AHA PEDIATRIC ADVANCED LIFE SUPPORT
EXAM II EXAM SCRIPT 2026 TESTED
QUESTIONS AND CORRECT ANSWERS
ALREADY PASSED
◉ Recognize *wide-complex tachycardia*. Answer:
◉ Recognize *SVT converting to sinus rhythm after adenosine
administration*. Answer:
◉ What oxygen delivery system most reliably delivers a high (90%
of greater) concentration of inspired oxygen to a 7-year-old child?.
Answer: Nonrebreathing face mask
◉ You are called to help treat an infant with severe symptomatic
bradycardia (heart rate 66/min) associated with respiratory
distress. Bradycardia persists despite establishment of an effective
airway, oxygenation, and ventilation. There is no heart block present.
What first drug should you administer?. Answer: *Epinephrine*
◉ You are part of a team attempting to resuscitate a child with
ventricular fibrillation cardiac arrest. You deliver 2 unsynchronized
shocks. A team member established IO access, so you give a dose of
epinephrine, 0.01 mg/kg IO. At next rhythm check, persistent
,ventricular fibrillation is present. You administer a 4-J/kg shock and
resume CPR. What drug and dose should be administered next?.
Answer: *Amiodarone 5 mg/kg IO*
- can be used for shock-refractory VF or pVT
◉ 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 sounds
(mild stridor) when agitated; otherwise, her breathing is quiet. Her
SpO2 is 92% on room air, and she has mild inspiratory intercostal
retractions. Lung auscultation reveals transmitted upper airway
sounds with adequate distal breath sounds bilaterally. Most
appropriate initial intervention for this child?. Answer: *Humidified
oxygen as tolerated*
◉ 7-year-old boy found unresponsive, apneic, and pulseless. CPR is
ongoing. Child is intubated, and vascular access is established. ECG
monitor shows organized rhythm with heart rate of 45/min, but a
pulse check reveals no palpable pulses. High-quality CPR is resumed,
and an initial IV dose of epinephrine is administered. What
intervention should you perform next?. Answer: *Identify and treat
reversible causes*
◉ You are caring for a 6-year-old patient who is receiving positive-
pressure mechanical ventilation via an endotracheal tube. Child
begins to move his head and suddenly becomes cyanotic, and his
,heart rate decreases. His SpO2 is 65%. You remove child from
mechanical ventilator and begin to provide manual ventilation with
a bag via endotracheal tube. During manual ventilation with 100%
oxygen, child's color and heart rate improve slightly and his BP
remains adequate. Breath sounds and chest expansion are present
and adequate on right side and are present but consistently
diminished on left side. Trachea not deviated, and neck veins are not
distended. Suction catheter passes easily beyond tip of the
endotracheal tube. Most likely cause of this child's acute
deterioration?. Answer: *Tracheal tube displacement into right main
bronchus*
◉ You are giving chest compressions for a child in cardiac arrest.
What is the proper depth of compressions for a child?. Answer:
*Compress the chest at least one third the depth of the chest, about 2
inches (5 cm)*
◉ During PALS, you and another rescuers begin CPR. Your colleague
begins compressions, and you noticed that the compression rate is
too slow. What should you say to offer constructive feedback?.
Answer: *You need to compress at a rate of 100 to 120 per minute*
◉ You are preparing to use a manual defibrillator in the pediatric
setting. What best describes when it is appropriate to use the
smaller pediatric-sized paddles?. Answer: *If the child weighs less
than 10 kg or is less than 1 year old*
, ◉ You need to provide rescue breaths to a child victim with a pulse.
What is the appropriate rate for delivering breaths?. Answer: *1
breath every 3 to 5 seconds*
◉ You find an infant who is unresponsive, is not breathing, and does
not have a pulse. You shout for nearby help, but no one arrives. What
action should you take next?. Answer: *Provide CPR for about 2
minutes before leaving to activate the emergency response system*
◉ 3 yo boy presents with multiple-system trauma. Child was an
unrestrained passenger in a high-speed MVC. On primary
assessment, he is unresponsive to voice or painful stimulation. His
RR is 5/min, HR and pulses are 170/min, systolic BC is 60 mmHg,
capillary refill is 5 seconds, and SpO2 is 75% on room air. What
action should you take first?. Answer: *While a colleague provides
spinal motion restriction, open the airway with a jaw thrust and
provide bag-mask ventilation*
◉ You are assisting in the elective intubation of an average-sized 4
yo child with respiratory failure. Colleague is retrieving the color-
coded length-based tape from the resuscitation chart. What is likely
to be the estimated size of the uncuffed endotracheal tube for this
child?. Answer: *5-mm tube*
◉ You find a 10 yo boy to be unresponsive. You shout for help, and
after finding that he is not breathing and has no pulse, you and a
colleague begin CPR. Another colleague activates the emergency
EXAM II EXAM SCRIPT 2026 TESTED
QUESTIONS AND CORRECT ANSWERS
ALREADY PASSED
◉ Recognize *wide-complex tachycardia*. Answer:
◉ Recognize *SVT converting to sinus rhythm after adenosine
administration*. Answer:
◉ What oxygen delivery system most reliably delivers a high (90%
of greater) concentration of inspired oxygen to a 7-year-old child?.
Answer: Nonrebreathing face mask
◉ You are called to help treat an infant with severe symptomatic
bradycardia (heart rate 66/min) associated with respiratory
distress. Bradycardia persists despite establishment of an effective
airway, oxygenation, and ventilation. There is no heart block present.
What first drug should you administer?. Answer: *Epinephrine*
◉ You are part of a team attempting to resuscitate a child with
ventricular fibrillation cardiac arrest. You deliver 2 unsynchronized
shocks. A team member established IO access, so you give a dose of
epinephrine, 0.01 mg/kg IO. At next rhythm check, persistent
,ventricular fibrillation is present. You administer a 4-J/kg shock and
resume CPR. What drug and dose should be administered next?.
Answer: *Amiodarone 5 mg/kg IO*
- can be used for shock-refractory VF or pVT
◉ 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 sounds
(mild stridor) when agitated; otherwise, her breathing is quiet. Her
SpO2 is 92% on room air, and she has mild inspiratory intercostal
retractions. Lung auscultation reveals transmitted upper airway
sounds with adequate distal breath sounds bilaterally. Most
appropriate initial intervention for this child?. Answer: *Humidified
oxygen as tolerated*
◉ 7-year-old boy found unresponsive, apneic, and pulseless. CPR is
ongoing. Child is intubated, and vascular access is established. ECG
monitor shows organized rhythm with heart rate of 45/min, but a
pulse check reveals no palpable pulses. High-quality CPR is resumed,
and an initial IV dose of epinephrine is administered. What
intervention should you perform next?. Answer: *Identify and treat
reversible causes*
◉ You are caring for a 6-year-old patient who is receiving positive-
pressure mechanical ventilation via an endotracheal tube. Child
begins to move his head and suddenly becomes cyanotic, and his
,heart rate decreases. His SpO2 is 65%. You remove child from
mechanical ventilator and begin to provide manual ventilation with
a bag via endotracheal tube. During manual ventilation with 100%
oxygen, child's color and heart rate improve slightly and his BP
remains adequate. Breath sounds and chest expansion are present
and adequate on right side and are present but consistently
diminished on left side. Trachea not deviated, and neck veins are not
distended. Suction catheter passes easily beyond tip of the
endotracheal tube. Most likely cause of this child's acute
deterioration?. Answer: *Tracheal tube displacement into right main
bronchus*
◉ You are giving chest compressions for a child in cardiac arrest.
What is the proper depth of compressions for a child?. Answer:
*Compress the chest at least one third the depth of the chest, about 2
inches (5 cm)*
◉ During PALS, you and another rescuers begin CPR. Your colleague
begins compressions, and you noticed that the compression rate is
too slow. What should you say to offer constructive feedback?.
Answer: *You need to compress at a rate of 100 to 120 per minute*
◉ You are preparing to use a manual defibrillator in the pediatric
setting. What best describes when it is appropriate to use the
smaller pediatric-sized paddles?. Answer: *If the child weighs less
than 10 kg or is less than 1 year old*
, ◉ You need to provide rescue breaths to a child victim with a pulse.
What is the appropriate rate for delivering breaths?. Answer: *1
breath every 3 to 5 seconds*
◉ You find an infant who is unresponsive, is not breathing, and does
not have a pulse. You shout for nearby help, but no one arrives. What
action should you take next?. Answer: *Provide CPR for about 2
minutes before leaving to activate the emergency response system*
◉ 3 yo boy presents with multiple-system trauma. Child was an
unrestrained passenger in a high-speed MVC. On primary
assessment, he is unresponsive to voice or painful stimulation. His
RR is 5/min, HR and pulses are 170/min, systolic BC is 60 mmHg,
capillary refill is 5 seconds, and SpO2 is 75% on room air. What
action should you take first?. Answer: *While a colleague provides
spinal motion restriction, open the airway with a jaw thrust and
provide bag-mask ventilation*
◉ You are assisting in the elective intubation of an average-sized 4
yo child with respiratory failure. Colleague is retrieving the color-
coded length-based tape from the resuscitation chart. What is likely
to be the estimated size of the uncuffed endotracheal tube for this
child?. Answer: *5-mm tube*
◉ You find a 10 yo boy to be unresponsive. You shout for help, and
after finding that he is not breathing and has no pulse, you and a
colleague begin CPR. Another colleague activates the emergency
