PALS Pre-Test 2026 | Pediatric Advanced Life Support Study Guide & Practice Questions
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired
oxygen to a 7-year-old child? - (answer)Nonrebreathing face mask
Which statement is correct about the effects of epinephrine during attempted resuscitation? -
(answer)Epinephrine stimulates spontaneous contractions when asystole is present
You are part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You
delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of
epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You
administer a 4-J/kg shock and resume CPR. Which drug and dose should be administered next. -
(answer)Amiodarone 5 mg/kg IO
You are called to help treat an infant with severe symptomatic bradycardia (heart rate 66/min)
associated with respiratory distress. The bradycardia persists despite establishment of an effective
airway, oxygenation, and ventilation. There is no heart block present. Which is the first drug you should
administer? - (answer)Epinephrine
A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency
department by her parents. During your assessment, you find that the infant responds only to painful
stimulation. The infant's respiratory rate is 40 breaths per minute and central pulses are rapid and weak.
The infant has good bilateral breath sounds, cool extremities, and capillary refill time of more than 5
seconds. The infant's blood pressure is 85/65 mm Hg, and glucose is 30 mg/dL (1.65 mmol/L). You
administer 100% oxygen via face mask and start an IV. Which treatment is the most appropriate for this
infant? - (answer)Administer a bolus of isotonic crystalloid 20 mL/kg over 5 to 20 minutes, and also give
D25W 2 to 4 mL/kg IV
Which statement is correct about the use of calcium chloride in pediatric patients? - (answer)Routine
administration is not indicated during cardiac arrest
Which statement is correct about endotracheal drug administration during resuscitative efforts for
pediatric patients? - (answer)It is the least desirable route of administration
A 9-year-old boy is agitated and leaning forward on the bed in obvious respiratory distress. The patient
is speaking in short phrases and tells you that he has asthma but does not carry an inhaler. He has nasal
flaring, severe suprasternal and intercostal retractions, and decreased air movement with prolonged
, PALS Pre-Test 2026 | Pediatric Advanced Life Support Study Guide & Practice Questions
respiratory time and wheezing. You administer 100% oxygen by a nonrebreathing mask. His SpO2 is
92%. Which medication do you prepare to give to this patient? - (answer)Albuterol
Paramedics are called to the home of a 1-year-old child. Their initial assessment reveals a child who
responds only to painful stimuli and has irregular breathing, faint central pulses, bruises over the
abdomen, abdominal distention, and cyanosis. Bag-mask ventilation with 100% oxygen is initiated. The
child's heart rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely
palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the
emergency department, the child is intubated and ventilated with 100% oxygen, and IV access is
established. The heart rate is no 150/min with weak central pulses but no distal pulses. Systolic blood
pressure is 74 mm Hg. Which intervention should be provided next? - (answer)Rapid bolus of 20ml/kg of
isotonic crystalloid
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 sound bilaterally. Which is the most appropriate initial intervention for this child?
- (answer)Humidified oxygen as tolerated
An 8-month-old infant is brought to the emergency department for evaluation of severe diarrhea and
dehydration. On arrival to the emergency department, the infant become unresponsive, apneic, and
pulseless. You should for help and start CPR. Another provider arrives, at which point you switch to 2-
rescuer CPR. The rhythm shown here is seen on the cardiac monitor. The infant is intubated and
ventilated with 100% oxygen. An IO line is established, and a dose of epinephrine is given. While
continuing high-quality CPR, what do you do next? - (answer)Give normal saline 20 mL/kg IO rapidly
You are alone and witness a child suddenly collapse. There is no suspected head or neck injury. A
colleague responded to your shout for help and is activating the emergency response system and is
retrieving the resuscitation equipment, including a defibrillator. After delivering 30 compressions, what
would be your next action? - (answer)Open the airway with a head tilt-chin lift maneuver and give 2
breaths
What ratio of compressions to breaths should be used for 1-rescuer child CPR? - (answer)30
compressions to 2 breaths
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired
oxygen to a 7-year-old child? - (answer)Nonrebreathing face mask
Which statement is correct about the effects of epinephrine during attempted resuscitation? -
(answer)Epinephrine stimulates spontaneous contractions when asystole is present
You are part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You
delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of
epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You
administer a 4-J/kg shock and resume CPR. Which drug and dose should be administered next. -
(answer)Amiodarone 5 mg/kg IO
You are called to help treat an infant with severe symptomatic bradycardia (heart rate 66/min)
associated with respiratory distress. The bradycardia persists despite establishment of an effective
airway, oxygenation, and ventilation. There is no heart block present. Which is the first drug you should
administer? - (answer)Epinephrine
A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency
department by her parents. During your assessment, you find that the infant responds only to painful
stimulation. The infant's respiratory rate is 40 breaths per minute and central pulses are rapid and weak.
The infant has good bilateral breath sounds, cool extremities, and capillary refill time of more than 5
seconds. The infant's blood pressure is 85/65 mm Hg, and glucose is 30 mg/dL (1.65 mmol/L). You
administer 100% oxygen via face mask and start an IV. Which treatment is the most appropriate for this
infant? - (answer)Administer a bolus of isotonic crystalloid 20 mL/kg over 5 to 20 minutes, and also give
D25W 2 to 4 mL/kg IV
Which statement is correct about the use of calcium chloride in pediatric patients? - (answer)Routine
administration is not indicated during cardiac arrest
Which statement is correct about endotracheal drug administration during resuscitative efforts for
pediatric patients? - (answer)It is the least desirable route of administration
A 9-year-old boy is agitated and leaning forward on the bed in obvious respiratory distress. The patient
is speaking in short phrases and tells you that he has asthma but does not carry an inhaler. He has nasal
flaring, severe suprasternal and intercostal retractions, and decreased air movement with prolonged
, PALS Pre-Test 2026 | Pediatric Advanced Life Support Study Guide & Practice Questions
respiratory time and wheezing. You administer 100% oxygen by a nonrebreathing mask. His SpO2 is
92%. Which medication do you prepare to give to this patient? - (answer)Albuterol
Paramedics are called to the home of a 1-year-old child. Their initial assessment reveals a child who
responds only to painful stimuli and has irregular breathing, faint central pulses, bruises over the
abdomen, abdominal distention, and cyanosis. Bag-mask ventilation with 100% oxygen is initiated. The
child's heart rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely
palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the
emergency department, the child is intubated and ventilated with 100% oxygen, and IV access is
established. The heart rate is no 150/min with weak central pulses but no distal pulses. Systolic blood
pressure is 74 mm Hg. Which intervention should be provided next? - (answer)Rapid bolus of 20ml/kg of
isotonic crystalloid
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 sound bilaterally. Which is the most appropriate initial intervention for this child?
- (answer)Humidified oxygen as tolerated
An 8-month-old infant is brought to the emergency department for evaluation of severe diarrhea and
dehydration. On arrival to the emergency department, the infant become unresponsive, apneic, and
pulseless. You should for help and start CPR. Another provider arrives, at which point you switch to 2-
rescuer CPR. The rhythm shown here is seen on the cardiac monitor. The infant is intubated and
ventilated with 100% oxygen. An IO line is established, and a dose of epinephrine is given. While
continuing high-quality CPR, what do you do next? - (answer)Give normal saline 20 mL/kg IO rapidly
You are alone and witness a child suddenly collapse. There is no suspected head or neck injury. A
colleague responded to your shout for help and is activating the emergency response system and is
retrieving the resuscitation equipment, including a defibrillator. After delivering 30 compressions, what
would be your next action? - (answer)Open the airway with a head tilt-chin lift maneuver and give 2
breaths
What ratio of compressions to breaths should be used for 1-rescuer child CPR? - (answer)30
compressions to 2 breaths
