PALS TEST QUESTIONS AND ANSWERS 2025
w w w w w
InwwhichwofwthewfollowingwsituationswmaywIOwaccesswbewused?w-wcorrectwanswerw -
Anwextremitywwithwslowwcapillarywrefillwtime.
Aw2w-
wweekwoldwinfantwiswbeingwevaluatedwirritabilitywandwpoorwfeeding.wHiswbloodwpressurewisw55/40wmmwHgw
andwcapillarywrefillwtimewisw5wseconds.wWhichwstatementwbestwdescribeswyourwassessmentwofwthiswinfants
wbloodwpressure?w-wcorrectwanswerw -ItwiswHypotensive
Youwarewcaringwforwpatientswinwthewemergencywdepartment.wWhichwtwowyearwoldwrequireswimmediatewinterve
ntions?w-wcorrectwanswerw -Awchildwwhowiswgrunting
Aw3wyearwoldwchildwiswhavingwdifficultywbreathing.wWhatwfindingwwouldwmostwlikelywleadwyouwtowexpectwa
nwupperwairwaywobstructionwinwthiswchild?w-wcorrectwanswerw -
Increasedwinspiratoryweffortwwithwretractions
Awteamwmemberwiswunablewtowperformwanwassignedwtaskwbecausewitwiswbeyondwthewteamwmember'swscop
ewofwpractice.wWhatwactionwshouldwthewteamwmemberwtake?w-wcorrectwanswerw -
Askwforwawnewwtaskworwrole.
Youwarewthewteamwleadwduringwawpediatricwresuscitationwattempt.wWhichwactionwiswhighwqualitywCPR?w-
wcorrectwanswerw -Allowwcompletewchestwwallwrecoilwafterweachwcompression.
Aw8wyearwoldwchildwiswbroughtwtowthewemergencywdepartmentwbywhiswmotherwforwdifficultlywbreathing.wHe
whaswawhistorywiswasthmawandwnutwallergies.wHiswmotherwtellswyouwthatwhewhaswrecentlywatewawcookiewatwaw
familywpicnic.wWhichwconditionwiswmostwlikelywpresentwwithwthiswchild?w-wcorrectwanswerw -
Upperwairywwaywobstruction
,Anw8-year-
oldwchildwiswbroughtwtowthewemergencywdepartmentwbywambulancewafterwbeingwinvolvedwinwawmotorwveh
iclewcollision.wWhatwfindingwwouldwsuggestwthatwimmediatewinterventionwiswneeded?w-wcorrectwanswerw -
Decreasedwlevelwofwconsciousness
Aw6-year-
oldwchildwiswfoundwunresponsive,wnotwbreathing,wandwwithoutwawpulse.wOnewhealthcarewworkerwleaveswto
wactivatewthewemergencywresponsewsystemwandwgetwthewresuscitationwequipment.wYouwandwanotherwhea
lthcarewproviderwimmediatelywbeginwperformingwCPR.wWhatwcompression-to-ventilationw-
ratiowdowyouwuse?w-wcorrectwanswerw -15:2
Aw3-year-oldwchildwiswinwcardiacwarrest,wandwhigh-
qualitywCPRwiswinwprogress.wYouwarewthewTeamwLeader.wThewfirstwrhythmwcheckwrevealswthewrhythmwshow
nwhere.wDefibrillationwiswattemptedwwithwawshockwdosewofw2wJ/kg.wAfterwshockwadministration,wwhatwsho
uldwyouwsaywtowyourwteamwmembers?w-wcorrectwanswerw -wResumewcompressions
Youwarewcaringwforwaw5-year-oldwboywwithwaw4-
daywhistorywofwhighwfeverwandwcough.wHewiswhavingwincreasingwlethargy,wgrunting,wandwsleepiness.wNoww
hewiswdifficultwtowarousewandwiswunresponsivewtowvoicewcommands.wHiswoxygenwsaturationwisw72%wonwroo
mwairwandw89%wwhenwonwawnonrebreathingwoxygenwmask.wHewhaswshallowwrespirationswwithwawrespirato
rywratewofw38/min.wAuscultationwofwthewlungswrevealswbilateralwcrackles.
11.wWhatwassessmentwfindingwiswconsistentwwithwrespiratorywfailurewinwthiswchild?w-wcorrectwanswerw -
OxygenwSaturation
Youwarewcaringwforwaw5-year-oldwboywwithwaw4-
daywhistorywofwhighwfeverwandwcough.wHewiswhavingwincreasingwlethargy,wgrunting,wandwsleepiness.wNoww
hewiswdifficultwtowarousewandwiswunresponsivewtowvoicewcommands.wHiswoxygenwsaturationwisw72%wonwroo
mwairwandw89%wwhenwonwawnonrebreathingwoxygenwmask.wHewhaswshallowwrespirationswwithwawrespirato
rywratewofw38/min.wAuscultationwofwthewlungswrevealswbilateralwcrackles.
Whatwmedicationwwouldwbewmostwappropriate?w-wcorrectwanswerw -Antibiotics
Duringwawresuscitationwattempt,wthewTeamwLeaderwaskswyouwtowadministerwanwinitialwdosewofwepinephrinewat
0.1wmg/kgwtowbewgivenwIO.wHowwshouldwyouwrespond?w-wcorrectwanswerw -
Iwthinkwthewcorrectwdosewisw0.01wmg/kg.wShouldwIwgivewthatwdosewinstead?'
Aw6-month-
oldwinfantwiswunresponsive.wYouwbeginwcheckingwforwbreathingwatwthewsamewtimewyouwcheckwforwthewinfa
nt'swpulse.wWhatwiswthewmaximumwtimewyouwshouldwspendwtryingwtowsimultaneouslywcheckwforwbreathin
gwandwpalpatewthewinfant'swpulsewbeforewstartingwCPR?w-wcorrectwanswerw -10wseconds
,Aw10-year-oldwchildwiswbeingwevaluatedwforwawheadache.wWhatwiswawnormalwfindingwforwthisw10-year-
oldwchild?w-wcorrectwanswerw -Heartwratewofw88wbpm
Aw6-year-
oldwboywiswbeingwevaluatedwforwdifficultywbreathing.wWhatwfindingwwouldwsuggestwthiswchildwhaswrespiratorywd
istress?w-wcorrectwanswerw -Audiblewinspiratorywstridor
Aw4-year-oldwchildwinwcardiacwarrestwiswbroughtwtowthewemergencywdepartmentwbywambulance.wHigh-
qualitywCPRwiswbeingwperformed.wThewcardiacwmonitorwdisplayswthewrhythmwstripwshownwhere.wThewesti
matedwweightwofwthewchildwisw20wkg.wWhatwdosagewrangewshouldwyouwusewforwinitialwdefibrillation?w-
wcorrectwanswer
-2wtow4wJ/kg
Aw4-year-oldwchildwinwcardiacwarrestwiswbroughtwtowthewemergencywdepartmentwbywambulance.wHigh-
qualitywCPRwiswbeingwperformed.wThewcardiacwmonitorwdisplayswthewrhythmwstripwshownwhere.wThewesti
matedwweightwofwthewchildwisw20wkg.
AswthewTeamwLeader,whowwmanywjouleswdowyouwtellwyourwteamwmemberwtowusewtowperformwinitialwdefibr
illation?w-wcorrectwanswerw -40J
Youwrespondwtowanwinfantwwhowiswunresponsive,wiswnotwbreathing,wandwdoeswnotwhavewawpulse.wYouwdown
otwhavewawmobilewdevice,wandwyouwshoutwforwnearbywhelpwbutwnowonewarrives.wWhatwactionwshouldwyouw
takewnext?w-wcorrectwanswerw -
BeginwCPRwforw2wminuteswbeforewleavingwtowactivatewthewemergencywresponsewsystem
Whatwratiowforwcompressionswtowbreathswshouldwbewusedwforw1-rescuerwinfantwCPR?w-wcorrectwanswerw -
Givew30wcompressionswtow2wbreaths
Aw3-year-
oldwboywiswbroughtwtowthewemergencywdepartmentwbywhiswmother.wHewiswlethargic,wwithwretractionswandw
nasalwflaring.wHewhaswawrespiratorywratewofw70/min,wwithwwarmwextremitieswandwbriskwcapillarywrefill.
Whichwimmediatewlife-
threateningwconditionwcouldwthiswchild'swconditionwmostwlikelywprogresswtowifwleftwuntreated?w-
wcorrectwanswerw -RespiratorywFailure
Youwarewevaluatingwaw10-year-
oldwchildwwhowiswfebrilewandwtachycardic.wThewchild'swcapillarywrefillwtimewisw5wseconds.wWhatwparamete
rwwillwdeterminewifwthewchildwiswinwcompensatedwshock?w-wcorrectwanswerw -BloodwPressure
, Anw18-
monthwoldwhaswhadwvomitingwandwdiarrheawforwthewpastw2wdays;wthewmotherwbringswhimwtowthewemerge
ncywdepartmentwbecausewhewiswbecomingwmorewlethargic.wWhatwdiagnosticwtestwshouldwyouworderwfirst?
w-wcorrectwanswerw -BloodwGlucose
Youwarewcaringwforwaw3-month-oldwboywwithwaw2-
daywhistorywofwfever,wvomiting,wandwdiarrhea.wHiswparentswstatewthatwhewhaswbeenwsleepingwmuchwmore.
wHiswheartwratewisw190/min,wtemperaturewisw38.3°Cw(101°F),wbloodwpressurewisw59/29wmmwHg,wrespirator
ywratewisw70/minwandwshallow,wandwoxygenwsaturationwisw94%wonw100%woxygen.wHiswcapillarywrefiliwtimewi
sw4wtow5wseconds,wandwhewhaswmottled,wcoolwextremities.wThewinfantwweighsw6wkg.
24.wWhatwassessmentwfindingwindicateswthatwthewinfantwhaswhypotensivewshock?w-wcorrectwanswerw -
BloodwPressure
Youwarewcaringwforwaw3-month-oldwboywwithwaw2-
daywhistorywofwfever,wvomiting,wandwdiarrhea.wHiswparentswstatewthatwhewhaswbeenwsleepingwmuchwmore.
wHiswheartwratewisw190/min,wtemperaturewisw38.3°Cw(101°F),wbloodwpressurewisw59/29wmmwHg,wrespirator
ywratewisw70/minwandwshallow,wandwoxygenwsaturationwisw94%wonw100%woxygen.wHiswcapillarywrefiliwtimewi
sw4wtow5wseconds,wandwhewhaswmottled,wcoolwextremities.wThewinfantwweighsw6wkg.
Onwthewbasiswofwthiswinfant'swpresentation,wwhatwtypewofwshockwdoeswthiswinfantwhave?w-wcorrectwanswerw -
wHypovolemicwShock
Youwarewcaringwforwaw3-month-oldwboywwithwaw2-
daywhistorywofwfever,wvomiting,wandwdiarrhea.wHiswparentswstatewthatwhewhaswbeenwsleepingwmuchwmore.
wHiswheartwratewisw190/min,wtemperaturewisw38.3°Cw(101°F),wbloodwpressurewisw59/29wmmwHg,wrespirator
ywratewisw70/minwandwshallow,wandwoxygenwsaturationwisw94%wonw100%woxygen.wHiswcapillarywrefiliwtimewi
sw4wtow5wseconds,wandwhewhaswmottled,wcoolwextremities.wThewinfantwweighsw6wkg.
Youwhavewdecidedwthatwthiswinfantwneedswfluidwresuscitation.wHowwmuchwfluidwshouldwyouwadminister?w-
wcorrectwanswerw -20wml/kgwnormalwsaline
Whatwabnormalitywhelpswidentifywchildrenwwithwacutewrespiratorywdistresswcausedwbywlungwtissuewdisease?w-
wcorrectwanswerw -Crackles
Youwarewcaringwforwaw9-month-
oldwgirlwwhowhaswincreasedwworkwofwbreathing,wawfever,wandwawcough.wOnwassessment,wyouwfindwanwalert
winfantwwithwstridorwandwretractions.wThewinfant'swSpOzwisw94%.wOnwauscultation,wthewlungswarewclearwbil
aterally.
Whatwiswthewmostwlikelywcausewofwthiswinfant'swrespiratorywdistress?w-wcorrectwanswerw -
Upperwairwaywobstruction
w w w w w
InwwhichwofwthewfollowingwsituationswmaywIOwaccesswbewused?w-wcorrectwanswerw -
Anwextremitywwithwslowwcapillarywrefillwtime.
Aw2w-
wweekwoldwinfantwiswbeingwevaluatedwirritabilitywandwpoorwfeeding.wHiswbloodwpressurewisw55/40wmmwHgw
andwcapillarywrefillwtimewisw5wseconds.wWhichwstatementwbestwdescribeswyourwassessmentwofwthiswinfants
wbloodwpressure?w-wcorrectwanswerw -ItwiswHypotensive
Youwarewcaringwforwpatientswinwthewemergencywdepartment.wWhichwtwowyearwoldwrequireswimmediatewinterve
ntions?w-wcorrectwanswerw -Awchildwwhowiswgrunting
Aw3wyearwoldwchildwiswhavingwdifficultywbreathing.wWhatwfindingwwouldwmostwlikelywleadwyouwtowexpectwa
nwupperwairwaywobstructionwinwthiswchild?w-wcorrectwanswerw -
Increasedwinspiratoryweffortwwithwretractions
Awteamwmemberwiswunablewtowperformwanwassignedwtaskwbecausewitwiswbeyondwthewteamwmember'swscop
ewofwpractice.wWhatwactionwshouldwthewteamwmemberwtake?w-wcorrectwanswerw -
Askwforwawnewwtaskworwrole.
Youwarewthewteamwleadwduringwawpediatricwresuscitationwattempt.wWhichwactionwiswhighwqualitywCPR?w-
wcorrectwanswerw -Allowwcompletewchestwwallwrecoilwafterweachwcompression.
Aw8wyearwoldwchildwiswbroughtwtowthewemergencywdepartmentwbywhiswmotherwforwdifficultlywbreathing.wHe
whaswawhistorywiswasthmawandwnutwallergies.wHiswmotherwtellswyouwthatwhewhaswrecentlywatewawcookiewatwaw
familywpicnic.wWhichwconditionwiswmostwlikelywpresentwwithwthiswchild?w-wcorrectwanswerw -
Upperwairywwaywobstruction
,Anw8-year-
oldwchildwiswbroughtwtowthewemergencywdepartmentwbywambulancewafterwbeingwinvolvedwinwawmotorwveh
iclewcollision.wWhatwfindingwwouldwsuggestwthatwimmediatewinterventionwiswneeded?w-wcorrectwanswerw -
Decreasedwlevelwofwconsciousness
Aw6-year-
oldwchildwiswfoundwunresponsive,wnotwbreathing,wandwwithoutwawpulse.wOnewhealthcarewworkerwleaveswto
wactivatewthewemergencywresponsewsystemwandwgetwthewresuscitationwequipment.wYouwandwanotherwhea
lthcarewproviderwimmediatelywbeginwperformingwCPR.wWhatwcompression-to-ventilationw-
ratiowdowyouwuse?w-wcorrectwanswerw -15:2
Aw3-year-oldwchildwiswinwcardiacwarrest,wandwhigh-
qualitywCPRwiswinwprogress.wYouwarewthewTeamwLeader.wThewfirstwrhythmwcheckwrevealswthewrhythmwshow
nwhere.wDefibrillationwiswattemptedwwithwawshockwdosewofw2wJ/kg.wAfterwshockwadministration,wwhatwsho
uldwyouwsaywtowyourwteamwmembers?w-wcorrectwanswerw -wResumewcompressions
Youwarewcaringwforwaw5-year-oldwboywwithwaw4-
daywhistorywofwhighwfeverwandwcough.wHewiswhavingwincreasingwlethargy,wgrunting,wandwsleepiness.wNoww
hewiswdifficultwtowarousewandwiswunresponsivewtowvoicewcommands.wHiswoxygenwsaturationwisw72%wonwroo
mwairwandw89%wwhenwonwawnonrebreathingwoxygenwmask.wHewhaswshallowwrespirationswwithwawrespirato
rywratewofw38/min.wAuscultationwofwthewlungswrevealswbilateralwcrackles.
11.wWhatwassessmentwfindingwiswconsistentwwithwrespiratorywfailurewinwthiswchild?w-wcorrectwanswerw -
OxygenwSaturation
Youwarewcaringwforwaw5-year-oldwboywwithwaw4-
daywhistorywofwhighwfeverwandwcough.wHewiswhavingwincreasingwlethargy,wgrunting,wandwsleepiness.wNoww
hewiswdifficultwtowarousewandwiswunresponsivewtowvoicewcommands.wHiswoxygenwsaturationwisw72%wonwroo
mwairwandw89%wwhenwonwawnonrebreathingwoxygenwmask.wHewhaswshallowwrespirationswwithwawrespirato
rywratewofw38/min.wAuscultationwofwthewlungswrevealswbilateralwcrackles.
Whatwmedicationwwouldwbewmostwappropriate?w-wcorrectwanswerw -Antibiotics
Duringwawresuscitationwattempt,wthewTeamwLeaderwaskswyouwtowadministerwanwinitialwdosewofwepinephrinewat
0.1wmg/kgwtowbewgivenwIO.wHowwshouldwyouwrespond?w-wcorrectwanswerw -
Iwthinkwthewcorrectwdosewisw0.01wmg/kg.wShouldwIwgivewthatwdosewinstead?'
Aw6-month-
oldwinfantwiswunresponsive.wYouwbeginwcheckingwforwbreathingwatwthewsamewtimewyouwcheckwforwthewinfa
nt'swpulse.wWhatwiswthewmaximumwtimewyouwshouldwspendwtryingwtowsimultaneouslywcheckwforwbreathin
gwandwpalpatewthewinfant'swpulsewbeforewstartingwCPR?w-wcorrectwanswerw -10wseconds
,Aw10-year-oldwchildwiswbeingwevaluatedwforwawheadache.wWhatwiswawnormalwfindingwforwthisw10-year-
oldwchild?w-wcorrectwanswerw -Heartwratewofw88wbpm
Aw6-year-
oldwboywiswbeingwevaluatedwforwdifficultywbreathing.wWhatwfindingwwouldwsuggestwthiswchildwhaswrespiratorywd
istress?w-wcorrectwanswerw -Audiblewinspiratorywstridor
Aw4-year-oldwchildwinwcardiacwarrestwiswbroughtwtowthewemergencywdepartmentwbywambulance.wHigh-
qualitywCPRwiswbeingwperformed.wThewcardiacwmonitorwdisplayswthewrhythmwstripwshownwhere.wThewesti
matedwweightwofwthewchildwisw20wkg.wWhatwdosagewrangewshouldwyouwusewforwinitialwdefibrillation?w-
wcorrectwanswer
-2wtow4wJ/kg
Aw4-year-oldwchildwinwcardiacwarrestwiswbroughtwtowthewemergencywdepartmentwbywambulance.wHigh-
qualitywCPRwiswbeingwperformed.wThewcardiacwmonitorwdisplayswthewrhythmwstripwshownwhere.wThewesti
matedwweightwofwthewchildwisw20wkg.
AswthewTeamwLeader,whowwmanywjouleswdowyouwtellwyourwteamwmemberwtowusewtowperformwinitialwdefibr
illation?w-wcorrectwanswerw -40J
Youwrespondwtowanwinfantwwhowiswunresponsive,wiswnotwbreathing,wandwdoeswnotwhavewawpulse.wYouwdown
otwhavewawmobilewdevice,wandwyouwshoutwforwnearbywhelpwbutwnowonewarrives.wWhatwactionwshouldwyouw
takewnext?w-wcorrectwanswerw -
BeginwCPRwforw2wminuteswbeforewleavingwtowactivatewthewemergencywresponsewsystem
Whatwratiowforwcompressionswtowbreathswshouldwbewusedwforw1-rescuerwinfantwCPR?w-wcorrectwanswerw -
Givew30wcompressionswtow2wbreaths
Aw3-year-
oldwboywiswbroughtwtowthewemergencywdepartmentwbywhiswmother.wHewiswlethargic,wwithwretractionswandw
nasalwflaring.wHewhaswawrespiratorywratewofw70/min,wwithwwarmwextremitieswandwbriskwcapillarywrefill.
Whichwimmediatewlife-
threateningwconditionwcouldwthiswchild'swconditionwmostwlikelywprogresswtowifwleftwuntreated?w-
wcorrectwanswerw -RespiratorywFailure
Youwarewevaluatingwaw10-year-
oldwchildwwhowiswfebrilewandwtachycardic.wThewchild'swcapillarywrefillwtimewisw5wseconds.wWhatwparamete
rwwillwdeterminewifwthewchildwiswinwcompensatedwshock?w-wcorrectwanswerw -BloodwPressure
, Anw18-
monthwoldwhaswhadwvomitingwandwdiarrheawforwthewpastw2wdays;wthewmotherwbringswhimwtowthewemerge
ncywdepartmentwbecausewhewiswbecomingwmorewlethargic.wWhatwdiagnosticwtestwshouldwyouworderwfirst?
w-wcorrectwanswerw -BloodwGlucose
Youwarewcaringwforwaw3-month-oldwboywwithwaw2-
daywhistorywofwfever,wvomiting,wandwdiarrhea.wHiswparentswstatewthatwhewhaswbeenwsleepingwmuchwmore.
wHiswheartwratewisw190/min,wtemperaturewisw38.3°Cw(101°F),wbloodwpressurewisw59/29wmmwHg,wrespirator
ywratewisw70/minwandwshallow,wandwoxygenwsaturationwisw94%wonw100%woxygen.wHiswcapillarywrefiliwtimewi
sw4wtow5wseconds,wandwhewhaswmottled,wcoolwextremities.wThewinfantwweighsw6wkg.
24.wWhatwassessmentwfindingwindicateswthatwthewinfantwhaswhypotensivewshock?w-wcorrectwanswerw -
BloodwPressure
Youwarewcaringwforwaw3-month-oldwboywwithwaw2-
daywhistorywofwfever,wvomiting,wandwdiarrhea.wHiswparentswstatewthatwhewhaswbeenwsleepingwmuchwmore.
wHiswheartwratewisw190/min,wtemperaturewisw38.3°Cw(101°F),wbloodwpressurewisw59/29wmmwHg,wrespirator
ywratewisw70/minwandwshallow,wandwoxygenwsaturationwisw94%wonw100%woxygen.wHiswcapillarywrefiliwtimewi
sw4wtow5wseconds,wandwhewhaswmottled,wcoolwextremities.wThewinfantwweighsw6wkg.
Onwthewbasiswofwthiswinfant'swpresentation,wwhatwtypewofwshockwdoeswthiswinfantwhave?w-wcorrectwanswerw -
wHypovolemicwShock
Youwarewcaringwforwaw3-month-oldwboywwithwaw2-
daywhistorywofwfever,wvomiting,wandwdiarrhea.wHiswparentswstatewthatwhewhaswbeenwsleepingwmuchwmore.
wHiswheartwratewisw190/min,wtemperaturewisw38.3°Cw(101°F),wbloodwpressurewisw59/29wmmwHg,wrespirator
ywratewisw70/minwandwshallow,wandwoxygenwsaturationwisw94%wonw100%woxygen.wHiswcapillarywrefiliwtimewi
sw4wtow5wseconds,wandwhewhaswmottled,wcoolwextremities.wThewinfantwweighsw6wkg.
Youwhavewdecidedwthatwthiswinfantwneedswfluidwresuscitation.wHowwmuchwfluidwshouldwyouwadminister?w-
wcorrectwanswerw -20wml/kgwnormalwsaline
Whatwabnormalitywhelpswidentifywchildrenwwithwacutewrespiratorywdistresswcausedwbywlungwtissuewdisease?w-
wcorrectwanswerw -Crackles
Youwarewcaringwforwaw9-month-
oldwgirlwwhowhaswincreasedwworkwofwbreathing,wawfever,wandwawcough.wOnwassessment,wyouwfindwanwalert
winfantwwithwstridorwandwretractions.wThewinfant'swSpOzwisw94%.wOnwauscultation,wthewlungswarewclearwbil
aterally.
Whatwiswthewmostwlikelywcausewofwthiswinfant'swrespiratorywdistress?w-wcorrectwanswerw -
Upperwairwaywobstruction
