AHA PALS PRACTICE EXAM WITH
COMPLETE SOLUTIONS
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 - ANSWER-
Unreliable; supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been
treated with chemotherapy. The child presents with lethargy and a high
fever. Heart rate is 195/min, respiratory rate is 36/min, blood pressure is
85/40 mm Hg, and capillary refill time is less than 2 seconds. What is the
child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock - ANSWER- Septic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding.
Blood pressure is 55/40 mm Hg. What term describes this infant's blood
pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated - ANSWER- Hypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of
epinephrine at 0.1 mg/kg to be given 10. What should the team member do?
A. Administer the drug as ordered
,B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug - ANSWER- Respectfully ask the team
leader to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds - ANSWER- Inadequate oxygenation and/or
ventilation
6. Which of the following is most likely to produce a prolonged expiratory
phase and wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
D. Upper airway obstruction - ANSWER- Lower airway obstruction
7. A 4-year-old child presents with seizures and irregular respirations. The
seizures stopped a few minutes ago. Which of the following most likely to be
abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing - ANSWER- Control of breathing
8. What abnormality is most likely to be present in children with acute
respiratory distress caused by lung tissue disease?
A. Decreased oxygen saturation
B. Stridor
C. Normal respiratory rate
D. Decreased respiratory effort - ANSWER- Decreased oxygen saturation
9. An alert 2-year-old child with an increased work of breathing and pink
color is being evaluated. Heart rate is 110/min, and respiratory rate is
30/min. What would best describe this patient's condition? A. Respiratory
distress
B. Respiratory arrest
C. Respiratory failure
, D. Disordered control of breathing - ANSWER- Respiratory distress
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 -
ANSWER- 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 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 - ANSWER- Place an intraosseous line
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 - ANSWER- 20 mL/kg normal saline
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
COMPLETE SOLUTIONS
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 - ANSWER-
Unreliable; supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been
treated with chemotherapy. The child presents with lethargy and a high
fever. Heart rate is 195/min, respiratory rate is 36/min, blood pressure is
85/40 mm Hg, and capillary refill time is less than 2 seconds. What is the
child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock - ANSWER- Septic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding.
Blood pressure is 55/40 mm Hg. What term describes this infant's blood
pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated - ANSWER- Hypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of
epinephrine at 0.1 mg/kg to be given 10. What should the team member do?
A. Administer the drug as ordered
,B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug - ANSWER- Respectfully ask the team
leader to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds - ANSWER- Inadequate oxygenation and/or
ventilation
6. Which of the following is most likely to produce a prolonged expiratory
phase and wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
D. Upper airway obstruction - ANSWER- Lower airway obstruction
7. A 4-year-old child presents with seizures and irregular respirations. The
seizures stopped a few minutes ago. Which of the following most likely to be
abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing - ANSWER- Control of breathing
8. What abnormality is most likely to be present in children with acute
respiratory distress caused by lung tissue disease?
A. Decreased oxygen saturation
B. Stridor
C. Normal respiratory rate
D. Decreased respiratory effort - ANSWER- Decreased oxygen saturation
9. An alert 2-year-old child with an increased work of breathing and pink
color is being evaluated. Heart rate is 110/min, and respiratory rate is
30/min. What would best describe this patient's condition? A. Respiratory
distress
B. Respiratory arrest
C. Respiratory failure
, D. Disordered control of breathing - ANSWER- Respiratory distress
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 -
ANSWER- 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 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 - ANSWER- Place an intraosseous line
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 - ANSWER- 20 mL/kg normal saline
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
