PALS 2025 ARRHYTHMIAS EXAM
QUESTIONS AND ANSWERS
Whenever a child has an abnormal heart rate or rhythm, you must quickly determine? - Correct
Answer✔️✔️-Determine if the arrhythmia is causing hemodynamic instability or other signs of
deterioration.
What are the signs of instability in a patient with arrhythmias? - Correct Answer✔️✔️-Respiratory
distress or failure
Shock with poor end-organ perfusion, may occur with or without hypotension
Irritability or decreased level of consciousness
Irritability or decreased level of consciousness
chest pain or vague feeling of discomfort in older children
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,sudden collapse
Priorities in initially managing arrhythmias are? - Correct Answer✔️✔️-The same as they are for all
critically ill children: Support ABC and treat underlying cause
Bradycardia - Correct Answer✔️✔️-A heart rate that is slow in comparison with a normal heart
rate range for the childs age, level of activity and clinical condition
What is the leading cause of symptomatic bradycardia in children? - Correct Answer✔️✔️-Tissue
hypoxia
Symptomatic Bradycardia - Correct Answer✔️✔️-Heart rate below 60/min associated with
cardiopulmonary compromise
Cardiopulmonary compromise - Correct Answer✔️✔️-* Hypotension
* Acutely altered mental status
* Signs of shock
Bradycardia is an ominous sign of? - Correct Answer✔️✔️-Sign of impending cardiac arrest in
infants and children. Especially if hypotension or poor tissue perfusion is present
Children with severe cardiovascular compromise from pulmonary embolism, what treatment should
be considered? - Correct Answer✔️✔️-Fibrinolytic agents
What is the initial treatment of pediatric bradycardia with cardiopulmonary compromise? - Correct
Answer✔️✔️-Bag mask ventilation with 100% O2
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
, Fibrinolytic agents - Correct Answer✔️✔️-tissue plasminogen activator, streptokinase, reteplase
tenecteplase
Primary bradycardia - Correct Answer✔️✔️-A result of congenital or acquired heart conditions
Causes of primary bradycardia - Correct Answer✔️✔️-Congenital abnormality of the heart
pacemaker or conduction system
Surgical injury to the pacemaker or conduction system
Cardiomyopathy
Myocarditis
Secondary bradycardia - Correct Answer✔️✔️-Result of noncardiac conditions that alter the
normal function of the heart (Slow sinus node pacemaker or slow conduction)
secondary bradycardia causes - Correct Answer✔️✔️-Hypoxia
Acidosis
Hypotension
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
QUESTIONS AND ANSWERS
Whenever a child has an abnormal heart rate or rhythm, you must quickly determine? - Correct
Answer✔️✔️-Determine if the arrhythmia is causing hemodynamic instability or other signs of
deterioration.
What are the signs of instability in a patient with arrhythmias? - Correct Answer✔️✔️-Respiratory
distress or failure
Shock with poor end-organ perfusion, may occur with or without hypotension
Irritability or decreased level of consciousness
Irritability or decreased level of consciousness
chest pain or vague feeling of discomfort in older children
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,sudden collapse
Priorities in initially managing arrhythmias are? - Correct Answer✔️✔️-The same as they are for all
critically ill children: Support ABC and treat underlying cause
Bradycardia - Correct Answer✔️✔️-A heart rate that is slow in comparison with a normal heart
rate range for the childs age, level of activity and clinical condition
What is the leading cause of symptomatic bradycardia in children? - Correct Answer✔️✔️-Tissue
hypoxia
Symptomatic Bradycardia - Correct Answer✔️✔️-Heart rate below 60/min associated with
cardiopulmonary compromise
Cardiopulmonary compromise - Correct Answer✔️✔️-* Hypotension
* Acutely altered mental status
* Signs of shock
Bradycardia is an ominous sign of? - Correct Answer✔️✔️-Sign of impending cardiac arrest in
infants and children. Especially if hypotension or poor tissue perfusion is present
Children with severe cardiovascular compromise from pulmonary embolism, what treatment should
be considered? - Correct Answer✔️✔️-Fibrinolytic agents
What is the initial treatment of pediatric bradycardia with cardiopulmonary compromise? - Correct
Answer✔️✔️-Bag mask ventilation with 100% O2
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
, Fibrinolytic agents - Correct Answer✔️✔️-tissue plasminogen activator, streptokinase, reteplase
tenecteplase
Primary bradycardia - Correct Answer✔️✔️-A result of congenital or acquired heart conditions
Causes of primary bradycardia - Correct Answer✔️✔️-Congenital abnormality of the heart
pacemaker or conduction system
Surgical injury to the pacemaker or conduction system
Cardiomyopathy
Myocarditis
Secondary bradycardia - Correct Answer✔️✔️-Result of noncardiac conditions that alter the
normal function of the heart (Slow sinus node pacemaker or slow conduction)
secondary bradycardia causes - Correct Answer✔️✔️-Hypoxia
Acidosis
Hypotension
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
