Many students who struggle with the PALS exam understand the material but have difficulty applying it under test conditions. They certainly know more than their scores show. The exam assesses more than memorized facts.  It tests your ability to assess a critically ill child, identify the likely problem, and follow the correct steps in a timely manner. You need to show this knowledge in both the written exam and the hands-on skills assessment.

This guide explains how to prepare for the PALS exam, organize your study time, and avoid common mistakes. For practical details about what to complete before class and what to bring, read our guide on how to prepare for PALS classes.

Know How Your PALS Course Is Tested

The rules depend on which organization issues your card, so check yours before you start studying.

AHA PALS. Every student must complete the PALS Precourse Self-Assessment, score at least 70%, and bring the printed score report to class. The AHA issues no course completion card without hands-on manikin skills testing, and students must also pass the required exam. The AHA's open-resource policy lets students use reference materials on exams taken online through eLearning. It does not allow discussion with other students or the instructor. The AHA's online PALS exam for the 2020 Guidelines course required a score of 84% or better, so confirm the current passing score with your instructor.

American Red Cross PALS. In the blended format, you pass a final written exam to complete the online portion. You then demonstrate your skills to a certified Red Cross instructor in person, and you must pass both parts. Experienced providers who show competency may be able to test out of some sessions.

Both certifications are valid for two years. KT Global CPR offers AHA PALS training and American Red Cross PALS training as blended classes. You must finish the online portion before your classroom session.

Study From Current Materials

The AHA released its 2025 Guidelines for CPR and Emergency Cardiovascular Care on October 22, 2025. AHA instructors were required to use the updated course materials starting March 1, 2026. Older study guides and flashcards may be out of date.

Use the provider materials issued for your course, and check the AHA's 2025 pediatric advanced life support guidelines for what changed.

Study Tips That Work

1. Use the precourse self-assessment as a map. Write down every question you miss, review that section of your provider materials, then retake the assessment.

2. Make the assessment approach automatic. The AHA course teaches an evaluate–identify–intervene sequence that repeats after every action. The Red Cross course teaches its own systematic approach. Learn the one your course uses until you can recite it under pressure.

3. Sort before you treat. Group respiratory problems by type and severity, shock by type, and rhythms into too fast, too slow, or pulseless. In PALS scenarios, the category points you to the treatment.

4. Pair every rhythm with its next step. Naming a rhythm is only half the answer. Know which algorithm it leads to and what changes when the child becomes unstable.

5. Understand weight-based dosing. Pediatric medication doses are calculated from the child's weight. Learn how the calculation works and where to find doses in your reference material, rather than memorizing a list of numbers.

6. Talk through cases out loud. Case scenarios are spoken, not written. Practice giving clear orders and confirming each task is done, the way a team leader would during a real resuscitation.

7. Practice infant and child CPR hands-on. BLS skills are tested in PALS classes, and instructors won't reteach CPR from scratch.

Common Mistakes on the PALS Exam

• Treating the self-assessment as a formality. Students who click through to reach 70% miss the clearest preview of the course.

• Confusing respiratory distress with respiratory failure. The two call for different levels of intervention.

• Skipping reassessment. PALS scenarios expect you to evaluate the child again after every intervention. Don't move on until you've checked how the child responded.

• Mixing up AHA and Red Cross requirements. The two programs use different course materials and assessment formats. Study only from the materials for the card you are earning.

• Leaning on open resource. Where the AHA open-resource policy applies, looking up every answer takes time and invites mistakes. Know your material well enough that the manual only confirms what you already think.

• Reading too fast. Exam questions hinge on details such as the child's age, level of consciousness, breathing effort, and perfusion. Read the whole scenario first.

• Arriving with rusty BLS skills. Weak compressions or slow AED use can set you back before the advanced content begins. If you're out of practice, take a BLS class before your PALS course.

Get Ready for PALS Classes in Houston

Start your precourse work early, study from current materials, and practice the assessment sequence until it feels routine.

KT Global CPR holds PALS classes at 400 N Sam Houston Pkwy E, Suite 280, Houston, Texas, for healthcare professionals across the Houston area. If your card is still current, see our AHA PALS certification renewal or Red Cross PALS certification renewal course. Call (832) 262-4622 with questions or to book your PALS course.