AHA PALS Practice exam Questions and Answers latest updated

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1. A 5-year-old child presents with lethargy, increased work of breathing, and pale color. The primary assessment reveals that the airway is open and the respiratory rate is 30/min, with crackles hear... d on auscultation. The cardiac monitor shows sinus tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of 95% and a pulse rate of 93/min. On the basis of this information, which of the following provides the best interpretation of the oxygen saturation of 95% by pulse oximetry? A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary oxygen should be administered C. Unreliable; no supplementary oxygen is indicated D. Unreliable; supplementary oxygen should be administered - ANSWER Unreliable; supplementary oxygen should be administered 2. A 3-year-old child was recently diagnosed with leukemia and has been treated with chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min, respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is less than 2 seconds. What is the child's most likely condition? A. Septic shock B. Hypovolemic shock C. Significant bradycardia D. Cardiogenic shock - ANSWER Septic shock 3. A 2-week-old infant presents with irritability and a history of poor feeding. Blood pressure is 55/40 mm Hg. What term describes this infant's blood pressure? A. Hypotensive B. Normal C. Hypertensive D. Compensated - ANSWER Hypotensive 4. During a resuscitation attempt, the team leader orders an initial dose of epinephrine at 0.1 mg/kg to be given 10. What should the team member do? A. Administer the drug as ordered B. Administer 0.01 mg/kg of epinephrine C. Respectfully ask the team leader to clarify the dose D. Refuse to administer the drug - ANSWER Respectfully ask the team leader to clarify the dose 5. Which of the following is a characteristic of respiratory failure? A. Inadequate oxygenation and/or ventilation B. Hypotension C. An increase in serum pH (alkalosis) D. Abnormal respiratory sounds - ANSWER Inadequate oxygenation and/or ventilation 6. Which of the following is most likely to produce a prolonged expiratory phase and wheezing? A. Disordered control of breathing B. Hypovolemic shock C. Lower airway obstruction D. Upper airway obstruction - ANSWER Lower airway obstruction 7. A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few minutes ago. Which of the following most likely to be abnormal? A. Vascular resistance B. Pulse rate C. Lung compliance D. Control of breathing - ANSWER Control of breathing 8. What abnormality is most likely to be present in children with acute respiratory distress caused by lung tissue disease? A. Decreased oxygen saturation B. Stridor C. Normal respiratory rate D. Decreased respiratory effort - ANSWER Decreased oxygen saturation 9. An alert 2-year-old child with an increased work of breathing and pink color is being evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would best describe this patient's condition? A. Respiratory distress B. Respiratory arrest C. Respiratory failure D. Disordered control of breathing - ANSWER Respiratory distress 10. The parents of a 7-year-old child who is undergoing chemotherapy report that the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals the following: The child is difficult to arouse, with pale color. The child's heart rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is the most appropriate intervention? A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30 minutes B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes C. Obtain immediate blood cultures and chest x-ray D. Obtain expert consultation with an oncologist to determine the chemotherapeutic regimen - ANSWER Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes 11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression reveals an unresponsive child with intermittent apnea and mottled color. Heart rate is 166/min, respiratory rate is now being supported with bag-mask ventilation, capillary refill time is 5 to 6 seconds, and temperature is 102°F (38.9°C). What is the best method of establishing immediate vascular access? A. Two providers may attempt peripheral vascular access twice each B. Three providers may attempt peripheral vascular access once each C. Place a central venous line D. Place an intraosseous line - ANSWER Place an intraosseous line 12. What is the appropriate fluid bolus to administer for a child with hypovolemic shock with adequate myocardial function? A. 10 mL/kg normal saline B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride C. 20 mL/kg normal saline D. 10 mL/kg lactated Ringer's - ANSWER 20 mL/kg normal saline 13. An alert toddler presents with a barking cough, moderate stridor, and moderate retractions. The child's color is pink. What is the most appropriate initial intervention? A. Obtain a chest radiograph B. Administer nebulized epinephrine C. Prepare for a surgical airway D. Use an epinephrine autoinjector - ANSWER Administer nebulized epinephrine 14. An 8-year-old child presents with a history of vomiting and diarrhea. The child has the following vital signs: heart rate 168/min, respiratory rate 15/min, blood pressure 9060 mm Hg, and temperature 98.6°F (37°C). The child's capillary refill time is 4 seconds. After 2 IV boluses of normal saline (20 mL/kg each), the child's vital signs are now as follows: heart rate 130/min, respiratory rate 16/min, blood pressure 94/62 mm Hg, capillary refill 2 seconds, and temperature 98.6°F (37°C). The child's urine output is 1 to 2 mL/kg in the past hour. The child is still lethargic. What diagnostic tests or information should be obtained first? A. Arterial blood gas B. Serum potassium concentration C. Glucose D. A 12-lead ECG - ANSWER Glucose 15. A 15-year-old boy presents with acute onset of severe respiratory distress, with retractions and an oxygen saturation of 85%. His trachea is deviated to the right, and there are no breath sounds on the left. His heart rate is 140/min, his blood pressure is 84/60 mm Hg, and his capillary refill time is 3 seconds. What is the most appropriate intervention? A. Obtain a chest x-ray B. Perform needle decompression on the left chest C. Insert a chest tube on the left side D. Insert an IV and administer 20 mL/kg of normal saline - ANSWER Perform needle decompression on the left chest 16. A 4-year-old is being treated for hypovolemic shock and has received a single fluid bolus of 20 mL/kg of normal saline. On reevaluation the child remains anxious, with a heart rate of 140/min, a blood pressure of 84/54 mm Hg, and a capillary refill time of 4 seconds. What describes this patient's condition? A. Hypotensive shock B. Compensated shock C. No longer in shock D. Cardiogenic shock - ANSWER Compensated shock 17. An 8-year-old child had a sudden onset of palpitations and light-headedness. At the time of evaluation the child is alert. His respiratory rate is 26/ min, and his blood pressure is 104/70 mm Hg. A cardiac monitor is applied, and the rhythm below is noted. What is the most appropriate initial intervention? A. Provide synchronized cardioversion at 0.5 to 1 J/kg B. Attempt vagal maneuvers C. Administer adenosine 0.1 mg/kg over 5 minutes D. Administer amiodarone 5 mg/kg over 20 minutes - ANSWER Attempt vagal maneuvers 18. A 10-year-old child had a sudden witnessed cardiac arrest and received immediate bystander CPR and defibrillation within 3 minutes. He had a return of spontaneous circulation. The child remains unresponsive and has an advanced airway in place. There is no history of trauma or signs of shock. What is the target range for oxygen saturation for this child? A. 92% to 100% B. 92% to 99% C. 94% to 99% D. 94% to 100% - ANSWER 94% to 99% 19. A 3-month-old infant with bronchiolitis is suctioned to remove upper airway secretions. The infant's heart rate decreases from 155/min to 65/min as shown below. The infant remains alert, with easily palpable pulses. Capillary refill time is 1 second. What is the most appropriate initial intervention? A. Administer oxygen and ensure adequate ventilation; be prepared to intervene further if heart rate does not increase B. Establish IV/IO access and administer epinephrine 0.01 mg/kg IV C. Establish IV/IO access and administer atropine 0.02 mg/kg IV D. Call for help and prepare to provide transthoracic pacing/transvenous pacing - ANSWER Administer oxygen and ensure adequate ventilation; be prepared to intervene further if heart rate 20. A 3-month-old infant with bronchiolitis is intubated for management of respiratory failure. During transport, the infant develops bradycardia with a heart rate of 60/min, and the infant's oxygen saturation decreases to 75%. There are breath sounds on the right side, but no air entry is heard on the left side. What is the most appropriate initial intervention? A. Administer epinephrine 0.01 mg/kg IV B. Place a chest tube on the left C. Verify the endotracheal tube position D. Aggressively suction the endotracheal tube - ANSWER Verify the endotracheal tube position 21. For a 6-month-old infant with supraventricular tachycardia and adequate perfusion, which of the following is the preferred vagal maneuver? A. Ocular pressure B. Carotid pressure C. Valsalva maneuver D. Ice to the face - ANSWER Ice to the face 22. A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10 minutes after eating peanuts. What is the most appropriate initial medication for this child? A. Nebulized albuterol B. Epinephrine IM C. Isotonic crystalloid IV D. Methylprednisolone - ANSWER Epinephrine IM 23. A 2-year-old child was found submerged in a swimming pool. She is unresponsive, not breathing, and pulseless. In addition to performing high-quality CPR and establishing vascular access, which of the following is the most appropriate intervention? A. Give atropine 0.02 mg/kg lIO/IV B. Apply cricoid pressure C. Give epinephrine 0.01 mg/kg IO/IV D. Provide transthoracic pacing - ANSWER Give epinephrine 0.01 mg/kg IO/IV 24. A 3-year-old child is unresponsive, not breathing, and pulseless. High-quality CPR is in progress. A cardiac monitor is applied, and the rhythm below is noted. What is the next appropriate intervention? A. Attempt defibrillation with a 2 J/kg shock B. Administer epinephrine 0.01 mg/kg C. Consider placement of an advanced airway D. Administer amiodarone 5 mg/kg - ANSWER Attempt defibrillation with a 2 J/kg shock 25. A pulseless 6-week-old infant arrives in the emergency department, and high-quality CPR is in progress. The initial rhythm strip is shown below. CPR continues, and vascular access has been established. What is the next appropriate intervention? A. Administer atropine 0.02 mg/kg IO/IV B. Attempt defibrillation with a 2 J/kg shock C. Administer epinephrine 0.01 mg/kg IO/IV D. Consider insertion of an advanced airway - ANSWER Administer epinephrine 0.01 mg/kg IO/IV 26. A 6-month-old infant is unresponsive and not breathing. What is the maximum time that should be spent trying to palpate the pulse before starting CPR? A. 10 seconds B. 15 seconds C. 30 seconds D. 60 seconds - ANSWER 10 seconds 27. What is the recommended location to check for a pulse in a 3- month-old infant? A. Carotid B. Radial C. Brachial D. Cardiac apex - ANSWER C. Brachial 28. A 7-year-old child presents in pulseless arrest. The child's ECG shows the rhythm below. Which of the following describes the patient's condition? A. Ventricular escape rhythm B. Ventricular tachycardia C. Pulseless electrical activity D. Sinus bradycardia - ANSWER Pulseless electrical activity 30. A 12-year-old child suddenly collapses while playing sports. He is unresponsive and not breathing. Emergency response is activated. The child has no pulse, and CPR is initiated. An AED arrives. What is the most appropriate next intervention? A. Contact the child's family B. Provide CPR for 2 minutes C. Drive the child to the hospital D. Use the AED - ANSWER Use the AED 31. A 6-year-old child is found unresponsive, not breathing, and pulseless. What is the correct compression-to-ventilation ratio when 2 or more healthcare providers are present to perform CPR? - ANSWER 15:2 32. A 5-year-old child has had severe respiratory distress for 2 days. During assessment the child's heart rate decreases from 140/min to 90/min, and the child's respiratory rate decreases from 66/min to 8/min. What intervention is most appropriate? A. Provide rescue breaths at a rate of 12 to 20/min B. Provide rescue breaths at a rate of 6 to 10/min C. Initiate chest compressions at a rate of at least 100/min D. Initiate chest compressions at a rate of 60/min - ANSWER Provide rescue breaths at a rate of 12 to 20/min 33. A 7-year-old child presents with a narrow-complex supraventricular tachycardia, lethargy, and poor perfusion. Pulses are weak and thready. Vascular access cannot be established. What is the most appropriate intervention? A. Unsynchronized shock with 0.5 to 1 J/kg B. Synchronized shock with 0.5 to 1 J/kg C. Unsynchronized shock with 2 J/kg D. Synchronized shock with 2 J/kg - ANSWER Synchronized shock with 0.5 to 1 J/kg 1. A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer. What is the next most appropriate intervention? A. Administer 0.1 mg/kg of adenosine B. Obtain a blood sample to evaluate arterial or venous blood gases C. Reassess breath sounds and clinical status D. Repeat the albuterol treatment - ANSWER Reassess breath sounds and clinical status 2. The respiratory rate of a 1-year-old child with respiratory distress has decreased from 65/min to 30/min. The child is more lethargic and continues to have subcostal retractions. What does this change likely indicate? A. Respiratory distress is unchanged B. Progression toward respiratory failure C. Improved respiratory status D. Neurologic impairment - ANSWER Progression toward respiratory failure 3. What is the most likely cause of head bobbing in infants? A. Increased respiratory effort B. Improving respiratory status C. Decompensated shock D. Brain injury - ANSWER Increased respiratory effort 4. Several healthcare providers are participating in an attempted resuscitation. Which of the following is most consistent with the responsibilities of the team leader of the resuscitation? A. Records medications and interventions B. Assigns roles to team members C. Administers defibrillation shocks D. Provides compressions - ANSWER Assigns roles to team members 5. Which of the following conditions is appropriate for use of an oropharyngeal airway? A. Conscious with no gag reflex B. Unconscious with a gag reflex C. Unconscious with no gag reflex D. Conscious with a gag reflex - ANSWER Unconscious with no gag reflex 7. A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10 minutes after eating peanuts. What is the most appropriate initial medication for this child? A. Nebulized albuterol B. Epinephrine IM C. Isotonic crystalloid IV D. Methylprednisolone IV - ANSWER Epinephrine IM 8. A mother brings her 7-year-old child to the emergency department. The mother states that the child has had a fever for the past 4 days and has had little to eat or drink during the past 24 hours. Your initial impression reveals a lethargic child with increased respiratory rate and pale color. Heart rate is 160/min, respiratory rate is 38/min, and blood pressure is 86/48 mm Hg. Capillary refill is 4 seconds. Which of the following is the most appropriate intervention for this child? A. Fluid bolus of 10 mL/kg of isotonic crystalloid B. Fluid bolus of 20 mL/kg of isotonic crystalloid C. Maintenance fluid infusion of isotonic crystalloid at 10 mL/h D. Maintenance fluid infusion of 5% dextrose and water at 20 mL/h - ANSWER Fluid bolus of 20 mL/kg of isotonic crystalloid 9. An intubated 5-year-old child who was in a motor vehicle collision becomes increasingly more difficult to ventilate. The child has diminished breath sounds and chest expansion on the right side of the chest, with audible breath sounds and visible chest expansion on the left. The endotracheal tube insertion depth has not changed. What is the most appropriate intervention? A. Deflate the cuff and pull the tube back B. Perform needle decompression on the right che [Show More]

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