PALS UPDATED FINAL EXAM QUESTIONS AND EXPERT VERIFIED
ANSWERS ALL GRADED A+
1. A 12-year-old child being evaluated in the pediatric intensive care unit dis- plays
the following ECG waveform. The team interprets this as which arrhyth- mia?...ANS....
second degree
2. 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?...ANS.... Lactate
3. A 9-year-old patient is presenting with decreased breath sounds, bradycardia,
slowed respiratory rate and a low O2 saturation level. The provider interprets these
findings as indicating which condition?...ANS.... Respiratory failure
4. 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?...ANS.... Deliver 1 BVM
ventilation every 3 to 5 seconds.
5. A 15-year-old patient is being evaluated during a follow-up visit after being
diagnosed with Lyme disease 2 months ago. A rhythm strip is obtained as shown
below. The provider interprets this rhythm as indicating which arrhyth- mia?...ANS.... First-
degree atrioventricular (AV) block
6. A child in cardiac arrest experiences return of spontaneous circulation but is
exhibiting signs of post-cardiac arrest syndrome (PCAS). The PALS resusci- tation team
determines that the child is experiencing a systemic response to
ischemia/reperfusion. The team bases this determination on which finding(s)?-
...ANS.... Hypotension
Fever
Hyperglycemia
1/8
, 7. A 2-year-old child arrives at the emergency department with the parents. The child
is unresponsive, is not breathing and has no pulse. Two emergency department
providers begin high-quality CPR. Which action(s) by the providers demonstrates high-
quality CPR?...ANS.... Allowing the chest to recoil fully after each compression
Providing ventilations that last about 1 second each
Compressing the chest about 2 inches
Giving 2 ventilations to every 15 compressions
8. A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac
arrest. For which rhythm(s) would this action be appropriate?...ANS.... VF and pVT are
shockable cardiac arrest rhythms.
9. A provider is assessing a child with suspected shock. Which statement cor- rectly
describes hypotension and shock?...ANS.... Hypotension is not a consistent feature of shock;
10. A provider is caring for a 4-year-old child in the urgent care clinic. Primary
assessment reveals difficulty breathing and an oxygen saturation of 91%. The
provider administers oxygen by nasal cannula with the goal of improving
the child's oxygen saturation above what percentage?...ANS.... Supplemental oxygen should be
administered as needed to maintain an oxygen saturation above 94%.
11. An 11-year-old soccer player is brought to the emergency department. After a quick
assessment, the team realizes this patient is experiencing a severe asth- ma
exacerbation. Which medication would the team administer first?...ANS.... Albuterol plus
ipratropium bromid
12. A child in the pediatric step-down unit is exhibiting signs of respiratory distress.
When assessing this child, which circulation finding might be present?-
...ANS.... Pallor is a circulation finding that may be seen in patients with respiratory distress.
13. A healthcare provider is performing a primary assessment of a child in res- piratory
distress. The provider documents increased work of breathing when which findings are
observed?...ANS.... Nasal flaring, use of accessory muscles to breathe and intercostal, substernal or suprasternal
retractions are all indicators of increased work or ettort of breathing. Grunting and inspiratory stridor are abnormal breath sounds.
14. An 11-year-old child develops unstable wide-complex tachycardia. Assess- ment
2/8
ANSWERS ALL GRADED A+
1. A 12-year-old child being evaluated in the pediatric intensive care unit dis- plays
the following ECG waveform. The team interprets this as which arrhyth- mia?...ANS....
second degree
2. 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?...ANS.... Lactate
3. A 9-year-old patient is presenting with decreased breath sounds, bradycardia,
slowed respiratory rate and a low O2 saturation level. The provider interprets these
findings as indicating which condition?...ANS.... Respiratory failure
4. 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?...ANS.... Deliver 1 BVM
ventilation every 3 to 5 seconds.
5. A 15-year-old patient is being evaluated during a follow-up visit after being
diagnosed with Lyme disease 2 months ago. A rhythm strip is obtained as shown
below. The provider interprets this rhythm as indicating which arrhyth- mia?...ANS.... First-
degree atrioventricular (AV) block
6. A child in cardiac arrest experiences return of spontaneous circulation but is
exhibiting signs of post-cardiac arrest syndrome (PCAS). The PALS resusci- tation team
determines that the child is experiencing a systemic response to
ischemia/reperfusion. The team bases this determination on which finding(s)?-
...ANS.... Hypotension
Fever
Hyperglycemia
1/8
, 7. A 2-year-old child arrives at the emergency department with the parents. The child
is unresponsive, is not breathing and has no pulse. Two emergency department
providers begin high-quality CPR. Which action(s) by the providers demonstrates high-
quality CPR?...ANS.... Allowing the chest to recoil fully after each compression
Providing ventilations that last about 1 second each
Compressing the chest about 2 inches
Giving 2 ventilations to every 15 compressions
8. A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac
arrest. For which rhythm(s) would this action be appropriate?...ANS.... VF and pVT are
shockable cardiac arrest rhythms.
9. A provider is assessing a child with suspected shock. Which statement cor- rectly
describes hypotension and shock?...ANS.... Hypotension is not a consistent feature of shock;
10. A provider is caring for a 4-year-old child in the urgent care clinic. Primary
assessment reveals difficulty breathing and an oxygen saturation of 91%. The
provider administers oxygen by nasal cannula with the goal of improving
the child's oxygen saturation above what percentage?...ANS.... Supplemental oxygen should be
administered as needed to maintain an oxygen saturation above 94%.
11. An 11-year-old soccer player is brought to the emergency department. After a quick
assessment, the team realizes this patient is experiencing a severe asth- ma
exacerbation. Which medication would the team administer first?...ANS.... Albuterol plus
ipratropium bromid
12. A child in the pediatric step-down unit is exhibiting signs of respiratory distress.
When assessing this child, which circulation finding might be present?-
...ANS.... Pallor is a circulation finding that may be seen in patients with respiratory distress.
13. A healthcare provider is performing a primary assessment of a child in res- piratory
distress. The provider documents increased work of breathing when which findings are
observed?...ANS.... Nasal flaring, use of accessory muscles to breathe and intercostal, substernal or suprasternal
retractions are all indicators of increased work or ettort of breathing. Grunting and inspiratory stridor are abnormal breath sounds.
14. An 11-year-old child develops unstable wide-complex tachycardia. Assess- ment
2/8
