PALS 2025 COMPREHENSIVE ACADEMIC STUDY GUIDE WITH
VERIFIED CONCEPTS AND EXAM-FOCUSED EXPLANATIONS
2025–2026
Conditions that [blank] air resistance lead to increased respiratory [blank]. - correct answer -
Increased
Effort
What are the signs of increased respiratory effort that can lead to fatigue & respiratory failure? -
correct answer -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]. - correct answer -30
2
Tachypnea is often the first sign of respiratory [blank] in infants. - correct answer -Distress
What do central chemoreceptors respond to? - correct answer -Hydrogen ions in the
cerebrospinal fluid
Why may excessive ventilation during CPR be harmful? - correct answer -It impedes venous
return
It increases intrathoracic pressure
,What should you do if you cannot achieve effective ventilation with a bag-mask device? -
correct answer -Reposition the airway
Verify the mask size
How are effective oxygenation & ventilation assessed? - correct answer -Oxygen saturation
Exhaled carbon dioxide
Visible chest rise w/ each breath
How can gastric inflation impair bag-mask ventilation? - correct answer -It decreases lung
compliance
What is the most appropriate precautionary action to minimize gastric inflation during a bag-
mask ventilation? - correct answer -Deliver each breath over about 1 second
Which is true about the difference between hypoxemia & tissue hypoxia? - correct answer -
Tissue hypoxia can occur with normal arterial oxygen saturation
What does hyperventilation, which refers to increased alveolar ventilation, result in? - correct
answer -PaCO2 less than 35 mm Hg
What happens to the arterial oxygen level in a child w/ severe anemia? - correct answer -May
increase when dissolved oxygen is increased
Which is true of increased carbon dioxide tension in arterial blood? - correct answer -May be
caused by disordered control of breathing
What happens when ventilation is inadequate? - correct answer -PaCO2 increases
,What is a critical symptom of hypercarbia? - correct answer -Decreased level of consciousness
Which of the following indicates mild respiratory distress? - correct answer -Mild increase in
respiratory effort
Which of the following indicates severe respiratory distress? - correct answer -Marked
tachypnea &/or apnea
Which of the following statements about respiratory failure is true? - correct answer -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]? - correct answer -Ability to maintain a patent airway
What steps should be taken as part of initial management of a child in respiratory distress? -
correct answer -Support an open airway
Monitor O2 saturation by pulse oximetry
Monitor heart rate, rhythm, & bp
Which are ideal characteristics of face masks for ventilation? - correct answer -Covers mouth &
nose
Has a soft rim
Transparent
What is the rationale for using a transparent mask? - correct answer -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? - correct answer
-Prevents rebreathing of carbon dioxide
Which of the following is required to appropriately ventilate a child with a flow-inflating bag? -
correct answer -Tidal volume needs to be delivered at the correct rate
What should be checked to ensure proper function of a bag-mask system? - correct answer -
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? - correct answer -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? - correct answer -The occiput
What actions are appropriate when providing 1-person bag-mask ventilation? - correct answer -
Perform a head tilt, insert an oral airway, & squeeze the bag until chest rise
What does the E-C clamp technique include? - correct answer -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? - correct answer -When making a
seal is difficult
When there is significant airway resistance
When suctioning a patient, which of the following should be monitored? - correct answer -
Clinical appearance
VERIFIED CONCEPTS AND EXAM-FOCUSED EXPLANATIONS
2025–2026
Conditions that [blank] air resistance lead to increased respiratory [blank]. - correct answer -
Increased
Effort
What are the signs of increased respiratory effort that can lead to fatigue & respiratory failure? -
correct answer -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]. - correct answer -30
2
Tachypnea is often the first sign of respiratory [blank] in infants. - correct answer -Distress
What do central chemoreceptors respond to? - correct answer -Hydrogen ions in the
cerebrospinal fluid
Why may excessive ventilation during CPR be harmful? - correct answer -It impedes venous
return
It increases intrathoracic pressure
,What should you do if you cannot achieve effective ventilation with a bag-mask device? -
correct answer -Reposition the airway
Verify the mask size
How are effective oxygenation & ventilation assessed? - correct answer -Oxygen saturation
Exhaled carbon dioxide
Visible chest rise w/ each breath
How can gastric inflation impair bag-mask ventilation? - correct answer -It decreases lung
compliance
What is the most appropriate precautionary action to minimize gastric inflation during a bag-
mask ventilation? - correct answer -Deliver each breath over about 1 second
Which is true about the difference between hypoxemia & tissue hypoxia? - correct answer -
Tissue hypoxia can occur with normal arterial oxygen saturation
What does hyperventilation, which refers to increased alveolar ventilation, result in? - correct
answer -PaCO2 less than 35 mm Hg
What happens to the arterial oxygen level in a child w/ severe anemia? - correct answer -May
increase when dissolved oxygen is increased
Which is true of increased carbon dioxide tension in arterial blood? - correct answer -May be
caused by disordered control of breathing
What happens when ventilation is inadequate? - correct answer -PaCO2 increases
,What is a critical symptom of hypercarbia? - correct answer -Decreased level of consciousness
Which of the following indicates mild respiratory distress? - correct answer -Mild increase in
respiratory effort
Which of the following indicates severe respiratory distress? - correct answer -Marked
tachypnea &/or apnea
Which of the following statements about respiratory failure is true? - correct answer -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]? - correct answer -Ability to maintain a patent airway
What steps should be taken as part of initial management of a child in respiratory distress? -
correct answer -Support an open airway
Monitor O2 saturation by pulse oximetry
Monitor heart rate, rhythm, & bp
Which are ideal characteristics of face masks for ventilation? - correct answer -Covers mouth &
nose
Has a soft rim
Transparent
What is the rationale for using a transparent mask? - correct answer -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? - correct answer
-Prevents rebreathing of carbon dioxide
Which of the following is required to appropriately ventilate a child with a flow-inflating bag? -
correct answer -Tidal volume needs to be delivered at the correct rate
What should be checked to ensure proper function of a bag-mask system? - correct answer -
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? - correct answer -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? - correct answer -The occiput
What actions are appropriate when providing 1-person bag-mask ventilation? - correct answer -
Perform a head tilt, insert an oral airway, & squeeze the bag until chest rise
What does the E-C clamp technique include? - correct answer -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? - correct answer -When making a
seal is difficult
When there is significant airway resistance
When suctioning a patient, which of the following should be monitored? - correct answer -
Clinical appearance
