PALS ACTUAL EXAM PAPER 2026 QUESTIONS
WITH ANSWERS GRADED A+
◉ 2 rescuer compression to breath ratio? Answer: 15:2
◉ Initial impression of a 2-year old girl shows her to be alert with mild
breathing difficulty during inspiration and pale skin color. On primary
assessment, she makes high pitched inspiratory sound (mild stridor)
when agitated; otherwise, intercoastal retractions. Lung auscultation
reveals transmitted upper airway sounds with adequate distal breath
sounds bilaterally. Which is the most appropriate initial intervention for
this child? Answer: humidified oxygen as tolerated
◉ Which statement is correct about use of calcium chloride in pediatric?
Answer: Routine administration is not indicated during cardiac arrest
◉ Which statement is correct about endotracheal drug administration
during resuscitative efforts for pediatric patients? Answer: It is the least
desirable route of administration
◉ You are a part of a team attempting to resuscitate a child with
ventricular fibrillation cardiac arrest. You delivered 2 unsynchronized
shocks. A team member established IO access, so you give a dose of
, epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent
ventricular fibrillation is present. You administer a 4-J/kg shock and
resume CPR. Which drug and dose should be administered next?
Answer: Amiodarone 5 mg/kg
◉ You are called to help treat an infant with severe symptomatic
bradycardia (HR 66/min) associated with respiratory distress. The
bradycardia persists despite establishment of an effective airway,
oxygenation, and ventilation. There is no heart block present. Which is
the first drug you should administer? Answer: Epinephrine
◉ Which statement is correct about the effects of epinephrine during
attempted resuscitation? Answer: Epinephrine stimulates spontaneous
contractions when asystole is present
◉ Paramedics are called to the home of a 1yo child. Their initial
assessment reveals a child who responds only to painful stimuli and has
irregular breathing, faint central pulses, bruises over the abdomen,
abdominal distention, and cyanosis. Bag-mask ventilation with 100%
oxygen is initiated. The child's heart rate is 36/min. Peripheral pulses
cannot be palpated, and central pulses are barely palpable. The cardiac
monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon
arrival to the emergency department, the child is intubated and ventilated
with 100% oxygen, and IV access is established. The heart rate is now
150/min with weak central pulses but no distal pulses. Systolic blood
pressure is 74 mmHg. Which intervention should be provided next?
Answer: Rapid bolus of 20 ml/kg of isotonic crystalloid
WITH ANSWERS GRADED A+
◉ 2 rescuer compression to breath ratio? Answer: 15:2
◉ Initial impression of a 2-year old girl shows her to be alert with mild
breathing difficulty during inspiration and pale skin color. On primary
assessment, she makes high pitched inspiratory sound (mild stridor)
when agitated; otherwise, intercoastal retractions. Lung auscultation
reveals transmitted upper airway sounds with adequate distal breath
sounds bilaterally. Which is the most appropriate initial intervention for
this child? Answer: humidified oxygen as tolerated
◉ Which statement is correct about use of calcium chloride in pediatric?
Answer: Routine administration is not indicated during cardiac arrest
◉ Which statement is correct about endotracheal drug administration
during resuscitative efforts for pediatric patients? Answer: It is the least
desirable route of administration
◉ You are a part of a team attempting to resuscitate a child with
ventricular fibrillation cardiac arrest. You delivered 2 unsynchronized
shocks. A team member established IO access, so you give a dose of
, epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent
ventricular fibrillation is present. You administer a 4-J/kg shock and
resume CPR. Which drug and dose should be administered next?
Answer: Amiodarone 5 mg/kg
◉ You are called to help treat an infant with severe symptomatic
bradycardia (HR 66/min) associated with respiratory distress. The
bradycardia persists despite establishment of an effective airway,
oxygenation, and ventilation. There is no heart block present. Which is
the first drug you should administer? Answer: Epinephrine
◉ Which statement is correct about the effects of epinephrine during
attempted resuscitation? Answer: Epinephrine stimulates spontaneous
contractions when asystole is present
◉ Paramedics are called to the home of a 1yo child. Their initial
assessment reveals a child who responds only to painful stimuli and has
irregular breathing, faint central pulses, bruises over the abdomen,
abdominal distention, and cyanosis. Bag-mask ventilation with 100%
oxygen is initiated. The child's heart rate is 36/min. Peripheral pulses
cannot be palpated, and central pulses are barely palpable. The cardiac
monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon
arrival to the emergency department, the child is intubated and ventilated
with 100% oxygen, and IV access is established. The heart rate is now
150/min with weak central pulses but no distal pulses. Systolic blood
pressure is 74 mmHg. Which intervention should be provided next?
Answer: Rapid bolus of 20 ml/kg of isotonic crystalloid
