Free PALS Practice Test

Question 1

A child is pulseless with an initial rhythm of PEA. Which medication priority belongs in the nonshockable cardiac-arrest algorithm?

Accepted Answer

Give epinephrine as soon as possible while CPR and ventilation continue

Answer

Delay medication until after two rhythm checks

Answer

Give amiodarone before epinephrine because any organized electrical activity should first be treated as a ventricular arrhythmia

Answer

Give atropine before beginning compressions

Question 2

A child has a wide-complex tachycardia on the monitor, but no definite pulse is felt within 10 seconds. Which algorithm should the team use?

Accepted Answer

The pediatric cardiac-arrest algorithm for pulseless VT

Answer

The wide-complex tachycardia branch for a child with a pulse

Answer

Sinus tachycardia evaluation only

Answer

The pediatric bradycardia algorithm

Question 3

A child younger than 8 years needs defibrillation, but no manual defibrillator is available. Which AED approach matches the course?

Accepted Answer

Use a pediatric attenuator when available; if it is unavailable, an AED without attenuation may be used

Answer

Withhold the AED until a manual defibrillator arrives because an unattenuated AED must never be used in a young child

Answer

Delay defibrillation until the child reaches a pediatric center

Answer

Place pads so they overlap to reduce delivered energy

Question 4

A 16-kg child in cardiac arrest needs epinephrine 0.01 mg/kg IV/IO. Which dose and concentration match the pediatric cardiac-arrest algorithm?

Accepted Answer

0.16 mg using the 0.1 mg/mL concentration

Answer

0.016 mg using the 1 mg/mL concentration

Answer

1.6 mg using the 0.1 mg/mL concentration

Answer

16 mg using the 1 mg/mL concentration

Question 5

A child has bradycardia with a pulse after progressive respiratory failure. What is the highest-priority initial treatment?

Accepted Answer

Open and support the airway, give oxygen, and provide effective ventilation

Answer

Begin with atropine before assessing breathing

Answer

Prepare synchronized cardioversion

Answer

Wait for a 12-lead ECG before supporting the airway

Question 6

A child being treated for bradycardia loses the pulse. What should the team do?

Accepted Answer

Enter the pediatric cardiac-arrest algorithm and classify the current arrest rhythm

Answer

Continue care as though the child still has a pulse

Answer

Pause compressions and obtain a 12-lead ECG before entering the arrest algorithm so the bradycardia mechanism can be documented

Answer

Attempt vagal maneuvers

Question 7

A child has probable narrow-complex SVT without cardiopulmonary compromise. What should the team try first?

Accepted Answer

Age-appropriate vagal maneuvers

Answer

Unsynchronized defibrillation

Answer

Pacing

Answer

Routine amiodarone bolus from the arrest algorithm

Question 8

A child has SVT with cardiopulmonary compromise that persists despite vagal maneuvers, adenosine, and synchronized cardioversion. Expert consultation is not available. Which actions match the course? Select all that apply.

Accepted Answer

Use a current pediatric medication reference for the selected drug's dose, infusion rate, and monitoring requirements

Accepted Answer

Consider one of these medications only after the measures stated in the scenario have failed

Answer

Improvise an infusion rate from the adult cardiac-arrest algorithm

Answer

Give procainamide, amiodarone, and sotalol together to maximize rhythm control

Question 9

A child deteriorates suddenly with findings consistent with tension pneumothorax and obstructive shock. Which action addresses the cause?

Accepted Answer

Urgently relieve the obstruction while supporting oxygenation and perfusion

Answer

Continue fluid alone until the obstruction resolves

Answer

Wait for hypotension before treating the chest problem

Answer

Treat the child as isolated distributive shock

Question 10

A comatose child who is at least 24 hours old and within the PALS age range has ROSC after cardiac arrest. Which temperature-control strategy matches the course?

Accepted Answer

Use either 32°C to 34°C for the first 48 hours followed by 36°C to 37.5°C for the remainder of the five-day course, or 36°C to 37.5°C for all five days

Answer

Use 32°C to 34°C for all five days, then rewarm as quickly as possible and stop central temperature monitoring once the child first reaches 36°C to 37.5°C, regardless of later fever risk

Answer

Use 36°C to 37.5°C for only the first 12 hours, then stop central temperature monitoring

Answer

Apply a single adult temperature target and duration to every child regardless of pediatric guidance