PALS All Questions with Correct Answers
Updated 2025
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 delayed capillary refill. Distal pulses are not palpable.
Which of the following would be the best treatment to provide without delay?
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,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
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
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, 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
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?
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
Updated 2025
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 delayed capillary refill. Distal pulses are not palpable.
Which of the following would be the best treatment to provide without delay?
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,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
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
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
, 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
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?
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
