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PALS PreTest Questions & answers
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PALS PreTestYou are called to help treat an infant with severe symptomatic bradycardia (heart rate
66/min) associated with respiratory distress. The bradycardia persists despite
establishment of an effective airway, oxygenation, and ventilation. There is no heart
block present. Which is the first drug you should administer? - ANS-Epinephrine
Initial impression of a 2yo girl shows her to be alert with mild breathing difficulty during
inspiration and pale skin color. On primary assessment, she makes high-pitched
inspiratory sounds (mild stridor) when agitated; otherwise, her breathing is quiet. Her
spO2 is 92% on room air, and she has mild inspiratory intercostal retractions. Lung
auscultation reveals transmitted upper airway sounds with adequate distal breath
sounds bilaterally. Which is the most appropriate initial intervention for this child? -
ANS-Humidified oxygen as tolerated
You are part of a team attempting to resuscitate a child with ventricular fibrillation
cardiac arrest. You delivered 2 unsynchronized shocks. A team member established IO
access, so you give a dose of epinephrine, 0.01 mg/kg IO. At the next rhythm check,
persistent ventricular fibrillation is present. You administer a 4 J/kg shock and resume
CPR. Which drug and dose should be administered next? - ANS-Amiodarone 5 mg/kg
IO
Which statement is correct about the effects of epinephrine during attempted
resuscitation? - ANS-Epinephrine stimulates spontaneous contractions when asystole is
present
A previously healthy infant with a history of vomiting and diarrhea is brought to the
emergency department by her parents. During your assessment, you find that the infant
responds only to painful stimulation. - ANS-Administer a bolus of isotonic crystalloid 20
ml/kg over 5-20 minutes, and also give D25W 2-4 ml/kg IV
Which statement is correct about endotracheal drug administration during resuscitative
efforts for pediatric patients? - ANS-It is the least desirable route of administration
Which statement is correct about the use of calcium chloride in pediatric patients? -
ANS-Routine administration is not indicated during cardiac arrest
A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. -
ANS-Albuterol
, Which oxygen delivery system most reliably delivers a high (90% or greater)
concentration of inspired oxygen to a 7yo child? - ANS-Nonrebreathing face mask
Paramedics are called to the home of a 1yo child. Their initial assessment reveals a
child who responds only to painful stimuli and has irregular breathing, faint central
pulses, bruises over the abdomen, abdominal distention, and cyanosis - ANS-Rapid
bolus of 20ml/kg of isotonic crystalloid
A 7yo boy is found unresponsive, apneic, and pulseless. CPR is ongoing - ANS-Identify
and treat reversible causes
You are preparing to use a manual defibrillator in the pediatric setting. Which best
describes when it is appropriate to use the smaller, pediatric-sized paddles? - ANS-If
the child weighs less than 10kg or is less than 1 year old
What compression-to-ventilation ratio should be used for 2-rescuer infant CPR? -
ANS-15 compressions to 2 breaths
You find an infant who is unresponsive, is not breathing, and does not have a pulse. You
shout for nearby help, but no one arrives. What action should you take next? -
ANS-Provide CPR for about 2 minutes before leaving to activate the emergency
response system
You are assisting in the elective intubation of an average-sized 4yo child with respiratory
failure. A colleague is retrieving the color-coded length-based tape from the
resuscitation cart. Which of the following is likely to be the estimated size of the
uncuffed endotracheal tube for this child? - ANS-5mm tube
A pale and very sleepy but arousable 3yo child with a hx of diarrhea is brought to the
hospital. Primary assessment reveals a respiratory rate of 45/min with good breath
sounds bilaterally - ANS-Administer a bolus of 20 ml/kg isotonic crystalloid
You are evaluating an irritable 6yo girl with mottled skin color. - ANS-Compensated
shock associated with tachycardia and inadequate tissue perfusion
You assisted with the elective endotracheal intubation of a child with respiratory failure
and a perfusing rhythm - ANS-Adequate bilateral breath sounds and chest expansion
plus detection of ETCO2 with waveform capnography
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