PALS EXAM STUDY SET WITH
COMPLETE SOLUTIONS
Ax6xmonthxoldxinfantxisxunresponsive.xYouxbeginxcheckingxforxbreathingxatxthexsamextim
exyouxcheckxforxthexinfantsxpulse.xWhichxisxthexmaximumxtimexyouxshouldxspendxwhenxt
ryingxtoxsimultaneouslyxcheckxforxbreathingxandxpalpatexthexinfantsxpulsexbeforexstartin
gxCPR?x-xcorrectxanswer-10xseconds
Ax4xyearxoldxchildxisxbroughtxtoxthexemergencyxdepartmentxforxseizures.xThexseizuresxst
oppedxaxfewxminutesxago,xbutxthexchildxcontinuesxtoxhavexslowxandxirregularxrespiration
s.xWhichxconditionxisxmostxconsistentxwithxyourxassessment?x-xcorrectxanswer-
DisorderedxControlxofxBreathing
Anx8xyearxoldxchildxisxbroughtxtoxthexemergencyxdepartmentxwithxax2xdayxhistoryxofxletha
rgyxandxpolyuria.xThexchildxhasxnewxonsetxrapid,xdeep,xandxlaboredxbreathing.xWhichxdi
agnosticxtestxshouldxyouxorderxfirst?x-xcorrectxanswer-bloodxglucose
Afterxrectalxadministrationxofxdiazepam,xanx8xyearxoldxboyxwithxaxhistoryxofxseizuresxisxn
oxunresponsivextoxpainfulxstimuli.xHisxrespirationsxarexshallow,xatxaxratexofx10/min.xHisx
Oxygenxsaturationxisx94%xonx2LxofxNCxoxygen.xOnxexamination,xthexchildxisxsnoringxwit
hxpoorxchestxrisexandxpoorxairxentryxbilaterally.xWhatxactionxshouldxyouxtakexnext?x-
xcorrectxanswer-Repositionxthexpatient,xandxinsertxanxoralxairway
Afterxrectalxadministrationxofxdiazepam,xanx8xyearxoldxboyxwithxaxhistoryxofxseizuresxisxn
oxunresponsivextoxpainfulxstimuli.xHisxrespirationsxarexshallow,xatxaxratexofx10/min.xHisx
Oxygenxsaturationxisx94%xonx2LxofxNCxoxygen.xOnxexamination,xthexchildxisxsnoringxwit
hxpoorxchestxrisexandxpoorxairxentryxbilaterally.xAfterxrepositioningxthexpatientxandxyouxin
sertxanxOralxairway,xthexpatientxcontinuesxtoxdeteriorate.xWhatxnextxstepxisxthexmostxapp
ropriate?x-xcorrectxanswer-Providexbagxmaskxventilation
Ax6xyearxoldxchildxisxfoundxunresponsive,xnotxbreathing,xandxwithoutxaxpulse.xonexhealth
xcarexworkerxleavesxtoxactivatexthexemergencyxresponsexsystemxandxgetxthexresuscitati
onxequipment.xYouxandxanotherxhealthcarexproviderximmediatlyxbeginxCPR.xWhichxco
mpressionxtoxventilationxratioxdoxyouxuse?x-xcorrectxanswer-15:2
Inxpostxresuscitationxmanagementxafterxcardiacxarrest,xextraxcarexshouldxbextakenxtoxav
oidxrepercussionxinjury.xwhatxshouldxthexidealxoxygenxsaturationxrangexmostxlikelyxbe?x-
xcorrectxanswer-94%-99%
Ax3xyearxoldxchildxisxinxcardiacxarrest,xandxhighxqualityxCPRxisxinxprogress.xYouxarexthext
eamxleader.xThexfirstxrhythmxcheckxrevealsxthexrhythmxshownxhere.xDefibrillationxisxatte
mptedxwithxaxshockxdosexofx2xJ/kg.xafterxadministrationxofxthexshock,xwhatxshouldxyouxs
ayxtoxyouxteamxmembers?x-xcorrectxanswer-"resumexcompressions"
, Ax4xyearxoldxchildxinxcardiacxarrestxisxbroughtxtoxthexemergencyxdepartmentxbyxambulan
ce.xHighxqualityxCPRxisxbeingxperformed.xThexcardiacxmonitorxdisplaysxthexrhythmxstripx
shownxhere.xThexestimatedxweightxofxthexchildxisx20xkg.xWhatxdosexrangexshouldxyouxus
exforxthexinitialxdefibrillation?x-xcorrectxanswer-2-4xJ/kg
Ax4xyearxoldxchildxinxcardiacxarrestxisxbroughtxtoxthexemergencyxdepartmentxbyxambulan
ce.xHighxqualityxCPRxisxbeingxperformed.xThexcardiacxmonitorxdisplaysxthexrhythmxstripx
shownxhere.xThexestimatedxweightxofxthexchildxisx20xkg.xAsxthexteamxleader,xhowxmanyxj
oulesxdoxyouxtellxyourxteamxmemberxtoxusextoxperformxinitialxDefib?x-xcorrectxanswer-
40xJoules
Youxarexthexteamxleaderxduringxaxpediatricxresuscitationxattempt.xwhichxactionxisxanxele
mentxofxhighxqualityxCPR?x-xcorrectxanswer-
Allowingxcompletexchestxwallxrecoilxafterxeachxcompression
Youxarexcaringxforxax3xmonthxoldxboyxwithxax2xdayxhistoryxofxfever,xvomitingxandxdiarrhea
.xHisxparentsxstatexthatxhexhasxbeenxsleepingxmuchxmore.xHisxHRxisx190/min,xtempxisx3
8.3xdegreesxCx(101xF)xbloodxpressurexisx59/29xmmHg,xRespxratexisx70/minxandxshallow
,xandxoxygenxsatxisx94%xonx100%xoxygen.xHisxcapillaryxrefillsxtimexisx4-
5xseconds,xandxhexhasxmottled,xcoolxextremities.xThexinfantxweighsx6xKg.xWhichxassess
mentxfindingxindicatesxthatxthexinfantxisxinxhypotensivexshock?x-xcorrectxanswer-
bloodxpressure
Youxarexcaringxforxax3xmonthxoldxboyxwithxax2xdayxhistoryxofxfever,xvomitingxandxdiarrhea
.xHisxparentsxstatexthatxhexhasxbeenxsleepingxmuchxmore.xHisxHRxisx190/min,xtempxisx3
8.3xdegreesxCx(101xF)xbloodxpressurexisx59/29xmmHg,xRespxratexisx70/minxandxshallow
,xandxoxygenxsatxisx94%xonx100%xoxygen.xHisxcapillaryxrefillsxtimexisx4-
5xseconds,xandxhexhasxmottled,xcoolxextremities.xThexinfantxweighsx6xKg.xOnxthexbasisx
ofxthisxinfantsxpresentation,xwhichxtypexofxshockxdoesxthisxinfantxhave?x-
xcorrectxanswer-hypovolemicxshock
Youxarexcaringxforxax3xmonthxoldxboyxwithxax2xdayxhistoryxofxfever,xvomitingxandxdiarrhea
.xHisxparentsxstatexthatxhexhasxbeenxsleepingxmuchxmore.xHisxHRxisx190/min,xtempxisx3
8.3xdegreesxCx(101xF)xbloodxpressurexisx59/29xmmHg,xRespxratexisx70/minxandxshallow
,xandxoxygenxsatxisx94%xonx100%xoxygen.xHisxcapillaryxrefillsxtimexisx4-
5xseconds,xandxhexhasxmottled,xcoolxextremities.xThexinfantxweighsx6xKg.xYouxhavexdec
idedxthatxthisxinfantxNeedsxfluidxresuscitation.xHowxmuchxfluidxshouldxyouxadminister?x-
xcorrectxanswer-20xml/kgxnormalxsaline
Ax2xweekxoldxinfantxisxbeingxevaluatedxforxirritabilityxandxpoorxfeeding.xHisxBPxisx55/40xm
mHg,xandxcapxrefillxtimexisx5xseconds.xWhichxstatementxbestxdescribesxyourxassessme
ntxofxthisxinfantsxBP?x-xcorrectxanswer-ItxisxHypotensive
Axteamxmemberxisxunablextoxperformxanxassignedxtaskxbecausexitxisxbeyondxthexteamxm
embersxscopexofxpractice.xWhichxactionxshouldxthexteamxmemberxtake?x-
xcorrectxanswer-Askxforxaxnewxtaskxorxrole
Whichxabnormalityxhelpsxidentifyxchildrenxwithxacutexrespiratoryxdistressxcausedxbyxlun
gxtissuexdisease?x-xcorrectxanswer-crackles
COMPLETE SOLUTIONS
Ax6xmonthxoldxinfantxisxunresponsive.xYouxbeginxcheckingxforxbreathingxatxthexsamextim
exyouxcheckxforxthexinfantsxpulse.xWhichxisxthexmaximumxtimexyouxshouldxspendxwhenxt
ryingxtoxsimultaneouslyxcheckxforxbreathingxandxpalpatexthexinfantsxpulsexbeforexstartin
gxCPR?x-xcorrectxanswer-10xseconds
Ax4xyearxoldxchildxisxbroughtxtoxthexemergencyxdepartmentxforxseizures.xThexseizuresxst
oppedxaxfewxminutesxago,xbutxthexchildxcontinuesxtoxhavexslowxandxirregularxrespiration
s.xWhichxconditionxisxmostxconsistentxwithxyourxassessment?x-xcorrectxanswer-
DisorderedxControlxofxBreathing
Anx8xyearxoldxchildxisxbroughtxtoxthexemergencyxdepartmentxwithxax2xdayxhistoryxofxletha
rgyxandxpolyuria.xThexchildxhasxnewxonsetxrapid,xdeep,xandxlaboredxbreathing.xWhichxdi
agnosticxtestxshouldxyouxorderxfirst?x-xcorrectxanswer-bloodxglucose
Afterxrectalxadministrationxofxdiazepam,xanx8xyearxoldxboyxwithxaxhistoryxofxseizuresxisxn
oxunresponsivextoxpainfulxstimuli.xHisxrespirationsxarexshallow,xatxaxratexofx10/min.xHisx
Oxygenxsaturationxisx94%xonx2LxofxNCxoxygen.xOnxexamination,xthexchildxisxsnoringxwit
hxpoorxchestxrisexandxpoorxairxentryxbilaterally.xWhatxactionxshouldxyouxtakexnext?x-
xcorrectxanswer-Repositionxthexpatient,xandxinsertxanxoralxairway
Afterxrectalxadministrationxofxdiazepam,xanx8xyearxoldxboyxwithxaxhistoryxofxseizuresxisxn
oxunresponsivextoxpainfulxstimuli.xHisxrespirationsxarexshallow,xatxaxratexofx10/min.xHisx
Oxygenxsaturationxisx94%xonx2LxofxNCxoxygen.xOnxexamination,xthexchildxisxsnoringxwit
hxpoorxchestxrisexandxpoorxairxentryxbilaterally.xAfterxrepositioningxthexpatientxandxyouxin
sertxanxOralxairway,xthexpatientxcontinuesxtoxdeteriorate.xWhatxnextxstepxisxthexmostxapp
ropriate?x-xcorrectxanswer-Providexbagxmaskxventilation
Ax6xyearxoldxchildxisxfoundxunresponsive,xnotxbreathing,xandxwithoutxaxpulse.xonexhealth
xcarexworkerxleavesxtoxactivatexthexemergencyxresponsexsystemxandxgetxthexresuscitati
onxequipment.xYouxandxanotherxhealthcarexproviderximmediatlyxbeginxCPR.xWhichxco
mpressionxtoxventilationxratioxdoxyouxuse?x-xcorrectxanswer-15:2
Inxpostxresuscitationxmanagementxafterxcardiacxarrest,xextraxcarexshouldxbextakenxtoxav
oidxrepercussionxinjury.xwhatxshouldxthexidealxoxygenxsaturationxrangexmostxlikelyxbe?x-
xcorrectxanswer-94%-99%
Ax3xyearxoldxchildxisxinxcardiacxarrest,xandxhighxqualityxCPRxisxinxprogress.xYouxarexthext
eamxleader.xThexfirstxrhythmxcheckxrevealsxthexrhythmxshownxhere.xDefibrillationxisxatte
mptedxwithxaxshockxdosexofx2xJ/kg.xafterxadministrationxofxthexshock,xwhatxshouldxyouxs
ayxtoxyouxteamxmembers?x-xcorrectxanswer-"resumexcompressions"
, Ax4xyearxoldxchildxinxcardiacxarrestxisxbroughtxtoxthexemergencyxdepartmentxbyxambulan
ce.xHighxqualityxCPRxisxbeingxperformed.xThexcardiacxmonitorxdisplaysxthexrhythmxstripx
shownxhere.xThexestimatedxweightxofxthexchildxisx20xkg.xWhatxdosexrangexshouldxyouxus
exforxthexinitialxdefibrillation?x-xcorrectxanswer-2-4xJ/kg
Ax4xyearxoldxchildxinxcardiacxarrestxisxbroughtxtoxthexemergencyxdepartmentxbyxambulan
ce.xHighxqualityxCPRxisxbeingxperformed.xThexcardiacxmonitorxdisplaysxthexrhythmxstripx
shownxhere.xThexestimatedxweightxofxthexchildxisx20xkg.xAsxthexteamxleader,xhowxmanyxj
oulesxdoxyouxtellxyourxteamxmemberxtoxusextoxperformxinitialxDefib?x-xcorrectxanswer-
40xJoules
Youxarexthexteamxleaderxduringxaxpediatricxresuscitationxattempt.xwhichxactionxisxanxele
mentxofxhighxqualityxCPR?x-xcorrectxanswer-
Allowingxcompletexchestxwallxrecoilxafterxeachxcompression
Youxarexcaringxforxax3xmonthxoldxboyxwithxax2xdayxhistoryxofxfever,xvomitingxandxdiarrhea
.xHisxparentsxstatexthatxhexhasxbeenxsleepingxmuchxmore.xHisxHRxisx190/min,xtempxisx3
8.3xdegreesxCx(101xF)xbloodxpressurexisx59/29xmmHg,xRespxratexisx70/minxandxshallow
,xandxoxygenxsatxisx94%xonx100%xoxygen.xHisxcapillaryxrefillsxtimexisx4-
5xseconds,xandxhexhasxmottled,xcoolxextremities.xThexinfantxweighsx6xKg.xWhichxassess
mentxfindingxindicatesxthatxthexinfantxisxinxhypotensivexshock?x-xcorrectxanswer-
bloodxpressure
Youxarexcaringxforxax3xmonthxoldxboyxwithxax2xdayxhistoryxofxfever,xvomitingxandxdiarrhea
.xHisxparentsxstatexthatxhexhasxbeenxsleepingxmuchxmore.xHisxHRxisx190/min,xtempxisx3
8.3xdegreesxCx(101xF)xbloodxpressurexisx59/29xmmHg,xRespxratexisx70/minxandxshallow
,xandxoxygenxsatxisx94%xonx100%xoxygen.xHisxcapillaryxrefillsxtimexisx4-
5xseconds,xandxhexhasxmottled,xcoolxextremities.xThexinfantxweighsx6xKg.xOnxthexbasisx
ofxthisxinfantsxpresentation,xwhichxtypexofxshockxdoesxthisxinfantxhave?x-
xcorrectxanswer-hypovolemicxshock
Youxarexcaringxforxax3xmonthxoldxboyxwithxax2xdayxhistoryxofxfever,xvomitingxandxdiarrhea
.xHisxparentsxstatexthatxhexhasxbeenxsleepingxmuchxmore.xHisxHRxisx190/min,xtempxisx3
8.3xdegreesxCx(101xF)xbloodxpressurexisx59/29xmmHg,xRespxratexisx70/minxandxshallow
,xandxoxygenxsatxisx94%xonx100%xoxygen.xHisxcapillaryxrefillsxtimexisx4-
5xseconds,xandxhexhasxmottled,xcoolxextremities.xThexinfantxweighsx6xKg.xYouxhavexdec
idedxthatxthisxinfantxNeedsxfluidxresuscitation.xHowxmuchxfluidxshouldxyouxadminister?x-
xcorrectxanswer-20xml/kgxnormalxsaline
Ax2xweekxoldxinfantxisxbeingxevaluatedxforxirritabilityxandxpoorxfeeding.xHisxBPxisx55/40xm
mHg,xandxcapxrefillxtimexisx5xseconds.xWhichxstatementxbestxdescribesxyourxassessme
ntxofxthisxinfantsxBP?x-xcorrectxanswer-ItxisxHypotensive
Axteamxmemberxisxunablextoxperformxanxassignedxtaskxbecausexitxisxbeyondxthexteamxm
embersxscopexofxpractice.xWhichxactionxshouldxthexteamxmemberxtake?x-
xcorrectxanswer-Askxforxaxnewxtaskxorxrole
Whichxabnormalityxhelpsxidentifyxchildrenxwithxacutexrespiratoryxdistressxcausedxbyxlun
gxtissuexdisease?x-xcorrectxanswer-crackles
