PALS COMPREHENSIVE EXAMINATION TEST 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
A 5-year-old child with a history of a chronic neuromuscular disease is experiencing respiratory distress.
The child is breathing spontaneously and receiving supplemental oxygen. Which additional intervention
is a critical component of airway management for this patient? . Answer. Airway clearance (e.g.,
suctioning)
>A child being cared for in the pediatric telemetry unit suddenly displays the following ECG waveform.
The provider prepares to intervene because the child is demonstrating which type of arrhythmia? .
Answer. Supraventricular tachycardia
>A child in cardiac arrest experiences return of spontaneous circulation but is exhibiting signs of post-
cardiac arrest syndrome (PCAS). The PALS resuscitation team determines that the child is experiencing a
systemic response to ischemia/reperfusion. The team bases this determination on which finding(s)? .
Answer. Hypotension, fever, hyperglycemia
>An 11-year-old soccer player is brought to the emergency department. After a quick assessment, the
team realizes this patient is experiencing a severe asthma exacerbation. Which medication would the
team administer immediately? . Answer. Albuterol with or without ipratropium bromide
>After ROSC, a child is experiencing post-cardiac arrest hypoperfusion. The PALS resuscitation team
would administer which element to restore intravascular volume and optimize preload? . Answer.
Isotonic fluid boluses
>A 2-year-old child of unknown weight arrives at the emergency department in cardiac arrest. When
preparing to administer medications, which action would be appropriate for the team to take? . Answer.
Estimate weight using a length-based resuscitation tape.
>A 4-year-old child is brought to the emergency department by the parents. Assessment reveals that the
child has only gasping respirations and the pulse rate is 65 beats per minute. Which action would the
provider initiate first? . Answer. Deliver 1 BVM ventilation every 2 to 3 seconds.
>The PALS team leader is conducting a debriefing session with the team. Which topic(s) would the team
leader most likely address during the session? . Answer. Discussion of the pros and cons of the
interventions
, Evaluation of the objective data gathered during the event, Summary of the event, including what
actions were taken, Identification of ways to improve
>The PALS resuscitation team notes the following ECG waveform and the child does not have a pulse.
The team prepares to intervene to address which arrhythmia? . Answer. Torsades de pointes
>What is the correct IV/IO dose of epinephrine for a pediatric patient in cardiac arrest? . Answer. 0.01
mg/kg every 3 to 5 min (max single dose 1 mg)
>Assessment of a 3-month-old infant admitted with respiratory distress reveals fever, grunting and a
wet, "junky" cough. The infant's parents said the child had a recent respiratory infection with a fever. A
rapid respiratory syncytial virus (RSV) test is positive. Which condition would the provider most likely
suspect as the cause? . Answer. Bronchiolitis
>A child is experiencing supraventricular tachycardia (SVT) with adequate perfusion and is to receive
treatment. Which initial treatment would the provider administer? . Answer. Vagal maneuvers
>A healthcare provider notices petechiae on the arms and legs while performing a rapid skin assessment
of a child with a high fever and respiratory distress. Based on this assessment, which condition should
the provider consider? . Answer. Life-threatening systemic infection
>A 7-year-old patient with septic shock has received three balanced/buffered crystalloid fluid boluses
(60-mL/kg) and reassessment reveals capillary refill of 3 seconds, diminished pulses, narrow pulse
pressure and cool, mottled extremities. The emergency response team interprets these findings as
indicating which type of septic shock? . Answer. Fluid-refractory
>A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the
provider administer? . Answer. Nebulized epinephrine, Corticosteroids
>A child exhibiting a narrow-complex tachycardia with adequate perfusion is to receive adenosine. The
provider would be alert for which result after administering this medication? . Answer. Transient asystole
GRADED A+
A 5-year-old child with a history of a chronic neuromuscular disease is experiencing respiratory distress.
The child is breathing spontaneously and receiving supplemental oxygen. Which additional intervention
is a critical component of airway management for this patient? . Answer. Airway clearance (e.g.,
suctioning)
>A child being cared for in the pediatric telemetry unit suddenly displays the following ECG waveform.
The provider prepares to intervene because the child is demonstrating which type of arrhythmia? .
Answer. Supraventricular tachycardia
>A child in cardiac arrest experiences return of spontaneous circulation but is exhibiting signs of post-
cardiac arrest syndrome (PCAS). The PALS resuscitation team determines that the child is experiencing a
systemic response to ischemia/reperfusion. The team bases this determination on which finding(s)? .
Answer. Hypotension, fever, hyperglycemia
>An 11-year-old soccer player is brought to the emergency department. After a quick assessment, the
team realizes this patient is experiencing a severe asthma exacerbation. Which medication would the
team administer immediately? . Answer. Albuterol with or without ipratropium bromide
>After ROSC, a child is experiencing post-cardiac arrest hypoperfusion. The PALS resuscitation team
would administer which element to restore intravascular volume and optimize preload? . Answer.
Isotonic fluid boluses
>A 2-year-old child of unknown weight arrives at the emergency department in cardiac arrest. When
preparing to administer medications, which action would be appropriate for the team to take? . Answer.
Estimate weight using a length-based resuscitation tape.
>A 4-year-old child is brought to the emergency department by the parents. Assessment reveals that the
child has only gasping respirations and the pulse rate is 65 beats per minute. Which action would the
provider initiate first? . Answer. Deliver 1 BVM ventilation every 2 to 3 seconds.
>The PALS team leader is conducting a debriefing session with the team. Which topic(s) would the team
leader most likely address during the session? . Answer. Discussion of the pros and cons of the
interventions
, Evaluation of the objective data gathered during the event, Summary of the event, including what
actions were taken, Identification of ways to improve
>The PALS resuscitation team notes the following ECG waveform and the child does not have a pulse.
The team prepares to intervene to address which arrhythmia? . Answer. Torsades de pointes
>What is the correct IV/IO dose of epinephrine for a pediatric patient in cardiac arrest? . Answer. 0.01
mg/kg every 3 to 5 min (max single dose 1 mg)
>Assessment of a 3-month-old infant admitted with respiratory distress reveals fever, grunting and a
wet, "junky" cough. The infant's parents said the child had a recent respiratory infection with a fever. A
rapid respiratory syncytial virus (RSV) test is positive. Which condition would the provider most likely
suspect as the cause? . Answer. Bronchiolitis
>A child is experiencing supraventricular tachycardia (SVT) with adequate perfusion and is to receive
treatment. Which initial treatment would the provider administer? . Answer. Vagal maneuvers
>A healthcare provider notices petechiae on the arms and legs while performing a rapid skin assessment
of a child with a high fever and respiratory distress. Based on this assessment, which condition should
the provider consider? . Answer. Life-threatening systemic infection
>A 7-year-old patient with septic shock has received three balanced/buffered crystalloid fluid boluses
(60-mL/kg) and reassessment reveals capillary refill of 3 seconds, diminished pulses, narrow pulse
pressure and cool, mottled extremities. The emergency response team interprets these findings as
indicating which type of septic shock? . Answer. Fluid-refractory
>A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the
provider administer? . Answer. Nebulized epinephrine, Corticosteroids
>A child exhibiting a narrow-complex tachycardia with adequate perfusion is to receive adenosine. The
provider would be alert for which result after administering this medication? . Answer. Transient asystole
