PALS Chapter 8: Tachycardia Practice Test 2026

Last Updated on May 5, 2026

Pediatric Advanced Life Support PALS Chapter 8: Tachycardia Practice Test 2026 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, the relaxation phase is shortened.

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 types of tachycardia, which can be challenging to differentiate on ECG in children 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) What is a distinguishing feature of ventricular tachycardia on ECG?

A) Heart rate always under 120 bpm

B) Wide QRS, often regular

C) P waves visible between beats

D) Narrow QRS, regular rhythm

2 / 20

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

A) Sinus tachycardia

B) Torsades de Pointes

C) Ventricular tachycardia

D) SVT

3 / 20

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

A) Respiratory distress

B) Temporary confusion

C) Fatigue

D) Progression to ventricular fibrillation

4 / 20

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

A) Irregular and wide complex

B) Always life-threatening

C) QRS duration > 0.12 seconds

D) QRS duration < 0.09 seconds

5 / 20

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

A) Wide QRS

B) P waves before every QRS

C) Polymorphic QRS patterns

D) Rate above 150 bpm

6 / 20

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

A) Epinephrine

B) Lidocaine

C) Adenosine

D) Atropine

7 / 20

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

A) Abrupt onset and termination

B) Irregular rhythm

C) Gradual increase in heart rate

D) Clear P waves

8 / 20

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

A) Fever or pain

B) Congenital arrhythmia

C) Structural heart disease

D) Electrocution

9 / 20

9) When is adenosine contraindicated in pediatric tachycardia?

A) In narrow QRS tachycardia

B) If the rhythm is irregular or polymorphic

C) After vagal maneuvers

D) In regular SVT

10 / 20

10) 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) Asystole

B) Ventricular tachycardia

C) Torsades de Pointes

D) Sinus tachycardia

11 / 20

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

A) Epinephrine

B) Synchronized cardioversion

C) Vagal maneuvers

D) Defibrillation

12 / 20

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

A) Torsades de Pointes

B) Sinus tachycardia

C) Ventricular tachycardia

D) Ventricular fibrillation

13 / 20

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

A) Torsades de Pointes

B) SVT

C) Sinus tachycardia

D) Ventricular fibrillation

14 / 20

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

A) Carotid massage

B) Administer epinephrine

C) Chest compressions

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

15 / 20

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

A) Repeat ECG

B) Administer adenosine

C) Observe

D) Perform synchronized cardioversion

16 / 20

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

A) Begin chest compressions

B) Give oxygen and wait

C) Administer adenosine

D) Call Poison Control

17 / 20

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

A) It is a stable rhythm

B) It shows organized QRS complexes

C) It requires defibrillation

D) It can be treated with adenosine

18 / 20

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

A) 12 mg

B) 0.1 mg/kg, maximum 6 mg

C) 0.2 mg/kg, maximum 12 mg

D) 6 mg

19 / 20

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

A) 1.0 mg/kg

B) Repeat first dose

C) 0.5 mg/kg

D) 0.2 mg/kg, max 12 mg

20 / 20

20) 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) Torsades de Pointes

B) Atrial flutter

C) Ventricular tachycardia

D) SVT

Your score is

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