PALS PEDIATRIC EMERGENCY CARE EXAM 2025 , 200
QUESTIONS WITH ACCURATE SOLUTIONS
1. A 3-month-old infant who is extremely lethargic has had a cough,
vomiting, and diarrhea for the past 3 days. Assessment reveals that he
responds to pain, has mottled skin color, and a capillary refill time of 4
seconds. He has a blood pressure of 74/60 mm Hg, a pulse of 190
beats/min, and rapid
respirations (60 breaths/min) without increased work of breathing. The
appropriate initial treatment is to:
Administer epinephrine via an intraosseous needle.
Perform endotracheal intubation.
Administer 100% oxygen by mask.
Administer dopamine intravenously.
2. If the infant's oxygen saturation remains low after verifying the
endotracheal tube position, what would be the next best step in
management?
Administer a bronchodilator
Perform a rapid sequence intubation
Place a chest tube on the left
Initiate positive pressure ventilation
3. A four-year-old female is having great difficulty breathing. She is
responsive to verbal stimuli and has an open airway. Her respiratory rate
is 40 breaths per minute, and she has an SpO2 reading of 88% while
receiving high-flow oxygen through a pediatric nonrebreather mask. Her
pulse is rapid, and her skin cool to the touch. As a knowledgeable EMT,
you would recognize what condition?
Respiratory arrest
Respiratory failure
Cardiopulmonary arrest
, Respiratory distress
4. The sign you should assess which indicates a child in respiratory
distress has transitioned to respiratory failure is a change in the
intensity of wheezes.
depth of sternal retractions.
level of consciousness.
ability to speak in full sentences.
5. Explain why nebulized epinephrine is the preferred intervention for a child
presenting with stridor and agitation due to croup.
It reduces inflammation and opens the
airway. It provides immediate sedation to calm
the child. It increases heart rate to improve
circulation.
It helps to clear mucus from the airways.
6. 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 a
recent onset of lethargy. Assessment reveals that the child is difficult to
arouse
and her skin color is pale. The child's heart rate is 160/min, respiratory
rate is 38/min, blood pressure is 76/45 mmHg, capillary refill time is 5 to 6
seconds, and temperature is 39.4 degrees C (103 F). Intravenous access has
been established, and blood cultures have been obtained. Which action
should you perform next?
Obtain vascular access and administer 20 mL/kg of isotonic
crystalloid over 30 minutes
Obtain vascular access and administer 20 mL/kg of isotonic
crystalloid over 5 to 10 minutes
Obtain immediate blood cultures and chest x-ray
, Obtain expert consultation with an oncologist to determine the
chemotherapeutic regimen
7. A 7-year-old girl has been brought to the Emergency because of disturbed
consciousness. For the last three days, she had several vomits and watery
diarrhea. On physical examination, she is normothermic, heart rate is
170/min, respiratory rate 20/min, systolic blood pressure 70 mmHg.
Capillary refill time is 5 seconds. She is almost insensitive to pain. Lab
studies reveal: pH - 6.9, BE - 18 mmol/L, blood glucose - 70 mg/dL. What is
the most likely diagnosis:
Anaphylactic
Shock Septic
Shock
Cardiogenic Shock
Hypovolemic Shock
Neurogenic Shock
8. During a pediatric resuscitation attempt, what is most likely to contribute
to high-quality CPR?
A depth of compressions of about one fourth the anterior-posterior
depth of the chest
A compression rate of 80/min
Pulse checks performed once per minute
Allowing the chest wall to recoil completely
between compressions
9. In pediatric patients experiencing seizures, which physiological parameter
is most likely to be affected immediately following the seizure activity?
Blood pressure
Heart rate
Respiratory rate
, Body temperature
10. What is the primary purpose of an Automated External Defibrillator (AED)
in a pediatric emergency situation?
To provide oxygen to the patient
To restore normal heart rhythm
To monitor vital signs
To administer medication
11. One category of pediatric emergency is shock, which results from
inadequate blood flow and oxygen delivery to meet tissue metabolic
demands. Fluid bolus is a priority intervention during shock. The provider
determines isotonic normal saline will be best, how much should the nurse
prepare to administer to the pediatric patient?
500 mL
1000 mL
50 mL/kg
20 mL/kg
12. Which of the following statements regarding the AED is correct?
The AED should be applied to patients at risk for cardiac
arrest. AEDs will analyze the patient's rhythm while CPR is in
progress.
The AED should not be used in patients with an implanted
defibrillator.
AEDs can safely be used in infants and children less than 8
years of age.
13. During your assessment you observe head bobbing, nasal flaring, and
grunting in your pediatric patient. Which of the following is the most likely
cause?
QUESTIONS WITH ACCURATE SOLUTIONS
1. A 3-month-old infant who is extremely lethargic has had a cough,
vomiting, and diarrhea for the past 3 days. Assessment reveals that he
responds to pain, has mottled skin color, and a capillary refill time of 4
seconds. He has a blood pressure of 74/60 mm Hg, a pulse of 190
beats/min, and rapid
respirations (60 breaths/min) without increased work of breathing. The
appropriate initial treatment is to:
Administer epinephrine via an intraosseous needle.
Perform endotracheal intubation.
Administer 100% oxygen by mask.
Administer dopamine intravenously.
2. If the infant's oxygen saturation remains low after verifying the
endotracheal tube position, what would be the next best step in
management?
Administer a bronchodilator
Perform a rapid sequence intubation
Place a chest tube on the left
Initiate positive pressure ventilation
3. A four-year-old female is having great difficulty breathing. She is
responsive to verbal stimuli and has an open airway. Her respiratory rate
is 40 breaths per minute, and she has an SpO2 reading of 88% while
receiving high-flow oxygen through a pediatric nonrebreather mask. Her
pulse is rapid, and her skin cool to the touch. As a knowledgeable EMT,
you would recognize what condition?
Respiratory arrest
Respiratory failure
Cardiopulmonary arrest
, Respiratory distress
4. The sign you should assess which indicates a child in respiratory
distress has transitioned to respiratory failure is a change in the
intensity of wheezes.
depth of sternal retractions.
level of consciousness.
ability to speak in full sentences.
5. Explain why nebulized epinephrine is the preferred intervention for a child
presenting with stridor and agitation due to croup.
It reduces inflammation and opens the
airway. It provides immediate sedation to calm
the child. It increases heart rate to improve
circulation.
It helps to clear mucus from the airways.
6. 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 a
recent onset of lethargy. Assessment reveals that the child is difficult to
arouse
and her skin color is pale. The child's heart rate is 160/min, respiratory
rate is 38/min, blood pressure is 76/45 mmHg, capillary refill time is 5 to 6
seconds, and temperature is 39.4 degrees C (103 F). Intravenous access has
been established, and blood cultures have been obtained. Which action
should you perform next?
Obtain vascular access and administer 20 mL/kg of isotonic
crystalloid over 30 minutes
Obtain vascular access and administer 20 mL/kg of isotonic
crystalloid over 5 to 10 minutes
Obtain immediate blood cultures and chest x-ray
, Obtain expert consultation with an oncologist to determine the
chemotherapeutic regimen
7. A 7-year-old girl has been brought to the Emergency because of disturbed
consciousness. For the last three days, she had several vomits and watery
diarrhea. On physical examination, she is normothermic, heart rate is
170/min, respiratory rate 20/min, systolic blood pressure 70 mmHg.
Capillary refill time is 5 seconds. She is almost insensitive to pain. Lab
studies reveal: pH - 6.9, BE - 18 mmol/L, blood glucose - 70 mg/dL. What is
the most likely diagnosis:
Anaphylactic
Shock Septic
Shock
Cardiogenic Shock
Hypovolemic Shock
Neurogenic Shock
8. During a pediatric resuscitation attempt, what is most likely to contribute
to high-quality CPR?
A depth of compressions of about one fourth the anterior-posterior
depth of the chest
A compression rate of 80/min
Pulse checks performed once per minute
Allowing the chest wall to recoil completely
between compressions
9. In pediatric patients experiencing seizures, which physiological parameter
is most likely to be affected immediately following the seizure activity?
Blood pressure
Heart rate
Respiratory rate
, Body temperature
10. What is the primary purpose of an Automated External Defibrillator (AED)
in a pediatric emergency situation?
To provide oxygen to the patient
To restore normal heart rhythm
To monitor vital signs
To administer medication
11. One category of pediatric emergency is shock, which results from
inadequate blood flow and oxygen delivery to meet tissue metabolic
demands. Fluid bolus is a priority intervention during shock. The provider
determines isotonic normal saline will be best, how much should the nurse
prepare to administer to the pediatric patient?
500 mL
1000 mL
50 mL/kg
20 mL/kg
12. Which of the following statements regarding the AED is correct?
The AED should be applied to patients at risk for cardiac
arrest. AEDs will analyze the patient's rhythm while CPR is in
progress.
The AED should not be used in patients with an implanted
defibrillator.
AEDs can safely be used in infants and children less than 8
years of age.
13. During your assessment you observe head bobbing, nasal flaring, and
grunting in your pediatric patient. Which of the following is the most likely
cause?
