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AHA PALS Exam 2026 – Updated Study Guide, Practice Questions, and Detailed Rationales for Pediatric Advanced Life Support Certification

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AHA PALS Exam 2026 – Updated Study Guide, Practice Questions, and Detailed Rationales for Pediatric Advanced Life Support Certification The AHA PALS (Pediatric Advanced Life Support) exam evaluates healthcare providers’ knowledge and skills in pediatric resuscitation, emergency response, and advanced life support protocols. This preparation guide provides practice questions with detailed rationales and structured review materials to help learners reinforce key concepts and clinical decision-making. Using comprehensive exam prep resources supports confidence, competence, and readiness for pediatric advanced life support certification.

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AHA PALS EXAM 2026 ACTUAL EXAM TEST BANK 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


QUESTION : 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



QUESTION : 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
B. Normal
C. Hypertensive

D. Compensated - CORRECT ANSWER Hypotensive




2026 2027 GRADED A+

,2|Page


QUESTION : 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


QUESTION : 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


QUESTION : 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



QUESTION : 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



2026 2027 GRADED A+

, 3|Page




QUESTION : 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



QUESTION : 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



QUESTION : 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


QUESTION : 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 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



2026 2027 GRADED A+

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