PALS Final Review Exam Study Guide Questions with Verified Answers 2025

Mikey, a 2-year-old boy, is sitting upright on a hospital bed in room 3 of your emergency department. Your initial impression from the door does not raise immediate concern. On your entry to the room, you are able to look at Mikey more closely and notice on inhalation his nostrils are flaring. This is a sign of: -Correct Answer Respiratory distress The proper site for a peripheral pulse assessment in the infant patient is: -Correct Answer brachial You are called to the scene of a 3-year-old patient who was found anxious, *cyanotic* and lethargic after a fall down a flight of stairs. On assessing the patient, you find vital signs with a respiratory rate of 30, regular pulse rate of 130, regular capillary refill time of 4 seconds, and a blood pressure of 102/61. What kind of shock is the patient experiencing? -Correct Answer compensate shock? A mnemonic that aids in performing a primary assessment is: -Correct Answer ABCDE A consideration of treatment for a pediatric patient with acute fulminant myocarditis who is in cardiac arrest or at a high risk of cardiac arrest is: -Correct Answer Extracorporeal membrane oxygenation (ECMO) Which of the following is the correct meaning for one of the individual letters in the AVPU scale? -Correct Answer Alert - The child is alert and awake and responds to normal stimuli based upon age and environment The recommended route of vascular access on a hypotensive pediatric patient is: -Correct Answer central IV You are called to the bedside of a 12-year-old male patient who was admitted after a week of persistent vomiting, diarrhea and limiting oral intake of both solids and liquids. The patient's airway is patent, ventilatory rate is within normal limits and the patient's circulatory status presents with tachycardia, a blood pressure of 70/40 and a capillary refill time of 5 seconds. The patient is speaking incoherently. The patient has no history of cardiac problems or congenital defects. The appropriate fluid administration dose for this patient is: -Correct Answer 20 ml/kg 0.9% NaCl over 10 minutes You suspect your 8-year-old female patient of being hypovolemic. Her parents brought her to the emergency department with persistent vomiting and diarrhea for 5 days. The patient presents with *mottled skin* and reports of periods where "she just stopped breathing!" according to her parents. The patient is being managed with a BVM and supplemental oxygen. What is the best route of establishing vascular access for the purpose of fluid resuscitation? -Correct Answer IV Which of the following cannot be administered through an ETT? -Correct Answer Sodium bicarbonate You are examining the rhythm strip of a patient who presents with bradycardia. Which of the following characteristics may you notice in the rhythm? -Correct Answer The most obvious sign of bradycardia on an ECG is slow heart rate. The characteristics of P-waves and the QRS complex may vary. When looking at an EKG, the following characteristics are seen with bradycardia patients: Slow heart rate, P-waves may not be noticeable, QRS complex may be wide or narrow, and P-waves and QRS complex may not be related to bradycardia. How do children's metabolic rates compare to adults'? -Correct Answer higher Children's demand for oxygen is ___________ adults. -Correct Answer greater Which of the following must you monitor while fluid resuscitating a patient? -Correct Answer Urine output What type of pressure is monitored to obtain right ventricular cardiac preload? -Correct Answer Central venous pressure (CVP) Define shock: -Correct Answer When oxygen and nutrient supply to body tissue is insufficient compared to metabolic tissue needs Your 5-year-old patient is admitted to the PICU and is being treated by your team for hypovolemic shock. The team has administered one bolus of 20ml/kg of 0.9% NaCl . On re-evaluation the patient is alert and anxious with a heart rate of 145 beats per minute, a blood pressure of 76/48mmHg and a capillary refill time of 4 seconds. Which of the following is the patient's clinical condition? -Correct Answer hypotensive shock To treat wheezing in a child, which medication is the most appropriate to administer? -Correct Answer Albuterol You arrive on scene to assess a 9-year-old boy who was stung by a bee. The patient is found to be suffering from urticaria and is displaying respiratory distress with a presentation of nasal flaring, tachypnea and accessory muscle use. The patient's mother relates he has never had an allergic reaction to a bee sting, but his father is gravely allergic to bee stings. The patient relates it is hard to breathe. While gathering your initial set of vital signs you note the patient has a room air SpO2 is 90%. This finding classifies the patient as: -Correct Answer When the blood is insufficiently oxygenated, hypoxemia can occur. Hypoxemia is a decreased saturation of oxyhemoglobin (oxygenated hemoglobin) in the blood. A noninvasive method of estimating arterial oxygen saturation (SaO2) is pulse oximetry, which calculates the saturation of oxyhemoglobin (SpO2). In a normal child, a room air measurement below 94% indicates hypoxemia.