Heartcode PALS Exam 2025
Questions and Answers
The infant is placed on the ambulance stretcher and responds with a groan when stimulated and has
a temperature of 36.3 C (97.3 F) - Correct Answer✔️✔️--Monitor and support ABCs
-Establish IV/IO access
-Monitor heart rate, blood pressure, and pulse oximetry
-Call for assistance if needed
When you evaluate the patient, you find the lungs are clear, skin is cool and mottled, glucose is 97
mg/dL and capillary refill time is 5 seconds. What are the warning signs that the patient is
progressing from compensated shock to hypotensive shock? - Correct Answer✔️✔️--Hypotension
(late sign)
-Increasing tachycardia
The patient still has a blood pressure of 58/38 mm Hg. Her condition would be classified as
___________ shock. - Correct Answer✔️✔️-Hypotensive
What should be included in the initial treatment for this patient? - Correct Answer✔️✔️--Rapid
fluid bolus administration
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,-Establishing IV/IO access
The mother does not recall the infant's most recent weight. What is the most appropriate way to
rapidly determine her weight and calculate correct medication? - Correct Answer✔️✔️-Measure her
by using color-coded length-based tape
You measure the infant to be 7 kg and prepare to administer a fluid bolus of what type? - Correct
Answer✔️✔️-Normal saline 20 mL/kg
What is the most appropriate method of delivering rapid fluid boluses to this patient? - Correct
Answer✔️✔️-A syringe and 3-way stopcock
After the first fluid bolus is administered, the child is reassessed and her vital signs are HR 167, BP
58/44 mm Hg, RR 56/min and SpO2 92%. Her skin is still cool and pale and she is still lethargic
and weak.
What should be the next intervention? - Correct Answer✔️✔️-Deliver a second fluid bolus of 20
mL/kg and reassess
When should vasoactive therapy be considered be considered in managing distributive shock? -
Correct Answer✔️✔️-If the child remains hypotensive and poorly perfused despite rapid bolus
fluid administration
How does the clinical presentation of distributive shock compare with hypovolemic shock? -
Correct Answer✔️✔️-Distributive shock has more variable presentation than that of hypovolemic
shock
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
, For general shock management, administer an isotonic crytalloid bolus of __ mL/kg over __ to __
minutes - Correct Answer✔️✔️-For general shock management, administer an isotonic crytalloid
bolus of 20 mL/kg over 5 to 20 minutes
What signs distinguish anaphylactic shock from other types of shock? - Correct Answer✔️✔️--
Angioedema (swelling of the face, lips and tongue)
-Urticaria (hives)
-Respiratory distress with stridor, wheezing or both
in a child with anaphylactic shock, what is the most appropriate initial treatment? - Correct
Answer✔️✔️-IM epinephrine
How soon after exposure do symptoms typically occur in anaphylactic shock? - Correct
Answer✔️✔️-Seconds to minutes
What should you evaluate to recognize septic shock? - Correct Answer✔️✔️--Temp
-Heart rate
-Systemic perfusion
-Blood pressure
-Clinical signs of end-organ perfusion
When should antibiotics be administered in septic shock? - Correct Answer✔️✔️-Within the first
hour
What are the initial assessment findings for septic shock? - Correct Answer✔️✔️--Fever
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
Questions and Answers
The infant is placed on the ambulance stretcher and responds with a groan when stimulated and has
a temperature of 36.3 C (97.3 F) - Correct Answer✔️✔️--Monitor and support ABCs
-Establish IV/IO access
-Monitor heart rate, blood pressure, and pulse oximetry
-Call for assistance if needed
When you evaluate the patient, you find the lungs are clear, skin is cool and mottled, glucose is 97
mg/dL and capillary refill time is 5 seconds. What are the warning signs that the patient is
progressing from compensated shock to hypotensive shock? - Correct Answer✔️✔️--Hypotension
(late sign)
-Increasing tachycardia
The patient still has a blood pressure of 58/38 mm Hg. Her condition would be classified as
___________ shock. - Correct Answer✔️✔️-Hypotensive
What should be included in the initial treatment for this patient? - Correct Answer✔️✔️--Rapid
fluid bolus administration
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,-Establishing IV/IO access
The mother does not recall the infant's most recent weight. What is the most appropriate way to
rapidly determine her weight and calculate correct medication? - Correct Answer✔️✔️-Measure her
by using color-coded length-based tape
You measure the infant to be 7 kg and prepare to administer a fluid bolus of what type? - Correct
Answer✔️✔️-Normal saline 20 mL/kg
What is the most appropriate method of delivering rapid fluid boluses to this patient? - Correct
Answer✔️✔️-A syringe and 3-way stopcock
After the first fluid bolus is administered, the child is reassessed and her vital signs are HR 167, BP
58/44 mm Hg, RR 56/min and SpO2 92%. Her skin is still cool and pale and she is still lethargic
and weak.
What should be the next intervention? - Correct Answer✔️✔️-Deliver a second fluid bolus of 20
mL/kg and reassess
When should vasoactive therapy be considered be considered in managing distributive shock? -
Correct Answer✔️✔️-If the child remains hypotensive and poorly perfused despite rapid bolus
fluid administration
How does the clinical presentation of distributive shock compare with hypovolemic shock? -
Correct Answer✔️✔️-Distributive shock has more variable presentation than that of hypovolemic
shock
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
, For general shock management, administer an isotonic crytalloid bolus of __ mL/kg over __ to __
minutes - Correct Answer✔️✔️-For general shock management, administer an isotonic crytalloid
bolus of 20 mL/kg over 5 to 20 minutes
What signs distinguish anaphylactic shock from other types of shock? - Correct Answer✔️✔️--
Angioedema (swelling of the face, lips and tongue)
-Urticaria (hives)
-Respiratory distress with stridor, wheezing or both
in a child with anaphylactic shock, what is the most appropriate initial treatment? - Correct
Answer✔️✔️-IM epinephrine
How soon after exposure do symptoms typically occur in anaphylactic shock? - Correct
Answer✔️✔️-Seconds to minutes
What should you evaluate to recognize septic shock? - Correct Answer✔️✔️--Temp
-Heart rate
-Systemic perfusion
-Blood pressure
-Clinical signs of end-organ perfusion
When should antibiotics be administered in septic shock? - Correct Answer✔️✔️-Within the first
hour
What are the initial assessment findings for septic shock? - Correct Answer✔️✔️--Fever
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
