PALS PEDIATRIC EMERGENCY
RESUSCITATION – FINAL EXAM (2025) |
UPDATED QUESTIONS & VERIFIED
ANSWERS
1. Why is it critical to perform a jaw thrust and provide bag-mask
ventilation for the unresponsive child in this scenario?
A. It allows for the assessment of neurological function in the child.
B. It helps to determine the need for medication administration.
C. It is important to stabilize the spine before any airway interventions.
D. It is critical to ensure adequate airway management and ventilation to prevent
hypoxia.
Answer: D. It is critical to ensure adequate airway management and ventilation to
prevent hypoxia.
Rationale: In an unresponsive child, airway obstruction can rapidly lead to hypoxia,
which can cause permanent brain damage or death. Performing a jaw thrust opens the
airway while maintaining cervical spine precautions. Bag-mask ventilation ensures
adequate oxygenation until advanced airway management can be established.
2. You are preparing to use a manual defibrillator and paddles in the
pediatric setting. When would it be most appropriate to use the
smaller "pediatric" sized paddles for shock delivery?
A. If the patient weighs less than approximately 25 kg, or is less than 8 years of age.
B. To attempt synchronized cardioversion but not defibrillation.
C. If the patient weighs less than approximately 10 kg or is less than 1 year of age.
D. Whenever you can compress the victim's chest using only the heel of one hand.
Answer: A. If the patient weighs less than approximately 25 kg, or is less than 8 years
of age.
,Rationale: Pediatric defibrillator paddles are smaller to ensure that the shock is
delivered effectively and safely for smaller chest sizes. Using adult paddles on children
can cause ineffective defibrillation or excessive myocardial injury. Weight-based or
age-based criteria guide paddle selection.
3. Initial impression of a 2yo girl shows her to be alert with mild
inspiratory stridor when agitated; otherwise, her breathing is quiet.
SpO₂ is 92%, with mild intercostal retractions. What is the most
appropriate initial intervention?
A. Humidified oxygen as tolerated
B. Nebulized albuterol
C. Endotracheal intubation
D. IV dexamethasone
Answer: A. Humidified oxygen as tolerated
Rationale: Mild stridor with normal distal lung sounds and adequate oxygenation
suggests mild upper airway obstruction (often viral croup). Providing humidified
oxygen is the first step to relieve hypoxemia. Medications or intubation are reserved
for worsening respiratory distress or hypoxia.
4. During the initial assessment, you find that an infant is
unresponsive and has HR < 60/min. What should be your next
action?
A. Obtain BGL
B. Begin CPR
C. Begin rescue breathing
D. Stimulate the infant
Answer: B. Begin CPR
,Rationale: In infants, a heart rate < 60/min with poor perfusion despite adequate
oxygenation is an indication for immediate CPR. Early compressions improve
perfusion and oxygen delivery to vital organs. Stimulation alone is insufficient, and
rescue breaths should accompany compressions.
5. Describe the significance of administering a bolus of isotonic
crystalloid in a pediatric patient presenting with signs of shock.
A. It is a method to reduce the child's blood pressure.
B. Administering a bolus of isotonic crystalloid helps to restore intravascular volume
and improve perfusion in a child showing signs of shock.
C. It serves to increase the child's heart rate during resuscitation.
D. It is primarily used to treat respiratory distress in children.
Answer: B. Administering a bolus of isotonic crystalloid helps to restore intravascular
volume and improve perfusion in a child showing signs of shock.
Rationale: Shock in children often results from hypovolemia. Rapid administration of
isotonic fluids (e.g., normal saline or Ringer's lactate) restores circulating volume,
improves tissue perfusion, and prevents organ failure. Blood pressure alone is a late
indicator, so early intervention is crucial.
6. In a scenario where two rescuers are performing CPR on an
infant, how would you adjust the technique if one rescuer becomes
fatigued?
A. Stop CPR and assess the infant's condition.
B. Continue with the same rescuer performing compressions until help arrives.
C. Increase the compression-to-ventilation ratio to 30:2.
D. Switch roles to allow the fatigued rescuer to provide ventilations while the other
continues compressions.
, Answer: D. Switch roles to allow the fatigued rescuer to provide ventilations while the
other continues compressions.
Rationale: High-quality compressions are critical for perfusion during CPR. Switching
roles reduces fatigue, ensures consistent compressions, and maintains an effective
ventilation-to-compression ratio.
7. What is the correct compression-to-breath ratio for 1-rescuer CPR
on a child?
A. 15 compressions to 2 breaths
B. 20 compressions to 2 breaths
C. 30 compressions to 2 breaths
D. 30 compressions to 1 breath
Answer: C. 30 compressions to 2 breaths
Rationale: For 1-rescuer CPR on a child or infant, the recommended ratio is 30:2.
This allows for adequate perfusion while minimizing interruptions in chest
compressions. Two-rescuer child CPR uses 15:2.
8. In a pediatric emergency where a child is experiencing
respiratory distress but has a pulse, how would you adjust your
intervention strategy based on the need for rescue breaths?
A. Administer rescue breaths continuously without checking the pulse.
B. Provide rescue breaths at a rate of 1 breath every 3–5 seconds while monitoring the
child's vital signs.
C. Give rescue breaths at a rate of 1 breath every 10 seconds.
D. Only perform chest compressions and skip rescue breaths.
Answer: B. Provide rescue breaths at a rate of 1 breath every 3–5 seconds while
monitoring the child's vital signs.
RESUSCITATION – FINAL EXAM (2025) |
UPDATED QUESTIONS & VERIFIED
ANSWERS
1. Why is it critical to perform a jaw thrust and provide bag-mask
ventilation for the unresponsive child in this scenario?
A. It allows for the assessment of neurological function in the child.
B. It helps to determine the need for medication administration.
C. It is important to stabilize the spine before any airway interventions.
D. It is critical to ensure adequate airway management and ventilation to prevent
hypoxia.
Answer: D. It is critical to ensure adequate airway management and ventilation to
prevent hypoxia.
Rationale: In an unresponsive child, airway obstruction can rapidly lead to hypoxia,
which can cause permanent brain damage or death. Performing a jaw thrust opens the
airway while maintaining cervical spine precautions. Bag-mask ventilation ensures
adequate oxygenation until advanced airway management can be established.
2. You are preparing to use a manual defibrillator and paddles in the
pediatric setting. When would it be most appropriate to use the
smaller "pediatric" sized paddles for shock delivery?
A. If the patient weighs less than approximately 25 kg, or is less than 8 years of age.
B. To attempt synchronized cardioversion but not defibrillation.
C. If the patient weighs less than approximately 10 kg or is less than 1 year of age.
D. Whenever you can compress the victim's chest using only the heel of one hand.
Answer: A. If the patient weighs less than approximately 25 kg, or is less than 8 years
of age.
,Rationale: Pediatric defibrillator paddles are smaller to ensure that the shock is
delivered effectively and safely for smaller chest sizes. Using adult paddles on children
can cause ineffective defibrillation or excessive myocardial injury. Weight-based or
age-based criteria guide paddle selection.
3. Initial impression of a 2yo girl shows her to be alert with mild
inspiratory stridor when agitated; otherwise, her breathing is quiet.
SpO₂ is 92%, with mild intercostal retractions. What is the most
appropriate initial intervention?
A. Humidified oxygen as tolerated
B. Nebulized albuterol
C. Endotracheal intubation
D. IV dexamethasone
Answer: A. Humidified oxygen as tolerated
Rationale: Mild stridor with normal distal lung sounds and adequate oxygenation
suggests mild upper airway obstruction (often viral croup). Providing humidified
oxygen is the first step to relieve hypoxemia. Medications or intubation are reserved
for worsening respiratory distress or hypoxia.
4. During the initial assessment, you find that an infant is
unresponsive and has HR < 60/min. What should be your next
action?
A. Obtain BGL
B. Begin CPR
C. Begin rescue breathing
D. Stimulate the infant
Answer: B. Begin CPR
,Rationale: In infants, a heart rate < 60/min with poor perfusion despite adequate
oxygenation is an indication for immediate CPR. Early compressions improve
perfusion and oxygen delivery to vital organs. Stimulation alone is insufficient, and
rescue breaths should accompany compressions.
5. Describe the significance of administering a bolus of isotonic
crystalloid in a pediatric patient presenting with signs of shock.
A. It is a method to reduce the child's blood pressure.
B. Administering a bolus of isotonic crystalloid helps to restore intravascular volume
and improve perfusion in a child showing signs of shock.
C. It serves to increase the child's heart rate during resuscitation.
D. It is primarily used to treat respiratory distress in children.
Answer: B. Administering a bolus of isotonic crystalloid helps to restore intravascular
volume and improve perfusion in a child showing signs of shock.
Rationale: Shock in children often results from hypovolemia. Rapid administration of
isotonic fluids (e.g., normal saline or Ringer's lactate) restores circulating volume,
improves tissue perfusion, and prevents organ failure. Blood pressure alone is a late
indicator, so early intervention is crucial.
6. In a scenario where two rescuers are performing CPR on an
infant, how would you adjust the technique if one rescuer becomes
fatigued?
A. Stop CPR and assess the infant's condition.
B. Continue with the same rescuer performing compressions until help arrives.
C. Increase the compression-to-ventilation ratio to 30:2.
D. Switch roles to allow the fatigued rescuer to provide ventilations while the other
continues compressions.
, Answer: D. Switch roles to allow the fatigued rescuer to provide ventilations while the
other continues compressions.
Rationale: High-quality compressions are critical for perfusion during CPR. Switching
roles reduces fatigue, ensures consistent compressions, and maintains an effective
ventilation-to-compression ratio.
7. What is the correct compression-to-breath ratio for 1-rescuer CPR
on a child?
A. 15 compressions to 2 breaths
B. 20 compressions to 2 breaths
C. 30 compressions to 2 breaths
D. 30 compressions to 1 breath
Answer: C. 30 compressions to 2 breaths
Rationale: For 1-rescuer CPR on a child or infant, the recommended ratio is 30:2.
This allows for adequate perfusion while minimizing interruptions in chest
compressions. Two-rescuer child CPR uses 15:2.
8. In a pediatric emergency where a child is experiencing
respiratory distress but has a pulse, how would you adjust your
intervention strategy based on the need for rescue breaths?
A. Administer rescue breaths continuously without checking the pulse.
B. Provide rescue breaths at a rate of 1 breath every 3–5 seconds while monitoring the
child's vital signs.
C. Give rescue breaths at a rate of 1 breath every 10 seconds.
D. Only perform chest compressions and skip rescue breaths.
Answer: B. Provide rescue breaths at a rate of 1 breath every 3–5 seconds while
monitoring the child's vital signs.
