AHA PALS EXAM NEWEST 2026 ACTUAL EXAM TEST BANK 230
QUESTIONS AND CORRECT DETAILED ANSWERS WITH COMPLETE
SOLUTIONS.
13. A 3-year-old child presents with dehydration after a 2-day history of vomiting and
diarrhea. The child after has received 2 fluid boluses of 20 mL/ kg of normal saline.
After the second bolus, the child is alert and interacting. Her heart rate is 110/ min,
respiratory rate is 30/min, and blood pressure is 92/64 mm Hg. Her capillary refill time
is 2 seconds, and oxygen saturation is 98%. What is the most appropriate next
intervention for this child?
A. Administer another 20 mL/kg normal saline fluid bolus
B. Administer 10 mL/kg of packed red cells
C. Continue to monitor and reevaluate
the child espiratory failure
D. Disordered control of breathing -answer: Respiratory distress
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale
color. The primary assessment reveals that the airway is open and the respiratory
rate is 30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of
95% and a pulse rate of 93/min. On the basis of this information, which of the following
provides the best interpretation of the oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary
oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered -answer: Unreliable;
supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been treated
with chemotherapy. The child presents with lethargy and a high fever. Heart rate is
195/min, respiratory rate is 36/min,
,blood pressure is 85/40 mm Hg, and capillary refill time is less than 2 seconds. What is
the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock -answer: Septic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding. Blood
pressure is 55/40 mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
10. The parents of a 7-year-old child who is undergoing chemotherapy report that the
child has been febrile and has not been feeling well, with recent onset of lethargy.
Assessment reveals the following: The child is difficult to arouse, with pale color. The
child's heart rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm
Hg, capillary refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is
the most appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30 minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10
minutes
C. Obtain immediate blood cultures and chest x-ray D. Obtain expert consultation with
an oncologist to determine the chemotherapeutic regimen -answer: Obtain vascular
access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression
reveals an unresponsive child with intermittent apnea and mottled color. Heart rate is
166/min, respiratory rate is now being supported with bag-mask ventilation, capillary
refill time is 5 to 6 seconds, and temperature is 102°F (38.9°C). What is the best
method of establishing immediate vascular access? A. Two providers may attempt
peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line -answer: Place an intraosseous line
C. R10. A 2-year-old child with a 2-day history of a barking cough presents with
, audible stridor on inspiration, intercostal retractions, and agitation. What is the
most appropriate intervention for this child?
QUESTIONS AND CORRECT DETAILED ANSWERS WITH COMPLETE
SOLUTIONS.
13. A 3-year-old child presents with dehydration after a 2-day history of vomiting and
diarrhea. The child after has received 2 fluid boluses of 20 mL/ kg of normal saline.
After the second bolus, the child is alert and interacting. Her heart rate is 110/ min,
respiratory rate is 30/min, and blood pressure is 92/64 mm Hg. Her capillary refill time
is 2 seconds, and oxygen saturation is 98%. What is the most appropriate next
intervention for this child?
A. Administer another 20 mL/kg normal saline fluid bolus
B. Administer 10 mL/kg of packed red cells
C. Continue to monitor and reevaluate
the child espiratory failure
D. Disordered control of breathing -answer: Respiratory distress
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale
color. The primary assessment reveals that the airway is open and the respiratory
rate is 30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of
95% and a pulse rate of 93/min. On the basis of this information, which of the following
provides the best interpretation of the oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary
oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered -answer: Unreliable;
supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been treated
with chemotherapy. The child presents with lethargy and a high fever. Heart rate is
195/min, respiratory rate is 36/min,
,blood pressure is 85/40 mm Hg, and capillary refill time is less than 2 seconds. What is
the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock -answer: Septic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding. Blood
pressure is 55/40 mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
10. The parents of a 7-year-old child who is undergoing chemotherapy report that the
child has been febrile and has not been feeling well, with recent onset of lethargy.
Assessment reveals the following: The child is difficult to arouse, with pale color. The
child's heart rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm
Hg, capillary refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is
the most appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30 minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10
minutes
C. Obtain immediate blood cultures and chest x-ray D. Obtain expert consultation with
an oncologist to determine the chemotherapeutic regimen -answer: Obtain vascular
access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression
reveals an unresponsive child with intermittent apnea and mottled color. Heart rate is
166/min, respiratory rate is now being supported with bag-mask ventilation, capillary
refill time is 5 to 6 seconds, and temperature is 102°F (38.9°C). What is the best
method of establishing immediate vascular access? A. Two providers may attempt
peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line -answer: Place an intraosseous line
C. R10. A 2-year-old child with a 2-day history of a barking cough presents with
, audible stridor on inspiration, intercostal retractions, and agitation. What is the
most appropriate intervention for this child?
