 165/min. The pulse
oximeter displays an oxygen saturation of 95% and a pulse rate of 93/min.
On the basis of this information, which of the following provides the best
interpretation of the oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable;
supplementary oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered - CORRECT
ANSWER✔✔ Unreliable; supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been
treated with chemotherapy. The child presents with lethargy and a high
fever. Heart rate is 195/min, respiratory rate is 36/min, blood pressure is
85/40 mm Hg, and capillary refill time is less than 2 seconds. What is the
child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock - CORRECT ANSWER✔✔ Septic shock
3. A 2-week-old infant presents with irritability and a history of poor
feeding. Blood pressure is 55/40 mm Hg. What term describes this infant's
blood pressure?
A. Hypotensive
ANSWERSHEET
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B. Normal
C. Hypertensive
D. Compensated - CORRECT ANSWER✔✔ Hypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of
epinephrine at 0.1 mg/kg to be given 10. What should the team member
do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug - CORRECT ANSWER✔✔ Respectfully ask
the team leader to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds - CORRECT ANSWER✔✔ Inadequate
oxygenation and/or ventilation
6. Which of the following is most likely to produce a prolonged expiratory
phase and wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
D. Upper airway obstruction - CORRECT ANSWER✔✔ Lower airway
obstruction
7. A 4-year-old child presents with seizures and irregular respirations. The
seizures stopped a few minutes ago. Which of the following most likely to
be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing - CORRECT ANSWER✔✔ Control of breathing
ANSWERSHEET
,3|Page
8. What abnormality is most likely to be present in children with acute
respiratory distress caused by lung tissue disease?
A. Decreased oxygen saturation
B. Stridor
C. Normal respiratory rate
D. Decreased respiratory effort - CORRECT ANSWER✔✔ Decreased oxygen
saturation
9. An alert 2-year-old child with an increased work of breathing and pink
color is being evaluated. Heart rate is 110/min, and respiratory rate is
30/min. What would best describe this patient's condition? A. Respiratory
distress
B. Respiratory arrest
C. Respiratory failure
D. Disordered control of breathing - CORRECT ANSWER✔✔ Respiratory
distress
10. The parents of a 7-year-old child who is undergoing chemotherapy
report that the child has been febrile and has not been feeling well, with
recent onset of lethargy. Assessment reveals the following: The child is
difficult to arouse, with pale color. The child's heart rate is 160/min,
respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill
time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is the most
appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid
over 30 minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid
over 5 to 10 minutes
C. Obtain immediate blood cultures and chest x-ray D. Obtain expert
consultation with an oncologist to determine the chemotherapeutic
regimen - CORRECT ANSWER✔✔ Obtain vascular access and administer 20
mL/kg of isotonic crystalloid over 5 to 10 minutes
11. A 2-year-old child presents with a 4-day history of vomiting. The initial
impression reveals an unresponsive child with intermittent apnea and
ANSWERSHEET
, 4|Page
mottled color. Heart rate is 166/min, respiratory rate is now being
supported with bag-mask ventilation, capillary refill time is 5 to 6 seconds,
and temperature is 102°F (38.9°C). What is the best method of establishing
immediate vascular access? A. Two providers may attempt peripheral
vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line - CORRECT ANSWER✔✔ Place an intraosseous
line
12. What is the appropriate fluid bolus to administer for a child with
hypovolemic shock with adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's - CORRECT ANSWER✔✔ 20 mL/kg normal
saline
13. An alert toddler presents with a barking cough, moderate stridor, and
moderate retractions. The child's color is pink. What is the most
appropriate initial intervention?
A. Obtain a chest radiograph
B. Administer nebulized epinephrine
C. Prepare for a surgical airway
D. Use an epinephrine autoinjector - CORRECT ANSWER✔✔ Administer
nebulized epinephrine
14. An 8-year-old child presents with a history of vomiting and diarrhea.
The child has the following vital signs: heart rate 168/min, respiratory rate
15/min, blood pressure 9060 mm Hg, and temperature 98.6°F (37°C). The
child's capillary refill time is 4 seconds. After 2 IV boluses of normal saline
(20 mL/kg each), the child's vital signs are now as follows: heart rate
130/min, respiratory rate 16/min, blood pressure 94/62 mm Hg, capillary
refill 2 seconds, and temperature 98.6°F (37°C). The child's urine output is 1
to 2 mL/kg in the past hour. The child is still lethargic. What diagnostic tests
or information should be obtained first?
ANSWERSHEET
