AHA PALS EXAM ACTUAL EXAM TEST BANK 200+ QUESTIONS
AND VERIFIED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) ALREADY A+
1
A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer.
What is the next most appropriate intervention?
A. Administer 0.1 mg/kg of adenosine
B. Obtain a blood sample to evaluate arterial or venous blood gases
C. Reassess breath sounds and clinical status
, Detailed Answers with Rationales
Correct Answer: C. Reassess breath sounds and clinical status
Clinical Rationale: After delivering any first-line respiratory intervention—such as an
inhaled bronchodilator (albuterol) and supplemental oxygen to an acute asthma
patient—the provider must immediately re-evaluate the patient's clinical response. This
critical step confirms whether the patient's air entry is improving, wheezing is resolving,
or if further escalation of therapy (such as repeated treatments or continuous
nebulizers) is required.
Question 2
The respiratory rate of a 1-year-old child with respiratory distress has decreased from
65/min to 30/min. The child is more lethargic and continues to have subcostal
retractions. What does this change likely indicate?
A. Respiratory distress is unchanged
B. Progression toward respiratory failure
C. Improved respiratory status
Detailed Answers with Rationales
Correct Answer: B. Progression toward respiratory failure
Clinical Rationale: A precipitous fall in respiratory rate (from a severely tachypneic
65/min to a near-normal 30/min) in a child with persistent work of breathing (subcostal
retractions) is an ominous sign. When combined with worsening neurological status
(lethargy), it signals that the child's respiratory muscles are fatiguing. This indicates
impending respiratory failure and arrest, requiring immediate respiratory support.
Question 3
You are caring for a 5-year-old child in cardiac arrest. An advanced airway
(endotracheal tube) is in place. What is the correct rate for delivering rescue breaths?
, A. 1 breath every 2 to 3 seconds (20 to 30 breaths per minute)
B. 1 breath every 6 seconds (10 breaths per minute)
C. 1 breath every 3 to 5 seconds (12 to 20 breaths per minute)
Correct Answer: A. 1 breath every 2 to 3 seconds (20 to 30 breaths per minute)
Rationale: Current PALS guidelines specify that when an advanced airway is placed
during pediatric CPR, ventilations should be delivered at a rate of 20 to 30 breaths per
minute (1 breath every 2 to 3 seconds) for all infants and children to optimize
oxygenation and maintain normocapnia.
Question 4
A 2-year-old child presents with a barking cough, audible stridor at rest, and severe
intercostal retractions. What is the first-line medication?
A. Nebulized albuterol
B. Nebulized L-epinephrine (racemic epinephrine)
C. Intravenous amiodarone
Correct Answer: B. Nebulized L-epinephrine (racemic epinephrine)
Rationale: The clinical presentation describes severe croup (laryngotracheobronchitis).
Nebulized epinephrine is the first-line emergency treatment because its alpha-
adrenergic effects cause mucosal vasoconstriction, rapidly reducing upper airway
edema. Albuterol (Option A) targets lower airway bronchospasm and is ineffective for
upper airway swelling.
Question 5
, What is the correct initial energy dose for manual defibrillation of a pediatric patient in
Ventricular Fibrillation (VF) or pulseless Ventricular Tachycardia (pVT)?
A. 2 J/kg
B. 4 J/kg
C. 10 J/kg
Correct Answer: A. 2 J/kg
Rationale: The recommended initial energy dose for manual defibrillation in pediatric
shockable cardiac arrest rhythms is 2 J/kg. If the rhythm fails to convert, the subsequent
shock should be escalated to 4 J/kg, with a maximum recommended dose not
exceeding 10 J/kg or the standard adult maximum.
Question 6
An 8-month-old infant is unresponsive with a heart rate of 45 bpm and signs of poor
peripheral perfusion despite optimal oxygenation and ventilation. What is the next
immediate action?
A. Continue monitoring and check blood pressure
B. Start high-quality CPR (chest compressions)
C. Administer a rapid fluid bolus
Correct Answer: B. Start high-quality CPR (chest compressions)
Rationale: In pediatric patients, if the heart rate is less than 60 bpm with signs of poor
systemic perfusion despite adequate oxygenation and ventilation, you must immediately
begin chest compressions. Waiting to monitor or attempting a fluid bolus delays critical
myocardial perfusion.
AND VERIFIED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) ALREADY A+
1
A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer.
What is the next most appropriate intervention?
A. Administer 0.1 mg/kg of adenosine
B. Obtain a blood sample to evaluate arterial or venous blood gases
C. Reassess breath sounds and clinical status
, Detailed Answers with Rationales
Correct Answer: C. Reassess breath sounds and clinical status
Clinical Rationale: After delivering any first-line respiratory intervention—such as an
inhaled bronchodilator (albuterol) and supplemental oxygen to an acute asthma
patient—the provider must immediately re-evaluate the patient's clinical response. This
critical step confirms whether the patient's air entry is improving, wheezing is resolving,
or if further escalation of therapy (such as repeated treatments or continuous
nebulizers) is required.
Question 2
The respiratory rate of a 1-year-old child with respiratory distress has decreased from
65/min to 30/min. The child is more lethargic and continues to have subcostal
retractions. What does this change likely indicate?
A. Respiratory distress is unchanged
B. Progression toward respiratory failure
C. Improved respiratory status
Detailed Answers with Rationales
Correct Answer: B. Progression toward respiratory failure
Clinical Rationale: A precipitous fall in respiratory rate (from a severely tachypneic
65/min to a near-normal 30/min) in a child with persistent work of breathing (subcostal
retractions) is an ominous sign. When combined with worsening neurological status
(lethargy), it signals that the child's respiratory muscles are fatiguing. This indicates
impending respiratory failure and arrest, requiring immediate respiratory support.
Question 3
You are caring for a 5-year-old child in cardiac arrest. An advanced airway
(endotracheal tube) is in place. What is the correct rate for delivering rescue breaths?
, A. 1 breath every 2 to 3 seconds (20 to 30 breaths per minute)
B. 1 breath every 6 seconds (10 breaths per minute)
C. 1 breath every 3 to 5 seconds (12 to 20 breaths per minute)
Correct Answer: A. 1 breath every 2 to 3 seconds (20 to 30 breaths per minute)
Rationale: Current PALS guidelines specify that when an advanced airway is placed
during pediatric CPR, ventilations should be delivered at a rate of 20 to 30 breaths per
minute (1 breath every 2 to 3 seconds) for all infants and children to optimize
oxygenation and maintain normocapnia.
Question 4
A 2-year-old child presents with a barking cough, audible stridor at rest, and severe
intercostal retractions. What is the first-line medication?
A. Nebulized albuterol
B. Nebulized L-epinephrine (racemic epinephrine)
C. Intravenous amiodarone
Correct Answer: B. Nebulized L-epinephrine (racemic epinephrine)
Rationale: The clinical presentation describes severe croup (laryngotracheobronchitis).
Nebulized epinephrine is the first-line emergency treatment because its alpha-
adrenergic effects cause mucosal vasoconstriction, rapidly reducing upper airway
edema. Albuterol (Option A) targets lower airway bronchospasm and is ineffective for
upper airway swelling.
Question 5
, What is the correct initial energy dose for manual defibrillation of a pediatric patient in
Ventricular Fibrillation (VF) or pulseless Ventricular Tachycardia (pVT)?
A. 2 J/kg
B. 4 J/kg
C. 10 J/kg
Correct Answer: A. 2 J/kg
Rationale: The recommended initial energy dose for manual defibrillation in pediatric
shockable cardiac arrest rhythms is 2 J/kg. If the rhythm fails to convert, the subsequent
shock should be escalated to 4 J/kg, with a maximum recommended dose not
exceeding 10 J/kg or the standard adult maximum.
Question 6
An 8-month-old infant is unresponsive with a heart rate of 45 bpm and signs of poor
peripheral perfusion despite optimal oxygenation and ventilation. What is the next
immediate action?
A. Continue monitoring and check blood pressure
B. Start high-quality CPR (chest compressions)
C. Administer a rapid fluid bolus
Correct Answer: B. Start high-quality CPR (chest compressions)
Rationale: In pediatric patients, if the heart rate is less than 60 bpm with signs of poor
systemic perfusion despite adequate oxygenation and ventilation, you must immediately
begin chest compressions. Waiting to monitor or attempting a fluid bolus delays critical
myocardial perfusion.
