PALS Certification Exam With Complete
Solutions Latest Update
Prev healthy infant w hx of vomiting and diarrhea. Infant only responds to painful
stimulation. RR is 40, central pulses rapid and weak. Good bilateral breath sounds, cool
extremities, and cap refill time >5 seconds. BP 85/65 mm Hg, glucose 30 mg/dL. You
administer 100% O2 via face mask and initiate an IV. Which tx is most appropriate?
A. D10W 20 mL/kg bolus over 5 minutes
B. LR solution 20 mL/kg bolus over 15 minutes
C. D50W 0.45% NaCl 20 mL/kg bolus over 15 minutes
D. Bolus of isotonic crystalloid 20 mL/kg over 5 - 20 minutes, and D25W2 to 4 mL/kg IV -
ANSWER D. Bolus of isotonic crystalloid 20 mL/kg over 5 - 20 minutes, and D25W2 to 4
mL/kg IV
Which of the following statements is true about endotracheal drug administration during
resuscitative efforts for peds pt?
A. It is the preferred route of drug administration
B. it is the least desirable route of administration
C. the IV drug dose should be used
D. The drug does used is lower than the IV drug - ANSWER B. it is the least desirable
route of administration
For the use of calcium chloride in pediatric patients, which of the following statements is
true?
A. It possesses the same bioavailability of elemental Calcium as calcium gluconate
B. It is indicated for hypercalcemia, hypokalemia and hypomanesemia
C. Dosage : 1 to 2 mg/kg
D. Not routinely used in cardiac arrest - ANSWER D. not routinely used in cardiac arrest
, You are working on a team trying to resuscitate a child who is in V fib cardiac arrest.
You administered 2 unsynchronized shocks. You then established IO access and
administer Epinephirne 0.01 mg/kg IO. At the next rhythm check, child still in V fib. You
administered 4-J/kg shock and resumed CPR. What is the next drug and dose to
administer?
A. Mag sulfrate 25 - 50 mg/kg IO
B. Epinephirne 0.1 mg/kg IO
C. Atropine 0.02 mg/kg IO
D. Amiodarone 5 mg/kg IO - ANSWER D. Amiodarone 5 mg/kg IO
Paramedics are called for 1 yo. Initial assessment reveals a child who responds to only
painful stimuli and has irregular breathing, faint central pulse, bruises over abdomen,
abdominal distention, and cyanosis. Bag ventilation with 100% O2 is started. HR is 36.
Pulses cannot be palpated, central pulses are barely palpable. Cardiac monitor shows
sinus brady. 2 rescuer CPR is initiated. On arrival to ED, child is intubated and ventilated
with 100% O2 and IV access is established. HR is now 150/min with weak central pulses
but no distal pulses. SBP is 74. What intervention should be next?
A. Atropine 0.02 mg/kg IV
B. Amiodarone 5 mg/kg IV
C. Rapid bolus of 20 mL/kg of isotonic cystalloid
D. Epinephine 0.01 mg/kg IV - ANSWER C. Rapid bolus of 20 mL/kg of isotonic cystalloid
9 yo boy is agitated and leaning forward on bed in obvious resp. distress. Pt is speaking
in short phrases and has Hx of asthma but does not have inhaler. Has nasal flaring,
severe suprasternal and intercostal retractions and decreased air movement with
prolonged expiratory time and wheezing. You give 100 % O2 by nonrebreathing mask.
SpO2 92%. What med do you give?
A. Albuterol
B. Adenosine
C. Procainamide
D. Ammiodarone - ANSWER A. Albuterol
Solutions Latest Update
Prev healthy infant w hx of vomiting and diarrhea. Infant only responds to painful
stimulation. RR is 40, central pulses rapid and weak. Good bilateral breath sounds, cool
extremities, and cap refill time >5 seconds. BP 85/65 mm Hg, glucose 30 mg/dL. You
administer 100% O2 via face mask and initiate an IV. Which tx is most appropriate?
A. D10W 20 mL/kg bolus over 5 minutes
B. LR solution 20 mL/kg bolus over 15 minutes
C. D50W 0.45% NaCl 20 mL/kg bolus over 15 minutes
D. Bolus of isotonic crystalloid 20 mL/kg over 5 - 20 minutes, and D25W2 to 4 mL/kg IV -
ANSWER D. Bolus of isotonic crystalloid 20 mL/kg over 5 - 20 minutes, and D25W2 to 4
mL/kg IV
Which of the following statements is true about endotracheal drug administration during
resuscitative efforts for peds pt?
A. It is the preferred route of drug administration
B. it is the least desirable route of administration
C. the IV drug dose should be used
D. The drug does used is lower than the IV drug - ANSWER B. it is the least desirable
route of administration
For the use of calcium chloride in pediatric patients, which of the following statements is
true?
A. It possesses the same bioavailability of elemental Calcium as calcium gluconate
B. It is indicated for hypercalcemia, hypokalemia and hypomanesemia
C. Dosage : 1 to 2 mg/kg
D. Not routinely used in cardiac arrest - ANSWER D. not routinely used in cardiac arrest
, You are working on a team trying to resuscitate a child who is in V fib cardiac arrest.
You administered 2 unsynchronized shocks. You then established IO access and
administer Epinephirne 0.01 mg/kg IO. At the next rhythm check, child still in V fib. You
administered 4-J/kg shock and resumed CPR. What is the next drug and dose to
administer?
A. Mag sulfrate 25 - 50 mg/kg IO
B. Epinephirne 0.1 mg/kg IO
C. Atropine 0.02 mg/kg IO
D. Amiodarone 5 mg/kg IO - ANSWER D. Amiodarone 5 mg/kg IO
Paramedics are called for 1 yo. Initial assessment reveals a child who responds to only
painful stimuli and has irregular breathing, faint central pulse, bruises over abdomen,
abdominal distention, and cyanosis. Bag ventilation with 100% O2 is started. HR is 36.
Pulses cannot be palpated, central pulses are barely palpable. Cardiac monitor shows
sinus brady. 2 rescuer CPR is initiated. On arrival to ED, child is intubated and ventilated
with 100% O2 and IV access is established. HR is now 150/min with weak central pulses
but no distal pulses. SBP is 74. What intervention should be next?
A. Atropine 0.02 mg/kg IV
B. Amiodarone 5 mg/kg IV
C. Rapid bolus of 20 mL/kg of isotonic cystalloid
D. Epinephine 0.01 mg/kg IV - ANSWER C. Rapid bolus of 20 mL/kg of isotonic cystalloid
9 yo boy is agitated and leaning forward on bed in obvious resp. distress. Pt is speaking
in short phrases and has Hx of asthma but does not have inhaler. Has nasal flaring,
severe suprasternal and intercostal retractions and decreased air movement with
prolonged expiratory time and wheezing. You give 100 % O2 by nonrebreathing mask.
SpO2 92%. What med do you give?
A. Albuterol
B. Adenosine
C. Procainamide
D. Ammiodarone - ANSWER A. Albuterol