PALS Pretest Questions and Answers

1) Imminent cardiac arrest during shock is signaled by which findings?

2) The most common cause of cardiac arrest in a 4-month-old infant is:

3) Where is V4 placed on a pediatric 12-lead ECG?

4) A 6-year-old with several days of watery stools now appears in shock. Which type of shock is most likely?

5) An 8-year-old in anaphylaxis with severe respiratory distress should receive which agent first?

6) The PALS team identifies torsades de pointes in a pulseless child. Which arrhythmia must they treat?

7) Tracheal deviation to the left, decreased right-side breath sounds and chest pain after trauma suggest obstructive shock from:

8) High-quality chest compressions for a 7-year-old require:

9) Laboratory tests are ordered for a child who has been vomiting for 3 days and is diaphoretic, tachypneic, lethargic and pale. Which test best determines the adequacy of oxygen delivery?

10) After ROSC a child has hemodynamic instability. Which intervention helps restore intravascular volume and preload?

11) A 9-year-old collapses at school and is hemodynamically unstable. Which primary-assessment findings indicate instability?

12) When a school nurse checks breathing and a central pulse on an unresponsive 10-year-old, the assessment should last:

13) Secondary assessment labs for a child in septic shock should include:

14) A 2-year-old with a barking cough and audible inspiratory stridor most likely has which condition?

15) During a post-event debriefing, which topic should the PALS leader cover?

16) To help manage increased intracranial pressure in a pediatric patient, the head should be:

17) In any type of shock, the primary goal is to balance tissue perfusion with metabolic demand by focusing on:

18) In post-cardiac-arrest care of an 8-year-old, the team should ensure which parameter to meet the primary hemodynamic goal?

19) A 9-year-old patient is presenting with decreased breath sounds, bradycardia, slowed respiratory rate and a low O₂ saturation. The provider interprets these findings as indicating which condition?

20) Using the Pediatric Assessment Triangle, which circulation cues should be assessed?

21) A child in respiratory distress may show which circulation sign?

22) A 4-year-old suddenly collapses in the playroom. What is the first assessment the healthcare provider should complete?

23) After return of spontaneous circulation a child shows signs of post-cardiac-arrest syndrome. Which finding(s) suggest a systemic ischemia/reperfusion response?

24) A PALS team is preparing to defibrillate a child in cardiac arrest. For which rhythm(s) is defibrillation appropriate?

25) For a pulseless, unknown-weight 2-year-old, how should drug doses be determined?

26) A 12-year-old with fever, vomiting and diarrhea shows sinus tachycardia on ECG. Which arrhythmia is present?

27) A 4-year-old in respiratory distress has an SpO₂ of 91 %. Oxygen is started by nasal cannula. The goal is to raise the saturation above what percentage?

28) First-line treatment for stable supraventricular tachycardia with adequate perfusion is:

29) An ECG shows pulseless monomorphic ventricular tachycardia. What arrhythmia is present?

30) A child on telemetry suddenly develops the ECG rhythm below. Which arrhythmia is this?

31) For an intubated child in cardiac arrest, which measurement best gauges chest-compression quality?

32) After adenosine for narrow-complex tachycardia, which brief effect should the provider anticipate?

33) After placing an advanced airway in a 5-year-old, correct placement is confirmed by:

34) A 15-year-old patient is being seen 2 months after a Lyme-disease diagnosis. A rhythm strip shows first-degree AV block. Which arrhythmia is present?

35) A 30-month-old with moderate croup should receive which medication(s)?

36) A 4-year-old child is brought to the emergency department. Assessment reveals only gasping respirations and a pulse of 65 beats/min. Which action should the provider initiate first?

37) In the Pediatric Assessment Triangle, the mnemonic TICLS (Tone, Interactiveness, Consolability, Look/gaze, Speech/cry) is used to assess:

38) An 11-year-old develops unstable wide-complex tachycardia with a pulse and poor perfusion. What is the first-line intervention?

39) A 7-year-old with septic shock shows delayed capillary refill, cool mottled skin and narrow pulse pressure. This presentation is typical of:

40) Using a three-electrode monitor, the red electrode should be placed:

41) When assessing a child for shock, which statement about hypotension is correct?

42) Two providers are giving high-quality CPR to an unresponsive, pulseless 2-year-old. Which actions demonstrate high-quality CPR?

43) An 11-year-old soccer player with severe asthma exacerbation arrives in the ED. Which medication should be given first?

44) Tachycardia, tachypnea, cold extremities, weak pulses, hepatomegaly and jugular-vein distension suggest which type of shock in a 4-year-old?

45) A 7-year-old in ventricular fibrillation should receive which immediate intervention?

46) A child with bradycardia and inadequate perfusion remains unstable despite CPR, oxygenation and ventilation. The next medication is:

47) A 3-month-old with fever, grunting and a wet “junky” cough tests RSV-positive. What is the likely diagnosis?

48) A 12-year-old child in the pediatric intensive care unit displays the ECG waveform shown below. The team interprets this rhythm as which arrhythmia?

49) In a 5-year-old with neuromuscular disease and respiratory distress, a critical airway-management step is:

50) During primary assessment of a child in respiratory distress, which finding indicates increased work of breathing?