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AHA PALS Practice exam
1. A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer. What is
the next most appropriate intervention?
A. Administer 0.1 mg/kg of adenosine
B. Obtain a blood sample to evaluate arterial or venous blood gases
C. Reassess breath sounds and clinical status
D. Repeat the albuterol treatment - ANS-Reassess breath sounds and clinical status
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale color. The
primary assessment reveals that the airway is open and the respiratory rate is 30/min, with
crackles heard on auscultation. The cardiac monitor shows sinus tachycardia at a rate of
165/min. The pulse oximeter displays an oxygen saturation of 95% and a pulse rate of 93/min.
On the basis of this information, which of the following provides the best interpretation of the
oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary oxygen should be
administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered - ANS-Unreliable; supplementary
oxygen should be administered
10. A 2-year-old child with a 2-day history of a barking cough presents with audible stridor on
inspiration, intercostal retractions, and agitation. What is the most appropriate intervention for
this child?
A. Lay the child flat on a stretcher
B. Suction the mouth and nose
C. Administer nebulized epinephrine
D. Administer inhaled albuterol - ANS-Administer nebulized epinephrine
10. 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
the following: The child is difficult to arouse, with pale color. The child's heart rate is 160/min,
respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds,
and temperature is 103°F (39.4°C). What is the most appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30 minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
C. Obtain immediate blood cultures and chest x-ray D. Obtain expert consultation with an
oncologist to determine the chemotherapeutic regimen - ANS-Obtain vascular access and
administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression reveals an
unresponsive child with intermittent apnea and mottled color. Heart rate is 166/min, respiratory
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rate is now being supported with bag-mask ventilation, capillary refill time is 5 to 6 seconds, and
temperature is 102°F (38.9°C). What is the best method of establishing immediate vascular
access? A. Two providers may attempt peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line - ANS-Place an intraosseous line
11. Which of the following oxygen saturations indicates the need for additional intervention?
A. 96% on room air
B. 95% on room air
C. 93% on 4 L of oxygen
D. 97% on 50% oxygen - ANS-93% on 4 L of oxygen
12. A 3-year-old child presents with a 2-day history of nausea and vomiting. She is alert, with no
increase in respiratory effort, and is pale in color. The child's heart rate is 160/min, respiratory
rate is 40/min, and blood pressure is 100/70 mm Hg. Her extremities are cool, with sluggish
capillary refill. Which term best describes this child's physiologic state?
A. Compensated shock
B. Cardiogenic shock
C. Hypotensive shock
D. Obstructive shock - ANS-Compensated shock
12. What is the appropriate fluid bolus to administer for a child with hypovolemic shock with
adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's - ANS-20 mL/kg normal saline
13. A 3-year-old child presents with dehydration after a 2-day history of vomiting and diarrhea.
The child after has received 2 fluid boluses of 20 mL/ kg of normal saline. After the second
bolus, the child is alert and interacting. Her heart rate is 110/ min, respiratory rate is 30/min, and
blood pressure is 92/64 mm Hg. Her capillary refill time is 2 seconds, and oxygen saturation is
98%. What is the most appropriate next intervention for this child?
A. Administer another 20 mL/kg normal saline fluid bolus
B. Administer 10 mL/kg of packed red cells
C. Continue to monitor and reevaluate the child
D. Initiate a dopamine drip of 20 mcg/kg per minute - ANS-Continue to monitor and reevaluate
the child
13. An alert toddler presents with a barking cough, moderate stridor, and moderate retractions.
The child's color is pink. What is the most appropriate initial intervention?
A. Obtain a chest radiograph
B. Administer nebulized epinephrine
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AHA PALS Practice exam
1. A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer. What is
the next most appropriate intervention?
A. Administer 0.1 mg/kg of adenosine
B. Obtain a blood sample to evaluate arterial or venous blood gases
C. Reassess breath sounds and clinical status
D. Repeat the albuterol treatment - ANS-Reassess breath sounds and clinical status
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale color. The
primary assessment reveals that the airway is open and the respiratory rate is 30/min, with
crackles heard on auscultation. The cardiac monitor shows sinus tachycardia at a rate of
165/min. The pulse oximeter displays an oxygen saturation of 95% and a pulse rate of 93/min.
On the basis of this information, which of the following provides the best interpretation of the
oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary oxygen should be
administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered - ANS-Unreliable; supplementary
oxygen should be administered
10. A 2-year-old child with a 2-day history of a barking cough presents with audible stridor on
inspiration, intercostal retractions, and agitation. What is the most appropriate intervention for
this child?
A. Lay the child flat on a stretcher
B. Suction the mouth and nose
C. Administer nebulized epinephrine
D. Administer inhaled albuterol - ANS-Administer nebulized epinephrine
10. 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
the following: The child is difficult to arouse, with pale color. The child's heart rate is 160/min,
respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds,
and temperature is 103°F (39.4°C). What is the most appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30 minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
C. Obtain immediate blood cultures and chest x-ray D. Obtain expert consultation with an
oncologist to determine the chemotherapeutic regimen - ANS-Obtain vascular access and
administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression reveals an
unresponsive child with intermittent apnea and mottled color. Heart rate is 166/min, respiratory
AHA PALS Practice exam.pdfhttps://www.stuvia.com/user/allatopnotch
https://www.stuvia.com/user/allatopnotch https://www.stuvia.com/user/allatopnotch
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AHA PALS Practice exam.pdfhttps://www.stuvia.com/user/allatopnotch
rate is now being supported with bag-mask ventilation, capillary refill time is 5 to 6 seconds, and
temperature is 102°F (38.9°C). What is the best method of establishing immediate vascular
access? A. Two providers may attempt peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line - ANS-Place an intraosseous line
11. Which of the following oxygen saturations indicates the need for additional intervention?
A. 96% on room air
B. 95% on room air
C. 93% on 4 L of oxygen
D. 97% on 50% oxygen - ANS-93% on 4 L of oxygen
12. A 3-year-old child presents with a 2-day history of nausea and vomiting. She is alert, with no
increase in respiratory effort, and is pale in color. The child's heart rate is 160/min, respiratory
rate is 40/min, and blood pressure is 100/70 mm Hg. Her extremities are cool, with sluggish
capillary refill. Which term best describes this child's physiologic state?
A. Compensated shock
B. Cardiogenic shock
C. Hypotensive shock
D. Obstructive shock - ANS-Compensated shock
12. What is the appropriate fluid bolus to administer for a child with hypovolemic shock with
adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's - ANS-20 mL/kg normal saline
13. A 3-year-old child presents with dehydration after a 2-day history of vomiting and diarrhea.
The child after has received 2 fluid boluses of 20 mL/ kg of normal saline. After the second
bolus, the child is alert and interacting. Her heart rate is 110/ min, respiratory rate is 30/min, and
blood pressure is 92/64 mm Hg. Her capillary refill time is 2 seconds, and oxygen saturation is
98%. What is the most appropriate next intervention for this child?
A. Administer another 20 mL/kg normal saline fluid bolus
B. Administer 10 mL/kg of packed red cells
C. Continue to monitor and reevaluate the child
D. Initiate a dopamine drip of 20 mcg/kg per minute - ANS-Continue to monitor and reevaluate
the child
13. An alert toddler presents with a barking cough, moderate stridor, and moderate retractions.
The child's color is pink. What is the most appropriate initial intervention?
A. Obtain a chest radiograph
B. Administer nebulized epinephrine
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