PALS 2025 questions and answers
2025\2026 A+ grade
Which pulses should be assessed to monitor systemic perfusion in a child?
- correct answer peripheral and central
What should the first rescuer arriving on the scene of an unresponsive infant or child do? (in order)
- correct answer 1. verify scene safety
2. check for responsiveness
3. shout for help
4. activate the emergency response system
Why may excessive ventilation during CPR be harmful?
- correct answer - it increases intrathoracic pressure
- it impedes venous return
If you cannot achieve effective ventilation (ie, the chest does not rise), do the following:
- correct answer - reposition/reopen the airway (sniffing position)
- verify mask size and ensure a tight face-mask seal
- suction the airway if needed
- check the O2 source
- check the ventilation bag and mask
- treat gastric inflation (NG/OG)
- consider 2-person bag-mask ventilation and inserting an OPA
Ventilation rate
- correct answer 1 breath every 2-3 seconds delivered over 1 second (20-30 breaths per minute)
, Early signs of tissue hypoxia
- correct answer - tachypnea
- increased respiratory effort (nasal flaring, retractions)
- tachycardia
- pallor, mottling, cyanosis
- agitation, anxiety, irritability
Late signs of tissue hypoxia
- correct answer - bradypnea, inadequate respiratory effort, apnea
- increased respiratory effort (head bobbing, seesaw respirations, grunting)
- bradycardia
- pallor, mottling, cyanosis
- decreased level of consciousness
What is the role of the diaphragm during normal breathing in infants?
- correct answer pulls the ribs slightly inward
S/S mild respiratory distress
- correct answer - mild tachypnea
- mild increase in respiratory effort (nasal flaring, retractions)
- abnormal airway sounds (stridor, wheezing, grunting)
S/S Severe respiratory distress
- correct answer - marked tachypnea
- marked increase in respiratory effort
- paradoxical throacoabdominal breathing (seesaw breathing)
- accessory muscle use (head bobbing)
- abnormal airway sounds (grunting)
- decreased level of consciousness
2025\2026 A+ grade
Which pulses should be assessed to monitor systemic perfusion in a child?
- correct answer peripheral and central
What should the first rescuer arriving on the scene of an unresponsive infant or child do? (in order)
- correct answer 1. verify scene safety
2. check for responsiveness
3. shout for help
4. activate the emergency response system
Why may excessive ventilation during CPR be harmful?
- correct answer - it increases intrathoracic pressure
- it impedes venous return
If you cannot achieve effective ventilation (ie, the chest does not rise), do the following:
- correct answer - reposition/reopen the airway (sniffing position)
- verify mask size and ensure a tight face-mask seal
- suction the airway if needed
- check the O2 source
- check the ventilation bag and mask
- treat gastric inflation (NG/OG)
- consider 2-person bag-mask ventilation and inserting an OPA
Ventilation rate
- correct answer 1 breath every 2-3 seconds delivered over 1 second (20-30 breaths per minute)
, Early signs of tissue hypoxia
- correct answer - tachypnea
- increased respiratory effort (nasal flaring, retractions)
- tachycardia
- pallor, mottling, cyanosis
- agitation, anxiety, irritability
Late signs of tissue hypoxia
- correct answer - bradypnea, inadequate respiratory effort, apnea
- increased respiratory effort (head bobbing, seesaw respirations, grunting)
- bradycardia
- pallor, mottling, cyanosis
- decreased level of consciousness
What is the role of the diaphragm during normal breathing in infants?
- correct answer pulls the ribs slightly inward
S/S mild respiratory distress
- correct answer - mild tachypnea
- mild increase in respiratory effort (nasal flaring, retractions)
- abnormal airway sounds (stridor, wheezing, grunting)
S/S Severe respiratory distress
- correct answer - marked tachypnea
- marked increase in respiratory effort
- paradoxical throacoabdominal breathing (seesaw breathing)
- accessory muscle use (head bobbing)
- abnormal airway sounds (grunting)
- decreased level of consciousness
