PALS EXAMINATION TEST 2026 FULL
SOLUTION GRADED A+
◉ What are the signs of instability in a patient with arrhythmias?
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
sudden collapse
◉ Priorities in initially managing arrhythmias are? Answer: The same as
they are for all critically ill children: Support ABC and treat underlying
cause
,◉ Bradycardia. 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?
Answer: Tissue hypoxia
◉ Symptomatic Bradycardia. Answer: Heart rate below 60/min
associated with cardiopulmonary compromise
◉ Cardiopulmonary compromise. Answer: * Hypotension
* Acutely altered mental status
* Signs of shock
◉ Bradycardia is an ominous sign of? 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? Answer: Fibrinolytic
agents
◉ What is the initial treatment of pediatric bradycardia with
cardiopulmonary compromise? Answer: Bag mask ventilation with
100% O2
, ◉ Fibrinolytic agents. Answer: tissue plasminogen activator,
streptokinase, reteplase tenecteplase
◉ Primary bradycardia. Answer: A result of congenital or acquired heart
conditions
◉ Causes of primary bradycardia. Answer: Congenital abnormality of
the heart pacemaker or conduction system
Surgical injury to the pacemaker or conduction system
Cardiomyopathy
Myocarditis
◉ Secondary bradycardia. Answer: Result of noncardiac conditions that
alter the normal function of the heart (Slow sinus node pacemaker or
slow conduction)
◉ secondary bradycardia causes. Answer: Hypoxia
Acidosis
SOLUTION GRADED A+
◉ What are the signs of instability in a patient with arrhythmias?
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
sudden collapse
◉ Priorities in initially managing arrhythmias are? Answer: The same as
they are for all critically ill children: Support ABC and treat underlying
cause
,◉ Bradycardia. 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?
Answer: Tissue hypoxia
◉ Symptomatic Bradycardia. Answer: Heart rate below 60/min
associated with cardiopulmonary compromise
◉ Cardiopulmonary compromise. Answer: * Hypotension
* Acutely altered mental status
* Signs of shock
◉ Bradycardia is an ominous sign of? 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? Answer: Fibrinolytic
agents
◉ What is the initial treatment of pediatric bradycardia with
cardiopulmonary compromise? Answer: Bag mask ventilation with
100% O2
, ◉ Fibrinolytic agents. Answer: tissue plasminogen activator,
streptokinase, reteplase tenecteplase
◉ Primary bradycardia. Answer: A result of congenital or acquired heart
conditions
◉ Causes of primary bradycardia. Answer: Congenital abnormality of
the heart pacemaker or conduction system
Surgical injury to the pacemaker or conduction system
Cardiomyopathy
Myocarditis
◉ Secondary bradycardia. Answer: Result of noncardiac conditions that
alter the normal function of the heart (Slow sinus node pacemaker or
slow conduction)
◉ secondary bradycardia causes. Answer: Hypoxia
Acidosis
