PALS Chapter 8: Tachycardia Practice Test 2025

Last Updated on June 28, 2025

Pediatric Advanced Life Support PALS Chapter 8: Tachycardia Practice Test 2025 Questions and Answers Quiz. Tachycardia is a heart rate greater than usual for a child’s age. Like bradycardia, tachycardia can be life-threatening if it compromises the heart’s ability to perfuse effectively. When the heart beats too quickly, there is a shortened relaxation phase.

This causes two main problems: the ventricles cannot fill, resulting in lowered cardiac output; the coronary arteries receive less blood, thereby decreasing supply to the heart. There are several kinds of tachycardia, which can be challenging to differentiate in children on ECG due to the elevated heart rate.

PALS Chapter 8: Tachycardia Practice Test

PALS Practice Test
Chapter 8: Tachycardia
Total Items: 20 MCQs
Time Limit: N/A

1 / 20

1) Which rhythm is characterized by a twisting of the QRS complexes around the isoelectric line?

A) Torsades de Pointes

B) SVT

C) Ventricular fibrillation

D) Sinus tachycardia

2 / 20

2) Which of the following rhythms usually has visible P waves and a gradual onset?

A) Ventricular tachycardia

B) SVT

C) Sinus tachycardia

D) Torsades de Pointes

3 / 20

3) What is the first-line drug for treating pediatric supraventricular tachycardia (SVT)?

A) Lidocaine

B) Atropine

C) Epinephrine

D) Adenosine

4 / 20

4) What treatment is preferred for a child with unstable ventricular tachycardia with a pulse?

A) Epinephrine

B) Vagal maneuvers

C) Synchronized cardioversion

D) Defibrillation

5 / 20

5) What is a critical risk associated with untreated ventricular tachycardia?

A) Progression to ventricular fibrillation

B) Respiratory distress

C) Fatigue

D) Temporary confusion

6 / 20

6) Which of the following best describes a narrow QRS complex tachycardia?

A) QRS duration < 0.09 seconds

B) QRS duration > 0.12 seconds

C) Always life-threatening

D) Irregular and wide complex

7 / 20

7) What is the most common cause of sinus tachycardia in pediatric patients?

A) Electrocution

B) Congenital arrhythmia

C) Structural heart disease

D) Fever or pain

8 / 20

8) What is the correct second dose of adenosine if the first dose fails in treating SVT?

A) Repeat first dose

B) 0.5 mg/kg

C) 1.0 mg/kg

D) 0.2 mg/kg, max 12 mg

9 / 20

9) A 13-year-old with a history of congenital heart disease has a narrow complex tachycardia at 175 bpm. Which is the most likely rhythm?

A) Ventricular tachycardia

B) SVT

C) Atrial flutter

D) Torsades de Pointes

10 / 20

10) Which of the following is true regarding ventricular fibrillation?

A) It requires defibrillation

B) It shows organized QRS complexes

C) It can be treated with adenosine

D) It is a stable rhythm

11 / 20

11) Which of the following is typically NOT seen in wide complex tachycardia?

A) Rate above 150 bpm

B) Wide QRS

C) P waves before every QRS

D) Polymorphic QRS patterns

12 / 20

12) A child presents with a narrow QRS complex and heart rate of 180 bpm. He is alert and perfusing well. What is the most likely rhythm?

A) Ventricular tachycardia

B) Asystole

C) Sinus tachycardia

D) Torsades de Pointes

13 / 20

13) You see a wide QRS tachycardia with no clear P waves. The child is hypotensive. What is the most urgent next step?

A) Administer adenosine

B) Repeat ECG

C) Observe

D) Perform synchronized cardioversion

14 / 20

14) Which of the following tachyarrhythmias is NOT considered life-threatening?

A) Ventricular tachycardia

B) Ventricular fibrillation

C) Sinus tachycardia

D) Torsades de Pointes

15 / 20

15) What is the correct first dose of adenosine in a 10-year-old child with SVT?

A) 6 mg

B) 12 mg

C) 0.1 mg/kg, maximum 6 mg

D) 0.2 mg/kg, maximum 12 mg

16 / 20

16) What ECG finding suggests SVT rather than sinus tachycardia?

A) Gradual increase in heart rate

B) Abrupt onset and termination

C) Irregular rhythm

D) Clear P waves

17 / 20

17) When is adenosine contraindicated in pediatric tachycardia?

A) After vagal maneuvers

B) In regular SVT

C) In narrow QRS tachycardia

D) If the rhythm is irregular or polymorphic

18 / 20

18) In a stable child with SVT, what non-pharmacologic intervention can be tried first?

A) Chest compressions

B) Vagal maneuvers (e.g., ice to face)

C) Carotid massage

D) Administer epinephrine

19 / 20

19) What is a distinguishing feature of ventricular tachycardia on ECG?

A) Heart rate always under 120 bpm

B) P waves visible between beats

C) Narrow QRS, regular rhythm

D) Wide QRS, often regular

20 / 20

20) A child with a heart rate of 200 bpm suddenly becomes unresponsive. What should you do first?

A) Begin chest compressions

B) Call Poison Control

C) Administer adenosine

D) Give oxygen and wait

Your score is

See also:

Free PALS Practice Test 2025 Official Study Guide [PDF]

Previous tests:

Chapter-wise tests: