PALS PRE COURSE SELF ASSESSMENT 2026
COMPLETE ANSWERS PEDIATRIC
RESUSCITATION PREPARATION RESOURCE
◉ Which oxygen delivery system most reliably delivers a high (90%
or greater) concentration of inspired oxygen to a 7-year-old child?
Answer: Nonrebreathing face mask
◉ Paramedics are called to the home of a 1-year-old child. Their
initial assessment reveals a child who responds only to painful
stimuli and has irregular breathing, faint central pulses, bruises over
the abdomen, abdominal distention, and cyanosis. Bag-mask
ventilation with 100% oxygen is initiated. The child's heart rate is
36/min. Peripheral pulses cannot be palpated, and central pulses are
barely palpable. The cardiac monitor shows sinus bradycardia. Two-
rescuer CPR is started. Upon arrival to the emergency department,
the child is intubated and ventilated with 100% oxygen, and IV
access is established. The heart rate is now 150/min with weak
central pulses but no distal pulses. Systolic blood pressure is 74 mm
Hg. Which intervention should be provided next?
Answer: Rapid bolus of 20 mL/kg of isotonic crystalloid
◉ A previously healthy infant with a history of vomiting and
diarrhea is brought to the emergency department by her parents.
During your assessment, you find that the infant responds only to
, painful stimulation. The infant's respiratory rate is 40 breaths per
minute, and central pulses are rapid and weak. The infant has good
bilateral breath sounds, cool extremities, and a capillary refill time of
more than 5 seconds. The infant's blood pressure is 85/65 mm Hg,
and glucose is 30 mg/dL (1.65 mol/L). You administer 100% oxygen
via face mask and start an IV. Which treatment is the most
appropriate for this infant?
Answer: Administer a bolus of isotonic crystalloid 20 mL/kg over 5
to 20 minutes, and also give D2;W 2 to 4 mL/kg IV
◉ 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?
Answer: Albuterol
◉ You are part of a team attempting to resuscitate a child with
ventricular fibrillation cardiac arrest. You delivered 2
unsynchronized shocks. A team member established I access, so you
give a dose of epinephrine, 0.01 mg/kg IO. At the next rhythm check,
persistent ventricular fibrillation is present. You administer a 4-J/kg
shock and resume CPR. Which drug and dose should be
administered next?
COMPLETE ANSWERS PEDIATRIC
RESUSCITATION PREPARATION RESOURCE
◉ Which oxygen delivery system most reliably delivers a high (90%
or greater) concentration of inspired oxygen to a 7-year-old child?
Answer: Nonrebreathing face mask
◉ Paramedics are called to the home of a 1-year-old child. Their
initial assessment reveals a child who responds only to painful
stimuli and has irregular breathing, faint central pulses, bruises over
the abdomen, abdominal distention, and cyanosis. Bag-mask
ventilation with 100% oxygen is initiated. The child's heart rate is
36/min. Peripheral pulses cannot be palpated, and central pulses are
barely palpable. The cardiac monitor shows sinus bradycardia. Two-
rescuer CPR is started. Upon arrival to the emergency department,
the child is intubated and ventilated with 100% oxygen, and IV
access is established. The heart rate is now 150/min with weak
central pulses but no distal pulses. Systolic blood pressure is 74 mm
Hg. Which intervention should be provided next?
Answer: Rapid bolus of 20 mL/kg of isotonic crystalloid
◉ A previously healthy infant with a history of vomiting and
diarrhea is brought to the emergency department by her parents.
During your assessment, you find that the infant responds only to
, painful stimulation. The infant's respiratory rate is 40 breaths per
minute, and central pulses are rapid and weak. The infant has good
bilateral breath sounds, cool extremities, and a capillary refill time of
more than 5 seconds. The infant's blood pressure is 85/65 mm Hg,
and glucose is 30 mg/dL (1.65 mol/L). You administer 100% oxygen
via face mask and start an IV. Which treatment is the most
appropriate for this infant?
Answer: Administer a bolus of isotonic crystalloid 20 mL/kg over 5
to 20 minutes, and also give D2;W 2 to 4 mL/kg IV
◉ 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?
Answer: Albuterol
◉ You are part of a team attempting to resuscitate a child with
ventricular fibrillation cardiac arrest. You delivered 2
unsynchronized shocks. A team member established I access, so you
give a dose of epinephrine, 0.01 mg/kg IO. At the next rhythm check,
persistent ventricular fibrillation is present. You administer a 4-J/kg
shock and resume CPR. Which drug and dose should be
administered next?
