PALS PEDIATRIC EMERGENCY RESUSCITATION EXAM SCRIPT 2026/2027 –
QUESTIONS WITH SOLUTIONS GRADED A+
Core Domains: Systematic Approach to Pediatric Assessment, High-Quality CPR & AED for
Infants/Children, Respiratory Emergencies & Airway Management, Shock Recognition & Management
(Hypovolemic, Distributive, Cardiogenic, Obstructive), Cardiac Dysrhythmias & Electrical Therapy,
Post-Resuscitation Care, Vascular Access & Medication Administration, Team Dynamics & Debriefing,
Acute Life-Threatening Event Recognition, and Ethical Considerations in Pediatric Resuscitation
Exam Structure: 50 multiple-choice questions designed to evaluate critical knowledge, clinical
reasoning, and psychomotor competencies required for effective resuscitation of critically ill or injured
infants and children.
[Systematic Approach to Pediatric Assessment]
1. What is the first step in the pediatric assessment triangle?
A) Assess breathing
B) Assess appearance (general impression)
C) Assess circulation
D) Assess disability
The pediatric assessment triangle begins with assessing the child’s appearance to form a
general impression of their condition (AHA PALS, 2025).
2. A 3-year-old child presents with lethargy, tachypnea, and mottled skin. What is the
priority action?
A) Administer oxygen via nasal cannula
, B) Assess airway, breathing, and circulation (ABCs) and provide high-flow oxygen
C) Obtain a detailed history from the parents
D) Start an IV and administer fluids
Immediate assessment of ABCs and provision of high-flow oxygen are critical in a child
with signs of respiratory distress and poor perfusion (AHA PALS, 2025).
3. What is the most reliable indicator of adequate oxygenation in a pediatric patient?
A) Heart rate
B) Oxygen saturation (SpO2) and clinical appearance
C) Blood pressure
D) Respiratory rate
Oxygen saturation (SpO2) combined with clinical appearance (e.g., skin color, work of
breathing) is the most reliable indicator of oxygenation (AHA PALS, 2025).
4. A 6-month-old infant presents with irritability, poor feeding, and a fever of 39°C. What is
the priority assessment?
A) Check blood glucose level
B) Assess for signs of respiratory distress and dehydration
C) Perform a lumbar puncture
, D) Administer acetaminophen
Infants with fever are at risk for serious bacterial infections; assessing for respiratory
distress and dehydration is critical (AHA PALS, 2025).
[High-Quality CPR & AED for Infants/Children]
5. What is the recommended compression-to-ventilation ratio for two-rescuer infant CPR?
A) 15:2
B) 15:2
C) 30:2
D) 5:1
The compression-to-ventilation ratio for two-rescuer infant CPR is 15:2 (AHA PALS,
2025).
6. What is the recommended depth of chest compressions for a child during CPR?
A) 1 inch
B) At least one-third the depth of the chest (approximately 2 inches)
C) 1.5 inches
D) 2.5 inches
Chest compressions for children should be at least one-third the depth of the chest, or
approximately 2 inches (AHA PALS, 2025).
QUESTIONS WITH SOLUTIONS GRADED A+
Core Domains: Systematic Approach to Pediatric Assessment, High-Quality CPR & AED for
Infants/Children, Respiratory Emergencies & Airway Management, Shock Recognition & Management
(Hypovolemic, Distributive, Cardiogenic, Obstructive), Cardiac Dysrhythmias & Electrical Therapy,
Post-Resuscitation Care, Vascular Access & Medication Administration, Team Dynamics & Debriefing,
Acute Life-Threatening Event Recognition, and Ethical Considerations in Pediatric Resuscitation
Exam Structure: 50 multiple-choice questions designed to evaluate critical knowledge, clinical
reasoning, and psychomotor competencies required for effective resuscitation of critically ill or injured
infants and children.
[Systematic Approach to Pediatric Assessment]
1. What is the first step in the pediatric assessment triangle?
A) Assess breathing
B) Assess appearance (general impression)
C) Assess circulation
D) Assess disability
The pediatric assessment triangle begins with assessing the child’s appearance to form a
general impression of their condition (AHA PALS, 2025).
2. A 3-year-old child presents with lethargy, tachypnea, and mottled skin. What is the
priority action?
A) Administer oxygen via nasal cannula
, B) Assess airway, breathing, and circulation (ABCs) and provide high-flow oxygen
C) Obtain a detailed history from the parents
D) Start an IV and administer fluids
Immediate assessment of ABCs and provision of high-flow oxygen are critical in a child
with signs of respiratory distress and poor perfusion (AHA PALS, 2025).
3. What is the most reliable indicator of adequate oxygenation in a pediatric patient?
A) Heart rate
B) Oxygen saturation (SpO2) and clinical appearance
C) Blood pressure
D) Respiratory rate
Oxygen saturation (SpO2) combined with clinical appearance (e.g., skin color, work of
breathing) is the most reliable indicator of oxygenation (AHA PALS, 2025).
4. A 6-month-old infant presents with irritability, poor feeding, and a fever of 39°C. What is
the priority assessment?
A) Check blood glucose level
B) Assess for signs of respiratory distress and dehydration
C) Perform a lumbar puncture
, D) Administer acetaminophen
Infants with fever are at risk for serious bacterial infections; assessing for respiratory
distress and dehydration is critical (AHA PALS, 2025).
[High-Quality CPR & AED for Infants/Children]
5. What is the recommended compression-to-ventilation ratio for two-rescuer infant CPR?
A) 15:2
B) 15:2
C) 30:2
D) 5:1
The compression-to-ventilation ratio for two-rescuer infant CPR is 15:2 (AHA PALS,
2025).
6. What is the recommended depth of chest compressions for a child during CPR?
A) 1 inch
B) At least one-third the depth of the chest (approximately 2 inches)
C) 1.5 inches
D) 2.5 inches
Chest compressions for children should be at least one-third the depth of the chest, or
approximately 2 inches (AHA PALS, 2025).
