PALS Final Review Exam [2026/2027]
Updated Version | Verified Questions &
Detailed Rationales for Top
Performance
Mikey, a 2-year-old boy, is sitting upright on a hospital bed in room 3 of your
emergency department. Your initial impression from the door does not raise
immediate concern. On your entry to the room, you are able to look at Mikey
more closely and notice on inhalation his nostrils are flaring. This is a sign of: -
ANSWER-Respiratory distress
The proper site for a peripheral pulse assessment in the infant patient is: -
ANSWER-brachial
You are called to the scene of a 3-year-old patient who was found anxious,
*cyanotic* and lethargic after a fall down a flight of stairs. On assessing the
patient, you find vital signs with a respiratory rate of 30, regular pulse rate of 130,
regular capillary refill time of 4 seconds, and a blood pressure of 102/61. What
kind of shock is the patient experiencing? - ANSWER-compensate shock?
A mnemonic that aids in performing a primary assessment is: - ANSWER-ABCDE
,A consideration of treatment for a pediatric patient with acute fulminant
myocarditis who is in cardiac arrest or at a high risk of cardiac arrest is: - ANSWER-
Extracorporeal membrane oxygenation (ECMO)
Which of the following is the correct meaning for one of the individual letters in
the AVPU scale? - ANSWER-Alert - The child is alert and awake and responds to
normal stimuli based upon age and environment
The recommended route of vascular access on a hypotensive pediatric patient is: -
ANSWER-central IV
You are called to the bedside of a 12-year-old male patient who was admitted
after a week of persistent vomiting, diarrhea and limiting oral intake of both solids
and liquids. The patient's airway is patent, ventilatory rate is within normal limits
and the patient's circulatory status presents with tachycardia, a blood pressure of
70/40 and a capillary refill time of 5 seconds. The patient is speaking incoherently.
The patient has no history of cardiac problems or congenital defects. The
appropriate fluid administration dose for this patient is: - ANSWER-20 ml/kg 0.9%
NaCl over 10 minutes
You suspect your 8-year-old female patient of being hypovolemic. Her parents
brought her to the emergency department with persistent vomiting and diarrhea
for 5 days. The patient presents with *mottled skin* and reports of periods where
"she just stopped breathing!" according to her parents. The patient is being
managed with a BVM and supplemental oxygen. What is the best route of
establishing vascular access for the purpose of fluid resuscitation? - ANSWER-IV
, Which of the following cannot be administered through an ETT? - ANSWER-
Sodium bicarbonate
You are examining the rhythm strip of a patient who presents with bradycardia.
Which of the following characteristics may you notice in the rhythm? - ANSWER-
The most obvious sign of bradycardia on an ECG is slow heart rate. The
characteristics of P-waves and the QRS complex may vary. When looking at an
EKG, the following characteristics are seen with bradycardia patients: Slow heart
rate, P-waves may not be noticeable, QRS complex may be wide or narrow, and P-
waves and QRS complex may not be related to bradycardia.
How do children's metabolic rates compare to adults'? - ANSWER-higher
Children's demand for oxygen is ___________ adults. - ANSWER-greater
Which of the following must you monitor while fluid resuscitating a patient? -
ANSWER-Urine output
What type of pressure is monitored to obtain right ventricular cardiac preload? -
ANSWER-Central venous pressure (CVP)
Define shock: - ANSWER-When oxygen and nutrient supply to body tissue is
insufficient compared to metabolic tissue needs
Your 5-year-old patient is admitted to the PICU and is being treated by your team
for hypovolemic shock. The team has administered one bolus of 20ml/kg of 0.9%
NaCl . On re-evaluation the patient is alert and anxious with a heart rate of 145
Updated Version | Verified Questions &
Detailed Rationales for Top
Performance
Mikey, a 2-year-old boy, is sitting upright on a hospital bed in room 3 of your
emergency department. Your initial impression from the door does not raise
immediate concern. On your entry to the room, you are able to look at Mikey
more closely and notice on inhalation his nostrils are flaring. This is a sign of: -
ANSWER-Respiratory distress
The proper site for a peripheral pulse assessment in the infant patient is: -
ANSWER-brachial
You are called to the scene of a 3-year-old patient who was found anxious,
*cyanotic* and lethargic after a fall down a flight of stairs. On assessing the
patient, you find vital signs with a respiratory rate of 30, regular pulse rate of 130,
regular capillary refill time of 4 seconds, and a blood pressure of 102/61. What
kind of shock is the patient experiencing? - ANSWER-compensate shock?
A mnemonic that aids in performing a primary assessment is: - ANSWER-ABCDE
,A consideration of treatment for a pediatric patient with acute fulminant
myocarditis who is in cardiac arrest or at a high risk of cardiac arrest is: - ANSWER-
Extracorporeal membrane oxygenation (ECMO)
Which of the following is the correct meaning for one of the individual letters in
the AVPU scale? - ANSWER-Alert - The child is alert and awake and responds to
normal stimuli based upon age and environment
The recommended route of vascular access on a hypotensive pediatric patient is: -
ANSWER-central IV
You are called to the bedside of a 12-year-old male patient who was admitted
after a week of persistent vomiting, diarrhea and limiting oral intake of both solids
and liquids. The patient's airway is patent, ventilatory rate is within normal limits
and the patient's circulatory status presents with tachycardia, a blood pressure of
70/40 and a capillary refill time of 5 seconds. The patient is speaking incoherently.
The patient has no history of cardiac problems or congenital defects. The
appropriate fluid administration dose for this patient is: - ANSWER-20 ml/kg 0.9%
NaCl over 10 minutes
You suspect your 8-year-old female patient of being hypovolemic. Her parents
brought her to the emergency department with persistent vomiting and diarrhea
for 5 days. The patient presents with *mottled skin* and reports of periods where
"she just stopped breathing!" according to her parents. The patient is being
managed with a BVM and supplemental oxygen. What is the best route of
establishing vascular access for the purpose of fluid resuscitation? - ANSWER-IV
, Which of the following cannot be administered through an ETT? - ANSWER-
Sodium bicarbonate
You are examining the rhythm strip of a patient who presents with bradycardia.
Which of the following characteristics may you notice in the rhythm? - ANSWER-
The most obvious sign of bradycardia on an ECG is slow heart rate. The
characteristics of P-waves and the QRS complex may vary. When looking at an
EKG, the following characteristics are seen with bradycardia patients: Slow heart
rate, P-waves may not be noticeable, QRS complex may be wide or narrow, and P-
waves and QRS complex may not be related to bradycardia.
How do children's metabolic rates compare to adults'? - ANSWER-higher
Children's demand for oxygen is ___________ adults. - ANSWER-greater
Which of the following must you monitor while fluid resuscitating a patient? -
ANSWER-Urine output
What type of pressure is monitored to obtain right ventricular cardiac preload? -
ANSWER-Central venous pressure (CVP)
Define shock: - ANSWER-When oxygen and nutrient supply to body tissue is
insufficient compared to metabolic tissue needs
Your 5-year-old patient is admitted to the PICU and is being treated by your team
for hypovolemic shock. The team has administered one bolus of 20ml/kg of 0.9%
NaCl . On re-evaluation the patient is alert and anxious with a heart rate of 145
