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PALS Study Guide 2026

Everything you need to pass the PALS exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.

📋 PALS Exam Format at a Glance

50
Questions
120 min
Time Limit
84%
Passing Score
Take a Full PALS Exam Simulation →

📚 PALS Topics to Study (21)

Cardiac Arrest · 11 cardsTachycardia · 11 cardsAirway Management · 7 cardsAirway Management · 7 cardsAirway Management · 7 cardsBradycardia With a Pulse · 6 cardsCardiac Arrest Algorithm · 6 cardsHigh-Quality Pediatric BLS · 6 cardsManaging Respiratory Emergencies · 6 cardsPharmacology · 6 cardsShock Management · 6 cardsSystematic Assessment · 6 cardsPost-Cardiac Arrest Care · 6 cardsResuscitation Team Dynamics · 6 cardsTachycardia With a Pulse · 6 cardsPediatric Arrhythmia Recognition · 6 cardsPediatric Arrhythmia Recognition · 6 cardsPediatric Arrhythmia Recognition · 6 cardsVascular Access and Fluid Management in Pediatric Emergencies · 6 cardsVascular Access and Fluid Management in Pediatric Emergencies · 6 cardsVascular Access and Fluid Management in Pediatric Emergencies · 6 cards

✍️ Sample PALS Questions & Answers

1. After endotracheal intubation of a pediatric patient, the capnography waveform is flat. What does this most likely indicate?
✓ Esophageal intubation with tube in the wrong position

A flat capnography trace after intubation indicates no CO2 is being detected, which is consistent with esophageal placement where no gas exchange occurs.

2. Which formula is most commonly used to estimate uncuffed endotracheal tube size for a child older than 1 year?
✓ (Age in years / 4) + 4

The formula (Age in years ÷ 4) + 4 provides a reliable estimate of uncuffed ET tube internal diameter in millimeters for children over 1 year old.

3. A child with SVT who is stable is given adenosine 0.1 mg/kg IV without effect. What is the next step?
✓ Double the dose to 0.2 mg/kg IV (max 12 mg)

If the first dose of adenosine is ineffective, PALS recommends doubling the dose to 0.2 mg/kg IV (maximum 12 mg).

4. Which isotonic crystalloid is most commonly used for initial fluid resuscitation in pediatric shock per PALS?
✓ Normal saline (0.9% NaCl) or lactated Ringer's solution

Normal saline and lactated Ringer's are recommended isotonic crystalloids for initial fluid resuscitation in pediatric emergencies.

5. Which of the following is considered the MOST common cause of bradycardia in infants and children?
✓ Hypoxia

Unlike in adults, bradycardia in the pediatric population is most often a secondary event caused by hypoxia from respiratory failure or shock. This is why the initial steps of the PALS Bradycardia Algorithm always focus on establishing a patent airway, ensuring adequate oxygenation, and assisting ventilation.

6. In a child with bradycardia and a pulse that is unresponsive to oxygenation and ventilation, what is the heart rate threshold at which CPR should be initiated?
✓ Less than 60 bpm with poor perfusion

PALS guidelines state CPR should begin if heart rate is <60 bpm with signs of poor perfusion despite adequate oxygenation and ventilation.

🎯 Free PALS Practice Tests

Cardiac Arrest · 11 questionsTachycardia · 11 questionsAirway Management · 7 questionsAirway Management · 7 questionsAirway Management · 7 questionsManaging Respiratory Emergencies · 6 questionsSystematic Assessment · 6 questionsBradycardia With a Pulse · 6 questionsCardiac Arrest Algorithm · 6 questionsShock Management · 6 questions

📖 PALS Guides & Articles

Your PALS Study Path
1. Learn with Flashcards → 2. Drill Practice Tests → 3. Take the Full Exam Simulation
🃏 Flashcards (139)🏆 Exam Simulation