American Heart Association
PALS Provider
Written Exam
Version A
October 2022
PALS Provider
Exam Version A (33 questions)
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale color. The
primary assessment reveals that the airway is open and the respiratory rate is 30/min, with
crackles heard on auscultation. The cardiac monitor shows sinus tachycardia at a rate of 165/min.
The pulse oximeter displays an oxygen saturation of 95% and a pulse rate of 93/min. On the basis
of this information, which of the following provides the best interpretation of the oxygen
saturation of 95% by pulse oximetry?
D. Unreliable; supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been treated with
chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min, respiratory
rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is less than 2 seconds.
What is the child’s most likely condition?
A. Septic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding. Blood pressure is
55/40 mm Hg. What term describes this infant’s blood pressure?
A. Hypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of epinephrine at 0.1
mg/kg to be given IO. What should the team member do?
C. Respectfully ask the team leader to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
, 6. Which of the following is most likely to produce a prolonged expiratory phase and wheezing?
C. Lower airway obstruction
7. A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few
minutes ago. Which of the following most likely to be abnormal?
D. Control of breathing
8. What abnormality is most likely to be present in children with acute respiratory distress caused
by lung tissue disease?
A. Decreased oxygen saturation
9. An alert 2-year-old child with an increased work of breathing and pink color is being evaluated.
Heart rate is 110/min, and respiratory rate is 30/min. What would best describe this patient’s
condition?
A. Respiratory distress
10. The parents of a 7-year-old child who is undergoing chemotherapy report that the child has
been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals the
following: The child is difficult to arouse, with pale color. The child’s heart rate is 160/min,
respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds,
and temperature is 103°F (39.4°C). What is the most appropriate intervention?
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression reveals an
unresponsive child with intermittent apnea and mottled color. Heart rate is 166/min, respiratory
rate is now being supported with bag-mask ventilation, capillary refill time is 5 to 6 seconds, and
temperature is 102°F (38.9°C). What is the best method of establishing immediate vascular
access?
D. Place an intraosseous line
12. What is the appropriate fluid bolus to administer for a child with hypovolemic shock with
adequate myocardial function?
C. 20 mL/kg normal saline
13. An alert toddler presents with a barking cough, moderate stridor, and moderate retractions.
The child’s color is pink. What is the most appropriate initial intervention?
B. Administer nebulized epinephrine
PALS Provider
Written Exam
Version A
October 2022
PALS Provider
Exam Version A (33 questions)
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale color. The
primary assessment reveals that the airway is open and the respiratory rate is 30/min, with
crackles heard on auscultation. The cardiac monitor shows sinus tachycardia at a rate of 165/min.
The pulse oximeter displays an oxygen saturation of 95% and a pulse rate of 93/min. On the basis
of this information, which of the following provides the best interpretation of the oxygen
saturation of 95% by pulse oximetry?
D. Unreliable; supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been treated with
chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min, respiratory
rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is less than 2 seconds.
What is the child’s most likely condition?
A. Septic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding. Blood pressure is
55/40 mm Hg. What term describes this infant’s blood pressure?
A. Hypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of epinephrine at 0.1
mg/kg to be given IO. What should the team member do?
C. Respectfully ask the team leader to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
, 6. Which of the following is most likely to produce a prolonged expiratory phase and wheezing?
C. Lower airway obstruction
7. A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few
minutes ago. Which of the following most likely to be abnormal?
D. Control of breathing
8. What abnormality is most likely to be present in children with acute respiratory distress caused
by lung tissue disease?
A. Decreased oxygen saturation
9. An alert 2-year-old child with an increased work of breathing and pink color is being evaluated.
Heart rate is 110/min, and respiratory rate is 30/min. What would best describe this patient’s
condition?
A. Respiratory distress
10. The parents of a 7-year-old child who is undergoing chemotherapy report that the child has
been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals the
following: The child is difficult to arouse, with pale color. The child’s heart rate is 160/min,
respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds,
and temperature is 103°F (39.4°C). What is the most appropriate intervention?
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression reveals an
unresponsive child with intermittent apnea and mottled color. Heart rate is 166/min, respiratory
rate is now being supported with bag-mask ventilation, capillary refill time is 5 to 6 seconds, and
temperature is 102°F (38.9°C). What is the best method of establishing immediate vascular
access?
D. Place an intraosseous line
12. What is the appropriate fluid bolus to administer for a child with hypovolemic shock with
adequate myocardial function?
C. 20 mL/kg normal saline
13. An alert toddler presents with a barking cough, moderate stridor, and moderate retractions.
The child’s color is pink. What is the most appropriate initial intervention?
B. Administer nebulized epinephrine
