PALS: Exam Practice Questions Solved to
Score A+
compression to breath ratio children with 1 rescuer - Answer 30:2
2 rescuer compression to breath ratio? - Answer 15:2
Initial impression of a 2-year-old girl shows her to be alert with mild breathing difficulty during
inspiration and pale skin color. On primary assessment, she makes high pitched inspiratory sound (mild
stridor) when agitated; otherwise, intercoastal retractions. Lung auscultation reveals transmitted upper
airway sounds with adequate distal breath sounds bilaterally. Which is the most appropriate initial
intervention for this child? - Answer humidified oxygen as tolerated
Which statement is correct about use of calcium chloride in pediatric? - Answer Routine administration
is not indicated during cardiac arrest
Which statement is correct about endotracheal drug administration during resuscitative efforts for
pediatric patients? - Answer It is the least desirable route of administration
You are a part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You
delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of
epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You
administer a 4-J/kg shock and resume CPR. Which drug and dose should be administered next? - Answer
Amiodarone 5 mg/kg
You are called to help treat an infant with severe symptomatic bradycardia (HR 66/min) associated with
respiratory distress. The bradycardia persists despite establishment of an effective airway, oxygenation,
and ventilation. There is no heart block present. Which is the first drug you should administer? - Answer
Epinephrine
Which statement is correct about the effects of epinephrine during attempted resuscitation? - Answer
Epinephrine stimulates spontaneous contractions when asystole is present
, Paramedics are called to the home of a 1yo child. Their initial assessment reveals a child who responds
only to painful stimuli and has irregular breathing, faint central pulses, bruises over the abdomen,
abdominal distention, and cyanosis. Bag-mask ventilation with 100% oxygen is initiated. The child's heart
rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely palpable. The cardiac
monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the emergency
department, the child is intubated and ventilated with 100% oxygen, and IV access is established. The
heart rate is now 150/min with weak central pulses but no distal pulses. Systolic blood pressure is 74
mmHg. Which intervention should be provided next? - Answer Rapid bolus of 20 ml/kg of isotonic
crystalloid
A 9-year old boy is agitated and leaning forward on the bed in obvious respiratory distress. The patient is
speaking in short phrases and tells you that he has asthma but does not carry an inhaler. He has nasal
flaring, severe suprasternal and intercoastal retractions, and decreased air movement with prolonged
expiratory time and wheezing. You administer 100% oxygen by a NRB mask. His SpO2 is 92%. Which
medication do you prepare to give to this patient? - Answer Albuterol
A previously healthy infant with a history of vomiting and diarrhea is brought to the ER by her parents.
During your assessment, you find that the infant responds only to painful stimulation. The infant's RR is
40/min, and central pulses are rapid and weak. The infant has good bilateral breath sounds, cool
extremities, and a capillary refill time of ore than 5 seconds. The infant's blood pressure is 85/65 mmHg,
and glucose is 30 mg/dL (1.56 mmol/L). You administer 100% oxygen via facemsk and start an IV. Which
treatment is the most appropriate for this infant? - Answer Administer a bolus of isotonic crystalloid 20
ml/kg over 5-20 minutes, and also give D25W to 4 ml/kg IV
How can rescuers ensure that they are providing effective breaths when using a bag-mask device? -
Answer By observing the chest rise with each breath
You need to provide rescue breaths to a child victim with a pulse. What is the appropriate rate for
delivering breaths? - Answer 1 breath every 3 to 5 seconds
You just assisted with elective endotracheal intubation of a child with respiratory failure and perfusing
rhythm. Which provide reliable , prompt assessment of correct endotracheal tube placement in this
child? - Answer Adequate bilateral breath sounds and chest expansion plus detection of ETCO2 with
waveform capnography.
An 18 month-old child has 1 week history of cough and runny nose. The child has diffuse cyanosis and
responsive only to painful stimulation with slow respirations and rapid central pulses. The child's
respiratory has decreased from 65/min to 10/min, severe inspiratory intercoastal retractions are
Score A+
compression to breath ratio children with 1 rescuer - Answer 30:2
2 rescuer compression to breath ratio? - Answer 15:2
Initial impression of a 2-year-old girl shows her to be alert with mild breathing difficulty during
inspiration and pale skin color. On primary assessment, she makes high pitched inspiratory sound (mild
stridor) when agitated; otherwise, intercoastal retractions. Lung auscultation reveals transmitted upper
airway sounds with adequate distal breath sounds bilaterally. Which is the most appropriate initial
intervention for this child? - Answer humidified oxygen as tolerated
Which statement is correct about use of calcium chloride in pediatric? - Answer Routine administration
is not indicated during cardiac arrest
Which statement is correct about endotracheal drug administration during resuscitative efforts for
pediatric patients? - Answer It is the least desirable route of administration
You are a part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You
delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of
epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You
administer a 4-J/kg shock and resume CPR. Which drug and dose should be administered next? - Answer
Amiodarone 5 mg/kg
You are called to help treat an infant with severe symptomatic bradycardia (HR 66/min) associated with
respiratory distress. The bradycardia persists despite establishment of an effective airway, oxygenation,
and ventilation. There is no heart block present. Which is the first drug you should administer? - Answer
Epinephrine
Which statement is correct about the effects of epinephrine during attempted resuscitation? - Answer
Epinephrine stimulates spontaneous contractions when asystole is present
, Paramedics are called to the home of a 1yo child. Their initial assessment reveals a child who responds
only to painful stimuli and has irregular breathing, faint central pulses, bruises over the abdomen,
abdominal distention, and cyanosis. Bag-mask ventilation with 100% oxygen is initiated. The child's heart
rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely palpable. The cardiac
monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the emergency
department, the child is intubated and ventilated with 100% oxygen, and IV access is established. The
heart rate is now 150/min with weak central pulses but no distal pulses. Systolic blood pressure is 74
mmHg. Which intervention should be provided next? - Answer Rapid bolus of 20 ml/kg of isotonic
crystalloid
A 9-year old boy is agitated and leaning forward on the bed in obvious respiratory distress. The patient is
speaking in short phrases and tells you that he has asthma but does not carry an inhaler. He has nasal
flaring, severe suprasternal and intercoastal retractions, and decreased air movement with prolonged
expiratory time and wheezing. You administer 100% oxygen by a NRB mask. His SpO2 is 92%. Which
medication do you prepare to give to this patient? - Answer Albuterol
A previously healthy infant with a history of vomiting and diarrhea is brought to the ER by her parents.
During your assessment, you find that the infant responds only to painful stimulation. The infant's RR is
40/min, and central pulses are rapid and weak. The infant has good bilateral breath sounds, cool
extremities, and a capillary refill time of ore than 5 seconds. The infant's blood pressure is 85/65 mmHg,
and glucose is 30 mg/dL (1.56 mmol/L). You administer 100% oxygen via facemsk and start an IV. Which
treatment is the most appropriate for this infant? - Answer Administer a bolus of isotonic crystalloid 20
ml/kg over 5-20 minutes, and also give D25W to 4 ml/kg IV
How can rescuers ensure that they are providing effective breaths when using a bag-mask device? -
Answer By observing the chest rise with each breath
You need to provide rescue breaths to a child victim with a pulse. What is the appropriate rate for
delivering breaths? - Answer 1 breath every 3 to 5 seconds
You just assisted with elective endotracheal intubation of a child with respiratory failure and perfusing
rhythm. Which provide reliable , prompt assessment of correct endotracheal tube placement in this
child? - Answer Adequate bilateral breath sounds and chest expansion plus detection of ETCO2 with
waveform capnography.
An 18 month-old child has 1 week history of cough and runny nose. The child has diffuse cyanosis and
responsive only to painful stimulation with slow respirations and rapid central pulses. The child's
respiratory has decreased from 65/min to 10/min, severe inspiratory intercoastal retractions are
