PALS Exam Questions & Answers 2023

1. 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 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 mmHg and glucose is 30 mg/dL. You administer 100% oxygen via face mask and start an IV. Which treatment is the most appropriate for this infant? a) Administer D50W 0.45% NaCl 20 mL/kg bolus over 15 minutes b) Administer LR solution 20 mL/kg over 60 minutes c) Administer a bolus of isotonic crystalloid 20 mL/kg over 5 to 20 minutes and also give D25W 2 to 4 mL/kg IV d) Administer D10W 20 mL/kg over 5 minutes - c) Administer a bolus of isotonic crystalloid 20 mL/kg over 5 to 20 minutes and also give D25W 2 to 4 mL/kg 2. Which statement is correct about endotracheal drug administration during resuscitative efforts for pediatric patients? a) The intravenous drug dose should be used b) It is the preferred route of drug administration c) The drug dose used is lower than the intravenous dose d) It is the least desirable route of administration - d) It is the least desirable route of administration 3. Which statement is correct about the effects of epinephrine during attempted resuscitation? a) Epi decreases peripheral vascular resistance and reduces myocardial afterload b) Epi stimulates spontaneous contractions when asystole is present c) Epi decreases myocardial oxygen consumption d) Epi is contraindicated in VFib - Epinephrine stimulates spontaneous contractions when asystole is present4. Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired oxygen to a 7yo child? a) nasal cannula b) simple oxygen mask c) nonrebreather face mask d) face tent - c) nonrebreathing face mask 5. 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 POx is 92%. Which medication do you prepare to give to this patient? a) Albuterol b) Adenosine c) Amiodarone d) Procainamide - a) Albuterol 6. You are part of team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You deliver 2 unsynchronized shocks. A team member established IO access, so you give a dose of epi, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You administer a 4-J/kg shock ad resume CPR. Which drug and dose should be administered next? a) Magnesium sulfate 25 to 50 mg/kg IO b) Epinephrine 0.1 mg/kg IO c) Atropine 0.02 mg/kg IO d) Amiodarone 5 mg/kg IO - d) Amiodarone 5 mg/kg IO