AHA PALS Precourse Assessment
Exam With Correct Answers. Graded
A+.
Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W 2-4
t t t t t t t t t t t t t t t t
ml/kg IV - correct answers ✔️
t ✔️ A previously healthy infant with a history of vomiting and
t t t t t t t t t t t t t t
diarrhea is brought to the emergency department by her parents. During your assessment,
t t t t t t t t t t t t t
you find that the infant responds only to painful stimulation. The infant's respiratory rate is 40
t t t t t t t t t t t t t t t t
breaths per minute, and central pulses are rapid and weak. The infant has good bilateral breath
t t t t t t t t t t t t t t t
sounds, cool extremities, and a capillary refill time of more than 5 seconds. The infant's blood
t t t t t t t t t t t t t t t t t
pressure is 85/65 mmHg, and glucose is 30 mg/dL (1.65 mmol/L). You administer 100%
t t t t t t t t t t t t t t
oxygen via face mask and start an IV. Which treatment is most appropriate for this infant?
t t t t t t t t t t t t t t t
Albuterol (duh) - correct answers ✔️✔️ A 9yo boy is agitated and leaning forward on the bed in
t t t t t t t t t t t t t t t t t
obvious respiratory distress. The patient is speaking in short phrases and tells you that he has
t t t t t t t t t t t t t t t t
asthma but does not carry an inhaler. He has nasal flaring, severe suprasternal and intercostal
t t t t t t t t t t t t t t t
retractions, and decreased air movement with prolonged expiratory time and wheezing. You t t t t t t t t t t t t
administer 100% oxygen by a nonrebreathing mask. His spO2 is 92%. Which med do you t t t t t t t t t t t t t t t
prepare to give to this patient? t t t t t
Rapid bolus of 20ml/kg of isotonic crystalloid - correct answers ✔️
t ✔️ Paramedics are called to t t t t t t t t t t t t t
the home of a 1yo child. Their initial assessment reveals a child who responds only to painful
t t t t t t t t t t t t t t t t t
stimuli and has irregular breathing, faint central pulses, bruises over the abdomen, abdominal
t t t t t t t t t t t t t
distention, and cyanosis. Bag-mask ventilation with 100% oxygen is initiated. The child's
t t t t t t t t t t t t
heart rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely
t t t t t t t t t t t t t t
palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon
t t t t t t t t t t t t
, arrival to the emergency department, the child is intubated and ventilated with 100% oxygen,
t t t t t t t t t t t t t t
and IV access is established. The heart rate is now 150/min with weak central pulses but no
t t t t t t t t t t t t t t t t t
distal pulses. Systolic blood pressure is 74 mmHg. Which intervention should be provided
t t t t t t t t t t t t t
next?
Epinephrine - correct answers ✔️ ✔️ You are called to help treat an infant with severe t t t t t t t t t t t t t t
symptomatic bradycardia (heart rate 66/min) associated with respiratory distress. The t t t t t t t t t t
bradycardia persists despite establishment of an effective airway, oxygenation, and t t t t t t t t t t
ventilation. There is no heart block present. Which is the first drug you should administer? t t t t t t t t t t t t t t
Routine administration is not indicated during cardiac arrest - correct answers ✔️
t ✔️Which t t t t t t t t t t t
statement is correct about the use of calcium chloride in pediatric patients? t t t t t t t t t t t
It is the least desirable route of administration - correct answers ✔️
t t t ✔️Which statement is t t t t t t t t t t t
correct about endotracheal drug administration during resuscitative efforts for pediatric
t t t t t t t t t t
patients?
Humidified oxygen as tolerated - correct answers ✔️ ✔️ Initial impression of a 2yo girl shows t t t t t t t t t t t t t t
her to be alert with mild breathing difficulty during inspiration and pale skin color. On primary
t t t t t t t t t t t t t t t t
assessment, she makes high-pitched inspiratory sounds (mild stridor) when agitated; t t t t t t t t t t
otherwise, her breathing is quiet. Her spO2 is 92% on room air, and she has mild inspiratory t t t t t t t t t t t t t t t t t
intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with t t t t t t t t t t
adequate distal breath sounds bilaterally. Which is the most appropriate initial intervention for
t t t t t t t t t t t t t
this child? t
Amiodarone 5 mg/kg IO - correct answers ✔️ ✔️ You are part of a team attempting to t t t t t t t t t t t t t t t
resuscitate a child with ventricular fibrillation cardiac arrest. You delivered 2 unsynchronized t t t t t t t t t t t t
shocks. A team member established IO access, so you give a dose of epinephrine, 0.01 mg/kg
t t t t t t t t t t t t t t t t
IO. At the next rhythm check, persistent ventricular fibrillation is present. You administer a 4
t t t t t t t t t t t t t t t
J/kg shock and resume CPR. Which drug and dose should be administered next?
t t t t t t t t t t t t
Nonrebreathing face mask - correct answers ✔️ ✔️ Which oxygen delivery system most t t t t t t t t t t t
reliably delivers a high (90% or greater) concentration of inspired oxygen to a 7yo child?
t t t t t t t t t t t t t t
Epinephrine stimulates spontaneous contractions when asystole is present - correct answers t t t t t t t t t t t
✔️ ✔️Which statement is correct about the effects of epinephrine during attempted t t t t t t t t t t t
resuscitation?
Epinephrine 0.01 mg/kg IV/IO - correct answers ✔️ ✔️ A 10mo infant boy is brought to the t t t t t t t t t t t t t t t
emergency department. Your initial assessment reveals a lethargic, pale infant with slow t t t t t t t t t t t t
respirations and slow, weak central pulses. One team member begins ventilation with a bag- t t t t t t t t t t t t t
mask device with 100% oxygen. A second team member attaches the monitor/defibrillator
t t t t t t t t t t t t
and obtains vital signs while a third team member attempts to establish IV/IO access. The
t t t t t t t t t t t t t t t
patient's heart rate is 38/min with the rhythm shown here. The infant's blood pressure is 58/38
t t t t t t t t t t t t t t t t
mmHg, and capillary refill is 4 seconds. His central pulses remain weak, and distal pulses
t t t t t t t t t t t t t t t
Exam With Correct Answers. Graded
A+.
Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W 2-4
t t t t t t t t t t t t t t t t
ml/kg IV - correct answers ✔️
t ✔️ A previously healthy infant with a history of vomiting and
t t t t t t t t t t t t t t
diarrhea is brought to the emergency department by her parents. During your assessment,
t t t t t t t t t t t t t
you find that the infant responds only to painful stimulation. The infant's respiratory rate is 40
t t t t t t t t t t t t t t t t
breaths per minute, and central pulses are rapid and weak. The infant has good bilateral breath
t t t t t t t t t t t t t t t
sounds, cool extremities, and a capillary refill time of more than 5 seconds. The infant's blood
t t t t t t t t t t t t t t t t t
pressure is 85/65 mmHg, and glucose is 30 mg/dL (1.65 mmol/L). You administer 100%
t t t t t t t t t t t t t t
oxygen via face mask and start an IV. Which treatment is most appropriate for this infant?
t t t t t t t t t t t t t t t
Albuterol (duh) - correct answers ✔️✔️ A 9yo boy is agitated and leaning forward on the bed in
t t t t t t t t t t t t t t t t t
obvious respiratory distress. The patient is speaking in short phrases and tells you that he has
t t t t t t t t t t t t t t t t
asthma but does not carry an inhaler. He has nasal flaring, severe suprasternal and intercostal
t t t t t t t t t t t t t t t
retractions, and decreased air movement with prolonged expiratory time and wheezing. You t t t t t t t t t t t t
administer 100% oxygen by a nonrebreathing mask. His spO2 is 92%. Which med do you t t t t t t t t t t t t t t t
prepare to give to this patient? t t t t t
Rapid bolus of 20ml/kg of isotonic crystalloid - correct answers ✔️
t ✔️ Paramedics are called to t t t t t t t t t t t t t
the home of a 1yo child. Their initial assessment reveals a child who responds only to painful
t t t t t t t t t t t t t t t t t
stimuli and has irregular breathing, faint central pulses, bruises over the abdomen, abdominal
t t t t t t t t t t t t t
distention, and cyanosis. Bag-mask ventilation with 100% oxygen is initiated. The child's
t t t t t t t t t t t t
heart rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely
t t t t t t t t t t t t t t
palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon
t t t t t t t t t t t t
, arrival to the emergency department, the child is intubated and ventilated with 100% oxygen,
t t t t t t t t t t t t t t
and IV access is established. The heart rate is now 150/min with weak central pulses but no
t t t t t t t t t t t t t t t t t
distal pulses. Systolic blood pressure is 74 mmHg. Which intervention should be provided
t t t t t t t t t t t t t
next?
Epinephrine - correct answers ✔️ ✔️ You are called to help treat an infant with severe t t t t t t t t t t t t t t
symptomatic bradycardia (heart rate 66/min) associated with respiratory distress. The t t t t t t t t t t
bradycardia persists despite establishment of an effective airway, oxygenation, and t t t t t t t t t t
ventilation. There is no heart block present. Which is the first drug you should administer? t t t t t t t t t t t t t t
Routine administration is not indicated during cardiac arrest - correct answers ✔️
t ✔️Which t t t t t t t t t t t
statement is correct about the use of calcium chloride in pediatric patients? t t t t t t t t t t t
It is the least desirable route of administration - correct answers ✔️
t t t ✔️Which statement is t t t t t t t t t t t
correct about endotracheal drug administration during resuscitative efforts for pediatric
t t t t t t t t t t
patients?
Humidified oxygen as tolerated - correct answers ✔️ ✔️ Initial impression of a 2yo girl shows t t t t t t t t t t t t t t
her to be alert with mild breathing difficulty during inspiration and pale skin color. On primary
t t t t t t t t t t t t t t t t
assessment, she makes high-pitched inspiratory sounds (mild stridor) when agitated; t t t t t t t t t t
otherwise, her breathing is quiet. Her spO2 is 92% on room air, and she has mild inspiratory t t t t t t t t t t t t t t t t t
intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with t t t t t t t t t t
adequate distal breath sounds bilaterally. Which is the most appropriate initial intervention for
t t t t t t t t t t t t t
this child? t
Amiodarone 5 mg/kg IO - correct answers ✔️ ✔️ You are part of a team attempting to t t t t t t t t t t t t t t t
resuscitate a child with ventricular fibrillation cardiac arrest. You delivered 2 unsynchronized t t t t t t t t t t t t
shocks. A team member established IO access, so you give a dose of epinephrine, 0.01 mg/kg
t t t t t t t t t t t t t t t t
IO. At the next rhythm check, persistent ventricular fibrillation is present. You administer a 4
t t t t t t t t t t t t t t t
J/kg shock and resume CPR. Which drug and dose should be administered next?
t t t t t t t t t t t t
Nonrebreathing face mask - correct answers ✔️ ✔️ Which oxygen delivery system most t t t t t t t t t t t
reliably delivers a high (90% or greater) concentration of inspired oxygen to a 7yo child?
t t t t t t t t t t t t t t
Epinephrine stimulates spontaneous contractions when asystole is present - correct answers t t t t t t t t t t t
✔️ ✔️Which statement is correct about the effects of epinephrine during attempted t t t t t t t t t t t
resuscitation?
Epinephrine 0.01 mg/kg IV/IO - correct answers ✔️ ✔️ A 10mo infant boy is brought to the t t t t t t t t t t t t t t t
emergency department. Your initial assessment reveals a lethargic, pale infant with slow t t t t t t t t t t t t
respirations and slow, weak central pulses. One team member begins ventilation with a bag- t t t t t t t t t t t t t
mask device with 100% oxygen. A second team member attaches the monitor/defibrillator
t t t t t t t t t t t t
and obtains vital signs while a third team member attempts to establish IV/IO access. The
t t t t t t t t t t t t t t t
patient's heart rate is 38/min with the rhythm shown here. The infant's blood pressure is 58/38
t t t t t t t t t t t t t t t t
mmHg, and capillary refill is 4 seconds. His central pulses remain weak, and distal pulses
t t t t t t t t t t t t t t t
