PALS Pediatric Emergency
Resuscitation Final Exam With Actual
Questions & Verified Answers ,Plus
Explained Rationales/Expert Verified
For Guaranteed Pass 2026/Latest
Update/Instant Download Pdf
1. A 4-year-old is found unresponsive and not breathing. What is
the first action you should take?
A) Start chest compressions immediately
B) Check for a pulse
C) Activate the emergency response system
D) Give rescue breaths
Answer: C) Activate the emergency response system
Rationale: In pediatric emergencies, early activation of emergency
services ensures timely advanced care. After confirming
unresponsiveness and lack of normal breathing, calling for help is
critical before starting interventions.
2. What is the recommended compression-to-ventilation ratio for
a single rescuer in a child cardiac arrest?
A) 15:2
B) 30:2
C) 5:1
D) 20:2
,Answer: B) 30:2
Rationale: For a single rescuer in pediatric CPR, the compression-to-
ventilation ratio is 30:2. If there are two rescuers, it is 15:2.
3. During a pediatric bradycardia with poor perfusion, what is the
first-line treatment?
A) Epinephrine
B) Atropine
C) Defibrillation
D) IV fluids
Answer: B) Atropine
Rationale: Bradycardia with poor perfusion due to vagal
stimulation or increased vagal tone may respond to atropine.
Epinephrine is used if bradycardia persists and is causing shock.
4. The most common cause of cardiac arrest in children is:
A) Ventricular fibrillation
B) Respiratory failure
C) Myocardial infarction
D) Stroke
Answer: B) Respiratory failure
Rationale: Unlike adults, pediatric cardiac arrest is usually
secondary to hypoxia from respiratory failure or shock, not primary
arrhythmias.
5. Which medication is recommended for pediatric pulseless
ventricular tachycardia or ventricular fibrillation?
A) Amiodarone
B) Adenosine
C) Dopamine
D) Calcium chloride
,Answer: A) Amiodarone
Rationale: Amiodarone is indicated for refractory shockable
rhythms like VT or VF in pediatric patients.
6. A child with severe anaphylaxis is unresponsive and has no
pulse. What is the first drug to administer?
A) Epinephrine IV
B) Epinephrine IM
C) Atropine
D) Amiodarone
Answer: A) Epinephrine IV
Rationale: In pulseless arrest due to anaphylaxis, IV epinephrine is
used as the first-line drug to restore circulation.
7. What is the recommended initial energy dose for defibrillation
in a pediatric patient?
A) 1-2 J/kg
B) 2-4 J/kg
C) 4-6 J/kg
D) 5-10 J/kg
Answer: B) 2-4 J/kg
Rationale: Initial defibrillation in pediatric VF or pulseless VT should
be 2-4 J/kg. Subsequent doses may be higher (4 J/kg).
8. In a pediatric patient with shock, which IV fluid is preferred
initially?
A) 5% dextrose
B) 0.9% normal saline
C) Lactated Ringer’s
D) Albumin
, Answer: B) 0.9% normal saline
Rationale: Isotonic crystalloids like normal saline are first-line for
fluid resuscitation in pediatric shock.
9. Which sign indicates inadequate perfusion in a child?
A) Warm extremities
B) Capillary refill >3 seconds
C) Bounding pulse
D) Normal heart rate
Answer: B) Capillary refill >3 seconds
Rationale: Delayed capillary refill (>3 seconds) indicates poor
perfusion and possible shock.
10. What is the first step in airway management for a
pediatric patient with severe respiratory distress?
A) Endotracheal intubation
B) Bag-mask ventilation
C) Oxygen via face mask
D) Suctioning
Answer: C) Oxygen via face mask
Rationale: Oxygen therapy is the first step to correct hypoxia before
progressing to advanced airway interventions.
11. A 7-year-old in respiratory arrest has a pulse of 70 bpm.
What is the correct intervention?
A) CPR immediately
B) Rescue breathing at 1 breath every 2-3 seconds
C) Chest compressions only
D) Administer epinephrine
Resuscitation Final Exam With Actual
Questions & Verified Answers ,Plus
Explained Rationales/Expert Verified
For Guaranteed Pass 2026/Latest
Update/Instant Download Pdf
1. A 4-year-old is found unresponsive and not breathing. What is
the first action you should take?
A) Start chest compressions immediately
B) Check for a pulse
C) Activate the emergency response system
D) Give rescue breaths
Answer: C) Activate the emergency response system
Rationale: In pediatric emergencies, early activation of emergency
services ensures timely advanced care. After confirming
unresponsiveness and lack of normal breathing, calling for help is
critical before starting interventions.
2. What is the recommended compression-to-ventilation ratio for
a single rescuer in a child cardiac arrest?
A) 15:2
B) 30:2
C) 5:1
D) 20:2
,Answer: B) 30:2
Rationale: For a single rescuer in pediatric CPR, the compression-to-
ventilation ratio is 30:2. If there are two rescuers, it is 15:2.
3. During a pediatric bradycardia with poor perfusion, what is the
first-line treatment?
A) Epinephrine
B) Atropine
C) Defibrillation
D) IV fluids
Answer: B) Atropine
Rationale: Bradycardia with poor perfusion due to vagal
stimulation or increased vagal tone may respond to atropine.
Epinephrine is used if bradycardia persists and is causing shock.
4. The most common cause of cardiac arrest in children is:
A) Ventricular fibrillation
B) Respiratory failure
C) Myocardial infarction
D) Stroke
Answer: B) Respiratory failure
Rationale: Unlike adults, pediatric cardiac arrest is usually
secondary to hypoxia from respiratory failure or shock, not primary
arrhythmias.
5. Which medication is recommended for pediatric pulseless
ventricular tachycardia or ventricular fibrillation?
A) Amiodarone
B) Adenosine
C) Dopamine
D) Calcium chloride
,Answer: A) Amiodarone
Rationale: Amiodarone is indicated for refractory shockable
rhythms like VT or VF in pediatric patients.
6. A child with severe anaphylaxis is unresponsive and has no
pulse. What is the first drug to administer?
A) Epinephrine IV
B) Epinephrine IM
C) Atropine
D) Amiodarone
Answer: A) Epinephrine IV
Rationale: In pulseless arrest due to anaphylaxis, IV epinephrine is
used as the first-line drug to restore circulation.
7. What is the recommended initial energy dose for defibrillation
in a pediatric patient?
A) 1-2 J/kg
B) 2-4 J/kg
C) 4-6 J/kg
D) 5-10 J/kg
Answer: B) 2-4 J/kg
Rationale: Initial defibrillation in pediatric VF or pulseless VT should
be 2-4 J/kg. Subsequent doses may be higher (4 J/kg).
8. In a pediatric patient with shock, which IV fluid is preferred
initially?
A) 5% dextrose
B) 0.9% normal saline
C) Lactated Ringer’s
D) Albumin
, Answer: B) 0.9% normal saline
Rationale: Isotonic crystalloids like normal saline are first-line for
fluid resuscitation in pediatric shock.
9. Which sign indicates inadequate perfusion in a child?
A) Warm extremities
B) Capillary refill >3 seconds
C) Bounding pulse
D) Normal heart rate
Answer: B) Capillary refill >3 seconds
Rationale: Delayed capillary refill (>3 seconds) indicates poor
perfusion and possible shock.
10. What is the first step in airway management for a
pediatric patient with severe respiratory distress?
A) Endotracheal intubation
B) Bag-mask ventilation
C) Oxygen via face mask
D) Suctioning
Answer: C) Oxygen via face mask
Rationale: Oxygen therapy is the first step to correct hypoxia before
progressing to advanced airway interventions.
11. A 7-year-old in respiratory arrest has a pulse of 70 bpm.
What is the correct intervention?
A) CPR immediately
B) Rescue breathing at 1 breath every 2-3 seconds
C) Chest compressions only
D) Administer epinephrine
