PALS PRETEST QUESTIONS AND
VERIFIED ANSWERS|100%
CORRECT|GRADE A+
You are called to help treat an infant with severe symptomatic bradycardia (heart rate 66/min)
associated with respiratory distress. The bradycardia persists despite establishment of an effective
airway, oxygenation, and ventilation. There is no heart block present. Which is the first drug you should
administer? - ANSWER Epinephrine
Initial impression of a 2yo girl shows her to be alert with mild breathing difficulty during inspiration and
pale skin color. On primary assessment, she makes high-pitched inspiratory sounds (mild stridor) when
agitated; otherwise, her breathing is quiet. Her spO2 is 92% on room air, and she has mild inspiratory
intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with adequate distal
breath sounds bilaterally. Which is the most appropriate initial intervention for this child? - ANSWER
Humidified oxygen as tolerated
You are part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You
delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of
epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You
administer a 4 J/kg shock and resume CPR. Which drug and dose should be administered next? -
ANSWER Amiodarone 5 mg/kg IO
Which statement is correct about the effects of epinephrine during attempted resuscitation? - ANSWER
Epinephrine stimulates spontaneous contractions when asystole is present
A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency
department by her parents. During your assessment, you find that the infant responds only to painful
stimulation. - ANSWER Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also
give D25W 2-4 ml/kg IV
Which statement is correct about endotracheal drug administration during resuscitative efforts for
pediatric patients? - ANSWER It is the least desirable route of administration
Which statement is correct about the use of calcium chloride in pediatric patients? - ANSWER Routine
administration is not indicated during cardiac arrest
, A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. - ANSWER Albuterol
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired
oxygen to a 7yo child? - ANSWER Nonrebreathing face mask
Paramedics are called to the home of a 1yo child. Their initial assessment reveals a child who responds
only to painful stimuli and has irregular breathing, faint central pulses, bruises over the abdomen,
abdominal distention, and cyanosis - ANSWER Rapid bolus of 20ml/kg of isotonic crystalloid
A 7yo boy is found unresponsive, apneic, and pulseless. CPR is ongoing - ANSWER Identify and treat
reversible causes
You are preparing to use a manual defibrillator in the pediatric setting. Which best describes when it is
appropriate to use the smaller, pediatric-sized paddles? - ANSWER If the child weighs less than 10kg or is
less than 1 year old
What compression-to-ventilation ratio should be used for 2-rescuer infant CPR? - ANSWER 15
compressions to 2 breaths
You find an infant who is unresponsive, is not breathing, and does not have a pulse. You shout for nearby
help, but no one arrives. What action should you take next? - ANSWER Provide CPR for about 2 minutes
before leaving to activate the emergency response system
You are assisting in the elective intubation of an average-sized 4yo child with respiratory failure. A
colleague is retrieving the color-coded length-based tape from the resuscitation cart. Which of the
following is likely to be the estimated size of the uncuffed endotracheal tube for this child? - ANSWER
5mm tube
A pale and very sleepy but arousable 3yo child with a hx of diarrhea is brought to the hospital. Primary
assessment reveals a respiratory rate of 45/min with good breath sounds bilaterally - ANSWER
Administer a bolus of 20 ml/kg isotonic crystalloid
VERIFIED ANSWERS|100%
CORRECT|GRADE A+
You are called to help treat an infant with severe symptomatic bradycardia (heart rate 66/min)
associated with respiratory distress. The bradycardia persists despite establishment of an effective
airway, oxygenation, and ventilation. There is no heart block present. Which is the first drug you should
administer? - ANSWER Epinephrine
Initial impression of a 2yo girl shows her to be alert with mild breathing difficulty during inspiration and
pale skin color. On primary assessment, she makes high-pitched inspiratory sounds (mild stridor) when
agitated; otherwise, her breathing is quiet. Her spO2 is 92% on room air, and she has mild inspiratory
intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with adequate distal
breath sounds bilaterally. Which is the most appropriate initial intervention for this child? - ANSWER
Humidified oxygen as tolerated
You are part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You
delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of
epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You
administer a 4 J/kg shock and resume CPR. Which drug and dose should be administered next? -
ANSWER Amiodarone 5 mg/kg IO
Which statement is correct about the effects of epinephrine during attempted resuscitation? - ANSWER
Epinephrine stimulates spontaneous contractions when asystole is present
A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency
department by her parents. During your assessment, you find that the infant responds only to painful
stimulation. - ANSWER Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also
give D25W 2-4 ml/kg IV
Which statement is correct about endotracheal drug administration during resuscitative efforts for
pediatric patients? - ANSWER It is the least desirable route of administration
Which statement is correct about the use of calcium chloride in pediatric patients? - ANSWER Routine
administration is not indicated during cardiac arrest
, A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. - ANSWER Albuterol
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired
oxygen to a 7yo child? - ANSWER Nonrebreathing face mask
Paramedics are called to the home of a 1yo child. Their initial assessment reveals a child who responds
only to painful stimuli and has irregular breathing, faint central pulses, bruises over the abdomen,
abdominal distention, and cyanosis - ANSWER Rapid bolus of 20ml/kg of isotonic crystalloid
A 7yo boy is found unresponsive, apneic, and pulseless. CPR is ongoing - ANSWER Identify and treat
reversible causes
You are preparing to use a manual defibrillator in the pediatric setting. Which best describes when it is
appropriate to use the smaller, pediatric-sized paddles? - ANSWER If the child weighs less than 10kg or is
less than 1 year old
What compression-to-ventilation ratio should be used for 2-rescuer infant CPR? - ANSWER 15
compressions to 2 breaths
You find an infant who is unresponsive, is not breathing, and does not have a pulse. You shout for nearby
help, but no one arrives. What action should you take next? - ANSWER Provide CPR for about 2 minutes
before leaving to activate the emergency response system
You are assisting in the elective intubation of an average-sized 4yo child with respiratory failure. A
colleague is retrieving the color-coded length-based tape from the resuscitation cart. Which of the
following is likely to be the estimated size of the uncuffed endotracheal tube for this child? - ANSWER
5mm tube
A pale and very sleepy but arousable 3yo child with a hx of diarrhea is brought to the hospital. Primary
assessment reveals a respiratory rate of 45/min with good breath sounds bilaterally - ANSWER
Administer a bolus of 20 ml/kg isotonic crystalloid
