HEART PALS EXAM WITH QUESTIONS AND
ANSWERS
Which of the following groups of clinical findings would be most consistent with
categorizing a patient with compensated shock?
Decreased level of consciousness, extensor posturing in response to pain,
hypertension, and apnea
Normal systolic blood pressure, decreased level of consciousness, cool extremities with
delayed capillary refill, and faint or nonpalpable distal pulsesd.
Normal blood pressure, normal level of consciousness, bounding distal pulses,
hypercarbia, hypoxemia, and normal urine output
Unresponsiveness, normal breathing, and good distal pulses - CORRECT ANSWER
Normal systolic blood pressure, decreased level of consciousness, cool extremities with
delayed capillary refill, and faint or nonpalpable distal pulsesd.
You are treating a 10-year-old patient after a motor vehicle crash. The patient is
unresponsive and flexes his arms at the elbow in response to a painful stimulus. An
endotracheal tube is in place with position confirmed. You are ventilating using a
resuscitation bag with oxygen, and the child has an Spot of 95% and good chest
excursion bilaterally. Blood pressure is 130/70 mm Hg and heart rate is 90/min with
good perfusion. You have established intravenous access. Which of the following
actions would be most appropriate at this time?
Give an intravenous bolus of mannitol
Provide continuous positive airway pressure (CPAP)
Obtain a CT scan of the head and neck
Begin manual hyperventilation - CORRECT ANSWER Obtain a CT scan of the head
and neck
You arrive on the scene where a 12-year-old child has suddenly collapsed on the
playground. The child is unresponsive, apneic, and pulseless, and CPR is in progress.
A lay rescuer just arrived with the school AED, turned it on, and attached it. The AED
recommends a shock. Which of the following should be done next?
Attempt endotracheal intubation
Obtain intravenous access
Attempt defibrillation
Change the compression-to-ventilation ratio from 30:2 to 15:2 - CORRECT ANSWER
Attempt defibrillation
You are caring for a child in persistent VF. Which of the following would best describe
the child's cardiac condition?
, The heart is not pumping blood at all
The heart is beating too slowly to maintain circulation
There is no electrical activity in the heart
The heart is pumping so fast that it cannot fill completely between beats - CORRECT
ANSWER The heart is not pumping blood at all
You are called to treat a 5-year-old with a 3-day history of worsening respiratory
distress. The child responds only to pain. The heart rate is initially 45/min and regular
with poor capillary refill. You provide bag-mask ventilation with high-flow oxygen, which
produces good chest rise with full and clear bilateral breath sounds. The heart rate 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?
Perform transcutaneous pacing
Resume bag-mask ventilation
Administer epinephrine IV
Administer atropine IV - CORRECT ANSWER Resume bag-mask ventilation
You are caring for a 7-year-old with respiratory distress that has worsened over the past
few hours. The child is alert and in moderate respiratory distress with prolonged
exhalation time. The respiratory rate is 28/min with bilateral expiratory wheezes. The
heart rate is 112/min with good capillary refill. The wheezing in this patient indicates:
Disordered control of breathing
Lung tissue (parenchymal) lung disease
Lower airway obstruction
Upper airway obstruction - CORRECT ANSWER Lower airway obstruction
Which of the following assessments is most useful in evaluating the effectiveness of
bagmask ventilation?
Hearing an air leak around the mask when the bag is fully compressed
Seeing the abdomen rise during ventilationcation
Observation of visible chest rise
A normal systolic, diastolic, and mean arterial pressure - CORRECT ANSWER
Observation of visible chest rise
You are assessing a 6-year-old child who appears to be unconscious after striking his
head on a concrete step. You pinch the patient's chest and the patient grabs your hand.
You would document this response as:
Localization of a painful stimulus
Withdrawal from a painful stimulus
Decerebrate posturing
Decorticate posturing - CORRECT ANSWER Localization of a painful stimulus
ANSWERS
Which of the following groups of clinical findings would be most consistent with
categorizing a patient with compensated shock?
Decreased level of consciousness, extensor posturing in response to pain,
hypertension, and apnea
Normal systolic blood pressure, decreased level of consciousness, cool extremities with
delayed capillary refill, and faint or nonpalpable distal pulsesd.
Normal blood pressure, normal level of consciousness, bounding distal pulses,
hypercarbia, hypoxemia, and normal urine output
Unresponsiveness, normal breathing, and good distal pulses - CORRECT ANSWER
Normal systolic blood pressure, decreased level of consciousness, cool extremities with
delayed capillary refill, and faint or nonpalpable distal pulsesd.
You are treating a 10-year-old patient after a motor vehicle crash. The patient is
unresponsive and flexes his arms at the elbow in response to a painful stimulus. An
endotracheal tube is in place with position confirmed. You are ventilating using a
resuscitation bag with oxygen, and the child has an Spot of 95% and good chest
excursion bilaterally. Blood pressure is 130/70 mm Hg and heart rate is 90/min with
good perfusion. You have established intravenous access. Which of the following
actions would be most appropriate at this time?
Give an intravenous bolus of mannitol
Provide continuous positive airway pressure (CPAP)
Obtain a CT scan of the head and neck
Begin manual hyperventilation - CORRECT ANSWER Obtain a CT scan of the head
and neck
You arrive on the scene where a 12-year-old child has suddenly collapsed on the
playground. The child is unresponsive, apneic, and pulseless, and CPR is in progress.
A lay rescuer just arrived with the school AED, turned it on, and attached it. The AED
recommends a shock. Which of the following should be done next?
Attempt endotracheal intubation
Obtain intravenous access
Attempt defibrillation
Change the compression-to-ventilation ratio from 30:2 to 15:2 - CORRECT ANSWER
Attempt defibrillation
You are caring for a child in persistent VF. Which of the following would best describe
the child's cardiac condition?
, The heart is not pumping blood at all
The heart is beating too slowly to maintain circulation
There is no electrical activity in the heart
The heart is pumping so fast that it cannot fill completely between beats - CORRECT
ANSWER The heart is not pumping blood at all
You are called to treat a 5-year-old with a 3-day history of worsening respiratory
distress. The child responds only to pain. The heart rate is initially 45/min and regular
with poor capillary refill. You provide bag-mask ventilation with high-flow oxygen, which
produces good chest rise with full and clear bilateral breath sounds. The heart rate 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?
Perform transcutaneous pacing
Resume bag-mask ventilation
Administer epinephrine IV
Administer atropine IV - CORRECT ANSWER Resume bag-mask ventilation
You are caring for a 7-year-old with respiratory distress that has worsened over the past
few hours. The child is alert and in moderate respiratory distress with prolonged
exhalation time. The respiratory rate is 28/min with bilateral expiratory wheezes. The
heart rate is 112/min with good capillary refill. The wheezing in this patient indicates:
Disordered control of breathing
Lung tissue (parenchymal) lung disease
Lower airway obstruction
Upper airway obstruction - CORRECT ANSWER Lower airway obstruction
Which of the following assessments is most useful in evaluating the effectiveness of
bagmask ventilation?
Hearing an air leak around the mask when the bag is fully compressed
Seeing the abdomen rise during ventilationcation
Observation of visible chest rise
A normal systolic, diastolic, and mean arterial pressure - CORRECT ANSWER
Observation of visible chest rise
You are assessing a 6-year-old child who appears to be unconscious after striking his
head on a concrete step. You pinch the patient's chest and the patient grabs your hand.
You would document this response as:
Localization of a painful stimulus
Withdrawal from a painful stimulus
Decerebrate posturing
Decorticate posturing - CORRECT ANSWER Localization of a painful stimulus
