PALS QUESTIONS & ANSWERS
A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is ongoing. The child is
intubated, and vascular access is established. The ECG monitor shows an organized rhythm with
a heart rate of 45/min, but a pulse check reveals no palpable pulses. High-quality CPR is
resumed, and an initial IV dose of epinephrine is administered. Which intervention should you
perform next?
A) Perform defibrillation
B) Perform synchronized cardioversion
C) Administer epinephrine
D) Identify and treat reversible causes ✔️✔️D) Identify and treat reversible causes
A 10-month-old infant boy is brought to the emergency department. Your initial assessment
reveals a lethargic, pale infant with slow respirations and slow, weak central pulses. One team
member begins ventilation with a bag-mask device with 100% oxygen. A second team member
attaches the monitor/defibrillator and obtains vital signs while a third team member attempts to
establish IV/IO access. The patient's heart rate is 38/min with the rhythm shown here. The
infant's blood pressure is 58/38 mm Hg, and capillary refill is 4 seconds. His central pulses
,remain weak, and distal pulses cannot be palpated. Chest compressions are started and IO access
is obtained. Which medication do you anticipate will be given next?
A) Atropine 0.02 mg/kg IV/IO
B) Epinephrine 0.01 mg/kg IV/IO
C) Adenosine 0.1 mg/kg rapid IV/IO
D) Epinephrine 0.1 mg/kg IV/IO ✔️✔️B) Epinephrine 0.01 mg/kg IV/IO
A 3-year-old unresponsive, apneic child is brought to the emergency department. EMS personnel
report that the child became unresponsive as they arrived at the hospital. The child is receiving
CPR with bag-mask ventilation. The rhythm shown here is on the cardiac monitor. A biphasic
manual defibrillator is present. You quickly use the length from head to heel of the child on a
color-coded length-based resuscitation tape to estimate the approximate weight as 15 kg. Which
therapy is most appropriate for this child at this time?
A) Attempt defibrillation at 30 J, and then resume CPR, beginning with compressions
B) Attempt defibrillation at 10 J, and then resume CPR, beginning with compressions
C) Attempt defibrillation at 30 J, and then open the airway and check for a pulse
, D) Establish IV/IO and administer epinephrine 0.01 mg/kg IV/IO ✔️✔️A) Attempt
defibrillation at 30 J, and then resume CPR, beginning with compressions
You are giving chest compressions for a child in cardiac arrest. What is the proper depth of
compressions for a child?
A) Compress the chest at least one third the depth of the chest, approximately 2 inches (5 cm)
B) Compress the chest at least one held the depth of the chest, approximately 3 inches (8 cm)
C) Compress the chest at least one fourth the depth of the chest, approximately 1.5 inches (4 cm)
D) Compress the chest at least two thirds the depth of the chest, approximately 4 inches (10 cm)
✔️✔️A) Compress the chest at least one third the depth of the chest, approximately 2 inches (5
cm)
A pale and very sleepy but arousable 3-year-old child with a history of diarrhea is brought to the
hospital. Primary assessment reveals a respiratory rate of 45/min with good breath sounds
bilaterally. Heart rate is 150/min, blood pressure is 90/64 mm Hg, and SpO2 is 92% in room air.
Capillary refill is 5 seconds, and peripheral pulses are weak. After placing the child on a
nonrebreathing face mask (10-L/min flow) with 100% oxygen and obtaining vascular access,
which is the most appropriate immediate treatment for this child?
A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is ongoing. The child is
intubated, and vascular access is established. The ECG monitor shows an organized rhythm with
a heart rate of 45/min, but a pulse check reveals no palpable pulses. High-quality CPR is
resumed, and an initial IV dose of epinephrine is administered. Which intervention should you
perform next?
A) Perform defibrillation
B) Perform synchronized cardioversion
C) Administer epinephrine
D) Identify and treat reversible causes ✔️✔️D) Identify and treat reversible causes
A 10-month-old infant boy is brought to the emergency department. Your initial assessment
reveals a lethargic, pale infant with slow respirations and slow, weak central pulses. One team
member begins ventilation with a bag-mask device with 100% oxygen. A second team member
attaches the monitor/defibrillator and obtains vital signs while a third team member attempts to
establish IV/IO access. The patient's heart rate is 38/min with the rhythm shown here. The
infant's blood pressure is 58/38 mm Hg, and capillary refill is 4 seconds. His central pulses
,remain weak, and distal pulses cannot be palpated. Chest compressions are started and IO access
is obtained. Which medication do you anticipate will be given next?
A) Atropine 0.02 mg/kg IV/IO
B) Epinephrine 0.01 mg/kg IV/IO
C) Adenosine 0.1 mg/kg rapid IV/IO
D) Epinephrine 0.1 mg/kg IV/IO ✔️✔️B) Epinephrine 0.01 mg/kg IV/IO
A 3-year-old unresponsive, apneic child is brought to the emergency department. EMS personnel
report that the child became unresponsive as they arrived at the hospital. The child is receiving
CPR with bag-mask ventilation. The rhythm shown here is on the cardiac monitor. A biphasic
manual defibrillator is present. You quickly use the length from head to heel of the child on a
color-coded length-based resuscitation tape to estimate the approximate weight as 15 kg. Which
therapy is most appropriate for this child at this time?
A) Attempt defibrillation at 30 J, and then resume CPR, beginning with compressions
B) Attempt defibrillation at 10 J, and then resume CPR, beginning with compressions
C) Attempt defibrillation at 30 J, and then open the airway and check for a pulse
, D) Establish IV/IO and administer epinephrine 0.01 mg/kg IV/IO ✔️✔️A) Attempt
defibrillation at 30 J, and then resume CPR, beginning with compressions
You are giving chest compressions for a child in cardiac arrest. What is the proper depth of
compressions for a child?
A) Compress the chest at least one third the depth of the chest, approximately 2 inches (5 cm)
B) Compress the chest at least one held the depth of the chest, approximately 3 inches (8 cm)
C) Compress the chest at least one fourth the depth of the chest, approximately 1.5 inches (4 cm)
D) Compress the chest at least two thirds the depth of the chest, approximately 4 inches (10 cm)
✔️✔️A) Compress the chest at least one third the depth of the chest, approximately 2 inches (5
cm)
A pale and very sleepy but arousable 3-year-old child with a history of diarrhea is brought to the
hospital. Primary assessment reveals a respiratory rate of 45/min with good breath sounds
bilaterally. Heart rate is 150/min, blood pressure is 90/64 mm Hg, and SpO2 is 92% in room air.
Capillary refill is 5 seconds, and peripheral pulses are weak. After placing the child on a
nonrebreathing face mask (10-L/min flow) with 100% oxygen and obtaining vascular access,
which is the most appropriate immediate treatment for this child?
