Advanced Pediatric Advanced Life Support
(PALS) Multiple Choice Questions (MCQs)
with Answers and Explanations for
Professional Certification Exams
1. A 4-year-old child is unresponsive, apneic, and pulseless. Which action should the
healthcare provider perform immediately after confirming pulselessness?
A. Obtain intravenous access
B. Administer epinephrine
C. Defibrillate at 2 J/kg
D. Begin high-quality cardiopulmonary resuscitation
Explanation: High-quality CPR is the priority intervention for any pulseless pediatric patient
and should be initiated immediately to maintain perfusion.
2. A 6-year-old child with ventricular fibrillation is undergoing resuscitation. What is the
recommended initial defibrillation dose?
A. 0.5 J/kg
B. 1 J/kg
C. 2 J/kg
D. 10 J/kg
Explanation: The initial recommended energy dose for pediatric defibrillation is 2 J/kg, followed
by subsequent doses of at least 4 J/kg if necessary.
3. Which rhythm is considered shockable in pediatric cardiac arrest?
A. Asystole
B. Pulseless electrical activity
C. Sinus bradycardia
D. Ventricular fibrillation
, Explanation: Ventricular fibrillation and pulseless ventricular tachycardia are shockable
rhythms requiring immediate defibrillation.
4. A 2-year-old child with severe respiratory distress has a heart rate of 55/min and signs of
poor perfusion despite oxygenation and ventilation. Which intervention is indicated?
A. Adenosine administration
B. Defibrillation
C. Synchronized cardioversion
D. Initiate chest compressions
Explanation: In infants and children, chest compressions are indicated when the heart rate is
below 60/min with signs of poor perfusion despite adequate oxygenation and ventilation.
5. Which medication is recommended as the first-line drug during pediatric pulseless
cardiac arrest?
A. Atropine
B. Lidocaine
C. Amiodarone
D. Epinephrine
Explanation: Epinephrine is the primary vasopressor used during pediatric cardiac arrest and
should be administered promptly.
6. A child presents with supraventricular tachycardia and remains hemodynamically stable.
Which intervention should be attempted first?
A. Immediate synchronized cardioversion
B. Defibrillation
C. Intravenous epinephrine
D. Vagal maneuvers
Explanation: Vagal maneuvers are the initial intervention for stable supraventricular
tachycardia in pediatric patients.
7. Which finding indicates compensated shock in a pediatric patient?
(PALS) Multiple Choice Questions (MCQs)
with Answers and Explanations for
Professional Certification Exams
1. A 4-year-old child is unresponsive, apneic, and pulseless. Which action should the
healthcare provider perform immediately after confirming pulselessness?
A. Obtain intravenous access
B. Administer epinephrine
C. Defibrillate at 2 J/kg
D. Begin high-quality cardiopulmonary resuscitation
Explanation: High-quality CPR is the priority intervention for any pulseless pediatric patient
and should be initiated immediately to maintain perfusion.
2. A 6-year-old child with ventricular fibrillation is undergoing resuscitation. What is the
recommended initial defibrillation dose?
A. 0.5 J/kg
B. 1 J/kg
C. 2 J/kg
D. 10 J/kg
Explanation: The initial recommended energy dose for pediatric defibrillation is 2 J/kg, followed
by subsequent doses of at least 4 J/kg if necessary.
3. Which rhythm is considered shockable in pediatric cardiac arrest?
A. Asystole
B. Pulseless electrical activity
C. Sinus bradycardia
D. Ventricular fibrillation
, Explanation: Ventricular fibrillation and pulseless ventricular tachycardia are shockable
rhythms requiring immediate defibrillation.
4. A 2-year-old child with severe respiratory distress has a heart rate of 55/min and signs of
poor perfusion despite oxygenation and ventilation. Which intervention is indicated?
A. Adenosine administration
B. Defibrillation
C. Synchronized cardioversion
D. Initiate chest compressions
Explanation: In infants and children, chest compressions are indicated when the heart rate is
below 60/min with signs of poor perfusion despite adequate oxygenation and ventilation.
5. Which medication is recommended as the first-line drug during pediatric pulseless
cardiac arrest?
A. Atropine
B. Lidocaine
C. Amiodarone
D. Epinephrine
Explanation: Epinephrine is the primary vasopressor used during pediatric cardiac arrest and
should be administered promptly.
6. A child presents with supraventricular tachycardia and remains hemodynamically stable.
Which intervention should be attempted first?
A. Immediate synchronized cardioversion
B. Defibrillation
C. Intravenous epinephrine
D. Vagal maneuvers
Explanation: Vagal maneuvers are the initial intervention for stable supraventricular
tachycardia in pediatric patients.
7. Which finding indicates compensated shock in a pediatric patient?
