PALS EXAM ALL QUESTIONS WITH
CORRECT ANSWERS
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
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock - ANSWER -Consider possible metabolic and
toxicologic causes
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 - ANSWER -
Using a resuscitation bag provide manual ventilation with 100% oxygen
You are caring for a 9-month-old patient with pronounced respiratory distress. 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 respiratory 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 ventilation
Administer magnesium sulfate IV
Intubate and ventilate - ANSWER -Provide bag-mask ventilation
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?
Obtaining a urine sample for toxicology screen
Obtaining chest and abdominal radiographs
Soliciting a history from the caregiver or family
, Obtaining a venous blood gas - ANSWER -Soliciting a history from the caregiver or
family
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 at the midclavicular 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 - ANSWER -Over the third rib at the
midclavicular line
You attempted synchronized cardioversion for an infant with supraventricular
tachycardia (SVT) and poor perfusion. The SVT persists after the initial 1 J/kg shock.
Which of the following should you attempt now?
Synchronized cardioversion at a dose of 2 J/kg
Synchronized cardioversion at a dose of 4 J/kg
Unsynchronized cardioversion at a dose of 2 J/kg
Unsynchronized cardioversion at a dose of 4 J/kg - ANSWER -Synchronized
cardioversion at a dose of 2 J/kg
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 - ANSWER -Provide a rapid 20 ml/kg isotonic
crystalloid fluid bolus
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 - ANSWER -Epinephrine IV
CORRECT ANSWERS
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
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock - ANSWER -Consider possible metabolic and
toxicologic causes
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 - ANSWER -
Using a resuscitation bag provide manual ventilation with 100% oxygen
You are caring for a 9-month-old patient with pronounced respiratory distress. 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 respiratory 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 ventilation
Administer magnesium sulfate IV
Intubate and ventilate - ANSWER -Provide bag-mask ventilation
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?
Obtaining a urine sample for toxicology screen
Obtaining chest and abdominal radiographs
Soliciting a history from the caregiver or family
, Obtaining a venous blood gas - ANSWER -Soliciting a history from the caregiver or
family
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 at the midclavicular 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 - ANSWER -Over the third rib at the
midclavicular line
You attempted synchronized cardioversion for an infant with supraventricular
tachycardia (SVT) and poor perfusion. The SVT persists after the initial 1 J/kg shock.
Which of the following should you attempt now?
Synchronized cardioversion at a dose of 2 J/kg
Synchronized cardioversion at a dose of 4 J/kg
Unsynchronized cardioversion at a dose of 2 J/kg
Unsynchronized cardioversion at a dose of 4 J/kg - ANSWER -Synchronized
cardioversion at a dose of 2 J/kg
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 - ANSWER -Provide a rapid 20 ml/kg isotonic
crystalloid fluid bolus
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 - ANSWER -Epinephrine IV
