PALS HEARTCODE 2025 EXAM, PRACTICE EXAM AND
STUDY GUIDE NEWEST 400 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
The infant is placed on the ambulance stretcher and responds with a groan when
stimulated and has a temperature of 36.3 C (97.3 F) - ANSWER: -Monitor and
support ABCs
-Establish IV/IO access
-Monitor heart rate, blood pressure, and pulse oximetry
-Call for assistance if needed
When you evaluate the patient, you find the lungs are clear, skin is cool and mottled,
glucose is 97 mg/dL and capillary refill time is 5 seconds. What are the warning signs
that the patient is progressing from compensated shock to hypotensive shock? -
ANSWER: -Hypotension (late sign)
-Increasing tachycardia
The patient still has a blood pressure of 58/38 mm Hg. Her condition would be
classified as ___________ shock. - ANSWER: Hypotensive
What should be included in the initial treatment for this patient? - ANSWER: -Rapid
fluid bolus administration
-Establishing IV/IO access
The mother does not recall the infant's most recent weight. What is the most
appropriate way to rapidly determine her weight and calculate correct medication? -
ANSWER: Measure her by using color-coded length-based tape
You measure the infant to be 7 kg and prepare to administer a fluid bolus of what
type? - ANSWER: Normal saline 20 mL/kg
What is the most appropriate method of delivering rapid fluid boluses to this
patient? - ANSWER: A syringe and 3-way stopcock
After the first fluid bolus is administered, the child is reassessed and her vital signs
are HR 167, BP 58/44 mm Hg, RR 56/min and SpO2 92%. Her skin is still cool and pale
and she is still lethargic and weak.
What should be the next intervention? - ANSWER: Deliver a second fluid bolus of 20
mL/kg and reassess
When should vasoactive therapy be considered be considered in managing
distributive shock? - ANSWER: If the child remains hypotensive and poorly perfused
despite rapid bolus fluid administration
, How does the clinical presentation of distributive shock compare with hypovolemic
shock? - ANSWER: Distributive shock has more variable presentation than that of
hypovolemic shock
For general shock management, administer an isotonic crytalloid bolus of __ mL/kg
over __ to __ minutes - ANSWER: For general shock management, administer an
isotonic crytalloid bolus of 20 mL/kg over 5 to 20 minutes
What signs distinguish anaphylactic shock from other types of shock? - ANSWER: -
Angioedema (swelling of the face, lips and tongue)
-Urticaria (hives)
-Respiratory distress with stridor, wheezing or both
in a child with anaphylactic shock, what is the most appropriate initial treatment? -
ANSWER: IM epinephrine
How soon after exposure do symptoms typically occur in anaphylactic shock? -
ANSWER: Seconds to minutes
What should you evaluate to recognize septic shock? - ANSWER: -Temp
-Heart rate
-Systemic perfusion
-Blood pressure
-Clinical signs of end-organ perfusion
When should antibiotics be administered in septic shock? - ANSWER: Within the first
hour
What are the initial assessment findings for septic shock? - ANSWER: -Fever
-Hypothermia
-Normal, elevated or decreased WBC
For septic shock, how soon should fluid resuscitation begin? - ANSWER: Within 10 to
15 minutes after recognizing shock
What is the recommendation for fluid bolus of isotonic crystalloids in cardiogenic
shock? - ANSWER: 5 to 10 mL/kg over 10 to 20 minutes
What is the focus of the initial management of distributive shock? - ANSWER: -
Correcting hypovolemia
-Filling expanded dilated vascular space
-Expanding intravascular volume
What are causes of obstructive shock? - ANSWER: -Pulmonary embolus
-Tension pneumothorax
-Congenital heart defects
STUDY GUIDE NEWEST 400 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
The infant is placed on the ambulance stretcher and responds with a groan when
stimulated and has a temperature of 36.3 C (97.3 F) - ANSWER: -Monitor and
support ABCs
-Establish IV/IO access
-Monitor heart rate, blood pressure, and pulse oximetry
-Call for assistance if needed
When you evaluate the patient, you find the lungs are clear, skin is cool and mottled,
glucose is 97 mg/dL and capillary refill time is 5 seconds. What are the warning signs
that the patient is progressing from compensated shock to hypotensive shock? -
ANSWER: -Hypotension (late sign)
-Increasing tachycardia
The patient still has a blood pressure of 58/38 mm Hg. Her condition would be
classified as ___________ shock. - ANSWER: Hypotensive
What should be included in the initial treatment for this patient? - ANSWER: -Rapid
fluid bolus administration
-Establishing IV/IO access
The mother does not recall the infant's most recent weight. What is the most
appropriate way to rapidly determine her weight and calculate correct medication? -
ANSWER: Measure her by using color-coded length-based tape
You measure the infant to be 7 kg and prepare to administer a fluid bolus of what
type? - ANSWER: Normal saline 20 mL/kg
What is the most appropriate method of delivering rapid fluid boluses to this
patient? - ANSWER: A syringe and 3-way stopcock
After the first fluid bolus is administered, the child is reassessed and her vital signs
are HR 167, BP 58/44 mm Hg, RR 56/min and SpO2 92%. Her skin is still cool and pale
and she is still lethargic and weak.
What should be the next intervention? - ANSWER: Deliver a second fluid bolus of 20
mL/kg and reassess
When should vasoactive therapy be considered be considered in managing
distributive shock? - ANSWER: If the child remains hypotensive and poorly perfused
despite rapid bolus fluid administration
, How does the clinical presentation of distributive shock compare with hypovolemic
shock? - ANSWER: Distributive shock has more variable presentation than that of
hypovolemic shock
For general shock management, administer an isotonic crytalloid bolus of __ mL/kg
over __ to __ minutes - ANSWER: For general shock management, administer an
isotonic crytalloid bolus of 20 mL/kg over 5 to 20 minutes
What signs distinguish anaphylactic shock from other types of shock? - ANSWER: -
Angioedema (swelling of the face, lips and tongue)
-Urticaria (hives)
-Respiratory distress with stridor, wheezing or both
in a child with anaphylactic shock, what is the most appropriate initial treatment? -
ANSWER: IM epinephrine
How soon after exposure do symptoms typically occur in anaphylactic shock? -
ANSWER: Seconds to minutes
What should you evaluate to recognize septic shock? - ANSWER: -Temp
-Heart rate
-Systemic perfusion
-Blood pressure
-Clinical signs of end-organ perfusion
When should antibiotics be administered in septic shock? - ANSWER: Within the first
hour
What are the initial assessment findings for septic shock? - ANSWER: -Fever
-Hypothermia
-Normal, elevated or decreased WBC
For septic shock, how soon should fluid resuscitation begin? - ANSWER: Within 10 to
15 minutes after recognizing shock
What is the recommendation for fluid bolus of isotonic crystalloids in cardiogenic
shock? - ANSWER: 5 to 10 mL/kg over 10 to 20 minutes
What is the focus of the initial management of distributive shock? - ANSWER: -
Correcting hypovolemia
-Filling expanded dilated vascular space
-Expanding intravascular volume
What are causes of obstructive shock? - ANSWER: -Pulmonary embolus
-Tension pneumothorax
-Congenital heart defects
