1
PEDIATRIC ADVANCED LIFE SUPPORT EXAM LATEST UPDATES -
2025/2026- ACTUAL QUESTIONS WITH VERIFIED ANSWERS
ALREADY GRADED A+ GUARANTEED SUCCESS
You are giving chest compressions for a child in cardiac arrest. What is the proper
depth of compressions for a child?
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?
You need to compress at a rate of 100 to 120 per minute
What oxygen delivery system most reliably delivers a high (90% of greater)
concentration of inspired oxygen to a 7-year-old child?
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?
Epinephrine
, 2
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?
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?
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?
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
, 3
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?
Tracheal tube displacement into right main bronchus
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?
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?
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?
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?
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?
, 4
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 response system, brings the emergency
equipment, and places the child on a cardiac monitor/defibrillator, which reveals
ventricular tachycardia. You attempt defib at 2 J/kg and give 2 minutes of CPR.
The rhythm persists at the second rhythm check, at which point you attempt
defibrillation with 4 J/kg. A fourth colleague arrives, starts an IV, and administers
1 dose of epinephrine 0.01 mg/kg. If v fib or pulseless ventricular tachycardia
persists after 2 minutes of CPR, you will administer another shock. What drug and
dose should be administered?
Lidocaine 1 mg/kg IV
During bag-mask ventilation, how should you hold the mask to make an effective
seal between the child's face and the mask?
Position your fingers using the E-C clamp technique
Age of infants
<1 yo (excluding the newly born)
Age of children
from 1 year of age to puberty
To perform a pulse check in an infant, palpate a
brachial pulse
- if you don't definitely feel a pulse within 10 seconds, starts CPR, beginning with
chest compressions
To perform a pulse check in a child, palpate a
PEDIATRIC ADVANCED LIFE SUPPORT EXAM LATEST UPDATES -
2025/2026- ACTUAL QUESTIONS WITH VERIFIED ANSWERS
ALREADY GRADED A+ GUARANTEED SUCCESS
You are giving chest compressions for a child in cardiac arrest. What is the proper
depth of compressions for a child?
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?
You need to compress at a rate of 100 to 120 per minute
What oxygen delivery system most reliably delivers a high (90% of greater)
concentration of inspired oxygen to a 7-year-old child?
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?
Epinephrine
, 2
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?
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?
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?
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
, 3
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?
Tracheal tube displacement into right main bronchus
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?
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?
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?
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?
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?
, 4
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 response system, brings the emergency
equipment, and places the child on a cardiac monitor/defibrillator, which reveals
ventricular tachycardia. You attempt defib at 2 J/kg and give 2 minutes of CPR.
The rhythm persists at the second rhythm check, at which point you attempt
defibrillation with 4 J/kg. A fourth colleague arrives, starts an IV, and administers
1 dose of epinephrine 0.01 mg/kg. If v fib or pulseless ventricular tachycardia
persists after 2 minutes of CPR, you will administer another shock. What drug and
dose should be administered?
Lidocaine 1 mg/kg IV
During bag-mask ventilation, how should you hold the mask to make an effective
seal between the child's face and the mask?
Position your fingers using the E-C clamp technique
Age of infants
<1 yo (excluding the newly born)
Age of children
from 1 year of age to puberty
To perform a pulse check in an infant, palpate a
brachial pulse
- if you don't definitely feel a pulse within 10 seconds, starts CPR, beginning with
chest compressions
To perform a pulse check in a child, palpate a
