PALS version B exam questions and
answers10
You are treating an 8-year-old with ventricular tachycardia (VT) 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
Initiate overdrive pacing transcutaneously
Consider possible metabolic and toxicologic causes
Deliver an unsynchronized shock - ANSWERS-Consider possible metabolic and toxicologic causes
You are caring for a patient who developed a tension pneumothorax after several hours of
positive-pressure ventilation. Which of the following would be the most appropriate site for
needle decompression?
Over the third rib (ie, second intercostal space) at the mid-clavicular line
Under the eighth rib at the midaxillary line
Over the fifth rib at the sternal border
Under the sixth rib at the midclavicular line - ANSWERS-Over the third rib (ie, second intercostal
space) at the mid-clavicular line
You are initiating treatment for a child with septic shock and hypotension. While administering
high-flow oxygen, you determine that the child's respirations are adequate and 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 colloidge
Administer repeated fluid boluses of isotonic crystalloid
Begin immediate dopamine infusion
Begin immediate dobutamine infusion - ANSWERS-Administer repeated fluid boluses of isotonic
crystalloid
You are caring for a 5-year-old patient with supraventricular tachycardia (SVT) (heart rate is
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?
Provide synchronized cardioversion at 0.5 to 1 J/kg
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 - ANSWERS-Provide synchronized cardioversion at 0.5
to 1 J/kg
You attempted synchronized cardioversion for an infant with SVT and poor perfusion. The SVT
persists after the initial shock of 1 J/kg. Which of the following should you attempt now?
Synchronized cardioversion at a dose of 4 J/kg
Synchronized cardioversion at a dose of 2 J/kg
Unsynchronized cardioversion at a dose of 2 J/kg
Unsynchronized cardioversion at a dose of 4 J/kg - ANSWERS-Synchronized cardioversion at a
dose of 2 J/kg
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:
answers10
You are treating an 8-year-old with ventricular tachycardia (VT) 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
Initiate overdrive pacing transcutaneously
Consider possible metabolic and toxicologic causes
Deliver an unsynchronized shock - ANSWERS-Consider possible metabolic and toxicologic causes
You are caring for a patient who developed a tension pneumothorax after several hours of
positive-pressure ventilation. Which of the following would be the most appropriate site for
needle decompression?
Over the third rib (ie, second intercostal space) at the mid-clavicular line
Under the eighth rib at the midaxillary line
Over the fifth rib at the sternal border
Under the sixth rib at the midclavicular line - ANSWERS-Over the third rib (ie, second intercostal
space) at the mid-clavicular line
You are initiating treatment for a child with septic shock and hypotension. While administering
high-flow oxygen, you determine that the child's respirations are adequate and 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 colloidge
Administer repeated fluid boluses of isotonic crystalloid
Begin immediate dopamine infusion
Begin immediate dobutamine infusion - ANSWERS-Administer repeated fluid boluses of isotonic
crystalloid
You are caring for a 5-year-old patient with supraventricular tachycardia (SVT) (heart rate is
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?
Provide synchronized cardioversion at 0.5 to 1 J/kg
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 - ANSWERS-Provide synchronized cardioversion at 0.5
to 1 J/kg
You attempted synchronized cardioversion for an infant with SVT and poor perfusion. The SVT
persists after the initial shock of 1 J/kg. Which of the following should you attempt now?
Synchronized cardioversion at a dose of 4 J/kg
Synchronized cardioversion at a dose of 2 J/kg
Unsynchronized cardioversion at a dose of 2 J/kg
Unsynchronized cardioversion at a dose of 4 J/kg - ANSWERS-Synchronized cardioversion at a
dose of 2 J/kg
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:
