PALS FINAL EXAM REVIEW/ PALS
PRACTICE EXAM | 150+ QUESTIONS
AND VERIFIED ANSWERS| 100%
CORRECT (LATEST 2023/ 2024)
Q: While assessing a pediatric patient using the ABCDE algorithm, life-threatening conditions
associated with the letter E for Exposure are:
Answer:
Severe hypothermia, substantial bleeding, petechiae, or purpura indicating septic shock
Q: The preferred initial method of removing a foreign body airway obstruction in a responsive
patient less than one year of age is:
Answer:
Back blows and chest thrusts
Q: What medication should be administered for severe cases of croup with imminent
respiratory failure?
Answer:
Dexamethasone
Q: Infection of the central nervous system (CNS) can cause hypoventilation or __.
Answer:
Apnea
Q: During a resuscitation, it is important that all members of the team understand the concept
of:
Answer:
Each member of the team caring for a pediatric patient must understand his role and the role of
other members. In most pediatric resuscitation efforts, there is one team leader who will ensure
that everything gets done by the right person at the right time.
Q: You are serving in the capacity of team leader during the resuscitation of a pediatric medical
patient. Which of the items listed below is a responsibility of the team leader?
Answer:
Assign roles to team members
Q: The best vasoactive agent for a child in warm septic shock is:
Answer:
NoE
Q: Anemic hypoxia results from:
Answer:
Anemic hypoxia results from the amount of functional hemoglobin is too small, and hence the
capacity of the blood to carry oxygen is too low
Q: Which of the following is correct regarding post resuscitation management of the pediatric
patient?
Answer:
The goal of post resuscitation care are to preserve neurologic function, prevent secondary organ
injury and treat the cause of the illness.
Q: You and your team members are currently resuscitating a 7-year-old male patient who was
found face down in a pool. EMS states the patient was in the water for an unknown amount of
time. The patient is currently in asystole, is cyanotic with an advanced airway in place. Inline
waveform capnography is showing a small peak upon mechanical ventilation with a ETCO2 of
- Which of the following is the most appropriate care for this patient?
Answer:
DOPE
Q: You and your partner are providing high-quality CPR to a 7-year-old female. The correct
compression to ventilation ratio is:
Answer:
15:2
Q: You decide that BLS ventilations are no longer effective in your pediatric patient
resuscitation. You elect to place an endotracheal tube. The preferred method for confirming and
monitoring the placement of this ETT is:
Answer:
End-tidal CO2 monitoring
Q: A 7-month-old patient presents with supraventricular tachycardia. The patient is
hemodynamically stable. The best method of a vagal maneuver is:
Answer:
Application of a cold stimulus to the face (e.g., a washcloth soaked in iced water, cold pack, or
crushed ice mixed with water in a plastic bag or glove) for up to 10 seconds.
Q: Atropine is indicated for:
Answer:
Symptomatic bradycardia
Q: Consideration for _ through devices such as BiPAP or CPAP is indicated for
infants or children with suspected lung tissue disease.
Answer:
Continuous PEEP
Q: An accepted initial therapy for a patient with suspected croup is:
Answer:
Nebulized epinephrine
Q: Which of the following is a sign of respiratory failure?
Answer:
Decrease in ventilation and oxygenation
Q: Which of the statements about supraventricular tachycardia (SVT) is correct?
Answer:
The clinical presentations demonstrate that children and infants lack the ability to tolerate this
rhythm well.
Q: The mother of a 9-year-old patient reports that her son was playing with a friend when he
collapsed while running. At the patients side, you apply an AED and deliver one shock. The
patient regains a pulse but remains unresponsive. you successfully place an ETT. There is no
evidence of shock or trauma. Your target range for SpO2 is:
PALS RED CROSS 2023/ 2024 FINAL
EXAM Version 1| 50 QUESTIONS AND
VERIFIED ANSWERS| GRADE A
Q: A child in the pediatric intensive care unit displays the following ECG waveform. The child
has no pulse. The resuscitation team interprets this as which arrhythmia?
Answer:
Monomorphic pulseless ventricular tachycardia
Q: A 15-year-old patient is being evaluated during a follow-up visit after being diagnosed with
Lyme disease 2 months ago. A rhythm strip is obtained as shown below. The provider interprets
this rhythm as indicating which arrhythmia?
Answer:
First-degree atrioventricular (AV) block
Q: A healthcare provider is performing a primary assessment of a child in respiratory distress.
The provider documents increased work of breathing when which findings are observed?
Answer:
Nasal flaring
Intercostal, substernal or suprasternal retractions
Accessory muscle use
Q: A 4-year-old patient presents with tachycardia, tachypnea, cold extremities and weak pulses.
Assessment also reveals an enlarged liver and neck vein distension. The provider interprets these
assessment findings as suggesting which type of shock?
Answer:
Cardiogenic
Q: A 6-year-old child is brought to the emergency department. The child has been experiencing
extremely watery stools over the past several days. After completing the assessment, the
healthcare provider suspects that the child may be experiencing shock. Which type of shock
would the provider most likely suspect?
Answer:
Hypovolemic
Q: A child is experiencing shock. The emergency response team prepares for imminent cardiac
arrest when assessment reveals which finding(s)?
Answer:
Bradycardia
Diminished central pulses
Hypotension
Q: Primary assessment of a 10-year-old child reveals septic shock. As part of the secondary
assessment, if not already done as part of initial sepsis care, laboratory testing is completed to
evaluate the child’s status. Which laboratory tests would be ordered for this child?
Answer:
Complete blood count (CBC)
Lactate level
Blood cultures
Q: A 10-year-old child has collapsed in the gym of the elementary school. The school nurse
arrives and determines that the child is unresponsive. The school nurse then simultaneously
checks for breathing and a central pulse, limiting this assessment to which time frame?
Answer:
No more than 10 seconds
PALS RED CROSS 2023/ 2024 FINAL
EXAM Version 2| 50 QUESTIONS AND
VERIFIED ANSWERS| GRADE A
Q: The PALS resuscitation team notes the following ECG waveform and the child does not
have a pulse. The team prepares to intervene to address which arrhythmia?
Answer:
Torsades de pointes
Q: A child who is stable and exhibiting a wide-complex tachycardia is to receive adenosine.
The provider would be alert for which result after administering this medication?
Answer:
Transient asystole
Q: The PALS team leader is conducting a debriefing session with the team. Which topic(s)
would the team leader most likely address during the session?
Answer:
- Identification of ways to improve
- Discussion of the pros and cons of the interventions
- Summary of the event, including what actions were taken
- Evaluation of the objective data gathered during the event
Q: A 12-year-old child being evaluated in the pediatric intensive care unit displays the
following ECG waveform. The team interprets this as which arrhythmia?
Answer:
Second-degree atrioventricular (AV) block, type I
Q: A provider is assessing a child with suspected shock. Which statement correctly describes
hypotension and shock?
Answer:
Hypotension is not a consistent feature of shock in children.
Q: An 11-year-old soccer player is brought to the emergency department. After a quick
assessment, the team realizes this patient is experiencing a severe asthma exacerbation. Which
medication would the team administer first?
Answer:
Albuterol plus ipratropium bromide
Q: An 11-year-old child develops unstable wide complex tachycardia. Assessment reveals signs
of significant hemodynamic compromise, but the child has a pulse. The PALS team would
prepare the child for which intervention?
Answer:
Synchronized cardioversion
Q: A 15-year-old patient is being evaluated during a follow-up visit after being diagnosed with
Lyme disease 2 months ago. A rhythm strip is obtained as shown below. The provider interprets
this rhythm as indicating which arrhythmia?
Answer:
First-degree atrioventricular (AV) block
Q: A 4-year-old patient presents with tachycardia, tachypnea, cold extremities and weak pulses.
Assessment also reveals an enlarged liver and neck vein distension. The provider interprets these
assessment findings as suggesting which type of shock?
PALS RED CROSS 2023/ 2024 FINAL
EXAM Version 3| 50 QUESTIONS AND
VERIFIED ANSWERS| GRADE A
Q: An advanced airway was placed in a 5-year-old child. Which action(s) would be most
appropriate for the team to take to confirm correct placement?
Answer:
Auscultate over the lungs and epigastrium for air movement, Observe for bilateral chest rise,
Evaluate results of capnography.
Q: A 12-year-old is being treated in the urgent care clinic. The mother reports that the child
came home from school yesterday with a high fever, vomiting and multiple episodes of watery
diarrhea. The healthcare provider obtains a rhythm strip and notes the following waveform. The
provider interprets this as which type of arrhythmia?
Answer:
Sinus tachycardia
Q: A child being cared for in the pediatric telemetry unit suddenly displays the following ECG
waveform. The provider prepares to intervene because the child is demonstrating which type of
arrhythmia?
Answer:
Supraventricular tachycardia
Q: A 30-month old child has been diagnosed with moderate croup. Which medication(s) would
the provider administer?
Answer:
Corticosteroids, Racemic epinephrine
Q: A child in the pediatric step-down unit is exhibiting signs of respiratory distress. When
assessing this child, which finding would be considered a late sign for this condition?
Answer:
Cyanosis
Q: Assessment of a 7-year-old patient with septic shock reveals capillary refill of 3 seconds,
diminished pulse and narrow pulse pressure. The emergency response team interprets these
findings as indicating which type of septic shock?
Answer:
hypotensive
Q: A 4-year-old patient presents with tachycardia, tachypnea, cold extremities and weak pulses.
Assessment also reveals an enlarged liver and neck vein distension. The provider interprets these
assessment findings as suggesting which type of shock?
Answer:
cardiogenic shock
Q: An 8-year-old child being treated in the emergency department has significant respiratory
distress. The child also exhibits hives, wheezing, angioedema, tachycardia and tachypnea. The
parents state that the child, who is allergic to peanuts, had eaten some popcorn that had peanuts
in it. The team initiates care, preparing to administer which agent first?
Answer:
Epinephrine
Q: A 10-year-old child has collapsed in the gym of the elementary school. The school nurse
arrives and determines that the child is unresponsive. The school nurse then simultaneously
checks for breathing and a central pulse, limiting this assessment to which time frame?
PALS 2023/ 2024 FINAL EXAM Version 1|
50 QUESTIONS AND VERIFIED
ANSWERS| GRADE A
Q: An 8-year-old child being treated in the emergency department has significant respiratory
distress. The child also exhibits hives, wheezing, angioedema, tachycardia and dyspnea. The
parents state that the child, who is allergic to peanuts, had eaten some popcorn that had peanuts
in it. The team initiates care, preparing to administer which agent first?
Answer:
Epinephrine
Q: A child in the pediatric intensive care unit displays the following ECG waveform. The child
has no pulse. The resuscitation team interprets this as which arrhythmia?
Answer:
Monomorphic pulseless ventricular tachycardia
Q: A 2-year-old child arrives at the emergency department with the parents. The child is
unresponsive, is not breathing and has no pulse. Two emergency department providers begin
high-quality CPR. Which action(s) by the providers demonstrates high-quality CPR?
Answer:
Compressing the chest about 2 inches
Providing ventilations that last about 1 second each
Giving 2 ventilations to every 15 compressions
Allowing the chest to recoil fully after each compression
Q: A 15-year-old patient is being evaluated during a follow-up visit after being diagnosed with
Lyme disease 2 months ago. A rhythm strip is obtained as shown below. The provider interprets
this rhythm as indicating which arrhythmia?
Answer:
First-degree atrioventricular (AV) block
Q: A 4-year-old patient presents with tachycardia, tachypnea, cold extremities and weak pulses.
Assessment also reveals an enlarged liver and neck vein distension. The provider interprets these
assessment findings as suggesting which type of shock?
Answer:
Cardiogenic
Q: A child being cared for in the pediatric telemetry unit suddenly displays the following ECG
waveform. The provider prepares to intervene because the child is demonstrating which type of
arrhythmia?
Answer:
Supraventricular tachycardia
Q: A child is experiencing supraventricular tachycardia (SVT) with adequate perfusion and is
to receive treatment. Which initial treatment would the provider administer?
Answer:
Vagal maneuvers
Q: A provider is caring for a 4-year-old child in the urgent care clinic. Primary assessment
reveals difficulty breathing and an oxygen saturation of 91%. The provider administers oxygen
by nasal cannula with the goal of improving the child’s oxygen saturation to what percentage
range?
Answer:
94% to 99%
PALS CERTIFICATION EXAM 2023/ 2024
Version 1| 50 QUESTIONS AND VERIFIED
ANSWERS| GRADE A
Q: A 2 week old infant is being evaluated for irritability and poor feeding. His BP is 55/40
mmHg, and cap refill time is 5 seconds. Which statement best describes your assessment of this
infants BP?
Answer:
It is Hypotensive
Q: A team member is unable to perform an assigned task because it is beyond the team
members scope of practice. Which action should the team member take?
Answer:
Ask for a new task or role
Q: Which abnormality helps identify children with acute respiratory distress caused by lung
tissue disease?
Answer:
crackles
Q: Which condition in a child would IO access most likely be attempted before vascular
access?
Answer:
cardiac arrest
Q: You respond to an infant who is unresponsive, in not breathing, and doe not have a pulse.
You shout for nearby help, but no one arrives. What action should you take next?
Answer:
Begin CPR for 2 mins before leaving to activate the emergency response system.
Q: An unresponsive 9 year old boy is pale and cool to the touch his blood pressure is 70/45
mmHg, heart rate is 190/min and respiratory rate is 12/min. The SpO2 is not detectable Cap refill
time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. What
rhythm is seen on the patient cardiac monitor?
Answer:
Supraventricular tachycardia
Q: An unresponsive 9 year old boy is pale and cool to the touch his blood pressure is 70/45
mmHg, heart rate is 190/min and respiratory rate is 12/min. The SpO2 is not detectable Cap refill
time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. If
initial treatment is unavailable or delayed, which intervention is indicated?
Answer:
Syncronized cardioversion.
Q: You are performing the airway component of the primary assessment. Which finding would
lead you to conclude that the child has an upper airway obstruction?
Answer:
inspiratory stridor
Q: A 3 year old child is having difficulty breathing. Which finding would most likely lead you
to suspect an upper airway obstruction in this child?
Answer:
PALS CERTIFICATION EXAM Review
(2023/ 2024) | QUESTIONS AND VERIFIED
ANSWERS| 100% CORRECT
Q: T or F some patients with upper airway obstruction and/or respiratory failure may respond to
noninvasive ventilation if airway reflexes are preserved.
Answer:
True! Certain populations of patients with upper airway obstruction and/or respiratory failure
may respond to noninvasive ventilation (CPAP or BiPAP) if airway reflexes are preserved.
Q: When a patient appears to be in shock, what should be the goal of the next action taken?
Answer:
The goal should be to recognize and categorize the type of shock in order to prioritize treatment
options
Q: Why is the early management of shock so critical for patient survival?
Answer:
Early treatment of shock may prevent the progression to cardiopulmonary failure
Q: In children, does shock present with low or high cardiac output?
Answer:
Shock in children usually presents with low cardiac output, but some patients may have high
cardiac output, such as with sepsis or severe anemia.
Q: How can shock be classified?
Answer:
Shock severity is usually classified based on its effect on systolic blood pressure at presentation
(i.e. compensated vs. decompensated) or based on its pathophysiology (i.e hypovolemic;
distributive; cardiogenic; obstructive shock)
Q: What is the meaning of “compensated” shock, when does it occur?
Answer:
Compensated shock occurs when compensatory mechanisms (including tachycardia, increased
systemic vascular resistance, increased inotropy, and increased venous tone) maintain a systolic
blood pressure within a normal range
Q: What is the meaning of hypovolemic “decompensated” shock? When does it occur?
Answer:
Hypotensive shock occurs when compensatory mechanisms fail to maintain systolic blood
pressure.
Q: Define hypotension in term infants?
Answer:
In term infants 0 to 1 month of age, systolic pressure <60 mmHg
Q: Define hypotension in infants 1 to 12 months of age?
Answer:
For infants 1 to 12 months of age, hypotension is defined by systolic pressure <70 mmHg
Q: Define hypotension in infants 1 to 10 years of age?
Answer:
In children 1 to 10 years of age, hypotension is defined as:
Systolic pressure (5th percentile) < (70 mmHg + [child’s age in years x 2])
Q: Define hypotension in children over 10 years of age?
Answer:
In children over 10 years of age, systolic blood pressure <90 mmHg
Q: What is key to know about hypotensive “decompensated” shock in contrast to compensated
shock?
Answer:
Hypotensive shock may rapidly progress to cardiopulmonary failure.
Q: How can shock be classified according to its pathophysiology?
Answer:
Shock can be classified as being hypotensive, distributive; cardiogenic or obstructive
Q: What is hypovolemic shock?
Answer:
Shock that is characterized by inadequate circulating blood volume (from fluid loss). Common
causes include diarrhea, hemorrhage (internal and external), vomiting, inadequate fluid intake,
osmotic diuresis (eg, diabetic ketoacidosis), third-space losses, and burns.
Q: What is distributive shock?
Answer:
A form of shock arising from inappropriately distributed blood volume typically associated with
decreased systemic vascular resistance. Common causes include septic shock, anaphylactic
shock, and neurogenic shock (eg, head injury, spinal injury).
Q: What is cardiogenic shock?
Answer:
A form of shock arising from impaired heart contractility. Common causes include congenital
heart disease, myocarditis, cardiomyopathy, arrhythmias, sepsis, poisoning or drug toxicity, and
myocardial injury (trauma).
Q: What is obstructive shock?
Answer:
A form of shock that arises from obstructed blood flow to the heart or great vessels. Common
causes include cardiac tamponade, tension pneumothorax, ductal-dependent congenital heart
lesions, and massive pulmonary embolism.
Q: Can patients suffer from more than one type of shock?
Answer:
Yes, any given patient may suffer from more than one type of shock. For example, a child in
septic shock may develop hypovolemia during the prodrome phase, distributive shock during the
early phase of sepsis, and cardiogenic shock later in the course.
Q: What is the definition of cardiopulmonary failure?
Answer:
Respiratory failure + hypotensive shock
PALS 2023/ 2024 FINAL EXAM Version 2|
50 QUESTIONS AND VERIFIED
ANSWERS| GRADE A
Q: A child in the pediatric intensive care unit displays the following ECG waveform. The child
has no pulse. The resuscitation team interprets this as which arrhythmia?
Torsades de pointes
Ventricular fibrillation
Asystole
Monomorphic pulseless ventricular tachycardia
Answer:
Monomorphic pulseless ventricular tachycardia
Q: An 11-year-old child develops ventricular tachycardia with a pulse with inadequate
perfusion. The PALS team would prepare the child for which intervention?
Select the correct answer to this question.
Transthoracic pacing
Vagal maneuvers
Synchronized electrical cardioversion
Sedation
Answer:
Synchronized electrical cardioversion
Q: A 6-year-old patient is brought to the emergency department after a bicycle accident.
Assessment reveals chest pain on inspiration, diminished breath sounds on the right side, and
respiratory distress. The provider suspects obstructive shock caused by what condition?
Select the correct answer to this question.
Obstructive cardiac lesion
Cardiac tamponade
Pulmonary embolism
Tension pneumothorax
Answer:
Tension pneumothorax
Q: What is the correct IV/IO dose of epinephrine for a pediatric patient in cardiac arrest?
Select the correct answer to this question.
0.01 mg/kg every 3 to 5 min (max single dose 1 mg)
10 mg/kg every 3 to 5 min (max single dose 20 mg)
5 mg/kg every 3 to 5 min (max single dose 10 mg)
1 mg/kg every 3 to 5 min (max single dose 2 mg)
Answer:
0.01 mg/kg every 3 to 5 min (max single dose 1 mg)
Q: A 12-year-old child being evaluated in the pediatric intensive care unit displays the
following ECG waveform. The team interprets this as which arrhythmia?
Select the correct answer to this question.
Second-degree atrioventricular (AV) block, type II
First-degree atrioventricular (AV) block
Third-degree (complete) atrioventricular (AV) block
Second-degree atrioventricular (AV) block, type I
Answer:
Second-degree atrioventricular (AV) block, type I
Q: While performing a rapid assessment and formulating an initial impression using the
Pediatric Assessment Triangle (PAT), the provider assesses the child’s circulation. Which
information would be important to consider?
Select all correct options that apply.
Evidence of bleeding
Skin pallor (or gray/dusky color)
Nasal flaring
Accessory muscle use
Flushing of the skin
Answer:
Evidence of bleeding
Skin pallor (or gray/dusky color)
Flushing of the skin
Q: A 7-year-old patient with septic shock has received three balanced/buffered crystalloid fluid
boluses (60-mL/kg) and reassessment reveals capillary refill of 3 seconds, diminished pulses,
narrow pulse pressure and cool, mottled extremities. The emergency response team interprets
these findings as indicating which type of septic shock?
Select the correct answer to this question.
Fluid-responsive
Hypertensive
Fluid-refractory
Mild
Answer:
Fluid-refractory
Q: A child is experiencing shock. The emergency response team prepares for imminent cardiac
arrest when assessment reveals which finding(s)?
Select all correct options that apply.
Hypotension
Diminished central pulses
Atrial flutter
Bradycardia
Cool extremities
Answer:
Hypotension
Diminished central pulses
Bradycardia
Q: A 12-year-old is being treated in the urgent care clinic. The mother reports that the child
came home from school yesterday with a high fever, vomiting and multiple episodes of watery
PALS 2023/ 2024 FINAL EXAM Version 3|
50 QUESTIONS AND VERIFIED
ANSWERS| GRADE A
Q: An 11-year-old child develops unstable wide-complex tachycardia. Assessment reveals signs
of significant hemodynamic compromise, but the child has a pulse. The PALS team would
prepare the child for which in- tervention?
Answer:
First-line treatment for unstable wide-complex tachycardias consists of synchronized electrical
cardioversion, particularly when signs of hemodynamic compromise are apparent.
Q: A 4-month old infant is brought to the emergency department in cardiac arrest. Which
condition would the team identify as the most common cause of cardiac arrest in an infant of this
age?
Answer:
Sudden infant death syndrome
Q: A 9-year-old child is brought to the emergency department because the child suddenly
collapsed at school. The child’s ECG reveals the following waveform, and primary assessment
findings indicate that the child is hemo- dynamically unstable. Which primary assessment
findings indicate this?
Answer:
Dif- ficulty breathing
Hypotension
Mottling
Decreased level of consciousnes
Q: 2-year-old child is brought to the pediatric urgent care clinic by the parent who says that the
child has had a barking cough for two days. During the rapid assessment of the child, the
provider hears audible inspiratory stridor. Which common cause of partial upper airway
obstruction in children would the provider most likely suspect?
Answer:
croup
Q: A 6-year-old child is brought to the emergency department. The child has been experiencing
extremely watery stools over the past several days. After completing the assessment, the
healthcare provider suspects that the child may be experiencing shock. Which type of shock
would the provider most likely suspect?
Answer:
hypovolemic
Q: While performing a rapid assessment and formulating an initial impression using the
Pediatric Assessment Triangle (PAT), the provider assesses the child’s circulation. Which
information would be important to consider?
Answer:
When assessing the adequacy of circulation, consider skin color and visible mucous membranes for pallor (or gray/dusky color), cyanosis, mottling or flushing and evidence of any
bleeding, including life-threatening bleeding.
Q: Assessment of a 3-month-old infant admitted with respiratory distress reveals fever, grunting
and a wet, “junky” cough. The infant’s parents said the child had a recent respiratory infection
with a fever. A rapid respiratory
syncytial virus (RSV) test is positive. Which condition would the provider most likely suspect as
the cause?
Answer:
bronchiolitis
Q: PALS resuscitation team notes the following ECG waveform and the child does not have a
pulse. The team prepares to intervene to address which arrhythmia?
PALS 2023/ 2024 FINAL EXAM Version 4|
50 QUESTIONS AND VERIFIED
ANSWERS| GRADE A
Q: Supraventricular tachycardia (SVT) can be caused by all of the following except:
Accessory pathway reentry
Long QT syndromes
Ectopic atrial focus
AV nodal reentry
Answer:
Long QT syndromes
Q: What is the preferred priority for drug delivery routes?
ET route, IV route, IO route
IO route, ET route, IV route
IV route, ET route, IO route
IV route, IO route, ET route
Answer:
IV route, IO route, ET route
Q: The purple of defibrillation is to:
Recharge the heart
Provide electrically stimulated contractions of the heart
Treat symptomatic bradycardia
Reset the electrical systems of the heart allowing a normal rhythm a chance to return
Answer:
Reset the electrical systems of the heart allowing normal rhythm a chance to return
Q: The first management step in cardiac arrest is to:
Stimulate more forceful myocardial contractility
Begin high-quality CPR
Increase coronary and cerebral perfusion pressures and blood flow
Suppress or treat arrhythimias
Answer:
Begin high-quality CPR
Q: Antiarrythmics that may be considered in the VF/VT algorithm include which of the
following?
Amiodarone
Atropine
Magnesium
All of the above
Answer:
Amiodarone
Q: When should a child be transferred to tertiary care post-cardiac arrest?
After the first phase of resuscitation management
As soon as possible
Immediately
If the child remains comatose post resuscitation
Answer:
As soon as possible
Q: What is the best vasoactive agent for cold septic shock?
Norepinephrine
Milrinone
PALS CERTIFICATION EXAM 2023/ 2024
Version 2| 50 QUESTIONS AND VERIFIED
ANSWERS| GRADE A
Q: 8 yo struck by car. He arrives in ED alert, anxious, and respiratory distress. Cerv spine is
immobilized, and he is getting 10 L/min flow of 100% O@ by nonrebreathing face mask. RR 60,
HR 150, SBP 70, SpO2 84%. Breath sounds absent over the R chest but over L, treachea
deviated to L. Weak central pulses and absent distal pulses. Which intervention should be
performed next?
A. Perform needle decompression of R chest
B. Perform endotracheal intubation
C. Establish IV access
D. Provide bag-mask ventilation
Answer:
A. Perform needle decompression of R chest
Q: You and another person start CPR. other person does compressions and you notice that rate
is too slow. What should you say?
A. Need to compress 120/minute at least
B. Need to compress 100 – 120/minute at least
C. Need to compress 100/minute at least
D. Need to compress 80 – 120 minute at least
Answer:
B. Need to compress 100 – 120/minute at least
Q: First AED shock should be how many Joules per kg?
What about 2nd and 3rd shock etc.?
Answer:
1st = 2 J/kg
2nd = 4 J/kg
3rd+ = 6 – 10 J/kg or adult shock
Q: What are the 2 shock-able rhythms?
Answer:
Ventricular fibrillation
Pulseless ventricular tachycardia
Q: What are the 2 non-shock-able rhythms?
Answer:
Pulseless electrical activity (PEA)
Asystole
Q: After how many shocks can you give epinephrine?
Answer:
After 2 shocks
Q: What is the dosage of epinephrine? (dose how often?)
Answer:
Epinephrine 0.01 mg/kg every 3 – 5 minutes
Q: What is the dosage of amiodarone? (dose how often?)
Answer:
Amiodarone 5 mg/kg
- may repeat up to 2 times
PALS CERTIFICATION EXAM 2023/ 2024
Version 3| 50 QUESTIONS AND VERIFIED
ANSWERS| GRADE A
Q: You are caring for a 10 year old child who is awake, but appears to be acutely ill. She is
responding appropriately.
A. Monitor the child.
B. Put the child on a non-rebreather mask.
C. Perform synchronized cardioversion.
D. Give a rapid fluid bolus of Ringer’s Lactate.
Answer:
A
Q: In a child with hypotension, the cardiac rhythm that is an ominous sign of impending arrest
is:
A. Bradycardia.
B. Sinus tachycardia.
C. Supraventricular tachycardia.
D. 1st degree heart block.
Answer:
A
Q: A child on the cardiac monitor has a QRS duration of 0.12 seconds and a heart rate of 120
beats per minute. This rhythm should be treated as:
A. Sinus tachycardia.
B. Supraventricular tachycardia.
C. Sinus rhythm.
D. Ventricular Tachycardia.
Answer:
D
Q: You arrive on the scene where a child is unresponsive with gasping breaths. After calling for
help, the most appropriate intervention is to
A. Look, listen and feel for breathing.
B. Open the airway and begin ventilations.
C. Check for a pulse.
D. Start CPR.
Answer:
C
Q: For a child in VF, the most appropriate intervention is to:
Answer:
Defibrillate
Q: A 6 year old child is brought to the pediatrician’s office with a reported history of fever for 2
days. His heart rate is 150 and systolic blood pressure is 60
A. Hypovolemic Shock.
B. Distributive Shock.
C. Cardiogenic Shock.
D. Obstructive Shock.
Answer:
B
Q: A sign of upper airway obstruction is:
Answer:
High pitched stridor with respirations