PALS - Red Cross Midterm Exam 2026-180 QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% Verified Solutions Updated Per Latest Guidelines Graded A+.
SECTION 1: SYSTEMATIC ASSESSMENT & RESPIRATORY (Questions 1-40)
1. A 5-year-old child with a history of chronic neuromuscular disease is
experiencing respiratory distress. The child is breathing spontaneously and
receiving supplemental oxygen. Which additional intervention is a critical
component of airway management for this patient?
A) Insertion of a nasopharyngeal airway
B) Airway clearance (e.g., suctioning)
C) Placement of a supraglottic airway
D) Endotracheal intubation
Answer: B) Airway clearance (e.g., suctioning)
Rationale: Children with neuromuscular disease often have ineffective cough and
poor secretion clearance. Airway clearance is critical to maintain patency and
prevent aspiration. While other options may be needed in progressive failure,
suctioning is the immediate priority.
,2. A 4-year-old child is brought to the ED. Assessment reveals only gasping
respirations and a pulse rate of 65 beats per minute. Which action should the
provider initiate first?
A) Start chest compressions
B) Deliver 1 BVM ventilation every 2 to 3 seconds
C) Administer epinephrine IV
D) Place a supraglottic airway
Answer: B) Deliver 1 BVM ventilation every 2 to 3 seconds
Rationale: Gasping is not effective breathing. The heart rate is below 60/min with
signs of poor perfusion, indicating the need for ventilatory support. Provide 1
breath every 2-3 seconds (20-30 breaths/min) with BVM.
3. A 3-month-old infant admitted with respiratory distress has fever, grunting, and
a wet cough. Parents report a recent respiratory infection. A rapid RSV test is
positive. Which condition would the provider most likely suspect?
A) Pneumonia
B) Croup
,C) Bronchiolitis
D) Epiglottitis
Answer: C) Bronchiolitis
Rationale: RSV-positive infant with grunting, fever, and cough in a 3-month-old is
classic for bronchiolitis, a common viral lower respiratory tract infection causing
airway obstruction and respiratory distress.
4. A 30-month-old child has been diagnosed with moderate croup. Which
medication would be most appropriate?
A) Albuterol nebulizer
B) Racemic epinephrine
C) Oral dexamethasone
D) Heliox therapy
Answer: C) Oral dexamethasone
, Rationale: For moderate croup (stridor at rest, barky cough), corticosteroids are
first-line treatment. Dexamethasone 0.15-0.6 mg/kg PO/IM reduces airway
inflammation. Racemic epinephrine is used for severe croup.
5. Which of the following is the most reliable indicator of adequate ventilation
during CPR in an intubated child?
A) Chest rise
B) SpO2 ≥ 94%
C) ETCO2 between 35-40 mm Hg
D) Heart rate improvement
Answer: C) ETCO2 between 35-40 mm Hg
Rationale: In intubated patients, capnography provides the most reliable feedback
on ventilation adequacy. During CPR, ETCO2 also reflects CPR quality and can
predict ROSC.
6. A 7-year-old child in respiratory distress has retractions, nasal flaring, and SpO2
88% on room air. The child is alert. What is the most appropriate next step?
GRADED A+. 100% Verified Solutions Updated Per Latest Guidelines Graded A+.
SECTION 1: SYSTEMATIC ASSESSMENT & RESPIRATORY (Questions 1-40)
1. A 5-year-old child with a history of chronic neuromuscular disease is
experiencing respiratory distress. The child is breathing spontaneously and
receiving supplemental oxygen. Which additional intervention is a critical
component of airway management for this patient?
A) Insertion of a nasopharyngeal airway
B) Airway clearance (e.g., suctioning)
C) Placement of a supraglottic airway
D) Endotracheal intubation
Answer: B) Airway clearance (e.g., suctioning)
Rationale: Children with neuromuscular disease often have ineffective cough and
poor secretion clearance. Airway clearance is critical to maintain patency and
prevent aspiration. While other options may be needed in progressive failure,
suctioning is the immediate priority.
,2. A 4-year-old child is brought to the ED. Assessment reveals only gasping
respirations and a pulse rate of 65 beats per minute. Which action should the
provider initiate first?
A) Start chest compressions
B) Deliver 1 BVM ventilation every 2 to 3 seconds
C) Administer epinephrine IV
D) Place a supraglottic airway
Answer: B) Deliver 1 BVM ventilation every 2 to 3 seconds
Rationale: Gasping is not effective breathing. The heart rate is below 60/min with
signs of poor perfusion, indicating the need for ventilatory support. Provide 1
breath every 2-3 seconds (20-30 breaths/min) with BVM.
3. A 3-month-old infant admitted with respiratory distress has fever, grunting, and
a wet cough. Parents report a recent respiratory infection. A rapid RSV test is
positive. Which condition would the provider most likely suspect?
A) Pneumonia
B) Croup
,C) Bronchiolitis
D) Epiglottitis
Answer: C) Bronchiolitis
Rationale: RSV-positive infant with grunting, fever, and cough in a 3-month-old is
classic for bronchiolitis, a common viral lower respiratory tract infection causing
airway obstruction and respiratory distress.
4. A 30-month-old child has been diagnosed with moderate croup. Which
medication would be most appropriate?
A) Albuterol nebulizer
B) Racemic epinephrine
C) Oral dexamethasone
D) Heliox therapy
Answer: C) Oral dexamethasone
, Rationale: For moderate croup (stridor at rest, barky cough), corticosteroids are
first-line treatment. Dexamethasone 0.15-0.6 mg/kg PO/IM reduces airway
inflammation. Racemic epinephrine is used for severe croup.
5. Which of the following is the most reliable indicator of adequate ventilation
during CPR in an intubated child?
A) Chest rise
B) SpO2 ≥ 94%
C) ETCO2 between 35-40 mm Hg
D) Heart rate improvement
Answer: C) ETCO2 between 35-40 mm Hg
Rationale: In intubated patients, capnography provides the most reliable feedback
on ventilation adequacy. During CPR, ETCO2 also reflects CPR quality and can
predict ROSC.
6. A 7-year-old child in respiratory distress has retractions, nasal flaring, and SpO2
88% on room air. The child is alert. What is the most appropriate next step?
