PALS 2025, ALL PALS - AND 2025 EXAM
QUESTIONS WITH CORRECT
ANSWERS WITH LATEST UPDATE
What is the most appropriate precautionary action to minimize gastric inflation during bag-mask
ventilation? - ANS-deliver each breath over about 1 sec
What happens to the arterial oxygen level in a child with severe anemia? - ANS-may increase
when dissolved oxygen is increased
The evaluate-identify-intervene sequence should be continued until - ANS-the child is stable
How can the CPR coach improve CPR quality in a resuscitation event? - ANS-Coach to
midrange targets
Which is true of increased carbon dioxide tension in arterial blood? - ANS-may be caused by
disordered control of breathing
which of the following statements about respiratory failure is true? - ANS-may occur without
signs of respiratory distress
which is most likely to present in a child who has respiratory distress (not respiratory failure)? -
ANS-ability to maintain patent airway
which of the following is required to appropriately ventilate a child with a flow-inflating bag? -
ANS-tidal volume needs to be delivered at the correct rate
what should be checked to ensure proper function of a bag-mask system? - ANS-the pop-off
valve can be closed
oxygen tubing is connected to the device and the oxygen source
what element of team dynamics describes when a team member needs to correct actions? -
ANS-constructive intervention
when may pulse oximetry be inaccurate? - ANS-the displayed heart rate does not correlate with
the child's heart rate
a chest compression fraction of at least 60% is recommended, and a goal of 80% is often
achievable with good teamwork - ANS-60%, 80%
,what is the first step for an intubated child whose condition deteriorates? - ANS-support
oxygenation and ventilation
what are the common cause of upper airway obstruction? - ANS-airway swelling
thick secretions
tonsillar hypertrophy (airway swelling)
which anatomical features may contribute to upper airway obstruction in infants? - ANS-large
tongue
large occiput
what are the signs of upper airway obstruction? - ANS-stridor
use of accessory muscles
which diagnosis may present with upper airway obstruction? - ANS-foreign body obstruction
epiglottitis
croup
in a less severe case of upper airway obstruction in a child, what intervention can relieve
obstruction caused by the tongue? - ANS-insert an oral airway
a child presents with a barking cough, good air entry during auscultation, a pulse oximetry
reading of 93% on room air, and retractions at rest.
what is the severity of the child's presentation? - ANS-moderate croup
an 8 month old boy is brought to the hospital by his parents. He has a hoarse cry and barking
cough. His mother says that during the night, her son had difficulty breathing, which has
progressively worsened throughout the day.
the infant most likely has what type of respiratory emergency? - ANS-Upper airway obstruction
according to the systematic approach algorithm, what are the correct assessments to perform
during the evaluation phase? - ANS-initial, primary, secondary
the infant is responsive and is breathing.
what is an initial measure that you can perform to maintain his airway? - ANS-sit him up
what are the components of breathing assessment? - ANS-lung and airway sounds
chest expansion and air movement
oxygen saturation
respiratory rate
respiratory effort
,when calculating the tube size based on the child's age, to avoid injury to the subglottic area,
you should use an endotracheal tube that is: - ANS-half a size smaller than predicted for the
child
how do infants initially respond to lower airway obstruction? - ANS-decreased interpleural
pressure
the anticipated results of the nebulized treatment should include which of the following
improvements in the patient? - ANS-decreased bronchoconstriction
decreased respiratory effort
decreased airway edema
if the patient does not improve with medication, what is your next intervention to ensure
oxygenation? - ANS-noninvasive positive-pressure ventilation
what are the characteristics of shock? - ANS-decreased level of consciousness
inadequate peripheral perfusion
decreased end-organ perfusion
what will occur if adequate oxygen delivery to the tissues is not mainatined? - ANS-organ
dysfunction
what are the major functions of the cardiopulmonary system? - ANS-deliver oxygen to body
tissues
removes metabolic by-products of cellular metabolism
As more time passes between the onset of signs of shock and the restoration of adequate
oxygen delivery and organ perfusion, the outcome is worse - ANS-worse
for general shock management, administer an isotonic crystalloid bolus of 20 mL/kg over 5 to 20
min - ANS-20 mL/kg over 5 to 20 min
what best assess a child's response to each fluid bolus? - ANS-vital signs
physical examination
urinary output
the patient still has a bp of 58/38 mm Hg. Her condition would be classified as hypotensive
shock - ANS-other answer: compensated
obstructive
anaphylactic
when should vasoactive therapy be considered in managing distributive shock? - ANS-if the
child remains hypotensive and poorly perfused despite rapid bolus fluid administration
, what is the focus of the initial management of distributive shock? - ANS-expanding
intravascular volume
filling expanded dilated vascular space
correcting hypovolemia
what signs distinguish anaphylactic shock from other types of shock? - ANS-respiratory distress
with stridor, wheezing or both
angioedema (swelling of the face, lips, and tongue)
urticaria (hives)
in whom should you suspect a tension pneumothorax? - ANS-any intubated child who
deteriorates suddenly while receiving positive-pressure ventilation
victim of chest trauma
a child who deteriorates suddenly while receiving bag-mask ventilation
what is an assessment finding unique to tension pneumothorax? - ANS-tracheal deviation
what circulation findings are specific to pericardial tamponade? - ANS-tachycardia
muffled or diminished heart sounds
narrowed pulse pressures
in what conditions is atropine preferred over epinephrine as the 1st-choice treatment of
symptomatic bradycardia? - ANS-increased vagal tone
av block due to primary bradycardia
cholinergic drug toxicity (organophosphates)
which signs and symptoms are consistent with sinus tachycardia? - ANS-HR <220/min in an
infant or <180 min in a child
hr varies with activity or stimulation
present and normal p waves
how should sinus tachycardia be treated? - ANS-by treating the underlying cause
signs of cardiac arrest in children - ANS-unresponsiveness
no pulse felt
agonal gasps
steps of treating asystole/PEA - ANS-provide cpr
administer epinephrine
consider advanced airway
establish IV/IO access
if myocardial function remains poor in a post- cardiac arrest child, what medications should be
considered? - ANS-epinephrine
QUESTIONS WITH CORRECT
ANSWERS WITH LATEST UPDATE
What is the most appropriate precautionary action to minimize gastric inflation during bag-mask
ventilation? - ANS-deliver each breath over about 1 sec
What happens to the arterial oxygen level in a child with severe anemia? - ANS-may increase
when dissolved oxygen is increased
The evaluate-identify-intervene sequence should be continued until - ANS-the child is stable
How can the CPR coach improve CPR quality in a resuscitation event? - ANS-Coach to
midrange targets
Which is true of increased carbon dioxide tension in arterial blood? - ANS-may be caused by
disordered control of breathing
which of the following statements about respiratory failure is true? - ANS-may occur without
signs of respiratory distress
which is most likely to present in a child who has respiratory distress (not respiratory failure)? -
ANS-ability to maintain patent airway
which of the following is required to appropriately ventilate a child with a flow-inflating bag? -
ANS-tidal volume needs to be delivered at the correct rate
what should be checked to ensure proper function of a bag-mask system? - ANS-the pop-off
valve can be closed
oxygen tubing is connected to the device and the oxygen source
what element of team dynamics describes when a team member needs to correct actions? -
ANS-constructive intervention
when may pulse oximetry be inaccurate? - ANS-the displayed heart rate does not correlate with
the child's heart rate
a chest compression fraction of at least 60% is recommended, and a goal of 80% is often
achievable with good teamwork - ANS-60%, 80%
,what is the first step for an intubated child whose condition deteriorates? - ANS-support
oxygenation and ventilation
what are the common cause of upper airway obstruction? - ANS-airway swelling
thick secretions
tonsillar hypertrophy (airway swelling)
which anatomical features may contribute to upper airway obstruction in infants? - ANS-large
tongue
large occiput
what are the signs of upper airway obstruction? - ANS-stridor
use of accessory muscles
which diagnosis may present with upper airway obstruction? - ANS-foreign body obstruction
epiglottitis
croup
in a less severe case of upper airway obstruction in a child, what intervention can relieve
obstruction caused by the tongue? - ANS-insert an oral airway
a child presents with a barking cough, good air entry during auscultation, a pulse oximetry
reading of 93% on room air, and retractions at rest.
what is the severity of the child's presentation? - ANS-moderate croup
an 8 month old boy is brought to the hospital by his parents. He has a hoarse cry and barking
cough. His mother says that during the night, her son had difficulty breathing, which has
progressively worsened throughout the day.
the infant most likely has what type of respiratory emergency? - ANS-Upper airway obstruction
according to the systematic approach algorithm, what are the correct assessments to perform
during the evaluation phase? - ANS-initial, primary, secondary
the infant is responsive and is breathing.
what is an initial measure that you can perform to maintain his airway? - ANS-sit him up
what are the components of breathing assessment? - ANS-lung and airway sounds
chest expansion and air movement
oxygen saturation
respiratory rate
respiratory effort
,when calculating the tube size based on the child's age, to avoid injury to the subglottic area,
you should use an endotracheal tube that is: - ANS-half a size smaller than predicted for the
child
how do infants initially respond to lower airway obstruction? - ANS-decreased interpleural
pressure
the anticipated results of the nebulized treatment should include which of the following
improvements in the patient? - ANS-decreased bronchoconstriction
decreased respiratory effort
decreased airway edema
if the patient does not improve with medication, what is your next intervention to ensure
oxygenation? - ANS-noninvasive positive-pressure ventilation
what are the characteristics of shock? - ANS-decreased level of consciousness
inadequate peripheral perfusion
decreased end-organ perfusion
what will occur if adequate oxygen delivery to the tissues is not mainatined? - ANS-organ
dysfunction
what are the major functions of the cardiopulmonary system? - ANS-deliver oxygen to body
tissues
removes metabolic by-products of cellular metabolism
As more time passes between the onset of signs of shock and the restoration of adequate
oxygen delivery and organ perfusion, the outcome is worse - ANS-worse
for general shock management, administer an isotonic crystalloid bolus of 20 mL/kg over 5 to 20
min - ANS-20 mL/kg over 5 to 20 min
what best assess a child's response to each fluid bolus? - ANS-vital signs
physical examination
urinary output
the patient still has a bp of 58/38 mm Hg. Her condition would be classified as hypotensive
shock - ANS-other answer: compensated
obstructive
anaphylactic
when should vasoactive therapy be considered in managing distributive shock? - ANS-if the
child remains hypotensive and poorly perfused despite rapid bolus fluid administration
, what is the focus of the initial management of distributive shock? - ANS-expanding
intravascular volume
filling expanded dilated vascular space
correcting hypovolemia
what signs distinguish anaphylactic shock from other types of shock? - ANS-respiratory distress
with stridor, wheezing or both
angioedema (swelling of the face, lips, and tongue)
urticaria (hives)
in whom should you suspect a tension pneumothorax? - ANS-any intubated child who
deteriorates suddenly while receiving positive-pressure ventilation
victim of chest trauma
a child who deteriorates suddenly while receiving bag-mask ventilation
what is an assessment finding unique to tension pneumothorax? - ANS-tracheal deviation
what circulation findings are specific to pericardial tamponade? - ANS-tachycardia
muffled or diminished heart sounds
narrowed pulse pressures
in what conditions is atropine preferred over epinephrine as the 1st-choice treatment of
symptomatic bradycardia? - ANS-increased vagal tone
av block due to primary bradycardia
cholinergic drug toxicity (organophosphates)
which signs and symptoms are consistent with sinus tachycardia? - ANS-HR <220/min in an
infant or <180 min in a child
hr varies with activity or stimulation
present and normal p waves
how should sinus tachycardia be treated? - ANS-by treating the underlying cause
signs of cardiac arrest in children - ANS-unresponsiveness
no pulse felt
agonal gasps
steps of treating asystole/PEA - ANS-provide cpr
administer epinephrine
consider advanced airway
establish IV/IO access
if myocardial function remains poor in a post- cardiac arrest child, what medications should be
considered? - ANS-epinephrine
