PALS 2024 QUESTIONS AND 100% CORRECT
ANSWERS WITH SOLUTIONS 2024
You are caring for an 8-year-old child who was struck by a car. The child is alert, very anxious,
and in respiratory distress. The child is receiving high-flow oxygen by face mask, has a
respiratory rate of 60/min, heart rate of 150/min, systolic blood pressure of 70 mm Hg, and Spot
of 86% and falling. Breath sounds and chest rise are absent over the right chest. Which of the
following is the most likely cause of this child's distress?
Cardiac tamponade
Severe hypovolemia
Tension pneumothorax
Cardiac asthma ✔️✔️Tension pneumothorax
Which of the following is likely to be the most helpful technique to identify potentially
reversible metabolic and toxic causes during the attempted resuscitation of a young child in
cardiac arrest?
Soliciting a history from the caregiver or family
Obtaining a urine sample for toxicology screen
Obtaining chest and abdominal radiographs
Obtaining a venous blood gas ✔️✔️Soliciting a history from the caregiver or family
Which of the following rhythms is shown on this ECG rhythm strip?
,Sinus bradycardia
Ventricular fibrillation (VF)
Asystole
Supraventricular tachycardia) ✔️✔️Ventricular fibrillation (VF)
You are caring for an 8-month-old with bradycardia and very poor perfusion that has persisted
despite effective ventilations with high-flow oxygen. You should begin chest compressions if the
heart rate is:
More than 200/min
More than 150/min
Less than 100/min
Less than 60/min ✔️✔️Less than 60/min
You are caring for a 3-year-old with myocarditis and heart failure. She has become poorly
responsive to a sternal rub and is difficult to rouse. She has a sinus rhythm with a heart rate of
175/min, and a blood pressure of 88/65 mm Hg. Her skin is cool and mottled, capillary refill time
is 5 seconds and she has barely palpable distal pulses. Oxygen saturation is 90% on high-flow,
high-concentration oxygen by face mask. Her respirations are labored at 50/min with moderate
retractions, and crackles are heard at the bases. Which of the following would be the most
appropriate therapy for this child?
, Obtain a STAT echocardiogram and chest x-ray
Perform synchronized cardioversion at 0.5 joules/kg
Provide assisted ventilations with 100% oxygen and prepare for endotracheal intubation
Administer epinephrine 0.1 mL/kg of 1:10,000 solution IV ✔️✔️Provide assisted ventilations
with 100% oxygen and prepare for endotracheal intubation
You are treating a 5-month-old with a 2-day history of vomiting and diarrhea. The patient is
listless. The respiratory rate is 52/min and unlabored. The heart rate is 170/min and pulses are
present but weak. Capillary refill is delayed. You are administering high-flow oxygen and
intravenous access is in place. At this point the most important therapy is to:
Administer an epinephrine bolus
Begin bag-mask ventilation
Provide a rapid 20 mL/kg isotonic crystalloid fluid bolus
Administer a bolus of 0.5 g/kg of dextrose ✔️✔️Provide a rapid 20 mL/kg isotonic crystalloid
fluid bolus
Which of the following groups of clinical findings would be most consistent with categorizing a
patient with compensated shock?
Decreased level of consciousness, extensor posturing in response to pain, hypertension, and
apnea
ANSWERS WITH SOLUTIONS 2024
You are caring for an 8-year-old child who was struck by a car. The child is alert, very anxious,
and in respiratory distress. The child is receiving high-flow oxygen by face mask, has a
respiratory rate of 60/min, heart rate of 150/min, systolic blood pressure of 70 mm Hg, and Spot
of 86% and falling. Breath sounds and chest rise are absent over the right chest. Which of the
following is the most likely cause of this child's distress?
Cardiac tamponade
Severe hypovolemia
Tension pneumothorax
Cardiac asthma ✔️✔️Tension pneumothorax
Which of the following is likely to be the most helpful technique to identify potentially
reversible metabolic and toxic causes during the attempted resuscitation of a young child in
cardiac arrest?
Soliciting a history from the caregiver or family
Obtaining a urine sample for toxicology screen
Obtaining chest and abdominal radiographs
Obtaining a venous blood gas ✔️✔️Soliciting a history from the caregiver or family
Which of the following rhythms is shown on this ECG rhythm strip?
,Sinus bradycardia
Ventricular fibrillation (VF)
Asystole
Supraventricular tachycardia) ✔️✔️Ventricular fibrillation (VF)
You are caring for an 8-month-old with bradycardia and very poor perfusion that has persisted
despite effective ventilations with high-flow oxygen. You should begin chest compressions if the
heart rate is:
More than 200/min
More than 150/min
Less than 100/min
Less than 60/min ✔️✔️Less than 60/min
You are caring for a 3-year-old with myocarditis and heart failure. She has become poorly
responsive to a sternal rub and is difficult to rouse. She has a sinus rhythm with a heart rate of
175/min, and a blood pressure of 88/65 mm Hg. Her skin is cool and mottled, capillary refill time
is 5 seconds and she has barely palpable distal pulses. Oxygen saturation is 90% on high-flow,
high-concentration oxygen by face mask. Her respirations are labored at 50/min with moderate
retractions, and crackles are heard at the bases. Which of the following would be the most
appropriate therapy for this child?
, Obtain a STAT echocardiogram and chest x-ray
Perform synchronized cardioversion at 0.5 joules/kg
Provide assisted ventilations with 100% oxygen and prepare for endotracheal intubation
Administer epinephrine 0.1 mL/kg of 1:10,000 solution IV ✔️✔️Provide assisted ventilations
with 100% oxygen and prepare for endotracheal intubation
You are treating a 5-month-old with a 2-day history of vomiting and diarrhea. The patient is
listless. The respiratory rate is 52/min and unlabored. The heart rate is 170/min and pulses are
present but weak. Capillary refill is delayed. You are administering high-flow oxygen and
intravenous access is in place. At this point the most important therapy is to:
Administer an epinephrine bolus
Begin bag-mask ventilation
Provide a rapid 20 mL/kg isotonic crystalloid fluid bolus
Administer a bolus of 0.5 g/kg of dextrose ✔️✔️Provide a rapid 20 mL/kg isotonic crystalloid
fluid bolus
Which of the following groups of clinical findings would be most consistent with categorizing a
patient with compensated shock?
Decreased level of consciousness, extensor posturing in response to pain, hypertension, and
apnea
