PALS ALL QUESTIONS AND ANSWERS
1. You are caring for a child who was resuscitated after a
drowning event. The child is intubated and ventilated with
100% oxygen with equal breath sounds and exhaled CO2
detected. The heart rate is slow and the monitor shows sinus
bradycardia. The skin is cool, mottled, and moist; distal
pulses are not palpable and the central pulses are weak.
Intravenous access has been established. The core
temperature is 37.3oC. Based on the PALS bradycardia
algorithm, which of the following should be provided first?
Epinephrine IV
Transcutaneous
pacing Atropine IV
Dobutamine IV infusion: Epinephrine IV
2. You are caring for a 5-year-old patient with
supraventricular tachycardia (heart rate = 220/min). The child
is lethargic. The skin is pale and cool with delayed capillary
refill. Distal pulses are not palpable. Which of the following
would be the best treatment to provide without delay?
Place cold packs on the distal upper and lower
extremities Ask the child to blow through a
small straw
Exert light pressure on the eyes bilaterally
Provide synchronized cardioversion at 0.5 to 1 J/kg: Provide
synchronized car- dioversion at 0.5 to 1 J/kg
3. You are initiating treatment for a child with septic shock
and hypotension. While administering high-flow oxygen you
determine that the child's respi- rations are adequate and
, PALS ALL QUESTIONS AND ANSWERS
SpO2 is 100%. You have just established vascular access and
obtained blood samples. Which of the following is the next
most appropriate therapy to support systemic perfusion?
Administer repeated fluid boluses of isotonic
colloid Administer repeated fluid boluses of
isotonic crystalloid Begin immediate dopamine
infusion
Begin immediate dobutamine infusion: Administer repeated fluid
boluses of iso- tonic crystalloid
4. You are treating an 8-year-old with ventricular tachycardia
with pulses and adequate perfusion. You attempted
synchronized cardioversion without success. While seeking
expert consultation, it would be most appropriate to:
Administer a loading dose of milrinone
Consider possible metabolic and toxicologic causes
, PALS ALL QUESTIONS AND ANSWERS
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock: Consider possible metabolic and
toxicologic causes
5. You are caring for a 2-year-old unconscious patient who is
intubated and receiving mechanical ventilation. The child's
heart rate suddenly drops to 40/min and his color becomes
mottled. You should respond to these changes by:
Increasing the
ventilator rate
Increasing tidal volume
Increasing positive end-expiratory pressure (PEEP)
Using a resuscitation bag provide manual ventilation with 100%
oxygen: Using a resuscitation bag provide manual ventilation with
100% oxygen
6. You are caring for a 9-month-old patient with pronounced
respiratory dis- tress. You initiated high-flow oxygen using a
nonrebreathing mask about 10 minutes ago and established
intravenous access. Initially the infant's heart rate was in the
150/min range with strong pulses. Suddenly the infant's respi-
ratory rate falls to 6/min with significant intercostals
retractions, and little air movement is heard. The infant
becomes cyanotic and the heart rate decreases to 95/min.
Which of the following treatments would be best for you to
provide now?
Administer epinephrine IV
Provide bag-mask
1. You are caring for a child who was resuscitated after a
drowning event. The child is intubated and ventilated with
100% oxygen with equal breath sounds and exhaled CO2
detected. The heart rate is slow and the monitor shows sinus
bradycardia. The skin is cool, mottled, and moist; distal
pulses are not palpable and the central pulses are weak.
Intravenous access has been established. The core
temperature is 37.3oC. Based on the PALS bradycardia
algorithm, which of the following should be provided first?
Epinephrine IV
Transcutaneous
pacing Atropine IV
Dobutamine IV infusion: Epinephrine IV
2. You are caring for a 5-year-old patient with
supraventricular tachycardia (heart rate = 220/min). The child
is lethargic. The skin is pale and cool with delayed capillary
refill. Distal pulses are not palpable. Which of the following
would be the best treatment to provide without delay?
Place cold packs on the distal upper and lower
extremities Ask the child to blow through a
small straw
Exert light pressure on the eyes bilaterally
Provide synchronized cardioversion at 0.5 to 1 J/kg: Provide
synchronized car- dioversion at 0.5 to 1 J/kg
3. You are initiating treatment for a child with septic shock
and hypotension. While administering high-flow oxygen you
determine that the child's respi- rations are adequate and
, PALS ALL QUESTIONS AND ANSWERS
SpO2 is 100%. You have just established vascular access and
obtained blood samples. Which of the following is the next
most appropriate therapy to support systemic perfusion?
Administer repeated fluid boluses of isotonic
colloid Administer repeated fluid boluses of
isotonic crystalloid Begin immediate dopamine
infusion
Begin immediate dobutamine infusion: Administer repeated fluid
boluses of iso- tonic crystalloid
4. You are treating an 8-year-old with ventricular tachycardia
with pulses and adequate perfusion. You attempted
synchronized cardioversion without success. While seeking
expert consultation, it would be most appropriate to:
Administer a loading dose of milrinone
Consider possible metabolic and toxicologic causes
, PALS ALL QUESTIONS AND ANSWERS
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock: Consider possible metabolic and
toxicologic causes
5. You are caring for a 2-year-old unconscious patient who is
intubated and receiving mechanical ventilation. The child's
heart rate suddenly drops to 40/min and his color becomes
mottled. You should respond to these changes by:
Increasing the
ventilator rate
Increasing tidal volume
Increasing positive end-expiratory pressure (PEEP)
Using a resuscitation bag provide manual ventilation with 100%
oxygen: Using a resuscitation bag provide manual ventilation with
100% oxygen
6. You are caring for a 9-month-old patient with pronounced
respiratory dis- tress. You initiated high-flow oxygen using a
nonrebreathing mask about 10 minutes ago and established
intravenous access. Initially the infant's heart rate was in the
150/min range with strong pulses. Suddenly the infant's respi-
ratory rate falls to 6/min with significant intercostals
retractions, and little air movement is heard. The infant
becomes cyanotic and the heart rate decreases to 95/min.
Which of the following treatments would be best for you to
provide now?
Administer epinephrine IV
Provide bag-mask
