Knowing the material is only part of passing PALS. Knowing exactly what to expect on exam day — how the day is structured, what the written test looks like, how the skills evaluation works, and what logistical details can trip you up — removes a layer of anxiety and helps you perform at your best. This is a complete walkthrough of what your PALS exam day will look like.
The Two Parts of PALS: Written Exam and Skills Test
PALS certification requires passing two separate evaluations on the same day:
| Component | Format | Passing Standard |
|---|---|---|
| Written Exam | 50 multiple-choice questions, 90 minutes | 84% (42/50 correct) |
| Skills Test (Megacode) | Simulated resuscitation scenario with mannequin | Satisfactory performance on instructor checklist |
You must pass both components to receive your PALS certification card. Most courses administer the written exam first, then the skills stations and megacode scenario.
Before You Arrive: What to Complete in Advance
Most PALS courses today use a blended learning format. This means you're expected to complete an online self-study portion before you show up to the in-person skills day. If you haven't completed the online portion, you may not be permitted to participate in the course.
The online portion typically takes 4–6 hours for initial certification (2–3 hours for renewal). It covers the foundational content: PALS algorithms, pharmacology, assessment approach, and the science behind high-quality CPR. Complete it at least 24–48 hours before your in-person session — not the morning of.
Pre-course checklist
- ✓ Complete the online self-study module
- ✓ Print or download your course completion certificate (some sites require it)
- ✓ Know the location and parking situation
- ✓ Confirm what to bring (see below)
- ✓ Get a full night of sleep
What to Bring to Your PALS Course
Requirements vary by training center, but here's what most AHA-authorized sites expect:
- Photo ID — Required at most training centers to verify your identity before issuing the certification card.
- Online pre-course completion certificate — Some sites require a printed copy; others can look it up by your name. Confirm with your training center in advance.
- Current PALS card (if renewing) — Instructors will typically note your card number. Bring it if you have it.
- Comfortable clothes — You'll be kneeling beside mannequins doing CPR. Dress practically. Scrubs are the standard choice.
- Pen and notepad — For jotting notes during the skills practice sessions. Phones are typically put away during the written exam.
How the Day Flows
A typical PALS in-person course day runs roughly like this (times vary by training center and group size):
Renewal courses follow the same structure but are compressed — typically finishing by early afternoon.
What the Written Exam Is Actually Like
The PALS written exam is 50 multiple-choice questions with a single best answer for each. Most questions are scenario-based — they describe a patient presentation and ask what you should do next, what the most likely problem is, or what the correct dose or intervention is. Pure knowledge recall questions (define this term, what is this rhythm) are less common than applied scenario questions.
A few things to know about the format:
- All questions are equal weight. There's no partial credit and no penalty for wrong answers. If you're genuinely unsure, make your best guess — a blank is a guaranteed miss.
- Read each stem carefully. Many wrong answers are designed to be plausible for a different scenario. The specific patient age, rhythm finding, or vital sign detail in the question often determines which answer is correct.
- You have roughly 1 minute 48 seconds per question. This is comfortable — most people finish well before the 90-minute limit. Don't rush, but don't over-analyze either.
- You can go back and review. Most formats allow you to flag questions and return to them. Use this — flag any question you're unsure of and come back with fresh eyes.
If You Don't Pass the Written Exam
Most PALS courses allow a second written exam attempt on the same day, using a different version of the test. If you score below 84% on your first attempt, the instructor will typically let you know your result and offer the second attempt before or after the skills session.
If you don't pass on the second attempt, you'll need to retake the full course before testing again. Ask the instructor which content area caused the most trouble — this helps you focus your remediation before the next attempt.
Don't panic if you fail the first attempt
A first-attempt fail is not unusual. Take a breath, use the time before your second attempt to review the algorithms, and go back in calmly. Many providers who fail the first attempt by a few questions pass comfortably on the second attempt.
When Do You Get Your Certification Card?
Some training centers issue your certification card on the same day. Others issue a temporary card immediately and mail the official card within 3–4 weeks. Either way, the temporary card is valid — your employer will accept it as proof of certification while you wait for the official card.
Your card will list your name, certification date, and expiration date (two years from issue). Keep a photo of it in your phone — you'll be asked for the expiration date more often than you might expect, especially when applying for travel contracts or new positions.