PALS UPDATED FINAL
EXAM
50+ (Fully Updated 2026) Exam
Questions + Verified & Rationalized
Answers | A+ Graded
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✓ This Exam contains: PALS Updated FINAL EXAM
✓ 100% Accurate Questions and Answers
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✓ Each Question Includes The Correct Answer
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,Question 1
A 12-year-old child being evaluated in the pediatric intensive care unit displays the following ECG
waveform. The team interprets this as which arrhythmia?
Correct Answer
second degree
Rationale:
The presence of a widened QRS complex, indicating delayed depolarization of the ventricles, is a hallmark of a second-degree AV
block, where some P waves are not conducted to the ventricles. This condition arises when there is a disruption in the normal
conduction pathway between the atria and ventricles, resulting in a variable block of atrial impulses.
Question 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?
Correct Answer
Lactate
Rationale:
The key concept here is the child's symptoms indicating shock and possible dehydration, which affects the body's ability to transport
oxygen. In this scenario, the provider would use a lactate test to determine the adequacy of oxygen delivery, as elevated lactate levels
are often a sign of inadequate oxygen utilization and tissue hypoxia.
Question 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?
Correct Answer
Respiratory failure
Rationale:
The combination of decreased breath sounds, bradycardia, slowed respiratory rate, and low O2 saturation level in a 9-year-old patient
suggests that the child is experiencing difficulty breathing and may not be getting enough oxygen to the lungs. This presentation is
consistent with respiratory failure, which occurs when the lungs are unable to take in enough oxygen or expel enough carbon dioxide,
leading to an accumulation of these gases in the body.
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, Question 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?
Correct Answer
Deliver 1 BVM ventilation every 3 to 5 seconds.
Rationale:
The provider initiates BVM (bag-valve-mask) ventilation because the child is experiencing gasping respirations, which is an inadequate
airway and breathing effort, and requires assisted ventilation to maintain oxygenation. BVM ventilation at a rate of 1 every 3 to 5
seconds is the correct initial action because it provides the necessary oxygenation and ventilation while also allowing for chest
compressions to be initiated if the child's heart rate does not improve with ventilation alone.
Question 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 arrhythmia?
Correct Answer
First-degree atrioventricular (AV) block
Rationale:
The rhythm strip in question is likely showing a P wave for every QRS complex, but with a prolonged PR interval, which is indicative of
an atrioventricular (AV) block. A first-degree atrioventricular block is the correct diagnosis because it is characterized by a prolonged
PR interval in the absence of dropped beats, which matches the pattern seen in the rhythm strip.
Question 6
A child in cardiac arrest experiences return of spontaneous circulation but is exhibiting signs of post–
cardiac arrest syndrome (PCAS). The PALS resuscitation team determines that the child is experiencing a
systemic response to ischemia/reperfusion. The team bases this determination on which finding(s)?
Correct Answer
Hypotension
Fever
Hyperglycemia
Rationale:
The key finding is the presence of hypotension, which indicates a systemic response to ischemia/reperfusion as the child's body
struggles to maintain blood pressure after cardiac arrest. This is accompanied by fever and hyperglycemia, which are common signs of
systemic inflammation and metabolic dysregulation associated with post-cardiac arrest syndrome (PCAS).
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EXAM
50+ (Fully Updated 2026) Exam
Questions + Verified & Rationalized
Answers | A+ Graded
100% Guarantee Pass
✓ This Exam contains: PALS Updated FINAL EXAM
✓ 100% Accurate Questions and Answers
✓ 100% Guarantee Pass - Verified by Experts
✓ Each Question Includes The Correct Answer
✓ Expert-Verified
Trusted by thousands of students and professionals worldwide Page 1 of 18
,Question 1
A 12-year-old child being evaluated in the pediatric intensive care unit displays the following ECG
waveform. The team interprets this as which arrhythmia?
Correct Answer
second degree
Rationale:
The presence of a widened QRS complex, indicating delayed depolarization of the ventricles, is a hallmark of a second-degree AV
block, where some P waves are not conducted to the ventricles. This condition arises when there is a disruption in the normal
conduction pathway between the atria and ventricles, resulting in a variable block of atrial impulses.
Question 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?
Correct Answer
Lactate
Rationale:
The key concept here is the child's symptoms indicating shock and possible dehydration, which affects the body's ability to transport
oxygen. In this scenario, the provider would use a lactate test to determine the adequacy of oxygen delivery, as elevated lactate levels
are often a sign of inadequate oxygen utilization and tissue hypoxia.
Question 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?
Correct Answer
Respiratory failure
Rationale:
The combination of decreased breath sounds, bradycardia, slowed respiratory rate, and low O2 saturation level in a 9-year-old patient
suggests that the child is experiencing difficulty breathing and may not be getting enough oxygen to the lungs. This presentation is
consistent with respiratory failure, which occurs when the lungs are unable to take in enough oxygen or expel enough carbon dioxide,
leading to an accumulation of these gases in the body.
Trusted by thousands of students and professionals worldwide Page 2 of 18
, Question 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?
Correct Answer
Deliver 1 BVM ventilation every 3 to 5 seconds.
Rationale:
The provider initiates BVM (bag-valve-mask) ventilation because the child is experiencing gasping respirations, which is an inadequate
airway and breathing effort, and requires assisted ventilation to maintain oxygenation. BVM ventilation at a rate of 1 every 3 to 5
seconds is the correct initial action because it provides the necessary oxygenation and ventilation while also allowing for chest
compressions to be initiated if the child's heart rate does not improve with ventilation alone.
Question 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 arrhythmia?
Correct Answer
First-degree atrioventricular (AV) block
Rationale:
The rhythm strip in question is likely showing a P wave for every QRS complex, but with a prolonged PR interval, which is indicative of
an atrioventricular (AV) block. A first-degree atrioventricular block is the correct diagnosis because it is characterized by a prolonged
PR interval in the absence of dropped beats, which matches the pattern seen in the rhythm strip.
Question 6
A child in cardiac arrest experiences return of spontaneous circulation but is exhibiting signs of post–
cardiac arrest syndrome (PCAS). The PALS resuscitation team determines that the child is experiencing a
systemic response to ischemia/reperfusion. The team bases this determination on which finding(s)?
Correct Answer
Hypotension
Fever
Hyperglycemia
Rationale:
The key finding is the presence of hypotension, which indicates a systemic response to ischemia/reperfusion as the child's body
struggles to maintain blood pressure after cardiac arrest. This is accompanied by fever and hyperglycemia, which are common signs of
systemic inflammation and metabolic dysregulation associated with post-cardiac arrest syndrome (PCAS).
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