PALS Exam 2026 Question and Answer |
Updated Questions and Answers | Grade A+
• What are the signs of increased respiratory effort that can lead to
fatigue & respiratory failure? -✓✓Nasal flaring
Retractions
Head bobbing
Seesaw respirations
• Determine the respiratory rate by counting the number of times the
chest rises in [blank] seconds & multiplying by [blank]. -✓✓30
2
• Tachypnea is often the first sign of respiratory [blank] in infants. -
✓✓Distress
• What do central chemoreceptors respond to? -✓✓Hydrogen ions in the
cerebrospinal fluid
• Why may excessive ventilation during CPR be harmful? -✓✓It
impedes venous return
It increases intrathoracic pressure
• What should you do if you cannot achieve effective ventilation with a
bag-mask device? -✓✓Reposition the airway
Verify the mask size
• How are effective oxygenation & ventilation assessed? -✓✓Oxygen
saturation
Exhaled carbon dioxide
Visible chest rise w/ each breath
,• How can gastric inflation impair bag-mask ventilation? -✓✓It
decreases lung compliance
• What is the most appropriate precautionary action to minimize gastric
inflation during a bag-mask ventilation? -✓✓Deliver each breath over
about 1 second
• Which is true about the difference between hypoxemia & tissue
hypoxia? -✓✓Tissue hypoxia can occur with normal arterial oxygen
saturation
• What does hyperventilation, which refers to increased alveolar
ventilation, result in? -✓✓PaCO2 less than 35 mm Hg
• What happens to the arterial oxygen level in a child w/ severe anemia?
-✓✓May increase when dissolved oxygen is increased
• Which is true of increased carbon dioxide tension in arterial blood? -
✓✓May be caused by disordered control of breathing
• What happens when ventilation is inadequate? -✓✓PaCO2 increases
• What is a critical symptom of hypercarbia? -✓✓Decreased level of
consciousness
• Which of the following indicates mild respiratory distress? -✓✓Mild
increase in respiratory effort
• Which of the following indicates severe respiratory distress? -
✓✓Marked tachypnea &/or apnea
• Which of the following statements about respiratory failure is true? -
✓✓May occur w/o signs of respiratory distress
,• Which is most likely to be present in a child who has respiratory
distress [not respiratory failure]? -✓✓Ability to maintain a patent
airway
• What steps should be taken as part of initial management of a child in
respiratory distress? -✓✓Support an open airway
Monitor O2 saturation by pulse oximetry
Monitor heart rate, rhythm, & bp
• Which are ideal characteristics of face masks for ventilation? -
✓✓Covers mouth & nose
Has a soft rim
Transparent
• What is the rationale for using a transparent mask? -✓✓Allows you to
see the color of the child's lips
• What is the function of the nonrebreathing outlet valve of a self-
inflating bag? -✓✓Prevents rebreathing of carbon dioxide
• Which of the following is required to appropriately ventilate a child
with a flow-inflating bag? -✓✓Tidal volume needs to be delivered at
the correct rate
• What should be checked to ensure proper function of a bag-mask
system? -✓✓The pop-off valve can be closed
Oxygen tubing is connected to the device & the oxygen source
• How is sniffing position achieved in an infant or a child? -✓✓Ensure
that the external ear canal is anterior to the shoulder
, • Where may padding be required under when properly positioning a
child older than 2 years of age to maintain a patent airway? -✓✓The
occiput
• What actions are appropriate when providing 1-person bag-mask
ventilation? -✓✓Perform a head tilt, insert an oral airway, & squeeze
the bag until chest rise
• What does the E-C clamp technique include? -✓✓Using the third,
fourth, & fifth fingers of one hand along the jaw to lift it forward
Using the thumb & index finger of the same hand to hold the face mask
• When may a 2-person bag-mask technique be preferable? -✓✓When
making a seal is difficult
When there is significant airway resistance
• When suctioning a patient, which of the following should be
monitored? -✓✓Clinical appearance
Oxygen saturation
Heart rate
• What should you do to help reduce the risk of hypoxemia during
suctioning? -✓✓Limit suction attempts to 10 seconds or less
• Under what circumstance should you use an oropharyngeal airway? -
✓✓The child must be unconscious
• What can happen if the oropharyngeal airway is too large? -✓✓It can
block the airway
• When measuring for an oropharyngeal airway, it should extend from
the corner of the mouth to the angle of the [blank]. -✓✓Jaw
Updated Questions and Answers | Grade A+
• What are the signs of increased respiratory effort that can lead to
fatigue & respiratory failure? -✓✓Nasal flaring
Retractions
Head bobbing
Seesaw respirations
• Determine the respiratory rate by counting the number of times the
chest rises in [blank] seconds & multiplying by [blank]. -✓✓30
2
• Tachypnea is often the first sign of respiratory [blank] in infants. -
✓✓Distress
• What do central chemoreceptors respond to? -✓✓Hydrogen ions in the
cerebrospinal fluid
• Why may excessive ventilation during CPR be harmful? -✓✓It
impedes venous return
It increases intrathoracic pressure
• What should you do if you cannot achieve effective ventilation with a
bag-mask device? -✓✓Reposition the airway
Verify the mask size
• How are effective oxygenation & ventilation assessed? -✓✓Oxygen
saturation
Exhaled carbon dioxide
Visible chest rise w/ each breath
,• How can gastric inflation impair bag-mask ventilation? -✓✓It
decreases lung compliance
• What is the most appropriate precautionary action to minimize gastric
inflation during a bag-mask ventilation? -✓✓Deliver each breath over
about 1 second
• Which is true about the difference between hypoxemia & tissue
hypoxia? -✓✓Tissue hypoxia can occur with normal arterial oxygen
saturation
• What does hyperventilation, which refers to increased alveolar
ventilation, result in? -✓✓PaCO2 less than 35 mm Hg
• What happens to the arterial oxygen level in a child w/ severe anemia?
-✓✓May increase when dissolved oxygen is increased
• Which is true of increased carbon dioxide tension in arterial blood? -
✓✓May be caused by disordered control of breathing
• What happens when ventilation is inadequate? -✓✓PaCO2 increases
• What is a critical symptom of hypercarbia? -✓✓Decreased level of
consciousness
• Which of the following indicates mild respiratory distress? -✓✓Mild
increase in respiratory effort
• Which of the following indicates severe respiratory distress? -
✓✓Marked tachypnea &/or apnea
• Which of the following statements about respiratory failure is true? -
✓✓May occur w/o signs of respiratory distress
,• Which is most likely to be present in a child who has respiratory
distress [not respiratory failure]? -✓✓Ability to maintain a patent
airway
• What steps should be taken as part of initial management of a child in
respiratory distress? -✓✓Support an open airway
Monitor O2 saturation by pulse oximetry
Monitor heart rate, rhythm, & bp
• Which are ideal characteristics of face masks for ventilation? -
✓✓Covers mouth & nose
Has a soft rim
Transparent
• What is the rationale for using a transparent mask? -✓✓Allows you to
see the color of the child's lips
• What is the function of the nonrebreathing outlet valve of a self-
inflating bag? -✓✓Prevents rebreathing of carbon dioxide
• Which of the following is required to appropriately ventilate a child
with a flow-inflating bag? -✓✓Tidal volume needs to be delivered at
the correct rate
• What should be checked to ensure proper function of a bag-mask
system? -✓✓The pop-off valve can be closed
Oxygen tubing is connected to the device & the oxygen source
• How is sniffing position achieved in an infant or a child? -✓✓Ensure
that the external ear canal is anterior to the shoulder
, • Where may padding be required under when properly positioning a
child older than 2 years of age to maintain a patent airway? -✓✓The
occiput
• What actions are appropriate when providing 1-person bag-mask
ventilation? -✓✓Perform a head tilt, insert an oral airway, & squeeze
the bag until chest rise
• What does the E-C clamp technique include? -✓✓Using the third,
fourth, & fifth fingers of one hand along the jaw to lift it forward
Using the thumb & index finger of the same hand to hold the face mask
• When may a 2-person bag-mask technique be preferable? -✓✓When
making a seal is difficult
When there is significant airway resistance
• When suctioning a patient, which of the following should be
monitored? -✓✓Clinical appearance
Oxygen saturation
Heart rate
• What should you do to help reduce the risk of hypoxemia during
suctioning? -✓✓Limit suction attempts to 10 seconds or less
• Under what circumstance should you use an oropharyngeal airway? -
✓✓The child must be unconscious
• What can happen if the oropharyngeal airway is too large? -✓✓It can
block the airway
• When measuring for an oropharyngeal airway, it should extend from
the corner of the mouth to the angle of the [blank]. -✓✓Jaw
