PALS Test Practice Questions and Answers
2023 (100% Verified Answers by Expert)
You are caring for a child who was resuscitated after a drowning event. The child is intubated &
ventilated with 100% oxygen with equal breath sounds & exhaled C02 detected. The HR is slow & the
monitor shows sinus bradycardia. The skin is cool, mottled, & moist; distal pulses are not palpable &
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
You are caring for a 5 yo patient with SVT. The child is lethargic. The skin is pale & cool with delayed
capillary refill. Distal pulses are not palpable. Which of the following would be the best treatment to
provide without delay?
Provide synchronized cardioversion at 0.5 to 1 J/kg
You are initiating treatment for a child with septic shock & hypotension. While administering high-
flow oxygen you determine that the child's respirations are adequate & Sp02 is 100%. You have just
established vascular access & obtained blood samples. Which of the following is the next most
appropriate therapy to support systemic perfusion?
Administer repeated fluid boluses of isotonic crystalloid
You are treating an 8 yo with ventricular tachycardia with pulses & adequate perfusion. You
attempted synchronized cardioversion without success. While seeking expert consultation, it would
be most appropriate to:
Consider possible metabolic & toxicologic causes
You are caring for a 2 yo unconscious pt who is intubated & receiving mechanical ventilation. The
child's HR suddenly drops to 40/min & his color becomes mottled. You should respond to these
changes by:
Using a resuscitation bag provide manual ventilation with 100% oxygen
You are caring for a 9 mo pt with pronounced respiratory distress. You initiated high-flow oxygen
using a nonrebreathing mask about 10 minutes ago & established IV access. Initially the infant's HR
was in the 150/min range with strong pulses. Suddenly the infant's respiratory rate falls to 6/min with
significant intercostal retractions, & little air movement is heard. The infant becomes cyanotic & the
HR decreases to 95/min. Which of the following treatments would be best for you to provide now?
Provide BMV
Which of the following is likely to be the most helpful technique to ID potentially reversible metabolic
& toxic causes during the attempted resuscitation of a young child in cardiac arrest?
Soliciting a history from the caregiver or family
You are caring for a pt who developed a tension pneumothorax after several hours of positive-
pressure ventilation. Which of the following would be the most appropriate site for needle
decompression?
Over the third rib at the midclavicular line
You attempted synchronized cardioversion for an infant with SVT & poor perfusion. The SVT persists
after the initial 1 J/kg shock. Which of the following should you attempt now?
, Synchronized cardioversion at a dose of 2 J/kg
You are treating a 5 mo with a 2 day history of vomiting & diarrhea. The pt is listless. The RR is 52/min
& unlabored. The HR is 170/min & pulses are present but weak. Capillary refill is delayed. You are
administering high-flow oxygen, & IV access is in place. At this point the most important therapy is to:
Provide a rapid 20 mL/kg isotonic crystalloid fluid bolus
Which of the following groups of clinical findings would be most consistent with categorizing a pt with
compensated shock?
Normal SBP, decreased level of consciousness, cool extremities with delayed capillary refill, & faint or
non-palpable distal pulses
You are treating a 10 yo pt after a MVC. The pt is unresponsive & flexes his arms at the elbow in
response to a painful stimulus. An ETT is in place with position confirmed. You are ventilating using a
resuscitation bag with oxygen, & the child has an Sp02 of 95% & good chest excursion bilaterally. The
BP is 130/70 mmHg, & the HR is 90/min with good perfusion. You have established IV access. Which
of the following actions would be most appropriate at this time?
Obtain a CT scan of the head and neck
You arrive on the scene of a 12 yo child who suddenly collapsed on the playground. The child is
unresponsive, apneic, & pulseless & CPR is in progress. a lay rescuer just brought the school AED,
turned it on, & attached it. The AED recommends a shock. Which of the following should be done
next?
Attempt defibrillation
You are caring for a child in persistent ventricular fibrillation. Which of the following would be best
describe the child's cardiac condition?
The heart is not pumping blood at all
You are called to treat a 5 yo with a 3 day history of worsening respiratory distress. The child responds
only to pain. The HR is initially 45/min & regular with poor capillary refill. You provide BMB with high-
flow oxygen that produces good chest rise with full & clear bilateral breath sounds. The HR rises in
response to ventilation, but after you suction the posterior pharynx, bradycardia recurs (40/min).
Which of the following interventions would be most appropriate for you to do first?
Resume BMV
You are caring for an 8 mo withe bradycardia & very poor perfusion that has persisted despite
effective ventilations with high-flow oxygen. You should begin chest compressions if the HR is:
Less than 60/min
You are caring for a 2 yo with a 1 day history of respiratory distress & stridor. The pt is alert. The
child's RR is 32/min with good chest rise. Sp02 is 98% in room air. The HR is 128/min & capillary refill
is normal. Skin is warm, pink, & dry. At this point you should:
Keep the pt calm & comfortable
You are caring for a 7 yo with respiratory distress that has worsened over the past few hours. The
child is alert & in moderate respiratory with prolonged exhalation time. The RR is 28/min with
2023 (100% Verified Answers by Expert)
You are caring for a child who was resuscitated after a drowning event. The child is intubated &
ventilated with 100% oxygen with equal breath sounds & exhaled C02 detected. The HR is slow & the
monitor shows sinus bradycardia. The skin is cool, mottled, & moist; distal pulses are not palpable &
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
You are caring for a 5 yo patient with SVT. The child is lethargic. The skin is pale & cool with delayed
capillary refill. Distal pulses are not palpable. Which of the following would be the best treatment to
provide without delay?
Provide synchronized cardioversion at 0.5 to 1 J/kg
You are initiating treatment for a child with septic shock & hypotension. While administering high-
flow oxygen you determine that the child's respirations are adequate & Sp02 is 100%. You have just
established vascular access & obtained blood samples. Which of the following is the next most
appropriate therapy to support systemic perfusion?
Administer repeated fluid boluses of isotonic crystalloid
You are treating an 8 yo with ventricular tachycardia with pulses & adequate perfusion. You
attempted synchronized cardioversion without success. While seeking expert consultation, it would
be most appropriate to:
Consider possible metabolic & toxicologic causes
You are caring for a 2 yo unconscious pt who is intubated & receiving mechanical ventilation. The
child's HR suddenly drops to 40/min & his color becomes mottled. You should respond to these
changes by:
Using a resuscitation bag provide manual ventilation with 100% oxygen
You are caring for a 9 mo pt with pronounced respiratory distress. You initiated high-flow oxygen
using a nonrebreathing mask about 10 minutes ago & established IV access. Initially the infant's HR
was in the 150/min range with strong pulses. Suddenly the infant's respiratory rate falls to 6/min with
significant intercostal retractions, & little air movement is heard. The infant becomes cyanotic & the
HR decreases to 95/min. Which of the following treatments would be best for you to provide now?
Provide BMV
Which of the following is likely to be the most helpful technique to ID potentially reversible metabolic
& toxic causes during the attempted resuscitation of a young child in cardiac arrest?
Soliciting a history from the caregiver or family
You are caring for a pt who developed a tension pneumothorax after several hours of positive-
pressure ventilation. Which of the following would be the most appropriate site for needle
decompression?
Over the third rib at the midclavicular line
You attempted synchronized cardioversion for an infant with SVT & poor perfusion. The SVT persists
after the initial 1 J/kg shock. Which of the following should you attempt now?
, Synchronized cardioversion at a dose of 2 J/kg
You are treating a 5 mo with a 2 day history of vomiting & diarrhea. The pt is listless. The RR is 52/min
& unlabored. The HR is 170/min & pulses are present but weak. Capillary refill is delayed. You are
administering high-flow oxygen, & IV access is in place. At this point the most important therapy is to:
Provide a rapid 20 mL/kg isotonic crystalloid fluid bolus
Which of the following groups of clinical findings would be most consistent with categorizing a pt with
compensated shock?
Normal SBP, decreased level of consciousness, cool extremities with delayed capillary refill, & faint or
non-palpable distal pulses
You are treating a 10 yo pt after a MVC. The pt is unresponsive & flexes his arms at the elbow in
response to a painful stimulus. An ETT is in place with position confirmed. You are ventilating using a
resuscitation bag with oxygen, & the child has an Sp02 of 95% & good chest excursion bilaterally. The
BP is 130/70 mmHg, & the HR is 90/min with good perfusion. You have established IV access. Which
of the following actions would be most appropriate at this time?
Obtain a CT scan of the head and neck
You arrive on the scene of a 12 yo child who suddenly collapsed on the playground. The child is
unresponsive, apneic, & pulseless & CPR is in progress. a lay rescuer just brought the school AED,
turned it on, & attached it. The AED recommends a shock. Which of the following should be done
next?
Attempt defibrillation
You are caring for a child in persistent ventricular fibrillation. Which of the following would be best
describe the child's cardiac condition?
The heart is not pumping blood at all
You are called to treat a 5 yo with a 3 day history of worsening respiratory distress. The child responds
only to pain. The HR is initially 45/min & regular with poor capillary refill. You provide BMB with high-
flow oxygen that produces good chest rise with full & clear bilateral breath sounds. The HR rises in
response to ventilation, but after you suction the posterior pharynx, bradycardia recurs (40/min).
Which of the following interventions would be most appropriate for you to do first?
Resume BMV
You are caring for an 8 mo withe bradycardia & very poor perfusion that has persisted despite
effective ventilations with high-flow oxygen. You should begin chest compressions if the HR is:
Less than 60/min
You are caring for a 2 yo with a 1 day history of respiratory distress & stridor. The pt is alert. The
child's RR is 32/min with good chest rise. Sp02 is 98% in room air. The HR is 128/min & capillary refill
is normal. Skin is warm, pink, & dry. At this point you should:
Keep the pt calm & comfortable
You are caring for a 7 yo with respiratory distress that has worsened over the past few hours. The
child is alert & in moderate respiratory with prolonged exhalation time. The RR is 28/min with
