1|Page
AHA PALS EXAM ACTUAL EXAM TEST BANK QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+||NEWEST VERSION 2026
BRADYCARDIA (Questions 1–30)
1. A 3-year-old presents with HR 48/min, lethargy, and poor perfusion. What is the first action?
A. Give atropine 0.02 mg/kg IV
B. Begin CPR
C. Place a defibrillator
D. Start epinephrine infusion
Answer: B — Begin CPR
Rationale: HR <60 with poor perfusion and altered mental status → pre-arrest bradycardia.
CPR is priority.
2. In pediatric bradycardia with a pulse and poor perfusion, which drug is recommended if
atropine is ineffective?
A. Dopamine
B. Epinephrine
C. Amiodarone
D. Adenosine
Answer: B — Epinephrine
Rationale: After atropine or if severe bradycardia persists → epinephrine 0.01 mg/kg IV/IO.
3. Which of the following is a common cause of bradycardia in children?
A. Hyperthermia
B. Hypoxia
C. Dehydration
D. Hyperglycemia
Answer: B — Hypoxia
Rationale: In pediatrics, bradycardia is usually secondary to hypoxia, not primary cardiac
disease.
4. First-line drug for symptomatic bradycardia in a child?
A. Atropine
B. Adenosine
2026 2027 GRADED A+
,2|Page
C. Epinephrine
D. Amiodarone
Answer: A — Atropine
Rationale: Symptomatic bradycardia with poor perfusion → Atropine 0.02 mg/kg IV/IO (min
0.1 mg, max 0.5 mg).
5. When is transcutaneous pacing indicated in pediatric bradycardia?
A. HR 90 with poor perfusion
B. Severe bradycardia unresponsive to drugs
C. Tachycardia >200 bpm
D. Stable bradycardia with normal perfusion
Answer: B — Severe bradycardia unresponsive to drugs
Rationale: Temporary pacing is used only if atropine/epinephrine fail and patient remains
unstable.
6. HR <60/min in an infant, lethargic, with weak pulses. Next step?
A. Ventilate with 100% O₂
B. Give adenosine
C. Observe
D. IV antibiotics
Answer: A — Ventilate with 100% O₂
Rationale: Most pediatric bradycardia is hypoxia-induced, so ventilation is critical.
7. Maximum single dose of atropine in children?
A. 0.5 mg
B. 1 mg
C. 0.3 mg
D. 2 mg
Answer: A — 0.5 mg
Rationale: Atropine dosing: 0.02 mg/kg IV/IO, min 0.1 mg, max 0.5 mg per dose.
8. Bradycardia with signs of shock requires:
A. Only oxygen
B. CPR and IV access
2026 2027 GRADED A+
, 3|Page
C. Observation
D. Only atropine
Answer: B — CPR and IV access
Rationale: Poor perfusion → immediate CPR + drugs once IV/IO access obtained.
9. Which rhythm is most commonly associated with pediatric bradycardia?
A. Sinus bradycardia
B. SVT
C. Ventricular fibrillation
D. Junctional rhythm
Answer: A — Sinus bradycardia
Rationale: Most pediatric bradycardia is sinus and secondary to hypoxia or acidosis.
10. Pediatric bradycardia algorithm emphasizes:
A. Drugs before CPR
B. CPR first if poor perfusion
C. Observation
D. Immediate defibrillation
Answer: B — CPR first if poor perfusion
Rationale: CAB approach: compressions take priority if perfusion is inadequate.
TACHYCARDIA (Questions 31–65)
31. A 7-year-old has HR 240, hypotension, altered mental status, narrow QRS. First action?
A. Vagal maneuvers
B. Adenosine IV push
C. Synchronized cardioversion
D. Amiodarone infusion
Answer: C — Synchronized cardioversion
Rationale: Unstable SVT → electric cardioversion is first-line.
2026 2027 GRADED A+
AHA PALS EXAM ACTUAL EXAM TEST BANK QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+||NEWEST VERSION 2026
BRADYCARDIA (Questions 1–30)
1. A 3-year-old presents with HR 48/min, lethargy, and poor perfusion. What is the first action?
A. Give atropine 0.02 mg/kg IV
B. Begin CPR
C. Place a defibrillator
D. Start epinephrine infusion
Answer: B — Begin CPR
Rationale: HR <60 with poor perfusion and altered mental status → pre-arrest bradycardia.
CPR is priority.
2. In pediatric bradycardia with a pulse and poor perfusion, which drug is recommended if
atropine is ineffective?
A. Dopamine
B. Epinephrine
C. Amiodarone
D. Adenosine
Answer: B — Epinephrine
Rationale: After atropine or if severe bradycardia persists → epinephrine 0.01 mg/kg IV/IO.
3. Which of the following is a common cause of bradycardia in children?
A. Hyperthermia
B. Hypoxia
C. Dehydration
D. Hyperglycemia
Answer: B — Hypoxia
Rationale: In pediatrics, bradycardia is usually secondary to hypoxia, not primary cardiac
disease.
4. First-line drug for symptomatic bradycardia in a child?
A. Atropine
B. Adenosine
2026 2027 GRADED A+
,2|Page
C. Epinephrine
D. Amiodarone
Answer: A — Atropine
Rationale: Symptomatic bradycardia with poor perfusion → Atropine 0.02 mg/kg IV/IO (min
0.1 mg, max 0.5 mg).
5. When is transcutaneous pacing indicated in pediatric bradycardia?
A. HR 90 with poor perfusion
B. Severe bradycardia unresponsive to drugs
C. Tachycardia >200 bpm
D. Stable bradycardia with normal perfusion
Answer: B — Severe bradycardia unresponsive to drugs
Rationale: Temporary pacing is used only if atropine/epinephrine fail and patient remains
unstable.
6. HR <60/min in an infant, lethargic, with weak pulses. Next step?
A. Ventilate with 100% O₂
B. Give adenosine
C. Observe
D. IV antibiotics
Answer: A — Ventilate with 100% O₂
Rationale: Most pediatric bradycardia is hypoxia-induced, so ventilation is critical.
7. Maximum single dose of atropine in children?
A. 0.5 mg
B. 1 mg
C. 0.3 mg
D. 2 mg
Answer: A — 0.5 mg
Rationale: Atropine dosing: 0.02 mg/kg IV/IO, min 0.1 mg, max 0.5 mg per dose.
8. Bradycardia with signs of shock requires:
A. Only oxygen
B. CPR and IV access
2026 2027 GRADED A+
, 3|Page
C. Observation
D. Only atropine
Answer: B — CPR and IV access
Rationale: Poor perfusion → immediate CPR + drugs once IV/IO access obtained.
9. Which rhythm is most commonly associated with pediatric bradycardia?
A. Sinus bradycardia
B. SVT
C. Ventricular fibrillation
D. Junctional rhythm
Answer: A — Sinus bradycardia
Rationale: Most pediatric bradycardia is sinus and secondary to hypoxia or acidosis.
10. Pediatric bradycardia algorithm emphasizes:
A. Drugs before CPR
B. CPR first if poor perfusion
C. Observation
D. Immediate defibrillation
Answer: B — CPR first if poor perfusion
Rationale: CAB approach: compressions take priority if perfusion is inadequate.
TACHYCARDIA (Questions 31–65)
31. A 7-year-old has HR 240, hypotension, altered mental status, narrow QRS. First action?
A. Vagal maneuvers
B. Adenosine IV push
C. Synchronized cardioversion
D. Amiodarone infusion
Answer: C — Synchronized cardioversion
Rationale: Unstable SVT → electric cardioversion is first-line.
2026 2027 GRADED A+
