PALS Best Graded Exam Questions And
Answers Latest update 2024/2025
A previously healthy infant with a history of vomiting and diarrhea is brought to the
emergency department by her parents. During your assessment, you find that the infant
responds only to painful stimulation. The infant has good bilateral breath sounds, cool
extremities, and a capillary refill time of more than 5 seconds. The infant's blood
pressure is 85/65 mmHg and glucose is 30 mg/dL. You administer 100% oxygen via
face mask and start an IV. Which treatment is the most appropriate for this infant?
a) Administer D50W 0.45% NaCl 20 mL/kg bolus over 15 minutes
b) Administer LR solution 20 mL/kg over 60 minutes
c) Administer a bolus of isotonic crystalloid 20 mL/kg over 5 to 20 minutes and also give
D25W 2 to 4 mL/kg IV
d) Administer D10W 20 mL/kg over 5 minutes - CORRECT ANSWER-c) Administer a
bolus of isotonic crystalloid 20 mL/kg over 5 to 20 minutes and also give D25W 2 to 4
mL/kg
Which statement is correct about endotracheal drug administration during resuscitative
efforts for pediatric patients?
a) The intravenous drug dose should be used
b) It is the preferred route of drug administration
c) The drug dose used is lower than the intravenous dose
d) It is the least desirable route of administration - CORRECT ANSWER-d) It is the least
desirable route of administration
,Which statement is correct about the effects of epinephrine during attempted
resuscitation?
a) Epi decreases peripheral vascular resistance and reduces myocardial afterload
b) Epi stimulates spontaneous contractions when asystole is present
c) Epi decreases myocardial oxygen consumption
d) Epi is contraindicated in VFib - CORRECT ANSWER-Epinephrine stimulates
spontaneous contractions when asystole is present
Which oxygen delivery system most reliably delivers a high (90% or greater)
concentration of inspired oxygen to a 7yo child?
a) nasal cannula
b) simple oxygen mask
c) nonrebreather face mask
d) face tent - CORRECT ANSWER-c) nonrebreathing face mask
A 9-year-old boy is agitated and leaning forward on the bed in obvious respiratory
distress. The patient is speaking in short phrases and tells you that he has asthma but
does not carry an inhaler. He has nasal flaring, severe suprasternal and intercostal
retractions, and decreased air movement with prolonged expiratory time and wheezing.
You administer 100% oxygen by a nonrebreathing mask. His POx is 92%. Which
medication do you prepare to give to this patient?
a) Albuterol
, b) Adenosine
c) Amiodarone
d) Procainamide - CORRECT ANSWER-a) Albuterol
You are part of team attempting to resuscitate a child with ventricular fibrillation cardiac
arrest. You deliver 2 unsynchronized shocks. A team member established IO access, so
you give a dose of epi, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular
fibrillation is present. You administer a 4-J/kg shock ad resume CPR. Which drug and
dose should be administered next?
a) Magnesium sulfate 25 to 50 mg/kg IO
b) Epinephrine 0.1 mg/kg IO
c) Atropine 0.02 mg/kg IO
d) Amiodarone 5 mg/kg IO - CORRECT ANSWER-d) Amiodarone 5 mg/kg IO
Paramedics are called to the home of a 1-year-old child. Their initial assessment
reveals a child who responds only to painful stimuli and has irregular breathing, faint
central pulse, bruises over the abdomen, abdominal distention, and cyanosis. Bag-mask
ventilation with 100% oxygen is initiated. The child's heart rate is 36/min. Peripheral
pulses cannot be palpated, and central pulses are barely palpable. The cardiac monitor
shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the emergency
department, the child is intubated and ventilated with 100% oxygen, and IV access is
established. The heart rate is now 150/min with weak central pulses but no distal
pulses. Systolic blood pressure is 74 mmHg. Which intervention should be provided?
a) Epinephrine 0.01 mg/kg IV
Answers Latest update 2024/2025
A previously healthy infant with a history of vomiting and diarrhea is brought to the
emergency department by her parents. During your assessment, you find that the infant
responds only to painful stimulation. The infant has good bilateral breath sounds, cool
extremities, and a capillary refill time of more than 5 seconds. The infant's blood
pressure is 85/65 mmHg and glucose is 30 mg/dL. You administer 100% oxygen via
face mask and start an IV. Which treatment is the most appropriate for this infant?
a) Administer D50W 0.45% NaCl 20 mL/kg bolus over 15 minutes
b) Administer LR solution 20 mL/kg over 60 minutes
c) Administer a bolus of isotonic crystalloid 20 mL/kg over 5 to 20 minutes and also give
D25W 2 to 4 mL/kg IV
d) Administer D10W 20 mL/kg over 5 minutes - CORRECT ANSWER-c) Administer a
bolus of isotonic crystalloid 20 mL/kg over 5 to 20 minutes and also give D25W 2 to 4
mL/kg
Which statement is correct about endotracheal drug administration during resuscitative
efforts for pediatric patients?
a) The intravenous drug dose should be used
b) It is the preferred route of drug administration
c) The drug dose used is lower than the intravenous dose
d) It is the least desirable route of administration - CORRECT ANSWER-d) It is the least
desirable route of administration
,Which statement is correct about the effects of epinephrine during attempted
resuscitation?
a) Epi decreases peripheral vascular resistance and reduces myocardial afterload
b) Epi stimulates spontaneous contractions when asystole is present
c) Epi decreases myocardial oxygen consumption
d) Epi is contraindicated in VFib - CORRECT ANSWER-Epinephrine stimulates
spontaneous contractions when asystole is present
Which oxygen delivery system most reliably delivers a high (90% or greater)
concentration of inspired oxygen to a 7yo child?
a) nasal cannula
b) simple oxygen mask
c) nonrebreather face mask
d) face tent - CORRECT ANSWER-c) nonrebreathing face mask
A 9-year-old boy is agitated and leaning forward on the bed in obvious respiratory
distress. The patient is speaking in short phrases and tells you that he has asthma but
does not carry an inhaler. He has nasal flaring, severe suprasternal and intercostal
retractions, and decreased air movement with prolonged expiratory time and wheezing.
You administer 100% oxygen by a nonrebreathing mask. His POx is 92%. Which
medication do you prepare to give to this patient?
a) Albuterol
, b) Adenosine
c) Amiodarone
d) Procainamide - CORRECT ANSWER-a) Albuterol
You are part of team attempting to resuscitate a child with ventricular fibrillation cardiac
arrest. You deliver 2 unsynchronized shocks. A team member established IO access, so
you give a dose of epi, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular
fibrillation is present. You administer a 4-J/kg shock ad resume CPR. Which drug and
dose should be administered next?
a) Magnesium sulfate 25 to 50 mg/kg IO
b) Epinephrine 0.1 mg/kg IO
c) Atropine 0.02 mg/kg IO
d) Amiodarone 5 mg/kg IO - CORRECT ANSWER-d) Amiodarone 5 mg/kg IO
Paramedics are called to the home of a 1-year-old child. Their initial assessment
reveals a child who responds only to painful stimuli and has irregular breathing, faint
central pulse, bruises over the abdomen, abdominal distention, and cyanosis. Bag-mask
ventilation with 100% oxygen is initiated. The child's heart rate is 36/min. Peripheral
pulses cannot be palpated, and central pulses are barely palpable. The cardiac monitor
shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the emergency
department, the child is intubated and ventilated with 100% oxygen, and IV access is
established. The heart rate is now 150/min with weak central pulses but no distal
pulses. Systolic blood pressure is 74 mmHg. Which intervention should be provided?
a) Epinephrine 0.01 mg/kg IV
