PALS Final Exam questions and answers
2025\2026 A+ Grade
A provider is assessing a child with suspected shock. Which statement correctly describes hypotension
and shock?
- correct answer Hypotension is not a consistent feature of shock presentation in children.
A 10-year-old child has collapsed in the gym of the elementary school. The school nurse arrives and
determines that the child is unresponsive. The school nurse then simultaneously checks for breathing
and a central pulse, limiting this assessment to which time frame?
- correct answer No more than 10 seconds
A 4-year-old child is brought to the emergency department by the parents. Assessment reveals that the
child has only gasping respirations and the pulse rate is 65 beats per minute. Which action would the
provider initiate first?
- correct answer Deliver 1 BVM ventilation every 2 to 3 seconds.
A 7-year-old child collapses on the playground at school. The school nurse is called to the scene and
determines that the child is unresponsive and is not breathing and has no pulse. The nurse initiates CPR.
At what rate and depth would the nurse deliver compressions to this child?
- correct answer 100 to 120 compressions per minute at a depth of about 2 inches
What is considered inadequate perfusion when assessing/caring for a pediatric patient with an
arrhythmia?
- correct answer Diminished peripheral pulses
Acutely altered mental status
Hypotension
A 9-year-old child is brought to the emergency department because the child suddenly collapsed at
school. The child's ECG reveals the following waveform, and primary assessment findings indicate that
the child has inadequate perfusion. Which primary assessment findings indicate this?
- correct answer Signs of shock
, Acutely altered mental status
Hypotension
A 9-year-old patient is presenting with diminished breath sounds, bradycardia, slowed respiratory rate
and a low O2 saturation level. The provider interprets these findings as indicating which condition?
- correct answer Respiratory failure
A 6-year-old child is brought to the emergency department. The child has been experiencing extremely
watery stools over the past several days. After completing the assessment, the healthcare provider
suspects that the child may be experiencing shock. Which type of shock would the provider most likely
suspect?
- correct answer Hypovolemia
A 2-year-old child of unknown weight arrives at the emergency department in cardiac arrest. When
preparing to administer medications, which action would be appropriate for the team to take?
- correct answer Estimate weight using a length-based resuscitation tape.
An 11-year-old child develops ventricular tachycardia with a pulse with inadequate perfusion. The PALS
team would prepare the child for which intervention?
- correct answer Synchronized electrical cardioversion
A 5-year-old child with a history of a chronic neuromuscular disease is experiencing respiratory distress.
The child is breathing spontaneously and receiving supplemental oxygen. Which additional intervention
is a critical component of airway management for this patient?
- correct answer Airway clearance (e.g., suctioning)
Primary assessment of a 10-year-old child reveals septic shock. As part of the secondary assessment, if
not already done as part of initial sepsis care, laboratory testing is completed to evaluate the child's
status. Which laboratory tests would be ordered for this child?
- correct answer Complete blood count (CBC)
Lactate level
Blood cultures
A 6-year-old patient is brought to the emergency department after a bicycle accident. Assessment
reveals chest pain on inspiration, diminished breath sounds on the right side, and respiratory distress.
2025\2026 A+ Grade
A provider is assessing a child with suspected shock. Which statement correctly describes hypotension
and shock?
- correct answer Hypotension is not a consistent feature of shock presentation in children.
A 10-year-old child has collapsed in the gym of the elementary school. The school nurse arrives and
determines that the child is unresponsive. The school nurse then simultaneously checks for breathing
and a central pulse, limiting this assessment to which time frame?
- correct answer No more than 10 seconds
A 4-year-old child is brought to the emergency department by the parents. Assessment reveals that the
child has only gasping respirations and the pulse rate is 65 beats per minute. Which action would the
provider initiate first?
- correct answer Deliver 1 BVM ventilation every 2 to 3 seconds.
A 7-year-old child collapses on the playground at school. The school nurse is called to the scene and
determines that the child is unresponsive and is not breathing and has no pulse. The nurse initiates CPR.
At what rate and depth would the nurse deliver compressions to this child?
- correct answer 100 to 120 compressions per minute at a depth of about 2 inches
What is considered inadequate perfusion when assessing/caring for a pediatric patient with an
arrhythmia?
- correct answer Diminished peripheral pulses
Acutely altered mental status
Hypotension
A 9-year-old child is brought to the emergency department because the child suddenly collapsed at
school. The child's ECG reveals the following waveform, and primary assessment findings indicate that
the child has inadequate perfusion. Which primary assessment findings indicate this?
- correct answer Signs of shock
, Acutely altered mental status
Hypotension
A 9-year-old patient is presenting with diminished breath sounds, bradycardia, slowed respiratory rate
and a low O2 saturation level. The provider interprets these findings as indicating which condition?
- correct answer Respiratory failure
A 6-year-old child is brought to the emergency department. The child has been experiencing extremely
watery stools over the past several days. After completing the assessment, the healthcare provider
suspects that the child may be experiencing shock. Which type of shock would the provider most likely
suspect?
- correct answer Hypovolemia
A 2-year-old child of unknown weight arrives at the emergency department in cardiac arrest. When
preparing to administer medications, which action would be appropriate for the team to take?
- correct answer Estimate weight using a length-based resuscitation tape.
An 11-year-old child develops ventricular tachycardia with a pulse with inadequate perfusion. The PALS
team would prepare the child for which intervention?
- correct answer Synchronized electrical cardioversion
A 5-year-old child with a history of a chronic neuromuscular disease is experiencing respiratory distress.
The child is breathing spontaneously and receiving supplemental oxygen. Which additional intervention
is a critical component of airway management for this patient?
- correct answer Airway clearance (e.g., suctioning)
Primary assessment of a 10-year-old child reveals septic shock. As part of the secondary assessment, if
not already done as part of initial sepsis care, laboratory testing is completed to evaluate the child's
status. Which laboratory tests would be ordered for this child?
- correct answer Complete blood count (CBC)
Lactate level
Blood cultures
A 6-year-old patient is brought to the emergency department after a bicycle accident. Assessment
reveals chest pain on inspiration, diminished breath sounds on the right side, and respiratory distress.
