AHA PALS PRACTICE EXAM WITH ALL ANSWERS RATED A
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale
color. The primary assessment reveals that the airway is open and the respiratory
rate is 30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation
of 95% and a pulse rate of 93/min. On the basis of this information, which of the
following provides the best interpretation of the oxygen saturation of 95% by pulse
oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary
oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered - correct answer-
Unreliable; supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been treated
with chemotherapy. The child presents with lethargy and a high fever. Heart rate is
195/min, respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary
refill time is less than 2 seconds. What is the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock - correct answer-Septic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding. Blood
pressure is 55/40 mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
,D. Compensated - correct answer-Hypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of
epinephrine at 0.1 mg/kg to be given 10. What should the team member do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug - correct answer-Respectfully ask the team leader
to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds - correct answer-Inadequate oxygenation and/or
ventilation
6. Which of the following is most likely to produce a prolonged expiratory phase and
wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
D. Upper airway obstruction - correct answer-Lower airway obstruction
7. A 4-year-old child presents with seizures and irregular respirations. The seizures
stopped a few minutes ago. Which of the following most likely to be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing - correct answer-Control of breathing
8. What abnormality is most likely to be present in children with acute respiratory
distress caused by lung tissue disease?
A. Decreased oxygen saturation
B. Stridor
C. Normal respiratory rate
D. Decreased respiratory effort - correct answer-Decreased oxygen saturation
9. An alert 2-year-old child with an increased work of breathing and pink color is
being evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would
best describe this patient's condition? A. Respiratory distress
B. Respiratory arrest
C. Respiratory failure
D. Disordered control of breathing - correct answer-Respiratory distress
10. The parents of a 7-year-old child who is undergoing chemotherapy report that the
child has been febrile and has not been feeling well, with recent onset of lethargy.
Assessment reveals the following: The child is difficult to arouse, with pale color. The
child's heart rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm
, Hg, capillary refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is
the most appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30
minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to
10 minutes
C. Obtain immediate blood cultures and chest x-ray D. Obtain expert consultation
with an oncologist to determine the chemotherapeutic regimen - correct answer-
Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10
minutes
11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression
reveals an unresponsive child with intermittent apnea and mottled color. Heart rate is
166/min, respiratory rate is now being supported with bag-mask ventilation, capillary
refill time is 5 to 6 seconds, and temperature is 102°F (38.9°C). What is the best
method of establishing immediate vascular access? A. Two providers may attempt
peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line - correct answer-Place an intraosseous line
12. What is the appropriate fluid bolus to administer for a child with hypovolemic
shock with adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's - correct answer-20 mL/kg normal saline
13. An alert toddler presents with a barking cough, moderate stridor, and moderate
retractions. The child's color is pink. What is the most appropriate initial intervention?
A. Obtain a chest radiograph
B. Administer nebulized epinephrine
C. Prepare for a surgical airway
D. Use an epinephrine autoinjector - correct answer-Administer nebulized
epinephrine
14. An 8-year-old child presents with a history of vomiting and diarrhea. The child
has the following vital signs: heart rate 168/min, respiratory rate 15/min, blood
pressure 9060 mm Hg, and temperature 98.6°F (37°C). The child's capillary refill
time is 4 seconds. After 2 IV boluses of normal saline (20 mL/kg each), the child's
vital signs are now as follows: heart rate 130/min, respiratory rate 16/min, blood
pressure 94/62 mm Hg, capillary refill 2 seconds, and temperature 98.6°F (37°C).
The child's urine output is 1 to 2 mL/kg in the past hour. The child is still lethargic.
What diagnostic tests or information should be obtained first?
A. Arterial blood gas
B. Serum potassium concentration
C. Glucose
D. A 12-lead ECG - correct answer-Glucose
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale
color. The primary assessment reveals that the airway is open and the respiratory
rate is 30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation
of 95% and a pulse rate of 93/min. On the basis of this information, which of the
following provides the best interpretation of the oxygen saturation of 95% by pulse
oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary
oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered - correct answer-
Unreliable; supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been treated
with chemotherapy. The child presents with lethargy and a high fever. Heart rate is
195/min, respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary
refill time is less than 2 seconds. What is the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock - correct answer-Septic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding. Blood
pressure is 55/40 mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
,D. Compensated - correct answer-Hypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of
epinephrine at 0.1 mg/kg to be given 10. What should the team member do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug - correct answer-Respectfully ask the team leader
to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds - correct answer-Inadequate oxygenation and/or
ventilation
6. Which of the following is most likely to produce a prolonged expiratory phase and
wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
D. Upper airway obstruction - correct answer-Lower airway obstruction
7. A 4-year-old child presents with seizures and irregular respirations. The seizures
stopped a few minutes ago. Which of the following most likely to be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing - correct answer-Control of breathing
8. What abnormality is most likely to be present in children with acute respiratory
distress caused by lung tissue disease?
A. Decreased oxygen saturation
B. Stridor
C. Normal respiratory rate
D. Decreased respiratory effort - correct answer-Decreased oxygen saturation
9. An alert 2-year-old child with an increased work of breathing and pink color is
being evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would
best describe this patient's condition? A. Respiratory distress
B. Respiratory arrest
C. Respiratory failure
D. Disordered control of breathing - correct answer-Respiratory distress
10. The parents of a 7-year-old child who is undergoing chemotherapy report that the
child has been febrile and has not been feeling well, with recent onset of lethargy.
Assessment reveals the following: The child is difficult to arouse, with pale color. The
child's heart rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm
, Hg, capillary refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is
the most appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30
minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to
10 minutes
C. Obtain immediate blood cultures and chest x-ray D. Obtain expert consultation
with an oncologist to determine the chemotherapeutic regimen - correct answer-
Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10
minutes
11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression
reveals an unresponsive child with intermittent apnea and mottled color. Heart rate is
166/min, respiratory rate is now being supported with bag-mask ventilation, capillary
refill time is 5 to 6 seconds, and temperature is 102°F (38.9°C). What is the best
method of establishing immediate vascular access? A. Two providers may attempt
peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line - correct answer-Place an intraosseous line
12. What is the appropriate fluid bolus to administer for a child with hypovolemic
shock with adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's - correct answer-20 mL/kg normal saline
13. An alert toddler presents with a barking cough, moderate stridor, and moderate
retractions. The child's color is pink. What is the most appropriate initial intervention?
A. Obtain a chest radiograph
B. Administer nebulized epinephrine
C. Prepare for a surgical airway
D. Use an epinephrine autoinjector - correct answer-Administer nebulized
epinephrine
14. An 8-year-old child presents with a history of vomiting and diarrhea. The child
has the following vital signs: heart rate 168/min, respiratory rate 15/min, blood
pressure 9060 mm Hg, and temperature 98.6°F (37°C). The child's capillary refill
time is 4 seconds. After 2 IV boluses of normal saline (20 mL/kg each), the child's
vital signs are now as follows: heart rate 130/min, respiratory rate 16/min, blood
pressure 94/62 mm Hg, capillary refill 2 seconds, and temperature 98.6°F (37°C).
The child's urine output is 1 to 2 mL/kg in the past hour. The child is still lethargic.
What diagnostic tests or information should be obtained first?
A. Arterial blood gas
B. Serum potassium concentration
C. Glucose
D. A 12-lead ECG - correct answer-Glucose
