PALS HEARTCODE 2 COMPETENCY REVIEW
2026 MOCK TEST COMPLETE KEY INSIGHTS
◉ What are the signs of instability in a patient with arrhythmias?
Answer: Respiratory distress or failure
Shock with poor end-organ perfusion, may occur with or without
hypotension
Irritability or decreased level of consciousness
Irritability or decreased level of consciousness
chest pain or vague feeling of discomfort in older children
sudden collapse
◉ Priorities in initially managing arrhythmias are?
Answer: The same as they are for all critically ill children: Support
ABC and treat underlying cause
◉ Bradycardia
,Answer: A heart rate that is slow in comparison with a normal heart
rate range for the childs age, level of activity and clinical condition
◉ What is the leading cause of symptomatic bradycardia in children?
Answer: Tissue hypoxia
◉ Symptomatic Bradycardia
Answer: Heart rate below 60/min associated with cardiopulmonary
compromise
◉ Cardiopulmonary compromise
Answer: * Hypotension
* Acutely altered mental status
* Signs of shock
◉ Bradycardia is an ominous sign of?
Answer: Sign of impending cardiac arrest in infants and children.
Especially if hypotension or poor tissue perfusion is present
◉ Children with severe cardiovascular compromise from pulmonary
embolism, what treatment should be considered?
Answer: Fibrinolytic agents
, ◉ What is the initial treatment of pediatric bradycardia with
cardiopulmonary compromise?
Answer: Bag mask ventilation with 100% O2
◉ Fibrinolytic agents
Answer: tissue plasminogen activator, streptokinase, reteplase
tenecteplase
◉ Primary bradycardia
Answer: A result of congenital or acquired heart conditions
◉ Causes of primary bradycardia
Answer: Congenital abnormality of the heart pacemaker or
conduction system
Surgical injury to the pacemaker or conduction system
Cardiomyopathy
Myocarditis
◉ Secondary bradycardia
2026 MOCK TEST COMPLETE KEY INSIGHTS
◉ What are the signs of instability in a patient with arrhythmias?
Answer: Respiratory distress or failure
Shock with poor end-organ perfusion, may occur with or without
hypotension
Irritability or decreased level of consciousness
Irritability or decreased level of consciousness
chest pain or vague feeling of discomfort in older children
sudden collapse
◉ Priorities in initially managing arrhythmias are?
Answer: The same as they are for all critically ill children: Support
ABC and treat underlying cause
◉ Bradycardia
,Answer: A heart rate that is slow in comparison with a normal heart
rate range for the childs age, level of activity and clinical condition
◉ What is the leading cause of symptomatic bradycardia in children?
Answer: Tissue hypoxia
◉ Symptomatic Bradycardia
Answer: Heart rate below 60/min associated with cardiopulmonary
compromise
◉ Cardiopulmonary compromise
Answer: * Hypotension
* Acutely altered mental status
* Signs of shock
◉ Bradycardia is an ominous sign of?
Answer: Sign of impending cardiac arrest in infants and children.
Especially if hypotension or poor tissue perfusion is present
◉ Children with severe cardiovascular compromise from pulmonary
embolism, what treatment should be considered?
Answer: Fibrinolytic agents
, ◉ What is the initial treatment of pediatric bradycardia with
cardiopulmonary compromise?
Answer: Bag mask ventilation with 100% O2
◉ Fibrinolytic agents
Answer: tissue plasminogen activator, streptokinase, reteplase
tenecteplase
◉ Primary bradycardia
Answer: A result of congenital or acquired heart conditions
◉ Causes of primary bradycardia
Answer: Congenital abnormality of the heart pacemaker or
conduction system
Surgical injury to the pacemaker or conduction system
Cardiomyopathy
Myocarditis
◉ Secondary bradycardia
