AHA PALS EXAM NEWEST 2025/2026 ACTUAL EXAM TEST
BANK 200 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+
Capillary refill..ANSWER..Capillary refill time is the time it takes for
blood to return to tissue blanched by pressure. It increases as skin
perfusion decreases. Note that normal capillary refill time is 2 seconds
or less, and a prolonged capillary refill time may indicate low cardiac
output
Evaluate capillary refill in a neutral thermal environment (ie, room
temperature) by..ANSWER..• Lifting the extremity slightly above the
level of the heart
• Pressing on the skin
• Rapidly releasing the pressure
BGL in pediatrics..ANSWER..Hypoglycemia refers to blood glucose 45
mg/dL or less in the newly born and 60 mg/dL or less in a child. It may
result in brain injury if not recognized and effectively treated. Base
treatment decisions on patient symptoms, and potentially include
oral glucose. Monitor the blood glucose concentration of any seriously
ill infant or child. A low blood glucose concentration may cause
altered level of consciousness or even brain injury if it is not quickly
identified and adequately treated. Measure the blood glucose
concentration with a point-of-care glucose test.
Important factors associated with increased work of
breathing:..ANSWER..• Increased airway resistance (upper and lower)
• Decreased lung compliance
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,• Use of accessory muscles of respiration
• Disordered central nervous system control of breathing
Airway resistance..ANSWER..• Airway resistance, or the impedance to
airflow within the airways, is primarily increased by reducing the size
of the conducting airways, either by airway constriction or
inflammation. Turbulent airflow also causes increased airway
resistance. Airflow may become turbulent when the flow rate
increases, even if the airway size remains unchanged. When airway
resistance increases, work of breathing increases in an attempt to
maintain airflow despite the increase in airway resistance.
• Larger airways provide lower resistance to airflow than smaller.
Airway resistance decreases as lung volume increases (inflation)
because airway dilation accompanies lung inflation.
• Conditions such as edema, bronchoconstriction, secretions, mucus,
or a mediastinal mass impinging on large or small airways can
decrease airway size, thereby increasing airway resistance.
• Resistance in the upper airway, particularly in the nasal or
nasopharyngeal passages, can represent a significant portion of tot
Lung compliance..ANSWER..• Compliance refers to the distensibility of
the lung, chest wall, or both. Specifically, lung compliance is defined
as the change in lung volume produced by a change in driving
pressure across the lung. When lung compliance is high, the lungs
easily inflate, a large change in volume produced by a slight change in
driving pressure.
2|Page
,• The lungs are stiffer in a child with low lung compliance, so it takes
more effort to inflate them. To create a significant pressure gradient
to produce air flow into the stiff lung, the diaphragm contracts more
forcefully, increasing intrathoracic volume and reducing intrathoracic
pressure. Poorly compliant lungs will also lead to increased work of
breathing. During mechanical ventilation, increased positive airway
pressure is needed to achieve adequate ventilation when lung
compliance decreases.
Decreased lung compliance..ANSWER..• The chest wall in infants and
young children is compliant. Therefore, relatively small pressure
changes can move the chest wall. During normal breathing,
diaphragm contraction in infants pulls the lower ribs slightly inward
but does not cause significant chest retraction. However, forcefully
contracting the diaphragm results in a large drop in pressure within
the chest, pulling the chest inward (ie, retracting it) during inspiration.
• When lung compliance is reduced, maximum inspiratory effort may
not produce adequate tidal volume because marked retractions of the
chest wall limit lung expansion during inspiration.
Breathing is controlled by complex mechanisms involving.....ANSWER..•
Brainstem respiratory centers
• Central and peripheral chemoreceptors
• Voluntary control
Respiratory center..ANSWER..A group of respiratory centers located in
the brainstem controls spontaneous breathing. Voluntary control
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, from the cerebral cortex, such as breath holding, panting, and sighing,
can also override breathing. Conditions like infection of the central
nervous system, traumatic brain injury, and drug overdose can impair
respiratory drive, resulting in hypoventilation or even apnea.
Chemoreceptors..ANSWER..Note that central chemoreceptors
respond to changes in the hydrogen ion concentration of
cerebrospinal fluid, which is largely determined by the arterial CO2
tension (Paco,). Peripheral chemoreceptors (eg, the carotid body)
respond primarily to a decrease in arterial oxygen (Pa02); some
receptors also respond to an increase in Paco2
Healthcare providers often deliver excessive ventilation during CPR,
which is harmful because it.....ANSWER..• Increases intrathoracic
pressure and impedes venous return, thus decreasing filling of the
heart between compressions, reducing blood flow generated by the
next compression, and reducing coronary perfusion and cerebral
blood flow
• Causes air trapping and barotrauma in children with small airway
obstruction
• Increases the risk of regurgitation and aspiration in children without
an advanced airway
Awareness of Lung Compliance..ANSWER..• When performing bag-
mask ventilation, be aware of the child's lung compliance. A poorly
compliant lung is "stiff" or difficult to inflate. A sudden increase in
lung stiffness during ventilation with a bag may indicate airway
4|Page
BANK 200 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+
Capillary refill..ANSWER..Capillary refill time is the time it takes for
blood to return to tissue blanched by pressure. It increases as skin
perfusion decreases. Note that normal capillary refill time is 2 seconds
or less, and a prolonged capillary refill time may indicate low cardiac
output
Evaluate capillary refill in a neutral thermal environment (ie, room
temperature) by..ANSWER..• Lifting the extremity slightly above the
level of the heart
• Pressing on the skin
• Rapidly releasing the pressure
BGL in pediatrics..ANSWER..Hypoglycemia refers to blood glucose 45
mg/dL or less in the newly born and 60 mg/dL or less in a child. It may
result in brain injury if not recognized and effectively treated. Base
treatment decisions on patient symptoms, and potentially include
oral glucose. Monitor the blood glucose concentration of any seriously
ill infant or child. A low blood glucose concentration may cause
altered level of consciousness or even brain injury if it is not quickly
identified and adequately treated. Measure the blood glucose
concentration with a point-of-care glucose test.
Important factors associated with increased work of
breathing:..ANSWER..• Increased airway resistance (upper and lower)
• Decreased lung compliance
1|Page
,• Use of accessory muscles of respiration
• Disordered central nervous system control of breathing
Airway resistance..ANSWER..• Airway resistance, or the impedance to
airflow within the airways, is primarily increased by reducing the size
of the conducting airways, either by airway constriction or
inflammation. Turbulent airflow also causes increased airway
resistance. Airflow may become turbulent when the flow rate
increases, even if the airway size remains unchanged. When airway
resistance increases, work of breathing increases in an attempt to
maintain airflow despite the increase in airway resistance.
• Larger airways provide lower resistance to airflow than smaller.
Airway resistance decreases as lung volume increases (inflation)
because airway dilation accompanies lung inflation.
• Conditions such as edema, bronchoconstriction, secretions, mucus,
or a mediastinal mass impinging on large or small airways can
decrease airway size, thereby increasing airway resistance.
• Resistance in the upper airway, particularly in the nasal or
nasopharyngeal passages, can represent a significant portion of tot
Lung compliance..ANSWER..• Compliance refers to the distensibility of
the lung, chest wall, or both. Specifically, lung compliance is defined
as the change in lung volume produced by a change in driving
pressure across the lung. When lung compliance is high, the lungs
easily inflate, a large change in volume produced by a slight change in
driving pressure.
2|Page
,• The lungs are stiffer in a child with low lung compliance, so it takes
more effort to inflate them. To create a significant pressure gradient
to produce air flow into the stiff lung, the diaphragm contracts more
forcefully, increasing intrathoracic volume and reducing intrathoracic
pressure. Poorly compliant lungs will also lead to increased work of
breathing. During mechanical ventilation, increased positive airway
pressure is needed to achieve adequate ventilation when lung
compliance decreases.
Decreased lung compliance..ANSWER..• The chest wall in infants and
young children is compliant. Therefore, relatively small pressure
changes can move the chest wall. During normal breathing,
diaphragm contraction in infants pulls the lower ribs slightly inward
but does not cause significant chest retraction. However, forcefully
contracting the diaphragm results in a large drop in pressure within
the chest, pulling the chest inward (ie, retracting it) during inspiration.
• When lung compliance is reduced, maximum inspiratory effort may
not produce adequate tidal volume because marked retractions of the
chest wall limit lung expansion during inspiration.
Breathing is controlled by complex mechanisms involving.....ANSWER..•
Brainstem respiratory centers
• Central and peripheral chemoreceptors
• Voluntary control
Respiratory center..ANSWER..A group of respiratory centers located in
the brainstem controls spontaneous breathing. Voluntary control
3|Page
, from the cerebral cortex, such as breath holding, panting, and sighing,
can also override breathing. Conditions like infection of the central
nervous system, traumatic brain injury, and drug overdose can impair
respiratory drive, resulting in hypoventilation or even apnea.
Chemoreceptors..ANSWER..Note that central chemoreceptors
respond to changes in the hydrogen ion concentration of
cerebrospinal fluid, which is largely determined by the arterial CO2
tension (Paco,). Peripheral chemoreceptors (eg, the carotid body)
respond primarily to a decrease in arterial oxygen (Pa02); some
receptors also respond to an increase in Paco2
Healthcare providers often deliver excessive ventilation during CPR,
which is harmful because it.....ANSWER..• Increases intrathoracic
pressure and impedes venous return, thus decreasing filling of the
heart between compressions, reducing blood flow generated by the
next compression, and reducing coronary perfusion and cerebral
blood flow
• Causes air trapping and barotrauma in children with small airway
obstruction
• Increases the risk of regurgitation and aspiration in children without
an advanced airway
Awareness of Lung Compliance..ANSWER..• When performing bag-
mask ventilation, be aware of the child's lung compliance. A poorly
compliant lung is "stiff" or difficult to inflate. A sudden increase in
lung stiffness during ventilation with a bag may indicate airway
4|Page
