PALS PRETEST 2026 COMPLETE STUDY GUIDE
WITH SOLUTIONS
◉ You are supervising a student when is inserting an IO needle into
an infant's tibia. The student asks you what she should look for to
know that she has successfully inserted the needle into the bone
marrow cavity. What do you tell her. Answer: 'Fluids can be
administered freely without local soft tissue swelling.'
◉ An 8-month-old infant is brought to the ED for evaluation of
severe diarrhea and dehydration. On arrival to the ED, the infant
becomes unresponsive, apneic, and pulseless. You should for help
and start CPR. Another provider arrives, at which point you switch
to 2-rescuer CPR. The rhythm shown here is seen on the cardiac
monitor. The infant is intubated and ventilated with 100% oxygen.
An IO line is established, and a dose of epi is given. While continuing
high-quality CPR, what do you do next. Answer: give NS 20mL/kg IO
rapidly
◉ You need to provide rescue breaths to a child victim with a pulse.
What is the appropriate rate for delivering breaths?. Answer: 1
breath q3-5 secs
◉ What ratio of compressions to breaths should be used for 1-
rescuer child CPR?. Answer: 30 compressions to 2 breaths
, ◉ A pale and very sleepy but arousable 3-year-old child with a
history of diarrhea is brought to the hospital. Primary assessment
reveals a RR of 45 bpm with good breath sounds bilaterally. HR is
150 bpm, BP is 90/64 mmHg, and SpO2 is 92% on room air.
Capillary refill is 5 secs and peripheral pulses are weak. After placing
the child on a nonrebreathing face mask (10-L/min flow) with 100%
oxygen and obtaining vascular access, what is the most appropriate
immediate treatment for this child?. Answer: bolus of 20mL/kg
isotonic crystalloid
◉ A 7-year-old boy is found unresponsive, apneic, and pulseless.
CPR is ongoing. The child is intubated, and vascular access is
established. The EKG monitor shows an organized rhythm with a HR
of 45 bpm, but a pulse check reveals no palpable pulse. High-quality
CPR is resumed, and an initial IV dose of epi is administered. What
intervention should you perform next?. Answer: identify and treat
reversible causes
◉ You are caring for a 6-year-old patient who is receiving positive-
pressure mechanical ventilation via an ET tube. The child begins to
move his head and suddenly becomes cyanotic, and his HR
decreases. His SpO2 is 65%. You remove the child from the
mechanical ventilator and begin to provide manual ventilation with
a bag via the ET tube. During manual ventilation with 100% oxygen,
the child's color and HR improve slightly but his BP remains
inadequate. Breath sounds and chest expansion are present and
adequate on the R side and are present but consistently diminished
WITH SOLUTIONS
◉ You are supervising a student when is inserting an IO needle into
an infant's tibia. The student asks you what she should look for to
know that she has successfully inserted the needle into the bone
marrow cavity. What do you tell her. Answer: 'Fluids can be
administered freely without local soft tissue swelling.'
◉ An 8-month-old infant is brought to the ED for evaluation of
severe diarrhea and dehydration. On arrival to the ED, the infant
becomes unresponsive, apneic, and pulseless. You should for help
and start CPR. Another provider arrives, at which point you switch
to 2-rescuer CPR. The rhythm shown here is seen on the cardiac
monitor. The infant is intubated and ventilated with 100% oxygen.
An IO line is established, and a dose of epi is given. While continuing
high-quality CPR, what do you do next. Answer: give NS 20mL/kg IO
rapidly
◉ You need to provide rescue breaths to a child victim with a pulse.
What is the appropriate rate for delivering breaths?. Answer: 1
breath q3-5 secs
◉ What ratio of compressions to breaths should be used for 1-
rescuer child CPR?. Answer: 30 compressions to 2 breaths
, ◉ A pale and very sleepy but arousable 3-year-old child with a
history of diarrhea is brought to the hospital. Primary assessment
reveals a RR of 45 bpm with good breath sounds bilaterally. HR is
150 bpm, BP is 90/64 mmHg, and SpO2 is 92% on room air.
Capillary refill is 5 secs and peripheral pulses are weak. After placing
the child on a nonrebreathing face mask (10-L/min flow) with 100%
oxygen and obtaining vascular access, what is the most appropriate
immediate treatment for this child?. Answer: bolus of 20mL/kg
isotonic crystalloid
◉ A 7-year-old boy is found unresponsive, apneic, and pulseless.
CPR is ongoing. The child is intubated, and vascular access is
established. The EKG monitor shows an organized rhythm with a HR
of 45 bpm, but a pulse check reveals no palpable pulse. High-quality
CPR is resumed, and an initial IV dose of epi is administered. What
intervention should you perform next?. Answer: identify and treat
reversible causes
◉ You are caring for a 6-year-old patient who is receiving positive-
pressure mechanical ventilation via an ET tube. The child begins to
move his head and suddenly becomes cyanotic, and his HR
decreases. His SpO2 is 65%. You remove the child from the
mechanical ventilator and begin to provide manual ventilation with
a bag via the ET tube. During manual ventilation with 100% oxygen,
the child's color and HR improve slightly but his BP remains
inadequate. Breath sounds and chest expansion are present and
adequate on the R side and are present but consistently diminished
