PALS FINAL EXAM QUESTIONS AND
ANSWERS 2027 QUESTIONS AND
ANSWERS
1. A 6-year-old child is in cardiac arrest. The initial rhythm is ventricular fibrillation. After the
first shock and 2 minutes of CPR, the rhythm remains VF. What is the recommended dose for
the second shock?
A. 2 J/kg
B. 6 J/kg
C. 4 J/kg
D. 10 J/kg
Answer: C
Conceptual Explanation: For pediatric cardiac arrest, the initial shock is 2 J/kg. The
second shock should be 4 J/kg. Subsequent shocks should be at least 4 J/kg, not to exceed
10 J/kg or the adult maximum dose.
2. Which of the following is a sign of probable respiratory failure in a child?
A. Nasal flaring with a respiratory rate of 30
,B. Tachycardia and mild wheezing
C. Decreased level of consciousness and bradypnea
D. Occasional grunting with preserved skin color
Answer: C
Conceptual Explanation: Respiratory failure is characterized by inadequate oxygenation
or ventilation. Clinical signs include a significantly decreased level of consciousness,
bradypnea (abnormally slow breathing), and cyanosis, indicating that the patient can no
longer maintain adequate gas exchange.
3. In 2-rescuer CPR for an infant, what is the correct compression-to-ventilation ratio?
A. 30:2
B. 5:1
C. 3:1
D. 15:2
Answer: D
Conceptual Explanation: While single-rescuer CPR for infants and children uses a 30:2
ratio, 2-rescuer PALS guidelines mandate a 15:2 ratio to provide more frequent
ventilations.
, 4. A 10-month-old infant presents with a heart rate of 220 bpm, narrow QRS complexes, and
absent P waves. The infant is lethargic with a capillary refill of 4 seconds. What is the most
likely rhythm?
A. Sinus Tachycardia
B. Supraventricular Tachycardia (SVT)
C. Ventricular Tachycardia
D. Atrial Flutter
Answer: B
Conceptual Explanation: SVT in infants typically presents with a heart rate >220 bpm,
narrow QRS, and lack of P-wave variability. The clinical presentation of poor perfusion
supports the need for immediate intervention.
5. What is the first-line medication for a child with symptomatic bradycardia that is
unresponsive to oxygenation and ventilation?
A. Atropine
B. Amiodarone
C. Lidocaine
D. Epinephrine
Answer: D
ANSWERS 2027 QUESTIONS AND
ANSWERS
1. A 6-year-old child is in cardiac arrest. The initial rhythm is ventricular fibrillation. After the
first shock and 2 minutes of CPR, the rhythm remains VF. What is the recommended dose for
the second shock?
A. 2 J/kg
B. 6 J/kg
C. 4 J/kg
D. 10 J/kg
Answer: C
Conceptual Explanation: For pediatric cardiac arrest, the initial shock is 2 J/kg. The
second shock should be 4 J/kg. Subsequent shocks should be at least 4 J/kg, not to exceed
10 J/kg or the adult maximum dose.
2. Which of the following is a sign of probable respiratory failure in a child?
A. Nasal flaring with a respiratory rate of 30
,B. Tachycardia and mild wheezing
C. Decreased level of consciousness and bradypnea
D. Occasional grunting with preserved skin color
Answer: C
Conceptual Explanation: Respiratory failure is characterized by inadequate oxygenation
or ventilation. Clinical signs include a significantly decreased level of consciousness,
bradypnea (abnormally slow breathing), and cyanosis, indicating that the patient can no
longer maintain adequate gas exchange.
3. In 2-rescuer CPR for an infant, what is the correct compression-to-ventilation ratio?
A. 30:2
B. 5:1
C. 3:1
D. 15:2
Answer: D
Conceptual Explanation: While single-rescuer CPR for infants and children uses a 30:2
ratio, 2-rescuer PALS guidelines mandate a 15:2 ratio to provide more frequent
ventilations.
, 4. A 10-month-old infant presents with a heart rate of 220 bpm, narrow QRS complexes, and
absent P waves. The infant is lethargic with a capillary refill of 4 seconds. What is the most
likely rhythm?
A. Sinus Tachycardia
B. Supraventricular Tachycardia (SVT)
C. Ventricular Tachycardia
D. Atrial Flutter
Answer: B
Conceptual Explanation: SVT in infants typically presents with a heart rate >220 bpm,
narrow QRS, and lack of P-wave variability. The clinical presentation of poor perfusion
supports the need for immediate intervention.
5. What is the first-line medication for a child with symptomatic bradycardia that is
unresponsive to oxygenation and ventilation?
A. Atropine
B. Amiodarone
C. Lidocaine
D. Epinephrine
Answer: D
