AHA PALS Final Exam Version A
Questions and Answers9
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 37.3°C. Based on the PALS bradycardia algorithm, which of
the following should be provided first?
- Epinephrine IV
- Transcutaneous pacing
- Atropine IV
- Dobutamine IV infusion - ANSWERS-Epinephrine IV
You are caring for a 5-year-old patient with supraventricular tachycardia (heart rate = 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?
- 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
- Provide synchronized cardioversion at 0.5 to 1 J/kg - ANSWERS-Provide synchronized
cardioversion at 0.5 to 1 J/kg
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 colloid
- 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 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 - ANSWERS-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 - ANSWERS-Using a
resuscitation bag provide manual ventilation with 100% oxygen
Questions and Answers9
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 37.3°C. Based on the PALS bradycardia algorithm, which of
the following should be provided first?
- Epinephrine IV
- Transcutaneous pacing
- Atropine IV
- Dobutamine IV infusion - ANSWERS-Epinephrine IV
You are caring for a 5-year-old patient with supraventricular tachycardia (heart rate = 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?
- 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
- Provide synchronized cardioversion at 0.5 to 1 J/kg - ANSWERS-Provide synchronized
cardioversion at 0.5 to 1 J/kg
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 colloid
- 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 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 - ANSWERS-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 - ANSWERS-Using a
resuscitation bag provide manual ventilation with 100% oxygen
