PALS Exam A Questions and Correct
Answers Updated
Question 1
You are caring for a 12 year old girl with acute lymphoblastic leukemia. She is
responsive but she does not feel well and appears to be flushed. Her Temp is 39
degrees C (102.2 F), HR is 118/min, respiratory rate is 36/min, BP is 100/40 mmHg,
and oxygen sat is 96% on room air. Your assessment reveals mild increase in work of
breathing and bounding pulses. The child is receiving 100% Oxygen by NRB mask.
What assessment finding is the most important in your determination of the severity
of the patients condition?
A. Blood pressure
B. Heart rate
C. Oxygen saturation
D. Respiratory rate
Correct Answer
A. Blood pressure
Question 2
A 3 year old boy is brought to the ED by his mother. His is lethargic, with retractions
and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk
cap refill. To which immediate life treating condition could this Childs condition most
likely progress if left untreated?
A. Cardiogenic shock
B. Hypovolemic shock
C. Respiratory distress
D. Respiratory failure
Correct Answer
D. Respiratory failure
Page 1 of 21
,Question 3
You are caring for a 3 month old boy with a 2 day history of fever, vomiting and
diarrhea. His parents state that he has been sleeping much more. His HR is 190/min,
temp is 38.3 degrees C (101 F) blood pressure is 59/29 mmHg, Resp rate is 70/min
and shallow, and oxygen sat is 94% on 100% oxygen. His capillary refills time is 4-5
seconds, and he has mottled, cool extremities. The infant weighs 6 Kg.
You have decided that this infant needs fluid resuscitation. How much fluid should
you administered?
A. 10 mL/kg lactated Ringer's
B. 15 mL/kg 5% dextrose in 0.45% normal saline
C. 20 mL/kg normal saline
D. 20 mL/kg 0.45% normal saline
Correct Answer
C. 20mL/kg normal saline
Question 4
After rectal administration of diazepam, an 8 year old boy with a history of seizures is
no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min.
His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is
snoring with poor chest rise and poor air entry bilaterally.
If the patient continues to snore and exhibit poor chest rise and poor air entry
bilaterally after your initial intervention what next step is most appropriate?
A. Increase nasal cannula flow
B. Provide bag mask ventilation
C. Subcostal retractions
D. Wheezing
Correct Answer
B. Provide bag mask ventilation
Page 2 of 21
, Question 5
A 6 month old infant is being evaluated for bradycardia. Which is the most likely
cause of bradycardia?
A. Hypovolemia
B. Hypoxia
C. Drug toxicity
D. Hyperglycemia
Correct Answer
B. Hypoxia
Question 6
The parents of a 7 year old child who is undergoing chemotherapy report that the
child has been febrile and has not been feeling well, with recent onset of lethargy.
Assessment reveals that the child is difficult to arouse and her skin color is pale. The
Childs HR is 160/min, respiratory rate is 38/min, blood pressure is 76/45 mmHg, cap
refill time is 5 to 6 seconds, and temp is 39.4 degrees C (103 F). IV access has been
established, and blood cultures have been obtained. What is the most appropriate
intervention?
A. Administer 10 to 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
B. Administer 20 to 30 mL/kg of isotonic crystalloid over 30 minutes
C. Administer 5 to 10 mL/kg of packed red blood cells
D. Obtain a chest x-ray
Correct Answer
A. Administer 10 to 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
Page 3 of 21
Answers Updated
Question 1
You are caring for a 12 year old girl with acute lymphoblastic leukemia. She is
responsive but she does not feel well and appears to be flushed. Her Temp is 39
degrees C (102.2 F), HR is 118/min, respiratory rate is 36/min, BP is 100/40 mmHg,
and oxygen sat is 96% on room air. Your assessment reveals mild increase in work of
breathing and bounding pulses. The child is receiving 100% Oxygen by NRB mask.
What assessment finding is the most important in your determination of the severity
of the patients condition?
A. Blood pressure
B. Heart rate
C. Oxygen saturation
D. Respiratory rate
Correct Answer
A. Blood pressure
Question 2
A 3 year old boy is brought to the ED by his mother. His is lethargic, with retractions
and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk
cap refill. To which immediate life treating condition could this Childs condition most
likely progress if left untreated?
A. Cardiogenic shock
B. Hypovolemic shock
C. Respiratory distress
D. Respiratory failure
Correct Answer
D. Respiratory failure
Page 1 of 21
,Question 3
You are caring for a 3 month old boy with a 2 day history of fever, vomiting and
diarrhea. His parents state that he has been sleeping much more. His HR is 190/min,
temp is 38.3 degrees C (101 F) blood pressure is 59/29 mmHg, Resp rate is 70/min
and shallow, and oxygen sat is 94% on 100% oxygen. His capillary refills time is 4-5
seconds, and he has mottled, cool extremities. The infant weighs 6 Kg.
You have decided that this infant needs fluid resuscitation. How much fluid should
you administered?
A. 10 mL/kg lactated Ringer's
B. 15 mL/kg 5% dextrose in 0.45% normal saline
C. 20 mL/kg normal saline
D. 20 mL/kg 0.45% normal saline
Correct Answer
C. 20mL/kg normal saline
Question 4
After rectal administration of diazepam, an 8 year old boy with a history of seizures is
no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min.
His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is
snoring with poor chest rise and poor air entry bilaterally.
If the patient continues to snore and exhibit poor chest rise and poor air entry
bilaterally after your initial intervention what next step is most appropriate?
A. Increase nasal cannula flow
B. Provide bag mask ventilation
C. Subcostal retractions
D. Wheezing
Correct Answer
B. Provide bag mask ventilation
Page 2 of 21
, Question 5
A 6 month old infant is being evaluated for bradycardia. Which is the most likely
cause of bradycardia?
A. Hypovolemia
B. Hypoxia
C. Drug toxicity
D. Hyperglycemia
Correct Answer
B. Hypoxia
Question 6
The parents of a 7 year old child who is undergoing chemotherapy report that the
child has been febrile and has not been feeling well, with recent onset of lethargy.
Assessment reveals that the child is difficult to arouse and her skin color is pale. The
Childs HR is 160/min, respiratory rate is 38/min, blood pressure is 76/45 mmHg, cap
refill time is 5 to 6 seconds, and temp is 39.4 degrees C (103 F). IV access has been
established, and blood cultures have been obtained. What is the most appropriate
intervention?
A. Administer 10 to 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
B. Administer 20 to 30 mL/kg of isotonic crystalloid over 30 minutes
C. Administer 5 to 10 mL/kg of packed red blood cells
D. Obtain a chest x-ray
Correct Answer
A. Administer 10 to 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
Page 3 of 21
