PALS TEST QUESTIONS AND ANSWERS 2025
COMPREHENSIVE ASSESSMENT
◉ What are the signs of increased respiratory effort that can lead to
fatigue & respiratory failure? Answer: Nasal flaring
Retractions
Head bobbing
Seesaw respirations
◉ Determine the respiratory rate by counting the number of times the
chest rises in [blank] seconds & multiplying by [blank]. Answer: 30
2
◉ Tachypnea is often the first sign of respiratory [blank] in infants.
Answer: Distress
◉ What do central chemoreceptors respond to? Answer: Hydrogen ions
in the cerebrospinal fluid
◉ Why may excessive ventilation during CPR be harmful? Answer: It
impedes venous return
It increases intrathoracic pressure
,◉ What should you do if you cannot achieve effective ventilation with a
bag-mask device? Answer: Reposition the airway
Verify the mask size
◉ How are effective oxygenation & ventilation assessed? Answer:
Oxygen saturation
Exhaled carbon dioxide
Visible chest rise w/ each breath
◉ How can gastric inflation impair bag-mask ventilation? Answer: It
decreases lung compliance
◉ What is the most appropriate precautionary action to minimize gastric
inflation during a bag-mask ventilation? Answer: Deliver each breath
over about 1 second
◉ Which is true about the difference between hypoxemia & tissue
hypoxia? Answer: Tissue hypoxia can occur with normal arterial oxygen
saturation
◉ What does hyperventilation, which refers to increased alveolar
ventilation, result in? Answer: PaCO2 less than 35 mm Hg
,◉ What happens to the arterial oxygen level in a child w/ severe
anemia? Answer: May increase when dissolved oxygen is increased
◉ Which is true of increased carbon dioxide tension in arterial blood?
Answer: May be caused by disordered control of breathing
◉ What happens when ventilation is inadequate? Answer: PaCO2
increases
◉ What is a critical symptom of hypercarbia? Answer: Decreased level
of consciousness
◉ Which of the following indicates mild respiratory distress? Answer:
Mild increase in respiratory effort
◉ Which of the following indicates severe respiratory distress? Answer:
Marked tachypnea &/or apnea
◉ Which of the following statements about respiratory failure is true?
Answer: May occur w/o signs of respiratory distress
◉ Which is most likely to be present in a child who has respiratory
distress [not respiratory failure]? Answer: Ability to maintain a patent
airway
, ◉ What steps should be taken as part of initial management of a child in
respiratory distress? Answer: Support an open airway
Monitor O2 saturation by pulse oximetry
Monitor heart rate, rhythm, & bp
◉ Which are ideal characteristics of face masks for ventilation? Answer:
Covers mouth & nose
Has a soft rim
Transparent
◉ What is the rationale for using a transparent mask? Answer: Allows
you to see the color of the child's lips
◉ What is the function of the nonrebreathing outlet valve of a self-
inflating bag? Answer: Prevents rebreathing of carbon dioxide
◉ Which of the following is required to appropriately ventilate a child
with a flow-inflating bag? Answer: Tidal volume needs to be delivered at
the correct rate
◉ What should be checked to ensure proper function of a bag-mask
system? Answer: The pop-off valve can be closed
Oxygen tubing is connected to the device & the oxygen source
COMPREHENSIVE ASSESSMENT
◉ What are the signs of increased respiratory effort that can lead to
fatigue & respiratory failure? Answer: Nasal flaring
Retractions
Head bobbing
Seesaw respirations
◉ Determine the respiratory rate by counting the number of times the
chest rises in [blank] seconds & multiplying by [blank]. Answer: 30
2
◉ Tachypnea is often the first sign of respiratory [blank] in infants.
Answer: Distress
◉ What do central chemoreceptors respond to? Answer: Hydrogen ions
in the cerebrospinal fluid
◉ Why may excessive ventilation during CPR be harmful? Answer: It
impedes venous return
It increases intrathoracic pressure
,◉ What should you do if you cannot achieve effective ventilation with a
bag-mask device? Answer: Reposition the airway
Verify the mask size
◉ How are effective oxygenation & ventilation assessed? Answer:
Oxygen saturation
Exhaled carbon dioxide
Visible chest rise w/ each breath
◉ How can gastric inflation impair bag-mask ventilation? Answer: It
decreases lung compliance
◉ What is the most appropriate precautionary action to minimize gastric
inflation during a bag-mask ventilation? Answer: Deliver each breath
over about 1 second
◉ Which is true about the difference between hypoxemia & tissue
hypoxia? Answer: Tissue hypoxia can occur with normal arterial oxygen
saturation
◉ What does hyperventilation, which refers to increased alveolar
ventilation, result in? Answer: PaCO2 less than 35 mm Hg
,◉ What happens to the arterial oxygen level in a child w/ severe
anemia? Answer: May increase when dissolved oxygen is increased
◉ Which is true of increased carbon dioxide tension in arterial blood?
Answer: May be caused by disordered control of breathing
◉ What happens when ventilation is inadequate? Answer: PaCO2
increases
◉ What is a critical symptom of hypercarbia? Answer: Decreased level
of consciousness
◉ Which of the following indicates mild respiratory distress? Answer:
Mild increase in respiratory effort
◉ Which of the following indicates severe respiratory distress? Answer:
Marked tachypnea &/or apnea
◉ Which of the following statements about respiratory failure is true?
Answer: May occur w/o signs of respiratory distress
◉ Which is most likely to be present in a child who has respiratory
distress [not respiratory failure]? Answer: Ability to maintain a patent
airway
, ◉ What steps should be taken as part of initial management of a child in
respiratory distress? Answer: Support an open airway
Monitor O2 saturation by pulse oximetry
Monitor heart rate, rhythm, & bp
◉ Which are ideal characteristics of face masks for ventilation? Answer:
Covers mouth & nose
Has a soft rim
Transparent
◉ What is the rationale for using a transparent mask? Answer: Allows
you to see the color of the child's lips
◉ What is the function of the nonrebreathing outlet valve of a self-
inflating bag? Answer: Prevents rebreathing of carbon dioxide
◉ Which of the following is required to appropriately ventilate a child
with a flow-inflating bag? Answer: Tidal volume needs to be delivered at
the correct rate
◉ What should be checked to ensure proper function of a bag-mask
system? Answer: The pop-off valve can be closed
Oxygen tubing is connected to the device & the oxygen source
