PALS HEARTCODE COMPLETE EXAM
SCRIPT 2026 QUESTIONS AND SOLUTIONS
⩥ You are caring for a 9-month-old patient with pronounced respiratory
distress. You initiated high-flow oxygen using a nonrebreathing mask
about 10 minutes ago and established intravenous access. Initially the
infant's heart rate was in the 150/min range with strong pulses. Suddenly
the infant's respiratory rate falls to 6/min with significant intercostals
retractions, and little air movement is heard. The infant becomes
cyanotic and the heart rate decreases to 95/min. Which of the following
treatments would be best for you to provide now?
Administer epinephrine IV
Provide bag-mask ventilation
Administer magnesium sulfate IV
Intubate and ventilate. Answer: Provide bag-mask ventilation
⩥ Which of the following is likely to be the most helpful technique to
identify potentially reversible metabolic and toxic causes during the
attempted resuscitation of a young child in cardiac arrest?
Obtaining a urine sample for toxicology screen
Obtaining chest and abdominal radiographs
Soliciting a history from the caregiver or family
,Obtaining a venous blood gas. Answer: Soliciting a history from the
caregiver or family
⩥ You are caring for a patient who developed a tension pneumothorax
after several hours of positive-pressure ventilation. Which of the
following would be the most appropriate site for needle decompression?
Over the third rib at the midclavicular line
Under the eighth rib at the midaxillary line
Over the fifth rib at the sternal border
Under the sixth rib at the midclavicular line. Answer: Over the third rib
at the midclavicular line
⩥ You attempted synchronized cardioversion for an infant with
supraventricular tachycardia (SVT) and poor perfusion. The SVT
persists after the initial 1 J/kg shock. Which of the following should you
attempt now?
Synchronized cardioversion at a dose of 2 J/kg
Synchronized cardioversion at a dose of 4 J/kg
Unsynchronized cardioversion at a dose of 2 J/kg
Unsynchronized cardioversion at a dose of 4 J/kg. Answer:
Synchronized cardioversion at a dose of 2 J/kg
, ⩥ You are treating a 5-month-old with a 2-day history of vomiting and
diarrhea. The patient is listless. The respiratory rate is 52/min and
unlabored. The heart rate is 170/min and pulses are present but weak.
Capillary refill is delayed. You are administering high-flow oxygen, and
intravenous access is in place. At this point the most important therapy is
to:
Administer an epinephrine bolus
Begin bag-mask ventilation
Provide a rapid 20 ml/kg isotonic crystalloid fluid bolus
Administer a bolus of 0.5 g/kg of dextrose. Answer: Provide a rapid 20
ml/kg isotonic crystalloid fluid bolus
⩥ Which of the following groups of clinical findings would be most
consistent with categorizing a patient with compensated shock?
Normal systolic blood pressure, decreased level of consciousness, cool
extremities with delayed capillary refill, and faint or nonpalpable distal
pulses
Decreased level of consciousness, extensor posturing in response to
pain, hypertension, and apnea
Normal blood pressure, normal level of consciousness, bounding distal
pulses, hypercarbia, hypoxemia, and normal urine output
Unresponsiveness, normal breathing, and good distal pulses. Answer:
Normal systolic blood pressure, decreased level of consciousness, cool
SCRIPT 2026 QUESTIONS AND SOLUTIONS
⩥ You are caring for a 9-month-old patient with pronounced respiratory
distress. You initiated high-flow oxygen using a nonrebreathing mask
about 10 minutes ago and established intravenous access. Initially the
infant's heart rate was in the 150/min range with strong pulses. Suddenly
the infant's respiratory rate falls to 6/min with significant intercostals
retractions, and little air movement is heard. The infant becomes
cyanotic and the heart rate decreases to 95/min. Which of the following
treatments would be best for you to provide now?
Administer epinephrine IV
Provide bag-mask ventilation
Administer magnesium sulfate IV
Intubate and ventilate. Answer: Provide bag-mask ventilation
⩥ Which of the following is likely to be the most helpful technique to
identify potentially reversible metabolic and toxic causes during the
attempted resuscitation of a young child in cardiac arrest?
Obtaining a urine sample for toxicology screen
Obtaining chest and abdominal radiographs
Soliciting a history from the caregiver or family
,Obtaining a venous blood gas. Answer: Soliciting a history from the
caregiver or family
⩥ You are caring for a patient who developed a tension pneumothorax
after several hours of positive-pressure ventilation. Which of the
following would be the most appropriate site for needle decompression?
Over the third rib at the midclavicular line
Under the eighth rib at the midaxillary line
Over the fifth rib at the sternal border
Under the sixth rib at the midclavicular line. Answer: Over the third rib
at the midclavicular line
⩥ You attempted synchronized cardioversion for an infant with
supraventricular tachycardia (SVT) and poor perfusion. The SVT
persists after the initial 1 J/kg shock. Which of the following should you
attempt now?
Synchronized cardioversion at a dose of 2 J/kg
Synchronized cardioversion at a dose of 4 J/kg
Unsynchronized cardioversion at a dose of 2 J/kg
Unsynchronized cardioversion at a dose of 4 J/kg. Answer:
Synchronized cardioversion at a dose of 2 J/kg
, ⩥ You are treating a 5-month-old with a 2-day history of vomiting and
diarrhea. The patient is listless. The respiratory rate is 52/min and
unlabored. The heart rate is 170/min and pulses are present but weak.
Capillary refill is delayed. You are administering high-flow oxygen, and
intravenous access is in place. At this point the most important therapy is
to:
Administer an epinephrine bolus
Begin bag-mask ventilation
Provide a rapid 20 ml/kg isotonic crystalloid fluid bolus
Administer a bolus of 0.5 g/kg of dextrose. Answer: Provide a rapid 20
ml/kg isotonic crystalloid fluid bolus
⩥ Which of the following groups of clinical findings would be most
consistent with categorizing a patient with compensated shock?
Normal systolic blood pressure, decreased level of consciousness, cool
extremities with delayed capillary refill, and faint or nonpalpable distal
pulses
Decreased level of consciousness, extensor posturing in response to
pain, hypertension, and apnea
Normal blood pressure, normal level of consciousness, bounding distal
pulses, hypercarbia, hypoxemia, and normal urine output
Unresponsiveness, normal breathing, and good distal pulses. Answer:
Normal systolic blood pressure, decreased level of consciousness, cool
