AHA PALS PRACTICE EXAM 2023
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale color.
The primary assessment reveals that the airway is open and the respiratory rate is
30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of
95% and a pulse rate of 93/min. On the basis of this information, which of the following
provides the best interpretation of the oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary oxygen
should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered - ✔Unreliable;
supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been treated with
chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min,
respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is less
than 2 seconds. What is the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock - ✔Septic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding. Blood
pressure is 55/40 mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated - ✔Hypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of epinephrine
at 0.1 mg/kg to be given 10. What should the team member do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug - ✔Respectfully ask the team leader to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds - ✔Inadequate oxygenation and/or ventilation
6. Which of the following is most likely to produce a prolonged expiratory phase and
wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
, AHA PALS PRACTICE EXAM 2023
D. Upper airway obstruction - ✔Lower airway obstruction
7. A 4-year-old child presents with seizures and irregular respirations. The seizures
stopped a few minutes ago. Which of the following most likely to be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing - ✔Control of breathing
8. 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 - ✔Decreased oxygen saturation
9. 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
B. Respiratory arrest
C. Respiratory failure
D. Disordered control of breathing - ✔Respiratory distress
10. 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 - ✔Obtain vascular access
and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
11. 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
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale color.
The primary assessment reveals that the airway is open and the respiratory rate is
30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of
95% and a pulse rate of 93/min. On the basis of this information, which of the following
provides the best interpretation of the oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary oxygen
should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered - ✔Unreliable;
supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been treated with
chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min,
respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is less
than 2 seconds. What is the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock - ✔Septic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding. Blood
pressure is 55/40 mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated - ✔Hypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of epinephrine
at 0.1 mg/kg to be given 10. What should the team member do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug - ✔Respectfully ask the team leader to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds - ✔Inadequate oxygenation and/or ventilation
6. Which of the following is most likely to produce a prolonged expiratory phase and
wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
, AHA PALS PRACTICE EXAM 2023
D. Upper airway obstruction - ✔Lower airway obstruction
7. A 4-year-old child presents with seizures and irregular respirations. The seizures
stopped a few minutes ago. Which of the following most likely to be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing - ✔Control of breathing
8. 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 - ✔Decreased oxygen saturation
9. 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
B. Respiratory arrest
C. Respiratory failure
D. Disordered control of breathing - ✔Respiratory distress
10. 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 - ✔Obtain vascular access
and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
11. 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
