PALS 2025 Exam Questions and
Answers
Conditions that [blank] air resistance lead to increased respiratory [blank]. - Correct Answer -
Increased
Effort
What are the signs of increased respiratory effort that can lead to fatigue & respiratory failure? -
Correct Answer -Nasal flaring
Retractions
Head bobbing
Seesaw respirations
Determine the respiratory rate by counting the number of times the chest rises in [blank] seconds &
multiplying by [blank]. - Correct Answer -30
2
Tachypnea is often the first sign of respiratory [blank] in infants. - Correct Answer -Distress
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,What do central chemoreceptors respond to? - Correct Answer -Hydrogen ions in the
cerebrospinal fluid
Why may excessive ventilation during CPR be harmful? - Correct Answer -It impedes venous
return
It increases intrathoracic pressure
What should you do if you cannot achieve effective ventilation with a bag-mask device? - Correct
Answer -Reposition the airway
Verify the mask size
How are effective oxygenation & ventilation assessed? - Correct Answer -Oxygen saturation
Exhaled carbon dioxide
Visible chest rise w/ each breath
How can gastric inflation impair bag-mask ventilation? - Correct Answer -It decreases lung
compliance
What is the most appropriate precautionary action to minimize gastric inflation during a bag-mask
ventilation? - Correct Answer -Deliver each breath over about 1 second
Which is true about the difference between hypoxemia & tissue hypoxia? - Correct Answer -
Tissue hypoxia can occur with normal arterial oxygen saturation
What does hyperventilation, which refers to increased alveolar ventilation, result in? - Correct
Answer -PaCO2 less than 35 mm Hg
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
,What happens to the arterial oxygen level in a child w/ severe anemia? - Correct Answer -May
increase when dissolved oxygen is increased
Which is true of increased carbon dioxide tension in arterial blood? - Correct Answer -May be
caused by disordered control of breathing
What happens when ventilation is inadequate? - Correct Answer -PaCO2 increases
What is a critical symptom of hypercarbia? - Correct Answer -Decreased level of
consciousness
Which of the following indicates mild respiratory distress? - Correct Answer -Mild increase in
respiratory effort
Which of the following indicates severe respiratory distress? - Correct Answer -Marked
tachypnea &/or apnea
Which of the following statements about respiratory failure is true? - Correct Answer -May
occur w/o signs of respiratory distress
Which is most likely to be present in a child who has respiratory distress [not respiratory failure]? -
Correct Answer -Ability to maintain a patent airway
What steps should be taken as part of initial management of a child in respiratory distress? - Correct
Answer -Support an open airway
Monitor O2 saturation by pulse oximetry
Monitor heart rate, rhythm, & bp
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
, Which are ideal characteristics of face masks for ventilation? - Correct Answer -Covers mouth
& nose
Has a soft rim
Transparent
What is the rationale for using a transparent mask? - Correct Answer -Allows you to see the
color of the child's lips
What is the function of the nonrebreathing outlet valve of a self-inflating bag? - Correct
Answer -Prevents rebreathing of carbon dioxide
Which of the following is required to appropriately ventilate a child with a flow-inflating bag? -
Correct Answer -Tidal volume needs to be delivered at the correct rate
What should be checked to ensure proper function of a bag-mask system? - Correct Answer -
The pop-off valve can be closed
Oxygen tubing is connected to the device & the oxygen source
How is sniffing position achieved in an infant or a child? - Correct Answer -Ensure that the
external ear canal is anterior to the shoulder
Where may padding be required under when properly positioning a child older than 2 years of age to
maintain a patent airway? - Correct Answer -The occiput
What actions are appropriate when providing 1-person bag-mask ventilation? - Correct
Answer -Perform a head tilt, insert an oral airway, & squeeze the bag until chest rise
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 4
Answers
Conditions that [blank] air resistance lead to increased respiratory [blank]. - Correct Answer -
Increased
Effort
What are the signs of increased respiratory effort that can lead to fatigue & respiratory failure? -
Correct Answer -Nasal flaring
Retractions
Head bobbing
Seesaw respirations
Determine the respiratory rate by counting the number of times the chest rises in [blank] seconds &
multiplying by [blank]. - Correct Answer -30
2
Tachypnea is often the first sign of respiratory [blank] in infants. - Correct Answer -Distress
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,What do central chemoreceptors respond to? - Correct Answer -Hydrogen ions in the
cerebrospinal fluid
Why may excessive ventilation during CPR be harmful? - Correct Answer -It impedes venous
return
It increases intrathoracic pressure
What should you do if you cannot achieve effective ventilation with a bag-mask device? - Correct
Answer -Reposition the airway
Verify the mask size
How are effective oxygenation & ventilation assessed? - Correct Answer -Oxygen saturation
Exhaled carbon dioxide
Visible chest rise w/ each breath
How can gastric inflation impair bag-mask ventilation? - Correct Answer -It decreases lung
compliance
What is the most appropriate precautionary action to minimize gastric inflation during a bag-mask
ventilation? - Correct Answer -Deliver each breath over about 1 second
Which is true about the difference between hypoxemia & tissue hypoxia? - Correct Answer -
Tissue hypoxia can occur with normal arterial oxygen saturation
What does hyperventilation, which refers to increased alveolar ventilation, result in? - Correct
Answer -PaCO2 less than 35 mm Hg
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
,What happens to the arterial oxygen level in a child w/ severe anemia? - Correct Answer -May
increase when dissolved oxygen is increased
Which is true of increased carbon dioxide tension in arterial blood? - Correct Answer -May be
caused by disordered control of breathing
What happens when ventilation is inadequate? - Correct Answer -PaCO2 increases
What is a critical symptom of hypercarbia? - Correct Answer -Decreased level of
consciousness
Which of the following indicates mild respiratory distress? - Correct Answer -Mild increase in
respiratory effort
Which of the following indicates severe respiratory distress? - Correct Answer -Marked
tachypnea &/or apnea
Which of the following statements about respiratory failure is true? - Correct Answer -May
occur w/o signs of respiratory distress
Which is most likely to be present in a child who has respiratory distress [not respiratory failure]? -
Correct Answer -Ability to maintain a patent airway
What steps should be taken as part of initial management of a child in respiratory distress? - Correct
Answer -Support an open airway
Monitor O2 saturation by pulse oximetry
Monitor heart rate, rhythm, & bp
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
, Which are ideal characteristics of face masks for ventilation? - Correct Answer -Covers mouth
& nose
Has a soft rim
Transparent
What is the rationale for using a transparent mask? - Correct Answer -Allows you to see the
color of the child's lips
What is the function of the nonrebreathing outlet valve of a self-inflating bag? - Correct
Answer -Prevents rebreathing of carbon dioxide
Which of the following is required to appropriately ventilate a child with a flow-inflating bag? -
Correct Answer -Tidal volume needs to be delivered at the correct rate
What should be checked to ensure proper function of a bag-mask system? - Correct Answer -
The pop-off valve can be closed
Oxygen tubing is connected to the device & the oxygen source
How is sniffing position achieved in an infant or a child? - Correct Answer -Ensure that the
external ear canal is anterior to the shoulder
Where may padding be required under when properly positioning a child older than 2 years of age to
maintain a patent airway? - Correct Answer -The occiput
What actions are appropriate when providing 1-person bag-mask ventilation? - Correct
Answer -Perform a head tilt, insert an oral airway, & squeeze the bag until chest rise
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 4
