PALS Pre course Self-Assessment | Questions and
Correct Answers | Latest Update 2026/2027 | 100%
PASS
A 10-month-old infant boy is brought to the emergency department. Your initial assessment reveals a
lethargic, pale infant with slow respirations and slow, weak central pulses. One team member begins
ventilation with a bag-mask device with 100% oxygen. A second team member attaches the
monitor/defibrillator and obtains vital signs while a third team member attempts to establish IV/O access.
The patient's heart rate is 38/min with the rhythm shown here. The infant's blood pressure is 58/38 mm Hg,
and capillary refill is 4 seconds. His central pulses remain weak, and distal pulses cannot be palpated. Chest
compressions are started and I0 access is obtained. Which medication do you anticipate will be given next?
- CORRECT ANSWER: Epinephrine 0.01 mg/kg IV/IO
A 3-year-old boy presents with multiple-system trauma. The child was an unrestrained passenger in a high-
speed motor vehicle crash. On primary assessment, he is unresponsive to voice or painful stimulation. His
respiratory rate is 5/min, heart rate and pulses are 170/min, systolic blood pressure is 60 mm Hg, capillary
refill is 5 seconds, and SpOz is 75% on room air. Which action should you take first? - CORRECT
ANSWER: While a colleague provides spinal motion restriction, open the airway with a jaw thrust and
provide bag-mask ventilation
A 3-year-old unresponsive, apneic child is brought to the emergency department. EMS personnel report
that the child became unresponsive as they arrived at the hospital. The child is receiving CPR with bag-
mask ventilation. The rhythm shown here is on the cardiac monitor. A biphasic manual defibrillator is
present. You quickly use the length from head to heel of the child on a color-coded length-based
resuscitation tape to estimate the approximate weight as 15 kg. Which therapy is most appropriate for this
child at this time? - CORRECT ANSWER: Attempt defibrillation at 30 J, and then resume CPR, and
resume chest compressions
A 4-year-old boy is in pulseless arrest in the pediatric intensive care unit. High-quality CPR is in progress.
You quickly review his chart and find that his baseline-corrected OT interval on a 12-lead ECG is
, prolonged. The monitor shows recurrent episodes of the rhythm shown here. The patient has received 1
dose of epinephrine 0.01 mg/kg, but the rhythm shown here continues. If this rhythm persists at the next
rhythm check, which medication would be most appropriate to administer at that time? - CORRECT
ANSWER: Magnesium sulfate 25 to 50 mg/kg IV
A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is ongoing. The child is intubated, and
vascular access is established. The ECG monitor shows an organized rhythm with a heart rate of 45/min,
but a pulse check reveals no palpable pulses. High-quality CPR is resumed, and an initial IV dose of
epinephrine is administered. Which intervention should you perform next? - CORRECT ANSWER:
Identify and treat reversible causes
A 9-year-old boy is agitated and leaning forward on the bed in obvious respiratory distress. The patient is
speaking in short phrases and tells you that he has asthma but does not carry an inhaler. He has nasal
flaring, severe suprasternal and intercostal retractions, and decreased air movement with prolonged
expiratory time and wheezing. You administer 100% oxygen by a nonrebreathing mask. His SpO, is 92%.
Which medication do you prepare to give to this patient? - CORRECT ANSWER: Albuterol
A child becomes unresponsive in the emergency department and is not breathing. You are uncertain if a
faint pulse is present. You shout for help and provide ventilation with 100% oxygen. The rhythm shown
here is seen on the cardiac monitor. What is your next action? - CORRECT ANSWER: Start high-quality
CPR
A pale and very sleepy but arousable 3-year-old child with a history of diarrhea is brought to the hospital.
Primary assessment reveals a respiratory rate of 45/min with good breath sounds bilaterally. Heart rate is
150/min, blood pressure is 90/64 mm Hg, and SpO, is 92% in room air. Capillary refill is 5 seconds, and
peripheral pulses are weak. After placing the child on a nonrebreathing face mask (10-L/min flow) with
100% oxygen and obtaining vascular access, which is the most appropriate immediate treatment for this
child? - CORRECT ANSWER: Administer a bolus of 20 mL/kg isotonic crystalloid
Correct Answers | Latest Update 2026/2027 | 100%
PASS
A 10-month-old infant boy is brought to the emergency department. Your initial assessment reveals a
lethargic, pale infant with slow respirations and slow, weak central pulses. One team member begins
ventilation with a bag-mask device with 100% oxygen. A second team member attaches the
monitor/defibrillator and obtains vital signs while a third team member attempts to establish IV/O access.
The patient's heart rate is 38/min with the rhythm shown here. The infant's blood pressure is 58/38 mm Hg,
and capillary refill is 4 seconds. His central pulses remain weak, and distal pulses cannot be palpated. Chest
compressions are started and I0 access is obtained. Which medication do you anticipate will be given next?
- CORRECT ANSWER: Epinephrine 0.01 mg/kg IV/IO
A 3-year-old boy presents with multiple-system trauma. The child was an unrestrained passenger in a high-
speed motor vehicle crash. On primary assessment, he is unresponsive to voice or painful stimulation. His
respiratory rate is 5/min, heart rate and pulses are 170/min, systolic blood pressure is 60 mm Hg, capillary
refill is 5 seconds, and SpOz is 75% on room air. Which action should you take first? - CORRECT
ANSWER: While a colleague provides spinal motion restriction, open the airway with a jaw thrust and
provide bag-mask ventilation
A 3-year-old unresponsive, apneic child is brought to the emergency department. EMS personnel report
that the child became unresponsive as they arrived at the hospital. The child is receiving CPR with bag-
mask ventilation. The rhythm shown here is on the cardiac monitor. A biphasic manual defibrillator is
present. You quickly use the length from head to heel of the child on a color-coded length-based
resuscitation tape to estimate the approximate weight as 15 kg. Which therapy is most appropriate for this
child at this time? - CORRECT ANSWER: Attempt defibrillation at 30 J, and then resume CPR, and
resume chest compressions
A 4-year-old boy is in pulseless arrest in the pediatric intensive care unit. High-quality CPR is in progress.
You quickly review his chart and find that his baseline-corrected OT interval on a 12-lead ECG is
, prolonged. The monitor shows recurrent episodes of the rhythm shown here. The patient has received 1
dose of epinephrine 0.01 mg/kg, but the rhythm shown here continues. If this rhythm persists at the next
rhythm check, which medication would be most appropriate to administer at that time? - CORRECT
ANSWER: Magnesium sulfate 25 to 50 mg/kg IV
A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is ongoing. The child is intubated, and
vascular access is established. The ECG monitor shows an organized rhythm with a heart rate of 45/min,
but a pulse check reveals no palpable pulses. High-quality CPR is resumed, and an initial IV dose of
epinephrine is administered. Which intervention should you perform next? - CORRECT ANSWER:
Identify and treat reversible causes
A 9-year-old boy is agitated and leaning forward on the bed in obvious respiratory distress. The patient is
speaking in short phrases and tells you that he has asthma but does not carry an inhaler. He has nasal
flaring, severe suprasternal and intercostal retractions, and decreased air movement with prolonged
expiratory time and wheezing. You administer 100% oxygen by a nonrebreathing mask. His SpO, is 92%.
Which medication do you prepare to give to this patient? - CORRECT ANSWER: Albuterol
A child becomes unresponsive in the emergency department and is not breathing. You are uncertain if a
faint pulse is present. You shout for help and provide ventilation with 100% oxygen. The rhythm shown
here is seen on the cardiac monitor. What is your next action? - CORRECT ANSWER: Start high-quality
CPR
A pale and very sleepy but arousable 3-year-old child with a history of diarrhea is brought to the hospital.
Primary assessment reveals a respiratory rate of 45/min with good breath sounds bilaterally. Heart rate is
150/min, blood pressure is 90/64 mm Hg, and SpO, is 92% in room air. Capillary refill is 5 seconds, and
peripheral pulses are weak. After placing the child on a nonrebreathing face mask (10-L/min flow) with
100% oxygen and obtaining vascular access, which is the most appropriate immediate treatment for this
child? - CORRECT ANSWER: Administer a bolus of 20 mL/kg isotonic crystalloid
