PALS Certification Review (96
Questions)
---
*QUESTION 1:*
A 4-year-old child is brought to the emergency department in respiratory distress. The child is sitting
upright and drooling, with a fever and stridor. What is the priority intervention?
A) Obtain a chest X-ray
B) Prepare for immediate intubation
C) Allow the child to remain in a position of comfort
D) Administer nebulized epinephrine
> 🎯 *CORRECT ANSWER:* C) Allow the child to remain in a position of comfort
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Manipulation may trigger complete airway obstruction in epiglottitis.
> * *Why Distractors Fail:* Nebulized epinephrine is for croup, not epiglottitis.
> * *Core Takeaway:* Maintain positioning and prepare for controlled airway intervention.
---
*QUESTION 2:*
A 3-year-old child is in cardiac arrest with a rhythm of asystole. The team has just completed 2 minutes
of CPR and administered epinephrine. What is the next appropriate action?
A) Check for a pulse and rhythm
B) Administer a second dose of epinephrine
C) Defibrillate at 4 J/kg
,D) Administer amiodarone
> 🎯 *CORRECT ANSWER:* A) Check for a pulse and rhythm
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Reassessment is required every 2 minutes during CPR.
> * *Why Distractors Fail:* Amiodarone and defibrillation are not indicated for asystole.
> * *Core Takeaway:* Reassess rhythm and pulse after each 2-minute CPR cycle.
---
*QUESTION 3:*
A 7-month-old infant is in cardiac arrest with a rhythm of ventricular fibrillation (VF). What is the initial
defibrillation dose?
A) 1 J/kg
B) 2 J/kg
C) 4 J/kg
D) 10 J/kg
> 🎯 *CORRECT ANSWER:* B) 2 J/kg
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* 2 J/kg is the first shock dose for pediatric VF/pulseless VT.
> * *Why Distractors Fail:* 4 J/kg is for subsequent shocks.
> * *Core Takeaway:* Initial defibrillation dose is 2 J/kg for children.
---
*QUESTION 4:*
A 6-year-old child is unresponsive and not breathing but has a palpable pulse of 60/min. What is the
correct ventilation rate?
A) 1 breath every 3-5 seconds
,B) 1 breath every 6-8 seconds
C) 2 breaths every 15 seconds
D) 20 breaths per minute
> 🎯 *CORRECT ANSWER:* A) 1 breath every 3-5 seconds
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* This provides 12-20 breaths/min for respiratory failure with a pulse.
> * *Why Distractors Fail:* 1 breath every 6 seconds is for adults.
> * *Core Takeaway:* Give 12-20 breaths/min for pediatric respiratory failure with a pulse.
---
*QUESTION 5:*
A 2-year-old child presents with severe respiratory distress and poor air entry, with a heart rate of
220/min. The rhythm on the monitor shows narrow-complex tachycardia. The child is hemodynamically
unstable with poor perfusion. What is the appropriate initial treatment?
A) Vagal maneuvers
B) Adenosine 0.1 mg/kg rapid IV push
C) Synchronized cardioversion
D) Amiodarone 5 mg/kg IV
> 🎯 *CORRECT ANSWER:* C) Synchronized cardioversion
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Unstable SVT requires immediate synchronized cardioversion.
> * *Why Distractors Fail:* Adenosine is for stable narrow-complex tachycardia.
> * *Core Takeaway:* Unstable tachycardia with poor perfusion needs cardioversion.
---
*QUESTION 6:*
, A 5-year-old child is in cardiac arrest. The team is performing CPR. The child has an advanced airway in
place. How often should breaths be delivered?
A) Every 2-3 seconds
B) Every 6-8 seconds
C) Continuous compressions with asynchronous breaths
D) 1 breath per second
> 🎯 *CORRECT ANSWER:* C) Continuous compressions with asynchronous breaths
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* With an advanced airway, ventilations are asynchronous with compressions.
> * *Why Distractors Fail:* Breaths every 6 seconds (10/min) are standard.
> * *Core Takeaway:* Continuous compressions with asynchronous breaths for advanced airway.
---
*QUESTION 7:*
A 4-year-old child has a witnessed cardiac arrest. The rhythm on the monitor is ventricular fibrillation.
What is the first step after confirming the rhythm?
A) Check for a pulse
B) Begin chest compressions
C) Defibrillate immediately
D) Administer epinephrine
> 🎯 *CORRECT ANSWER:* C) Defibrillate immediately
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* VF is a shockable rhythm; immediate defibrillation is indicated.
> * *Why Distractors Fail:* CPR is important but shock is primary for VF.
> * *Core Takeaway:* Defibrillate witnessed VF as soon as possible.
Questions)
---
*QUESTION 1:*
A 4-year-old child is brought to the emergency department in respiratory distress. The child is sitting
upright and drooling, with a fever and stridor. What is the priority intervention?
A) Obtain a chest X-ray
B) Prepare for immediate intubation
C) Allow the child to remain in a position of comfort
D) Administer nebulized epinephrine
> 🎯 *CORRECT ANSWER:* C) Allow the child to remain in a position of comfort
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Manipulation may trigger complete airway obstruction in epiglottitis.
> * *Why Distractors Fail:* Nebulized epinephrine is for croup, not epiglottitis.
> * *Core Takeaway:* Maintain positioning and prepare for controlled airway intervention.
---
*QUESTION 2:*
A 3-year-old child is in cardiac arrest with a rhythm of asystole. The team has just completed 2 minutes
of CPR and administered epinephrine. What is the next appropriate action?
A) Check for a pulse and rhythm
B) Administer a second dose of epinephrine
C) Defibrillate at 4 J/kg
,D) Administer amiodarone
> 🎯 *CORRECT ANSWER:* A) Check for a pulse and rhythm
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Reassessment is required every 2 minutes during CPR.
> * *Why Distractors Fail:* Amiodarone and defibrillation are not indicated for asystole.
> * *Core Takeaway:* Reassess rhythm and pulse after each 2-minute CPR cycle.
---
*QUESTION 3:*
A 7-month-old infant is in cardiac arrest with a rhythm of ventricular fibrillation (VF). What is the initial
defibrillation dose?
A) 1 J/kg
B) 2 J/kg
C) 4 J/kg
D) 10 J/kg
> 🎯 *CORRECT ANSWER:* B) 2 J/kg
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* 2 J/kg is the first shock dose for pediatric VF/pulseless VT.
> * *Why Distractors Fail:* 4 J/kg is for subsequent shocks.
> * *Core Takeaway:* Initial defibrillation dose is 2 J/kg for children.
---
*QUESTION 4:*
A 6-year-old child is unresponsive and not breathing but has a palpable pulse of 60/min. What is the
correct ventilation rate?
A) 1 breath every 3-5 seconds
,B) 1 breath every 6-8 seconds
C) 2 breaths every 15 seconds
D) 20 breaths per minute
> 🎯 *CORRECT ANSWER:* A) 1 breath every 3-5 seconds
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* This provides 12-20 breaths/min for respiratory failure with a pulse.
> * *Why Distractors Fail:* 1 breath every 6 seconds is for adults.
> * *Core Takeaway:* Give 12-20 breaths/min for pediatric respiratory failure with a pulse.
---
*QUESTION 5:*
A 2-year-old child presents with severe respiratory distress and poor air entry, with a heart rate of
220/min. The rhythm on the monitor shows narrow-complex tachycardia. The child is hemodynamically
unstable with poor perfusion. What is the appropriate initial treatment?
A) Vagal maneuvers
B) Adenosine 0.1 mg/kg rapid IV push
C) Synchronized cardioversion
D) Amiodarone 5 mg/kg IV
> 🎯 *CORRECT ANSWER:* C) Synchronized cardioversion
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* Unstable SVT requires immediate synchronized cardioversion.
> * *Why Distractors Fail:* Adenosine is for stable narrow-complex tachycardia.
> * *Core Takeaway:* Unstable tachycardia with poor perfusion needs cardioversion.
---
*QUESTION 6:*
, A 5-year-old child is in cardiac arrest. The team is performing CPR. The child has an advanced airway in
place. How often should breaths be delivered?
A) Every 2-3 seconds
B) Every 6-8 seconds
C) Continuous compressions with asynchronous breaths
D) 1 breath per second
> 🎯 *CORRECT ANSWER:* C) Continuous compressions with asynchronous breaths
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* With an advanced airway, ventilations are asynchronous with compressions.
> * *Why Distractors Fail:* Breaths every 6 seconds (10/min) are standard.
> * *Core Takeaway:* Continuous compressions with asynchronous breaths for advanced airway.
---
*QUESTION 7:*
A 4-year-old child has a witnessed cardiac arrest. The rhythm on the monitor is ventricular fibrillation.
What is the first step after confirming the rhythm?
A) Check for a pulse
B) Begin chest compressions
C) Defibrillate immediately
D) Administer epinephrine
> 🎯 *CORRECT ANSWER:* C) Defibrillate immediately
> 💡 *CLINICAL RATIONALE:*
> * *Why It's Right:* VF is a shockable rhythm; immediate defibrillation is indicated.
> * *Why Distractors Fail:* CPR is important but shock is primary for VF.
> * *Core Takeaway:* Defibrillate witnessed VF as soon as possible.
