AHA PALS EXAM 2024-2025 ACTUAL
EXAM TEST BANK QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+||NEWEST
VERSION
2. What abnormality is most likely to be present in children with acute respiratory
distress caused by lung tissue disease?
A. Decreased oxygen saturation
B. Stridor
C. Normal respiratory rate
D. Decreased respiratory effort - ANSWER//Decreased oxygen saturation
3. An alert 2-year-old child with an increased work of breathing and pink color is being
evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would best
describe this patient's condition? A. Respiratory distress
A. Respiratory arrest
B. Respiratory failure
C. Disordered control of breathing - ANSWER//Respiratory distress
4. 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
5. 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
6. What is the appropriate fluid bolus to administer for a child with hypovolemic shock
with adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's - ANSWER//20 mL/kg normal saline
7. An alert toddler presents with a barking cough, moderate stridor, and moderate
retractions. The child's color is pink. What is the most appropriate initial intervention?
A. Obtain a chest radiograph
B. Administer nebulized epinephrine
C. Prepare for a surgical airway
D. Use an epinephrine autoinjector - ANSWER//Administer nebulized epinephrine
8. An 8-year-old child presents with a history of vomiting and diarrhea. The child has
the following vital signs: heart rate 168/min, respiratory rate 15/min, blood pressure
9060 mm Hg, and temperature 98.6°F (37°C). The child's capillary refill time is 4
seconds. After 2 IV boluses of normal saline (20 mL/kg each), the child's vital signs are
now as follows: heart rate 130/min, respiratory rate 16/min, blood pressure 94/62 mm
Hg, capillary refill 2 seconds, and temperature 98.6°F (37°C). The child's urine output is
1 to 2 mL/kg in the past hour. The child is still lethargic. What diagnostic tests or
information should be obtained first?
A. Arterial blood gas
B. Serum potassium concentration
C. Glucose
D. A 12-lead ECG - ANSWER//Glucose
9. A 15-year-old boy presents with acute onset of severe respiratory distress, with
retractions and an oxygen saturation of 85%. His trachea is deviated to the right, and
there are no breath sounds on the left. His heart rate is 140/min, his blood pressure is
, 84/60 mm Hg, and his capillary refill time is 3 seconds. What is the most appropriate
intervention?
A. Obtain a chest x-ray
B. Perform needle decompression on the left chest C. Insert a chest tube on the left
side
D. Insert an IV and administer 20 mL/kg of normal saline - ANSWER//Perform needle
decompression on the left chest
10. A 4-year-old is being treated for hypovolemic shock and has received a single fluid
bolus of 20 mL/kg of normal saline. On reevaluation the child remains anxious, with a
heart rate of 140/min, a blood pressure of 84/54 mm Hg, and a capillary refill time of 4
seconds. What describes this patient's condition?
A. Hypotensive shock
B. Compensated shock
C. No longer in shock
D. Cardiogenic shock - ANSWER//Compensated shock
11. An 8-year-old child had a sudden onset of palpitations and light-headedness. At the
time of evaluation the child is alert. His respiratory rate is 26/ min, and his blood
pressure is 104/70 mm Hg. A cardiac monitor is applied, and the rhythm below is noted.
What is the most appropriate initial intervention?
A. Provide synchronized cardioversion at 0.5 to 1 J/kg
B. Attempt vagal maneuvers
C. Administer adenosine 0.1 mg/kg over 5 minutes D. Administer amiodarone 5 mg/kg
over 20 minutes - ANSWER//Attempt vagal maneuvers
12. A 10-year-old child had a sudden witnessed cardiac arrest and received immediate
bystander CPR and defibrillation within 3 minutes. He had a return of spontaneous
circulation. The child remains unresponsive and has an advanced airway in place.
There is no history of trauma or signs of shock. What is the target range for oxygen
saturation for this child?
A. 92% to 100%
B. 92% to 99%
C. 94% to 99%
D. 94% to 100% - ANSWER//94% to 99%
13. A 3-month-old infant with bronchiolitis is suctioned to remove upper airway
secretions. The infant's heart rate decreases from 155/min to 65/min as shown below.
The infant remains alert, with easily palpable pulses. Capillary refill time is 1 second.
What is the most appropriate initial intervention?
A. Administer oxygen and ensure adequate ventilation; be prepared to intervene further
if heart rate does not increase
B. Establish IV/IO access and administer epinephrine 0.01 mg/kg IV
C. Establish IV/IO access and administer atropine 0.02 mg/kg IV
EXAM TEST BANK QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+||NEWEST
VERSION
2. What abnormality is most likely to be present in children with acute respiratory
distress caused by lung tissue disease?
A. Decreased oxygen saturation
B. Stridor
C. Normal respiratory rate
D. Decreased respiratory effort - ANSWER//Decreased oxygen saturation
3. An alert 2-year-old child with an increased work of breathing and pink color is being
evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would best
describe this patient's condition? A. Respiratory distress
A. Respiratory arrest
B. Respiratory failure
C. Disordered control of breathing - ANSWER//Respiratory distress
4. 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
5. 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
6. What is the appropriate fluid bolus to administer for a child with hypovolemic shock
with adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's - ANSWER//20 mL/kg normal saline
7. An alert toddler presents with a barking cough, moderate stridor, and moderate
retractions. The child's color is pink. What is the most appropriate initial intervention?
A. Obtain a chest radiograph
B. Administer nebulized epinephrine
C. Prepare for a surgical airway
D. Use an epinephrine autoinjector - ANSWER//Administer nebulized epinephrine
8. An 8-year-old child presents with a history of vomiting and diarrhea. The child has
the following vital signs: heart rate 168/min, respiratory rate 15/min, blood pressure
9060 mm Hg, and temperature 98.6°F (37°C). The child's capillary refill time is 4
seconds. After 2 IV boluses of normal saline (20 mL/kg each), the child's vital signs are
now as follows: heart rate 130/min, respiratory rate 16/min, blood pressure 94/62 mm
Hg, capillary refill 2 seconds, and temperature 98.6°F (37°C). The child's urine output is
1 to 2 mL/kg in the past hour. The child is still lethargic. What diagnostic tests or
information should be obtained first?
A. Arterial blood gas
B. Serum potassium concentration
C. Glucose
D. A 12-lead ECG - ANSWER//Glucose
9. A 15-year-old boy presents with acute onset of severe respiratory distress, with
retractions and an oxygen saturation of 85%. His trachea is deviated to the right, and
there are no breath sounds on the left. His heart rate is 140/min, his blood pressure is
, 84/60 mm Hg, and his capillary refill time is 3 seconds. What is the most appropriate
intervention?
A. Obtain a chest x-ray
B. Perform needle decompression on the left chest C. Insert a chest tube on the left
side
D. Insert an IV and administer 20 mL/kg of normal saline - ANSWER//Perform needle
decompression on the left chest
10. A 4-year-old is being treated for hypovolemic shock and has received a single fluid
bolus of 20 mL/kg of normal saline. On reevaluation the child remains anxious, with a
heart rate of 140/min, a blood pressure of 84/54 mm Hg, and a capillary refill time of 4
seconds. What describes this patient's condition?
A. Hypotensive shock
B. Compensated shock
C. No longer in shock
D. Cardiogenic shock - ANSWER//Compensated shock
11. An 8-year-old child had a sudden onset of palpitations and light-headedness. At the
time of evaluation the child is alert. His respiratory rate is 26/ min, and his blood
pressure is 104/70 mm Hg. A cardiac monitor is applied, and the rhythm below is noted.
What is the most appropriate initial intervention?
A. Provide synchronized cardioversion at 0.5 to 1 J/kg
B. Attempt vagal maneuvers
C. Administer adenosine 0.1 mg/kg over 5 minutes D. Administer amiodarone 5 mg/kg
over 20 minutes - ANSWER//Attempt vagal maneuvers
12. A 10-year-old child had a sudden witnessed cardiac arrest and received immediate
bystander CPR and defibrillation within 3 minutes. He had a return of spontaneous
circulation. The child remains unresponsive and has an advanced airway in place.
There is no history of trauma or signs of shock. What is the target range for oxygen
saturation for this child?
A. 92% to 100%
B. 92% to 99%
C. 94% to 99%
D. 94% to 100% - ANSWER//94% to 99%
13. A 3-month-old infant with bronchiolitis is suctioned to remove upper airway
secretions. The infant's heart rate decreases from 155/min to 65/min as shown below.
The infant remains alert, with easily palpable pulses. Capillary refill time is 1 second.
What is the most appropriate initial intervention?
A. Administer oxygen and ensure adequate ventilation; be prepared to intervene further
if heart rate does not increase
B. Establish IV/IO access and administer epinephrine 0.01 mg/kg IV
C. Establish IV/IO access and administer atropine 0.02 mg/kg IV
