PALS Final Exam 2024/2025 – UPDATED AHA Guidelines – 100%
Verified Answers – Graded A+
A 12-year-old child being evaluated in the pediatric intensive care unit displays the following
ECG waveform. The team interprets this as which arrhythmia?
Answer-First-degree atrioventricular (AV) block
Laboratory tests are ordered for a child who has been vomiting for 3 days and is diaphoretic,
tachypneic, lethargic and pale. Which test would the provider use to determine the adequacy
of oxygen delivery?
Answer-Lactate
A provider is caring for a 4-year-old child in the urgent care clinic. Primary assessment reveals
difficulty breathing and an oxygen saturation of 91%. The provider administers oxygen by
nasal cannula with the goal of improving the child's oxygen saturation above what
percentage?
Answer-Above 94%
An 11-year-old soccer player is brought to the emergency department. After a quick
assessment, the team realizes this patient is experiencing a severe asthma exacerbation.
Which medication would the team administer first?
Answer-Albuterol plus ipratropium bromide
A child in the pediatric step-down unit is exhibiting signs of respiratory distress. When
assessing this child, which circulation finding might be present?
Answer-Pallor
An 11-year-old child develops unstable wide-complex tachycardia. Assessment reveals signs
of significant hemodynamic compromise, but the child has a pulse. The PALS team would
prepare the child for which intervention?
Answer-Synchronized electrical cardioversion
A 9-year-old patient is presenting with decreased breath sounds, bradycardia, slowed
respiratory rate and a low O2 saturation level. The provider interprets these findings as
indicating which condition?
Answer-Respiratory failure
A 4-year-old child is brought to the emergency department by the parents. Assessment
reveals that the child has only gasping respirations and the pulse rate is 65 beats per minute.
, Which action would the provider initiate first?
Answer-Deliver 1 BVM ventilation every 3 to 5 seconds
A 15-year-old patient is being evaluated during a follow-up visit after being diagnosed with
Lyme disease 2 months ago. A rhythm strip is obtained. The provider interprets this rhythm as
indicating which arrhythmia?
Answer-Second-degree AV block
A child in cardiac arrest experiences return of spontaneous circulation but is exhibiting signs
of post-cardiac arrest syndrome (PCAS). The team bases this determination on which
finding(s)?
Answer-Systemic response to ischemia/reperfusion
A 2-year-old child arrives at the emergency department unresponsive, not breathing, and
without a pulse. Two providers begin high-quality CPR. Which actions demonstrate high-
quality CPR?
Answer:
Allowing the chest to recoil fully after each compression
Providing ventilations that last about 1 second each
Compressing the chest about 2 inches
Giving 2 ventilations to every 15 compressions
A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest. For
which rhythm(s) would this action be appropriate?
Answer-VF and pulseless VT
A provider is assessing a child with suspected shock. Which statement correctly describes
hypotension and shock?
Answer-Hypotension is not a consistent feature of shock
A healthcare provider is performing a primary assessment of a child in respiratory distress.
What findings indicate increased work of breathing?
Answer:
Nasal flaring
Use of accessory muscles
Intercostal, substernal, or suprasternal retractions
Grunting
Verified Answers – Graded A+
A 12-year-old child being evaluated in the pediatric intensive care unit displays the following
ECG waveform. The team interprets this as which arrhythmia?
Answer-First-degree atrioventricular (AV) block
Laboratory tests are ordered for a child who has been vomiting for 3 days and is diaphoretic,
tachypneic, lethargic and pale. Which test would the provider use to determine the adequacy
of oxygen delivery?
Answer-Lactate
A provider is caring for a 4-year-old child in the urgent care clinic. Primary assessment reveals
difficulty breathing and an oxygen saturation of 91%. The provider administers oxygen by
nasal cannula with the goal of improving the child's oxygen saturation above what
percentage?
Answer-Above 94%
An 11-year-old soccer player is brought to the emergency department. After a quick
assessment, the team realizes this patient is experiencing a severe asthma exacerbation.
Which medication would the team administer first?
Answer-Albuterol plus ipratropium bromide
A child in the pediatric step-down unit is exhibiting signs of respiratory distress. When
assessing this child, which circulation finding might be present?
Answer-Pallor
An 11-year-old child develops unstable wide-complex tachycardia. Assessment reveals signs
of significant hemodynamic compromise, but the child has a pulse. The PALS team would
prepare the child for which intervention?
Answer-Synchronized electrical cardioversion
A 9-year-old patient is presenting with decreased breath sounds, bradycardia, slowed
respiratory rate and a low O2 saturation level. The provider interprets these findings as
indicating which condition?
Answer-Respiratory failure
A 4-year-old child is brought to the emergency department by the parents. Assessment
reveals that the child has only gasping respirations and the pulse rate is 65 beats per minute.
, Which action would the provider initiate first?
Answer-Deliver 1 BVM ventilation every 3 to 5 seconds
A 15-year-old patient is being evaluated during a follow-up visit after being diagnosed with
Lyme disease 2 months ago. A rhythm strip is obtained. The provider interprets this rhythm as
indicating which arrhythmia?
Answer-Second-degree AV block
A child in cardiac arrest experiences return of spontaneous circulation but is exhibiting signs
of post-cardiac arrest syndrome (PCAS). The team bases this determination on which
finding(s)?
Answer-Systemic response to ischemia/reperfusion
A 2-year-old child arrives at the emergency department unresponsive, not breathing, and
without a pulse. Two providers begin high-quality CPR. Which actions demonstrate high-
quality CPR?
Answer:
Allowing the chest to recoil fully after each compression
Providing ventilations that last about 1 second each
Compressing the chest about 2 inches
Giving 2 ventilations to every 15 compressions
A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest. For
which rhythm(s) would this action be appropriate?
Answer-VF and pulseless VT
A provider is assessing a child with suspected shock. Which statement correctly describes
hypotension and shock?
Answer-Hypotension is not a consistent feature of shock
A healthcare provider is performing a primary assessment of a child in respiratory distress.
What findings indicate increased work of breathing?
Answer:
Nasal flaring
Use of accessory muscles
Intercostal, substernal, or suprasternal retractions
Grunting
