PALS All Questions 2025/2026 Exam All
Answers and Illustrations Given
You are caring for a child who was resuscitated after a drowning event. The
child is intubated and ventilated with 100% oxygen with equal breath
sounds and exhaled CO2 detected. The heart rate is slow and the monitor
shows sinus bradycardia. The skin is cool, mottled, and moist; distal pulses
are not palpable and the central pulses are weak. Intravenous access has
been established. The core temperature is 37.3oC. Based on the PALS
bradycardia algorithm, which of the following should be provided first?
Epinephrine IV
Transcutaneous pacing
Atropine IV
Dobutamine IV infusion - 🧠 ANSWER ✔✔Epinephrine IV
You are caring for a 5-year-old patient with supraventricular tachycardia
(heart rate = 220/min). The child is lethargic. The skin is pale and cool with
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,delayed capillary refill. Distal pulses are not palpable. Which of the
following would be the best treatment to provide without delay?
Place cold packs on the distal upper and lower extremities
Ask the child to blow through a small straw
Exert light pressure on the eyes bilaterally
Provide synchronized cardioversion at 0.5 to 1 J/kg - 🧠 ANSWER
✔✔Provide synchronized cardioversion at 0.5 to 1 J/kg
You are initiating treatment for a child with septic shock and hypotension.
While administering high-flow oxygen you determine that the child's
respirations are adequate and SpO2 is 100%. You have just established
vascular access and obtained blood samples. Which of the following is the
next most appropriate therapy to support systemic perfusion?
Administer repeated fluid boluses of isotonic colloid
Administer repeated fluid boluses of isotonic crystalloid
Begin immediate dopamine infusion
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,Begin immediate dobutamine infusion - 🧠 ANSWER ✔✔Administer
repeated fluid boluses of isotonic crystalloid
You are treating an 8-year-old with ventricular tachycardia with pulses and
adequate perfusion. You attempted synchronized cardioversion without
success. While seeking expert consultation, it would be most appropriate
to:
Administer a loading dose of milrinone
Consider possible metabolic and toxicologic causes
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock - 🧠 ANSWER ✔✔Consider possible
metabolic and toxicologic causes
You are caring for a 2-year-old unconscious patient who is intubated and
receiving mechanical ventilation. The child's heart rate suddenly drops to
40/min and his color becomes mottled. You should respond to these
changes by:
Increasing the ventilator rate
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, Increasing tidal volume
Increasing positive end-expiratory pressure (PEEP)
Using a resuscitation bag provide manual ventilation with 100% oxygen - 🧠
ANSWER ✔✔Using a resuscitation bag provide manual ventilation with
100% oxygen
You are caring for a 9-month-old patient with pronounced respiratory
distress. You initiated high-flow oxygen using a nonrebreathing mask about
10 minutes ago and established intravenous access. Initially the infant's
heart rate was in the 150/min range with strong pulses. Suddenly the
infant's respiratory rate falls to 6/min with significant intercostals retractions,
and little air movement is heard. The infant becomes cyanotic and the heart
rate decreases to 95/min. Which of the following treatments would be best
for you to provide now?
Administer epinephrine IV
Provide bag-mask ventilation
Administer magnesium sulfate IV
Intubate and ventilate - 🧠 ANSWER ✔✔Provide bag-mask ventilation
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Answers and Illustrations Given
You are caring for a child who was resuscitated after a drowning event. The
child is intubated and ventilated with 100% oxygen with equal breath
sounds and exhaled CO2 detected. The heart rate is slow and the monitor
shows sinus bradycardia. The skin is cool, mottled, and moist; distal pulses
are not palpable and the central pulses are weak. Intravenous access has
been established. The core temperature is 37.3oC. Based on the PALS
bradycardia algorithm, which of the following should be provided first?
Epinephrine IV
Transcutaneous pacing
Atropine IV
Dobutamine IV infusion - 🧠 ANSWER ✔✔Epinephrine IV
You are caring for a 5-year-old patient with supraventricular tachycardia
(heart rate = 220/min). The child is lethargic. The skin is pale and cool with
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
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STATEMENT. ALL RIGHTS RESERVED
,delayed capillary refill. Distal pulses are not palpable. Which of the
following would be the best treatment to provide without delay?
Place cold packs on the distal upper and lower extremities
Ask the child to blow through a small straw
Exert light pressure on the eyes bilaterally
Provide synchronized cardioversion at 0.5 to 1 J/kg - 🧠 ANSWER
✔✔Provide synchronized cardioversion at 0.5 to 1 J/kg
You are initiating treatment for a child with septic shock and hypotension.
While administering high-flow oxygen you determine that the child's
respirations are adequate and SpO2 is 100%. You have just established
vascular access and obtained blood samples. Which of the following is the
next most appropriate therapy to support systemic perfusion?
Administer repeated fluid boluses of isotonic colloid
Administer repeated fluid boluses of isotonic crystalloid
Begin immediate dopamine infusion
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
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STATEMENT. ALL RIGHTS RESERVED
,Begin immediate dobutamine infusion - 🧠 ANSWER ✔✔Administer
repeated fluid boluses of isotonic crystalloid
You are treating an 8-year-old with ventricular tachycardia with pulses and
adequate perfusion. You attempted synchronized cardioversion without
success. While seeking expert consultation, it would be most appropriate
to:
Administer a loading dose of milrinone
Consider possible metabolic and toxicologic causes
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock - 🧠 ANSWER ✔✔Consider possible
metabolic and toxicologic causes
You are caring for a 2-year-old unconscious patient who is intubated and
receiving mechanical ventilation. The child's heart rate suddenly drops to
40/min and his color becomes mottled. You should respond to these
changes by:
Increasing the ventilator rate
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STATEMENT. ALL RIGHTS RESERVED
, Increasing tidal volume
Increasing positive end-expiratory pressure (PEEP)
Using a resuscitation bag provide manual ventilation with 100% oxygen - 🧠
ANSWER ✔✔Using a resuscitation bag provide manual ventilation with
100% oxygen
You are caring for a 9-month-old patient with pronounced respiratory
distress. You initiated high-flow oxygen using a nonrebreathing mask about
10 minutes ago and established intravenous access. Initially the infant's
heart rate was in the 150/min range with strong pulses. Suddenly the
infant's respiratory rate falls to 6/min with significant intercostals retractions,
and little air movement is heard. The infant becomes cyanotic and the heart
rate decreases to 95/min. Which of the following treatments would be best
for you to provide now?
Administer epinephrine IV
Provide bag-mask ventilation
Administer magnesium sulfate IV
Intubate and ventilate - 🧠 ANSWER ✔✔Provide bag-mask ventilation
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