PALS EXAM ALL QUESTIONS AND ANSWERS
1.You are caring for a child who was resuscitated after a
drowning event. The child is intubated and ventilated with
100% oxygen with equal breath sounds and exhaled CO2
detected. The heart rate is slow and the monitor shows sinus
bradycardia. The skin is cool, mottled, and moist; distal pulses
are not palpable and the central pulses are weak. Intravenous
access has been established. The core temperature is 37.3oC.
Based on the PALS bradycardia algorithm, which of the
following should be provided first?
Epinephrine IV
Transcutaneous pacing
Atropine IV
Dobutamine IV infusion
ANS Epinephrine IV
2.You are caring for a 5-year-old patient with supraventricular
tachycardia (heart rate = 220/min). The child is lethargic. The
skin is pale and cool with delayed capillary refill. Distal pulses
are not palpable. Which of the following would be the best
treatment to provide without delay?
Place cold packs on the distal upper and lower
extremities Ask the child to blow through a
,small straw
Exert light pressure on the eyes bilaterally
Provide synchronized cardioversion at 0.5 to 1 J/kg
ANS Provide synchronized car- dioversion at 0.5 to 1 J/kg
3.You are initiating treatment for a child with septic shock and
hypotension. While administering high-flow oxygen you
determine that the child's respi- rations are adequate and
SpO2 is 100%. You have just established vascular access and
obtained blood samples. Which of the following is the next
most appropriate therapy to support systemic perfusion?
Administer repeated fluid boluses of isotonic
colloid Administer repeated fluid boluses of
isotonic crystalloid Begin immediate dopamine
infusion
Begin immediate dobutamine infusion
ANS Administer repeated fluid boluses of iso- tonic crystalloid
4.You are treating an 8-year-old with ventricular tachycardia
with pulses and adequate perfusion. You attempted
synchronized cardioversion without success. While seeking
expert consultation, it would be most appropriate to
Administer a loading dose of milrinone
, Consider possible metabolic and toxicologic causes
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock
ANS Consider possible metabolic and toxicologic causes
5.You are caring for a 2-year-old unconscious patient who is
intubated and receiving mechanical ventilation. The child's
heart rate suddenly drops to 40/min and his color becomes
mottled. You should respond to these changes by
Increasing the
ventilator rate
Increasing tidal volume
Increasing positive end-expiratory pressure (PEEP)
Using a resuscitation bag provide manual ventilation with 100%
oxygen
ANS Using a resuscitation bag provide manual ventilation with 100%
oxygen
6.You are caring for a 9-month-old patient with pronounced
respiratory dis- tress. You initiated high-flow oxygen using a
nonrebreathing mask about 10 minutes ago and established
intravenous access. Initially the infant's heart rate was in the
150/min range with strong pulses. Suddenly the infant's respi-
ratory rate falls to 6/min with significant intercostals
1.You are caring for a child who was resuscitated after a
drowning event. The child is intubated and ventilated with
100% oxygen with equal breath sounds and exhaled CO2
detected. The heart rate is slow and the monitor shows sinus
bradycardia. The skin is cool, mottled, and moist; distal pulses
are not palpable and the central pulses are weak. Intravenous
access has been established. The core temperature is 37.3oC.
Based on the PALS bradycardia algorithm, which of the
following should be provided first?
Epinephrine IV
Transcutaneous pacing
Atropine IV
Dobutamine IV infusion
ANS Epinephrine IV
2.You are caring for a 5-year-old patient with supraventricular
tachycardia (heart rate = 220/min). The child is lethargic. The
skin is pale and cool with delayed capillary refill. Distal pulses
are not palpable. Which of the following would be the best
treatment to provide without delay?
Place cold packs on the distal upper and lower
extremities Ask the child to blow through a
,small straw
Exert light pressure on the eyes bilaterally
Provide synchronized cardioversion at 0.5 to 1 J/kg
ANS Provide synchronized car- dioversion at 0.5 to 1 J/kg
3.You are initiating treatment for a child with septic shock and
hypotension. While administering high-flow oxygen you
determine that the child's respi- rations are adequate and
SpO2 is 100%. You have just established vascular access and
obtained blood samples. Which of the following is the next
most appropriate therapy to support systemic perfusion?
Administer repeated fluid boluses of isotonic
colloid Administer repeated fluid boluses of
isotonic crystalloid Begin immediate dopamine
infusion
Begin immediate dobutamine infusion
ANS Administer repeated fluid boluses of iso- tonic crystalloid
4.You are treating an 8-year-old with ventricular tachycardia
with pulses and adequate perfusion. You attempted
synchronized cardioversion without success. While seeking
expert consultation, it would be most appropriate to
Administer a loading dose of milrinone
, Consider possible metabolic and toxicologic causes
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock
ANS Consider possible metabolic and toxicologic causes
5.You are caring for a 2-year-old unconscious patient who is
intubated and receiving mechanical ventilation. The child's
heart rate suddenly drops to 40/min and his color becomes
mottled. You should respond to these changes by
Increasing the
ventilator rate
Increasing tidal volume
Increasing positive end-expiratory pressure (PEEP)
Using a resuscitation bag provide manual ventilation with 100%
oxygen
ANS Using a resuscitation bag provide manual ventilation with 100%
oxygen
6.You are caring for a 9-month-old patient with pronounced
respiratory dis- tress. You initiated high-flow oxygen using a
nonrebreathing mask about 10 minutes ago and established
intravenous access. Initially the infant's heart rate was in the
150/min range with strong pulses. Suddenly the infant's respi-
ratory rate falls to 6/min with significant intercostals
