PALS TEST BANK EXAM Questions With
DETAILED Answers Updated 2026 FOR
(GUARANTEED PASS)
Question
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the
left shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid
resuscitation his blood pressure increases to 122/84 mm Hg. His heart rate is
now 100 beats per minute and his respiratory rate is 28 breaths per minute. A
tube thoracostomy is performed for decreased left chest breath sounds with
the return of a small amount of blood and no air leak. After chest tube
insertion, the most appropriate next step is:
A. reexamine the chest
B. perform an aortogram
C. obtain a CT scan of the chest
D. obtain arterial blood gas analyses
Answer A. reexamine the chest
Rationale Following any intervention, the patient should be reassessed to
evaluate the response. In this case, re-examination of the chest is essential to
determine the reason for the persistent findings and guide further
management.
Question
Laboratory tests are ordered for a child who has been vomiting for 3 days and
is diaphoretic, tachypneic, lethargic and pale. Which test would the provider
use to determine the adequacy of oxygen delivery?
Answer Lactate
,Rationale Lactate levels are used to assess the adequacy of tissue
oxygenation. Elevated lactate indicates anaerobic metabolism and inadequate
oxygen delivery, which is common in shock states.
Question
A 4-year-old child suddenly collapses in the playroom of the facility. A
healthcare provider observes the event and hurries over to assess the child.
The healthcare provider completes which assessment first?
Answer Rapid assessment
Rationale In a collapsed child, the initial step is a rapid assessment to
determine responsiveness, breathing, and circulation before proceeding with
further interventions.
Question
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 is hemodynamically
unstable. Which primary assessment findings indicate this?
1. Decreased level of consciousness
2. Mottling
3. Hypotension
4. Difficulty breathing
Answer 1, 2, 3, 4
Rationale Hemodynamic instability is characterized by signs of inadequate
tissue perfusion including altered mental status, mottled skin, hypotension, and
respiratory difficulty.
Question
A child who is stable and exhibiting a wide-complex tachycardia is to receive
,adenosine. The provider would be alert for which result after administering this
medication?
Answer Transient asystole
Rationale Adenosine can cause temporary asystole or heart block as it
interrupts AV nodal conduction. This is typically brief and self-limited.
Question
A provider is forming an initial impression of a child using the Pediatric
Assessment Triangle (PAT). During which step of the PAT may the provider use
the mnemonic TICLS to assess the patient?
Answer Appearance
Rationale TICLS (Tone, Interactiveness, Consolability, Look/gaze, Speech/cry)
is used to assess appearance, which is one of the three components of the
Pediatric Assessment Triangle along with work of breathing and circulation.
Question
A child is experiencing shock. The emergency response team prepares for
imminent cardiac arrest when assessment reveals which finding(s)?
1. Bradycardia
2. Diminished central pulses
3. Hypotension
Answer 1, 2, 3
Rationale Bradycardia, diminished central pulses, and hypotension are late
signs of decompensated shock indicating impending cardiac arrest.
Question
A PALS resuscitation team is preparing to defibrillate a child experiencing
cardiac arrest. For which rhythm(s) would this action be appropriate?
, 1. Ventricular fibrillation (VF)
2. Pulseless ventricular tachycardia (pVT)
Answer 1, 2
Rationale Defibrillation is indicated for shockable rhythms including
ventricular fibrillation and pulseless ventricular tachycardia.
Question
A child is experiencing stable supraventricular tachycardia (SVT) and is to
receive treatment. Which initial treatment would the provider administer?
Answer Vagal maneuvers
Rationale Vagal maneuvers (such as blowing through a straw, ice to face, or
Valsalva) are the first-line treatment for stable SVT in children.
Question
A 4-year-old child is brought to the emergency department by the parents.
Assessment reveals that the child is gasping and the pulse rate is 65 beats per
minute. Which action would the provider initiate first?
Answer Deliver 1 BVM ventilation every 3 to 5 seconds.
Rationale For a child with gasping respirations and bradycardia, assisted
ventilations with a bag-valve-mask should be provided at a rate appropriate for
the child's age.
Question
The PALS resuscitation team notes the following ECG waveform and the child
does not have a pulse. The team prepares to intervene to address which
arrhythmia?
Answer Torsades de pointes
DETAILED Answers Updated 2026 FOR
(GUARANTEED PASS)
Question
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the
left shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid
resuscitation his blood pressure increases to 122/84 mm Hg. His heart rate is
now 100 beats per minute and his respiratory rate is 28 breaths per minute. A
tube thoracostomy is performed for decreased left chest breath sounds with
the return of a small amount of blood and no air leak. After chest tube
insertion, the most appropriate next step is:
A. reexamine the chest
B. perform an aortogram
C. obtain a CT scan of the chest
D. obtain arterial blood gas analyses
Answer A. reexamine the chest
Rationale Following any intervention, the patient should be reassessed to
evaluate the response. In this case, re-examination of the chest is essential to
determine the reason for the persistent findings and guide further
management.
Question
Laboratory tests are ordered for a child who has been vomiting for 3 days and
is diaphoretic, tachypneic, lethargic and pale. Which test would the provider
use to determine the adequacy of oxygen delivery?
Answer Lactate
,Rationale Lactate levels are used to assess the adequacy of tissue
oxygenation. Elevated lactate indicates anaerobic metabolism and inadequate
oxygen delivery, which is common in shock states.
Question
A 4-year-old child suddenly collapses in the playroom of the facility. A
healthcare provider observes the event and hurries over to assess the child.
The healthcare provider completes which assessment first?
Answer Rapid assessment
Rationale In a collapsed child, the initial step is a rapid assessment to
determine responsiveness, breathing, and circulation before proceeding with
further interventions.
Question
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 is hemodynamically
unstable. Which primary assessment findings indicate this?
1. Decreased level of consciousness
2. Mottling
3. Hypotension
4. Difficulty breathing
Answer 1, 2, 3, 4
Rationale Hemodynamic instability is characterized by signs of inadequate
tissue perfusion including altered mental status, mottled skin, hypotension, and
respiratory difficulty.
Question
A child who is stable and exhibiting a wide-complex tachycardia is to receive
,adenosine. The provider would be alert for which result after administering this
medication?
Answer Transient asystole
Rationale Adenosine can cause temporary asystole or heart block as it
interrupts AV nodal conduction. This is typically brief and self-limited.
Question
A provider is forming an initial impression of a child using the Pediatric
Assessment Triangle (PAT). During which step of the PAT may the provider use
the mnemonic TICLS to assess the patient?
Answer Appearance
Rationale TICLS (Tone, Interactiveness, Consolability, Look/gaze, Speech/cry)
is used to assess appearance, which is one of the three components of the
Pediatric Assessment Triangle along with work of breathing and circulation.
Question
A child is experiencing shock. The emergency response team prepares for
imminent cardiac arrest when assessment reveals which finding(s)?
1. Bradycardia
2. Diminished central pulses
3. Hypotension
Answer 1, 2, 3
Rationale Bradycardia, diminished central pulses, and hypotension are late
signs of decompensated shock indicating impending cardiac arrest.
Question
A PALS resuscitation team is preparing to defibrillate a child experiencing
cardiac arrest. For which rhythm(s) would this action be appropriate?
, 1. Ventricular fibrillation (VF)
2. Pulseless ventricular tachycardia (pVT)
Answer 1, 2
Rationale Defibrillation is indicated for shockable rhythms including
ventricular fibrillation and pulseless ventricular tachycardia.
Question
A child is experiencing stable supraventricular tachycardia (SVT) and is to
receive treatment. Which initial treatment would the provider administer?
Answer Vagal maneuvers
Rationale Vagal maneuvers (such as blowing through a straw, ice to face, or
Valsalva) are the first-line treatment for stable SVT in children.
Question
A 4-year-old child is brought to the emergency department by the parents.
Assessment reveals that the child is gasping and the pulse rate is 65 beats per
minute. Which action would the provider initiate first?
Answer Deliver 1 BVM ventilation every 3 to 5 seconds.
Rationale For a child with gasping respirations and bradycardia, assisted
ventilations with a bag-valve-mask should be provided at a rate appropriate for
the child's age.
Question
The PALS resuscitation team notes the following ECG waveform and the child
does not have a pulse. The team prepares to intervene to address which
arrhythmia?
Answer Torsades de pointes
