PALS Final Review exam 2025/2026 with
100% correct answers Graded A+.
Mikey, a 2-year-old boy, is sitting upright on a hospital bed in room 3 of your emergency department.
Your initial impression from the door does not raise immediate concern. On your entry to the room, you
are able to look at Mikey more closely and notice on inhalation his nostrils are flaring. This is a sign of: -
correct answer Respiratory distress
The proper site for a peripheral pulse assessment in the infant patient is: -correct answer brachial
You are called to the scene of a 3-year-old patient who was found anxious, *cyanotic* and lethargic
after a fall down a flight of stairs. On assessing the patient, you find vital signs with a respiratory rate of
30, regular pulse rate of 130, regular capillary refill time of 4 seconds, and a blood pressure of 102/61.
What kind of shock is the patient experiencing? -correct answer compensate shock?
A mnemonic that aids in performing a primary assessment is: -correct answer ABCDE
A consideration of treatment for a pediatric patient with acute fulminant myocarditis who is in cardiac
arrest or at a high risk of cardiac arrest is: -correct answer Extracorporeal membrane oxygenation
(ECMO)
Which of the following is the correct meaning for one of the individual letters in the AVPU scale? -
correct answer Alert - The child is alert and awake and responds to normal stimuli based upon age and
environment
The recommended route of vascular access on a hypotensive pediatric patient is: -correct answer
central IV
You are called to the bedside of a 12-year-old male patient who was admitted after a week of persistent
vomiting, diarrhea and limiting oral intake of both solids and liquids. The patient's airway is patent,
ventilatory rate is within normal limits and the patient's circulatory status presents with tachycardia, a
blood pressure of 70/40 and a capillary refill time of 5 seconds. The patient is speaking incoherently. The
patient has no history of cardiac problems or congenital defects. The appropriate fluid administration
dose for this patient is: -correct answer 20 ml/kg 0.9% NaCl over 10 minutes
, You suspect your 8-year-old female patient of being hypovolemic. Her parents brought her to the
emergency department with persistent vomiting and diarrhea for 5 days. The patient presents with
*mottled skin* and reports of periods where "she just stopped breathing!" according to her parents. The
patient is being managed with a BVM and supplemental oxygen. What is the best route of establishing
vascular access for the purpose of fluid resuscitation? -correct answer IV
Which of the following cannot be administered through an ETT? -correct answer Sodium bicarbonate
You are examining the rhythm strip of a patient who presents with bradycardia. Which of the following
characteristics may you notice in the rhythm? -correct answer The most obvious sign of bradycardia on
an ECG is slow heart rate. The characteristics of P-waves and the QRS complex may vary. When looking
at an EKG, the following characteristics are seen with bradycardia patients: Slow heart rate, P-waves
may not be noticeable, QRS complex may be wide or narrow, and P-waves and QRS complex may not be
related to bradycardia.
How do children's metabolic rates compare to adults'? -correct answer higher
Children's demand for oxygen is ___________ adults. -correct answer greater
Which of the following must you monitor while fluid resuscitating a patient? -correct answer Urine
output
What type of pressure is monitored to obtain right ventricular cardiac preload? -correct answer Central
venous pressure (CVP)
Define shock: -correct answer When oxygen and nutrient supply to body tissue is insufficient compared
to metabolic tissue needs
Your 5-year-old patient is admitted to the PICU and is being treated by your team for hypovolemic
shock. The team has administered one bolus of 20ml/kg of 0.9% NaCl . On re-evaluation the patient is
alert and anxious with a heart rate of 145 beats per minute, a blood pressure of 76/48mmHg and a
capillary refill time of 4 seconds. Which of the following is the patient's clinical condition? -correct
answer hypotensive shock
100% correct answers Graded A+.
Mikey, a 2-year-old boy, is sitting upright on a hospital bed in room 3 of your emergency department.
Your initial impression from the door does not raise immediate concern. On your entry to the room, you
are able to look at Mikey more closely and notice on inhalation his nostrils are flaring. This is a sign of: -
correct answer Respiratory distress
The proper site for a peripheral pulse assessment in the infant patient is: -correct answer brachial
You are called to the scene of a 3-year-old patient who was found anxious, *cyanotic* and lethargic
after a fall down a flight of stairs. On assessing the patient, you find vital signs with a respiratory rate of
30, regular pulse rate of 130, regular capillary refill time of 4 seconds, and a blood pressure of 102/61.
What kind of shock is the patient experiencing? -correct answer compensate shock?
A mnemonic that aids in performing a primary assessment is: -correct answer ABCDE
A consideration of treatment for a pediatric patient with acute fulminant myocarditis who is in cardiac
arrest or at a high risk of cardiac arrest is: -correct answer Extracorporeal membrane oxygenation
(ECMO)
Which of the following is the correct meaning for one of the individual letters in the AVPU scale? -
correct answer Alert - The child is alert and awake and responds to normal stimuli based upon age and
environment
The recommended route of vascular access on a hypotensive pediatric patient is: -correct answer
central IV
You are called to the bedside of a 12-year-old male patient who was admitted after a week of persistent
vomiting, diarrhea and limiting oral intake of both solids and liquids. The patient's airway is patent,
ventilatory rate is within normal limits and the patient's circulatory status presents with tachycardia, a
blood pressure of 70/40 and a capillary refill time of 5 seconds. The patient is speaking incoherently. The
patient has no history of cardiac problems or congenital defects. The appropriate fluid administration
dose for this patient is: -correct answer 20 ml/kg 0.9% NaCl over 10 minutes
, You suspect your 8-year-old female patient of being hypovolemic. Her parents brought her to the
emergency department with persistent vomiting and diarrhea for 5 days. The patient presents with
*mottled skin* and reports of periods where "she just stopped breathing!" according to her parents. The
patient is being managed with a BVM and supplemental oxygen. What is the best route of establishing
vascular access for the purpose of fluid resuscitation? -correct answer IV
Which of the following cannot be administered through an ETT? -correct answer Sodium bicarbonate
You are examining the rhythm strip of a patient who presents with bradycardia. Which of the following
characteristics may you notice in the rhythm? -correct answer The most obvious sign of bradycardia on
an ECG is slow heart rate. The characteristics of P-waves and the QRS complex may vary. When looking
at an EKG, the following characteristics are seen with bradycardia patients: Slow heart rate, P-waves
may not be noticeable, QRS complex may be wide or narrow, and P-waves and QRS complex may not be
related to bradycardia.
How do children's metabolic rates compare to adults'? -correct answer higher
Children's demand for oxygen is ___________ adults. -correct answer greater
Which of the following must you monitor while fluid resuscitating a patient? -correct answer Urine
output
What type of pressure is monitored to obtain right ventricular cardiac preload? -correct answer Central
venous pressure (CVP)
Define shock: -correct answer When oxygen and nutrient supply to body tissue is insufficient compared
to metabolic tissue needs
Your 5-year-old patient is admitted to the PICU and is being treated by your team for hypovolemic
shock. The team has administered one bolus of 20ml/kg of 0.9% NaCl . On re-evaluation the patient is
alert and anxious with a heart rate of 145 beats per minute, a blood pressure of 76/48mmHg and a
capillary refill time of 4 seconds. Which of the following is the patient's clinical condition? -correct
answer hypotensive shock
