2020 PALS EXAM A COMPREHENSIVE ACADEMIC STUDY GUIDE WITH
VERIFIED CONCEPTS AND EXAM-FOCUSED EXPLANATIONS 2025–2026
In which of the following situations may IO access be used?
A. An extremity with signs of infection
B. An extremity with a sign of a crush injury
C. An extremity with a previous unsuccessful IO attempt
D. An extremity with slow a capillary refill time - correct answer -D. An extremity with slow a
capillary refill time
A 2 week old infant is being evaluated for irritability and poor feeding. His BP is 55/40 mmHg,
and cap refill time is 5 seconds. Which statement best describes your assessment of this infants
BP?
A. It represents compensated shock
B. It is hypertensive
C. It is Hypotensive
D. It is normal - correct answer -C. It is Hypotensive
You are caring for patients in the emergency department. Which 2 year old child requires
immediate intervention?
A. A child who is grunting
B. A child with an Sp02 of 95% on room air
C. A child with a systolic blood pressure of 92 mm Hg
D. A child with a temperature of 37.4 C (99.3 F) - correct answer -A. A child who is grunting
,A 3 year old child is having difficulty breathing. Which finding would most likely lead you to
suspect an upper airway obstruction in this child?
A. Expiratory breath sounds
B. Decreased expiratory effort
C. Increased inspiratory effort with retractions
D. Normal inspiratory sounds - correct answer -C. Increased inspiratory effort with retractions
A team member is unable to perform an assigned task because it is beyond the team members
scope of practice. Which action should the team member take?
A. Ask for a new task or role
B. Refuse to perform the task
C. Do it anyway
D. Seek expert consultation - correct answer -A. Ask for a new task or role
You are the team leader during a pediatric resuscitation attempt. which action is an element of
high quality CPR?
A. Providing a compression depth of one fourth the depth of the chest
B. Providing a compression rate of 80 to 100/min
C. Allowing complete chest wall recoil after each compression
D. Performing pulse checks every minute - correct answer -C. Allowing complete chest wall
recoil after each compression
, An 8 year old child is brought to the ED by his mother for difficulty breathing. He has a history of
asthma and nut allergies. He's mother tells you that he recently ate a cookie at a family picnic.
Which condition is most likely to be present in this child?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lung tissue disease
D. upper airway obstruction - correct answer -D. upper airway obstruction
An 8 year old child is brought to the ED by ambulance after being involved in a MVC. Which
finding would suggest that immediate intervention is needed?
A. Decreased level of consciousness
B. Systolic blood pressure of 106 mm Hg
C. Temperature of 38.1 C (100.5 F)
D. Warm, moist skin - correct answer -A. Decreased level of consciousness
A 6 year old child is found unresponsive, not breathing, and without a pulse. one health care
worker leaves to activate the emergency response system and get the resuscitation equipment.
You and another healthcare provider immediatly begin CPR. Which compression to ventilation
ratio do you use?
A. 15:1
B. 30:1
C. 15:2
D. 30:2 - correct answer -C. 15:2
VERIFIED CONCEPTS AND EXAM-FOCUSED EXPLANATIONS 2025–2026
In which of the following situations may IO access be used?
A. An extremity with signs of infection
B. An extremity with a sign of a crush injury
C. An extremity with a previous unsuccessful IO attempt
D. An extremity with slow a capillary refill time - correct answer -D. An extremity with slow a
capillary refill time
A 2 week old infant is being evaluated for irritability and poor feeding. His BP is 55/40 mmHg,
and cap refill time is 5 seconds. Which statement best describes your assessment of this infants
BP?
A. It represents compensated shock
B. It is hypertensive
C. It is Hypotensive
D. It is normal - correct answer -C. It is Hypotensive
You are caring for patients in the emergency department. Which 2 year old child requires
immediate intervention?
A. A child who is grunting
B. A child with an Sp02 of 95% on room air
C. A child with a systolic blood pressure of 92 mm Hg
D. A child with a temperature of 37.4 C (99.3 F) - correct answer -A. A child who is grunting
,A 3 year old child is having difficulty breathing. Which finding would most likely lead you to
suspect an upper airway obstruction in this child?
A. Expiratory breath sounds
B. Decreased expiratory effort
C. Increased inspiratory effort with retractions
D. Normal inspiratory sounds - correct answer -C. Increased inspiratory effort with retractions
A team member is unable to perform an assigned task because it is beyond the team members
scope of practice. Which action should the team member take?
A. Ask for a new task or role
B. Refuse to perform the task
C. Do it anyway
D. Seek expert consultation - correct answer -A. Ask for a new task or role
You are the team leader during a pediatric resuscitation attempt. which action is an element of
high quality CPR?
A. Providing a compression depth of one fourth the depth of the chest
B. Providing a compression rate of 80 to 100/min
C. Allowing complete chest wall recoil after each compression
D. Performing pulse checks every minute - correct answer -C. Allowing complete chest wall
recoil after each compression
, An 8 year old child is brought to the ED by his mother for difficulty breathing. He has a history of
asthma and nut allergies. He's mother tells you that he recently ate a cookie at a family picnic.
Which condition is most likely to be present in this child?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lung tissue disease
D. upper airway obstruction - correct answer -D. upper airway obstruction
An 8 year old child is brought to the ED by ambulance after being involved in a MVC. Which
finding would suggest that immediate intervention is needed?
A. Decreased level of consciousness
B. Systolic blood pressure of 106 mm Hg
C. Temperature of 38.1 C (100.5 F)
D. Warm, moist skin - correct answer -A. Decreased level of consciousness
A 6 year old child is found unresponsive, not breathing, and without a pulse. one health care
worker leaves to activate the emergency response system and get the resuscitation equipment.
You and another healthcare provider immediatly begin CPR. Which compression to ventilation
ratio do you use?
A. 15:1
B. 30:1
C. 15:2
D. 30:2 - correct answer -C. 15:2
