PALS Pre-Test With Complete Solution Graded
A
You are called to help treat an infant with severe symptomatic bradycardia (heart rate 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? Correct Answers: Epinephrine
Initial impression of a 2yo girl shows her to be alert with mild breathing difficulty during inspiration and
pale skin color. On primary assessment, she makes high-pitched inspiratory sounds (mild stridor)
when agitated; otherwise, her breathing is quiet. Her spO2 is 92% on room air, and she has mild
inspiratory intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with
adequate distal breath sounds bilaterally. Which is the most appropriate initial intervention for this
child? Correct Answers: Humidified oxygen as tolerated
You are 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?
Correct Answers: Amiodarone 5 mg/kg IO
Which statement is correct about the effects of epinephrine during attempted resuscitation? Correct
Answers: Epinephrine stimulates spontaneous contractions when asystole is present
A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency
department by her parents. During your assessment, you find that the infant responds only to painful
stimulation. Correct Answers: Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes,
and also give D25W 2-4 ml/kg IV
Which statement is correct about endotracheal drug administration during resuscitative efforts for
pediatric patients? Correct Answers: It is the least desirable route of administration
Which statement is correct about the use of calcium chloride in pediatric patients? Correct Answers:
Routine administration is not indicated during cardiac arrest
A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. Correct
Answers: Albuterol
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired
oxygen to a 7yo child? Correct Answers: Nonrebreathing face mask
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 Correct Answers: Rapid bolus of 20ml/kg of isotonic
crystalloid
A
You are called to help treat an infant with severe symptomatic bradycardia (heart rate 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? Correct Answers: Epinephrine
Initial impression of a 2yo girl shows her to be alert with mild breathing difficulty during inspiration and
pale skin color. On primary assessment, she makes high-pitched inspiratory sounds (mild stridor)
when agitated; otherwise, her breathing is quiet. Her spO2 is 92% on room air, and she has mild
inspiratory intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with
adequate distal breath sounds bilaterally. Which is the most appropriate initial intervention for this
child? Correct Answers: Humidified oxygen as tolerated
You are 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?
Correct Answers: Amiodarone 5 mg/kg IO
Which statement is correct about the effects of epinephrine during attempted resuscitation? Correct
Answers: Epinephrine stimulates spontaneous contractions when asystole is present
A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency
department by her parents. During your assessment, you find that the infant responds only to painful
stimulation. Correct Answers: Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes,
and also give D25W 2-4 ml/kg IV
Which statement is correct about endotracheal drug administration during resuscitative efforts for
pediatric patients? Correct Answers: It is the least desirable route of administration
Which statement is correct about the use of calcium chloride in pediatric patients? Correct Answers:
Routine administration is not indicated during cardiac arrest
A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. Correct
Answers: Albuterol
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired
oxygen to a 7yo child? Correct Answers: Nonrebreathing face mask
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 Correct Answers: Rapid bolus of 20ml/kg of isotonic
crystalloid
