2024 PALS VERSION A EXAM WITH
CORRECT ANSWERS
You are caring for a child who was resuscitated after a drowning event. The
child is intubated and ventilated with 100% oxygen with equal breath sounds
and exhaled CO2 detected. The heart rate is slow and the monitor shows
sinus bradycardia. The skin is cool, mottled, and moist; distal pulses are not
palpable and the central pulses are weak. Intravenous access has been
established. The core temperature is 37.3oC. Based on the PALS bradycardia
algorithm, which of the following should be provided first?
Epinephrine IV
Transcutaneous pacing
Atropine IV
Dobutamine IV infusion - CORRECT ANSWERS-Epinephrine IV
You are caring for a 7-year-old with respiratory distress that has worsened
over the past few hours. The child is alert and in moderate respiratory
distress with prolonged exhalation time. The respiratory rate is 28/min with
bilateral expiratory wheezes. The heart rate is 112/min with good capillary
refill. The wheezing in this patient indicates:
Lung tissue (parenchymal) lung disease
Disordered control of breathing
Upper airway obstruction
Lower airway obstruction - CORRECT ANSWERS-Lower airway obstruction
Which of the following assessments is most useful in evaluating the
effectiveness of bag-mask ventilations?
Hearing an air leak around the mask when the bag is fully compressed
Seeing the abdomen rise during ventilation
Observation of visible chest rise
A normal systolic, diastolic, and mean arterial pressure - CORRECT
ANSWERS-Observation of visible chest rise
You are assessing a 6-year-old child who appears unconscious after striking
his head on a concrete step. You pinch the patient's chest and the patient
grabs your hand. You would document this response as:
Decerebrate posturing
Decorticate posturing
Withdrawal from a painful stimulus
, Localization of a painful stimulus - CORRECT ANSWERS-Localization of a
painful stimulus
You are caring for an 8-year-old child who was struck by a car. The child is
alert, very anxious, and in respiratory distress. The child is receiving high-
flow oxygen by face mask, has a respiratory rate of 60/min, the heart rate is
150/min, systolic blood pressure is 70 mm Hg, and a SpO2 of 86% and
falling. Breath sounds and chest rise are absent over the right chest. Which
of the following is the most likely cause of this child's distress?
You are treating a 10-year-old victim of multisystem trauma. The child is
very anxious and confused. The respiratory rate is 44/min and unlabored. the
pulse is rapid and weak. Capillary refill is delayed. High-flow oxygen and an
intravenous line are in place. The most appropriate initial fluid for rapid
volume expansion is:
10% dextrose in water
5% dextrose in Ringer's lactate
5% dextrose in normal saline
Normal saline or Ringer's lactate - CORRECT ANSWERS-Normal saline or
Ringer's lactate
You are caring for a 5-year-old patient with supraventricular tachycardia
(heart rate = 220/min). The child is lethargic. The skin is pale and cool with
delayed capillary refill. Distal pulses are not palpable. Which of the following
would be the best treatment to provide without delay?
Place cold packs on the distal upper and lower extremities
Ask the child to blow through a small straw
Exert light pressure on the eyes bilaterally
Provide synchronized cardioversion at 0.5 to 1 J/kg - CORRECT ANSWERS-
Provide synchronized cardioversion at 0.5 to 1 J/kg
You are initiating treatment for a child with septic shock and hypotension.
While administering high-flow oxygen you determine that the child's
respirations are adequate and SpO2 is 100%. You have just established
vascular access and obtained blood samples. Which of the following is the
next most appropriate therapy to support systemic perfusion?
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