PALS PRE TEST COMPREHENSIVE ACADEMIC STUDY GUIDE WITH
VERIFIED CONCEPTS AND EXAM-FOCUSED EXPLANATIONS 2025–2026
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? - correct 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? - correct 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? - correct answer -Amiodarone 5 mg/kg IO
Which statement is correct about the effects of epinephrine during attempted resuscitation? -
correct 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. - correct 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? - correct answer -It is the least desirable route of administration
, Which statement is correct about the use of calcium chloride in pediatric patients? - correct
answer -Routine administration is not indicated during cardiac arrest
A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. - correct
answer -Albuterol
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of
inspired oxygen to a 7yo child? - correct 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 - correct answer -Rapid bolus of 20ml/kg of
isotonic crystalloid
A 7yo boy is found unresponsive, apneic, and pulseless. CPR is ongoing - correct 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? - correct 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? - correct
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? - correct 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
VERIFIED CONCEPTS AND EXAM-FOCUSED EXPLANATIONS 2025–2026
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? - correct 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? - correct 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? - correct answer -Amiodarone 5 mg/kg IO
Which statement is correct about the effects of epinephrine during attempted resuscitation? -
correct 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. - correct 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? - correct answer -It is the least desirable route of administration
, Which statement is correct about the use of calcium chloride in pediatric patients? - correct
answer -Routine administration is not indicated during cardiac arrest
A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. - correct
answer -Albuterol
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of
inspired oxygen to a 7yo child? - correct 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 - correct answer -Rapid bolus of 20ml/kg of
isotonic crystalloid
A 7yo boy is found unresponsive, apneic, and pulseless. CPR is ongoing - correct 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? - correct 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? - correct
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? - correct 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
