Page 1 of 62
PALS Pre Test EXAM LATEST VERSION WITH
COMPLETE 200 QUESTIONS AND CORRECT
ANSWERS JUST RELEASED THIS YEAR
A 3-year-old boy presents with multiple system trauma. The child was an unrestrained
passenger in a motor vehicle crash. On primary assessment he is unresponsive to voice or
painful stimulation. His respiratory rate is less than 6/min, heart rate is 170/min, systolic
blood pressure is 60 mm Hg, cap refill is 5 seconds, and SpO2 is 75% in room air. Which of the
following most accurately summarizes the first interventions you should take to support this
child?
A. Establish immediate vascular access, administer 20 mL/kg isotonic crystalloid, and reassess
the patient; if the child's systemic perfusion does not improve, administer 10 to 20 mL/kg
packed red blood cells.
B. Provide 100% oxygen by simple mask and perform a head-to-toe survey to identify the
extent of all injuries; begin an epinephrine infusion and titrate to maintain a systolic blood
pressure of at least 76 mm Hg
C. Open the airway (jaw-thrust technique) while stabilizing the cervical spine, administer
positive-pressure ventilation with 100% oxygen, and establish immediate IV/IO access.
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,Page 2 of 62
D. Provide 100% oxygen by simple mask, stabilize the cervical spine, establish vascular access,
and provide maintenance IV fluids.
C
Initial impression of a 10-month-old male in the emergency department reveals a lethargic
pale infant with slow respirations. You begin assisted ventilation with a bag-mask device using
100% oxygen. On primary assessment heart rate is 38/min, central pulses are weak, but distal
pulses cannot be palpated. Blood pressure is 60/40, and cap refill is 4 seconds. During your
assessment, as colleague places the child on a cardiac monitor and you observe the rhythm
above (sinus bradycardia, 40 bpm). The rhythm remains unchanged despite ventilation with
100% oxygen. What are your next management steps?
A. Administer adenosine 0.1 mg/kg rapid IV/IO and prepare for synchronized cardioversion.
B. Start chest compressions and give epinephrine 0.1 mg/kg (0.1 mg/kg of 1:1,000) IV/IO
C. Start chest compressions and give epinephrine 0.01 mg/kg (0.1 mL/kg of 1:10,000) IV/IO
D. Administer 20 mL/kg isotonic crystalloid and epinephrine 0.1 mg/kg (0.1 mL/kg of
1:10,000) IV/IO
C
2
SUCCESS!
,Page 3 of 62
A 1-year-old male is brought to the emergency department for evaluation of poor feeding,
fussiness, and sweating. On initial impression he is lethargic but arousable and has labored
breathing and a dusky color. Primary assessment reveals a respiratory rate of 68/min, heart
rate 300/min that does not very with activity or sleep, blood pressure 70/45 mm Hg, weak
brachial pulses and absent radial pulses, cap refill 6 seconds, SpO2 85% in room air, and good
bilateral breath sounds. You administer high-flow oxygen and place the child on a cardiac
monitor. You see the above rhythm (SVT) with little beat-to-beat variability of the heart rate.
Secondary assessment reveals no history of congenital heart disease. IV access has been
established. Which of the following therapies is most appropriate for this infant?
A. Adenosine 0.1 mg/kg IV rapidly; if adenosine is not immediately available, perform
synchronized cardioversion.
B. Make an appointment with a pediatric cardiologist for later in the week.
C. Establish IV access and administer a flid bolus of 20 mL/kg isotonic crystalloid.
D. Perform immediate defibrillation without waiting for IV access
A
You are preparing to use a manual defibrillator and paddles in the pediatric setting. When
would it be most appropriate to use the smaller "pediatric" sized paddles for shock delivery?
3
SUCCESS!
, Page 4 of 62
A. If the patient weighs less than approximately 10 kg or is less than 1 year of age.
B. Whenever you can compress the victim's chest using only the heel of one hand
C. To attempt synchronized cardioversion but not defibrillation
D. If the patient weighs less than approximately 25 kg, or is less than 8 years of age.
A
Parents of a 1-year-old female phoned EMS when they picked up their daughter from the
babysitter. Paramedics perform an initial impression revealing an obtunded infant with
irregular breathing, bruises over the abdomen, abdominal distension, and cyanosis. Assisted
bag-mask ventilation with 100% oxygen is initiated. On primary assessment heart rate is
36/min, peripheral pulses cannot be palpated, and central pulses are barely palpable. Cardiac
monitor shows sinus bradycardia. Chest compressions are started at 15:2. In the ED the infant
is intubated and ventilated, and IV access is established. The heart rate is now up to 150/min,
but there are weak central pulses and no distal pulses. Systolic BP is 74. Of the following,
which would be most useful in management of this infant?
A. Synchronized cardioversion
B. Epinephrine 0.01 mg/kg (0.1 mL/kg of 1:10,000 dilution) IV
4
SUCCESS!
PALS Pre Test EXAM LATEST VERSION WITH
COMPLETE 200 QUESTIONS AND CORRECT
ANSWERS JUST RELEASED THIS YEAR
A 3-year-old boy presents with multiple system trauma. The child was an unrestrained
passenger in a motor vehicle crash. On primary assessment he is unresponsive to voice or
painful stimulation. His respiratory rate is less than 6/min, heart rate is 170/min, systolic
blood pressure is 60 mm Hg, cap refill is 5 seconds, and SpO2 is 75% in room air. Which of the
following most accurately summarizes the first interventions you should take to support this
child?
A. Establish immediate vascular access, administer 20 mL/kg isotonic crystalloid, and reassess
the patient; if the child's systemic perfusion does not improve, administer 10 to 20 mL/kg
packed red blood cells.
B. Provide 100% oxygen by simple mask and perform a head-to-toe survey to identify the
extent of all injuries; begin an epinephrine infusion and titrate to maintain a systolic blood
pressure of at least 76 mm Hg
C. Open the airway (jaw-thrust technique) while stabilizing the cervical spine, administer
positive-pressure ventilation with 100% oxygen, and establish immediate IV/IO access.
1
SUCCESS!
,Page 2 of 62
D. Provide 100% oxygen by simple mask, stabilize the cervical spine, establish vascular access,
and provide maintenance IV fluids.
C
Initial impression of a 10-month-old male in the emergency department reveals a lethargic
pale infant with slow respirations. You begin assisted ventilation with a bag-mask device using
100% oxygen. On primary assessment heart rate is 38/min, central pulses are weak, but distal
pulses cannot be palpated. Blood pressure is 60/40, and cap refill is 4 seconds. During your
assessment, as colleague places the child on a cardiac monitor and you observe the rhythm
above (sinus bradycardia, 40 bpm). The rhythm remains unchanged despite ventilation with
100% oxygen. What are your next management steps?
A. Administer adenosine 0.1 mg/kg rapid IV/IO and prepare for synchronized cardioversion.
B. Start chest compressions and give epinephrine 0.1 mg/kg (0.1 mg/kg of 1:1,000) IV/IO
C. Start chest compressions and give epinephrine 0.01 mg/kg (0.1 mL/kg of 1:10,000) IV/IO
D. Administer 20 mL/kg isotonic crystalloid and epinephrine 0.1 mg/kg (0.1 mL/kg of
1:10,000) IV/IO
C
2
SUCCESS!
,Page 3 of 62
A 1-year-old male is brought to the emergency department for evaluation of poor feeding,
fussiness, and sweating. On initial impression he is lethargic but arousable and has labored
breathing and a dusky color. Primary assessment reveals a respiratory rate of 68/min, heart
rate 300/min that does not very with activity or sleep, blood pressure 70/45 mm Hg, weak
brachial pulses and absent radial pulses, cap refill 6 seconds, SpO2 85% in room air, and good
bilateral breath sounds. You administer high-flow oxygen and place the child on a cardiac
monitor. You see the above rhythm (SVT) with little beat-to-beat variability of the heart rate.
Secondary assessment reveals no history of congenital heart disease. IV access has been
established. Which of the following therapies is most appropriate for this infant?
A. Adenosine 0.1 mg/kg IV rapidly; if adenosine is not immediately available, perform
synchronized cardioversion.
B. Make an appointment with a pediatric cardiologist for later in the week.
C. Establish IV access and administer a flid bolus of 20 mL/kg isotonic crystalloid.
D. Perform immediate defibrillation without waiting for IV access
A
You are preparing to use a manual defibrillator and paddles in the pediatric setting. When
would it be most appropriate to use the smaller "pediatric" sized paddles for shock delivery?
3
SUCCESS!
, Page 4 of 62
A. If the patient weighs less than approximately 10 kg or is less than 1 year of age.
B. Whenever you can compress the victim's chest using only the heel of one hand
C. To attempt synchronized cardioversion but not defibrillation
D. If the patient weighs less than approximately 25 kg, or is less than 8 years of age.
A
Parents of a 1-year-old female phoned EMS when they picked up their daughter from the
babysitter. Paramedics perform an initial impression revealing an obtunded infant with
irregular breathing, bruises over the abdomen, abdominal distension, and cyanosis. Assisted
bag-mask ventilation with 100% oxygen is initiated. On primary assessment heart rate is
36/min, peripheral pulses cannot be palpated, and central pulses are barely palpable. Cardiac
monitor shows sinus bradycardia. Chest compressions are started at 15:2. In the ED the infant
is intubated and ventilated, and IV access is established. The heart rate is now up to 150/min,
but there are weak central pulses and no distal pulses. Systolic BP is 74. Of the following,
which would be most useful in management of this infant?
A. Synchronized cardioversion
B. Epinephrine 0.01 mg/kg (0.1 mL/kg of 1:10,000 dilution) IV
4
SUCCESS!
