AHA PALS FINAL EXAM – QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A 4-year-old child is brought to the emergency department with a 3-day history of fever,
barky cough, and inspiratory stridor at rest. The child is agitated, and oxygen saturation is
92% on room air. What is the most appropriate initial management?
A. Administer nebulized racemic epinephrine
B. Perform endotracheal intubation
C. Obtain a lateral neck X-ray
D. Administer intramuscular dexamethasone
Rationale: Nebulized racemic epinephrine is the indicated treatment for a child with stridor at
rest to reduce airway edema. Intubation is reserved for respiratory failure. A lateral neck X-
ray is unnecessary if the clinical presentation is classic for croup. Dexamethasone is indicated
but has a delayed onset, making epinephrine the priority for immediate relief of respiratory
distress.
2. A 6-month-old infant in the pediatric intensive care unit suddenly develops bradycardia
with a heart rate of 50 bpm and poor perfusion. You have provided bag-mask ventilation
with 100% oxygen for 30 seconds, but the heart rate remains 50 bpm. What is the next
most appropriate step?
A. Administer a bolus of normal saline
B. Start chest compressions
C. Administer epinephrine 0.01 mg/kg IV
D. Attempt intubation
Rationale: PALS guidelines state that if a child or infant remains bradycardic (HR < 60 bpm)
with signs of poor perfusion despite adequate oxygenation and ventilation, chest compressions
must be initiated.
3. During a cardiac arrest, an IO line is established in a 2-year-old. What is the correct dose
of epinephrine for the first dose?
A. 0.1 mg/kg
B. 0.01 mg/kg
C. 1 mg/kg
D. 0.05 mg/kg
Rationale: The standard dose for intravenous or intraosseous epinephrine in pediatric cardiac
arrest is 0.01 mg/kg (0.1 mL/kg of the 1:10,000 concentration).
, 4. Which of the following best describes compensated shock in a pediatric patient?
A. Hypotension with tachycardia
B. Normal blood pressure with signs of poor perfusion
C. Altered mental status and bradycardia
D. Decreased urine output and unresponsiveness
Rationale: Compensated shock is defined by the body’s ability to maintain a normal systolic
blood pressure despite insults, evidenced by tachycardia, delayed capillary refill, and cool
extremities. Hypotension is the hallmark of decompensated shock.
5. A 10-year-old is found in ventricular fibrillation. After the first shock, what is the
immediate next step?
A. Check for a pulse
B. Administer a vasopressor
C. Resume chest compressions
D. Check the rhythm on the monitor
Rationale: Following a shock, the immediate priority is to resume high-quality CPR starting
with chest compressions for 2 minutes before rhythm assessment or pulse checks.
6. Which rhythm is most commonly associated with a prolonged QT interval and can
degenerate into Torsades de Pointes?
A. Sinus tachycardia
B. Supraventricular tachycardia
C. Polymorphic ventricular tachycardia
D. Atrial flutter
Rationale: Polymorphic VT, specifically Torsades de Pointes, is frequently associated with
prolonged QT intervals, often caused by electrolyte imbalances or congenital channelopathies.
7. A 3-year-old patient has a heart rate of 220 bpm. The ECG shows a narrow-QRS
complex tachycardia with no visible P waves. The patient is pale and lethargic. What is the
most appropriate treatment?
A. Vagal maneuvers
B. Adenosine 0.1 mg/kg
C. Synchronized cardioversion
D. Amiodarone infusion
Rationale: In a patient with symptomatic SVT (poor perfusion, altered mental status, or
hypotension), synchronized cardioversion is the immediate treatment of choice. Adenosine is
for stable patients.
VERIFIED AND WELL DETAILED ANSWERS PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A 4-year-old child is brought to the emergency department with a 3-day history of fever,
barky cough, and inspiratory stridor at rest. The child is agitated, and oxygen saturation is
92% on room air. What is the most appropriate initial management?
A. Administer nebulized racemic epinephrine
B. Perform endotracheal intubation
C. Obtain a lateral neck X-ray
D. Administer intramuscular dexamethasone
Rationale: Nebulized racemic epinephrine is the indicated treatment for a child with stridor at
rest to reduce airway edema. Intubation is reserved for respiratory failure. A lateral neck X-
ray is unnecessary if the clinical presentation is classic for croup. Dexamethasone is indicated
but has a delayed onset, making epinephrine the priority for immediate relief of respiratory
distress.
2. A 6-month-old infant in the pediatric intensive care unit suddenly develops bradycardia
with a heart rate of 50 bpm and poor perfusion. You have provided bag-mask ventilation
with 100% oxygen for 30 seconds, but the heart rate remains 50 bpm. What is the next
most appropriate step?
A. Administer a bolus of normal saline
B. Start chest compressions
C. Administer epinephrine 0.01 mg/kg IV
D. Attempt intubation
Rationale: PALS guidelines state that if a child or infant remains bradycardic (HR < 60 bpm)
with signs of poor perfusion despite adequate oxygenation and ventilation, chest compressions
must be initiated.
3. During a cardiac arrest, an IO line is established in a 2-year-old. What is the correct dose
of epinephrine for the first dose?
A. 0.1 mg/kg
B. 0.01 mg/kg
C. 1 mg/kg
D. 0.05 mg/kg
Rationale: The standard dose for intravenous or intraosseous epinephrine in pediatric cardiac
arrest is 0.01 mg/kg (0.1 mL/kg of the 1:10,000 concentration).
, 4. Which of the following best describes compensated shock in a pediatric patient?
A. Hypotension with tachycardia
B. Normal blood pressure with signs of poor perfusion
C. Altered mental status and bradycardia
D. Decreased urine output and unresponsiveness
Rationale: Compensated shock is defined by the body’s ability to maintain a normal systolic
blood pressure despite insults, evidenced by tachycardia, delayed capillary refill, and cool
extremities. Hypotension is the hallmark of decompensated shock.
5. A 10-year-old is found in ventricular fibrillation. After the first shock, what is the
immediate next step?
A. Check for a pulse
B. Administer a vasopressor
C. Resume chest compressions
D. Check the rhythm on the monitor
Rationale: Following a shock, the immediate priority is to resume high-quality CPR starting
with chest compressions for 2 minutes before rhythm assessment or pulse checks.
6. Which rhythm is most commonly associated with a prolonged QT interval and can
degenerate into Torsades de Pointes?
A. Sinus tachycardia
B. Supraventricular tachycardia
C. Polymorphic ventricular tachycardia
D. Atrial flutter
Rationale: Polymorphic VT, specifically Torsades de Pointes, is frequently associated with
prolonged QT intervals, often caused by electrolyte imbalances or congenital channelopathies.
7. A 3-year-old patient has a heart rate of 220 bpm. The ECG shows a narrow-QRS
complex tachycardia with no visible P waves. The patient is pale and lethargic. What is the
most appropriate treatment?
A. Vagal maneuvers
B. Adenosine 0.1 mg/kg
C. Synchronized cardioversion
D. Amiodarone infusion
Rationale: In a patient with symptomatic SVT (poor perfusion, altered mental status, or
hypotension), synchronized cardioversion is the immediate treatment of choice. Adenosine is
for stable patients.
