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AHA PALS EXAM 2024-2025 ACTUAL
EXAM TEST BANK QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
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VERSION
- 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 heard 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
Unreliable; supplementary oxygen should be administered
- 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
Septic shock
- A 2-week-old infant presents with irritability and a history of poor feeding. Blood pressure is 55/ mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated
Hypotensive
- 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
Respectfully ask the team leader to clarify the dose
- 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
Decreased oxygen saturation
- 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
Respiratory distress
- 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
Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
- 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
Place an intraosseous line
- 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
20 mL/kg normal saline
- 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
Administer nebulized epinephrine
- 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
- 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
Attempt vagal maneuvers
- 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%
94% to 99%
- 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
Administer oxygen and ensure adequate ventilation; be prepared to intervene further if heart rate
- 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
Verify the endotracheal tube position
- 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
Ice to the face
- 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 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
Administer epinephrine 0.01 mg/kg IO/IV
- 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
10 seconds
- 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
C. Brachial
- 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
Pulseless electrical activity
- 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
Use the AED
- 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?
15:
- 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
A. Respiratory distress is unchanged
B. Progression toward respiratory failure
C. Improved respiratory status
D. Neurologic impairment
Progression toward respiratory failure
- 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
Increased respiratory effort
- 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
Assigns roles to team members
- 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
Unconscious with no gag reflex
- 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
Epinephrine IM
- 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
Fluid bolus of 20 mL/kg of isotonic crystalloid
- A 3-year-old child presents with a 2-day history of nausea and vomiting. She is alert, with no increase in respiratory effort, and is pale in color. The child's heart rate is 160/min, respiratory rate is 40/min, and blood pressure is 100/70 mm Hg. Her extremities are cool, with sluggish capillary refill. Which term best describes this child's physiologic state?
A. Compensated shock
B. Cardiogenic shock
C. Hypotensive shock
D. Obstructive shock
Compensated shock
- A 3-year-old child presents with dehydration after a 2-day history of vomiting and diarrhea. The child after has received 2 fluid boluses of 20 mL/ kg of normal saline. After the second bolus, the child is alert and interacting. Her heart rate is 110/ min, respiratory rate is 30/min, and blood pressure is 92/64 mm Hg. Her capillary refill time is 2 seconds, and oxygen saturation is 98%. What is the most appropriate next intervention for this child?
A. Administer another 20 mL/kg normal saline fluid bolus
B. Administer 10 mL/kg of packed red cells
C. Continue to monitor and reevaluate the child
D. Initiate a dopamine drip of 20 mcg/kg per minute
Continue to monitor and reevaluate the child
- A 3-year-old child presents with a high fever and a petechial rash. The child is lethargic, has no signs of increased work of breathing, and is pale in color. His heart rate is 180/min, respiratory rate is 30/min, blood pressure is 80/68 mm Hg. Capillary refill time is 4 seconds, and oxygen saturation is 88%. Airway and lungs are clear. Peripheral pulses are diminished. Which of the following is the most appropriate initial intervention?
A. Provide 100% oxygen via a nonrebreathing mask B. Obtain IV access
C. Administer dopamine
D. Administer an antibiotic
Provide 100% oxygen via a nonrebreathing mask
- 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
Administer nebulized epinephrine
- The initial impression of a 4-year-old child reveals a lethargic child who is diaphoretic, with no increased work of breathing and pink color. Her heart rate is 220/min, respiratory rate is 24/min, blood pressure is 84/46 mm Hg, and capillary refill time is 5 seconds. IV access has been established. The rhythm below is seen on the cardiac monitor. What is the most appropriate initial intervention?
A. Give adenosine 0.1 mg/kg rapid IV push
B. Perform carotid sinus massage
C. Perform synchronized cardioversion at 0.5 J/kg D. Attempt defibrillation at 2 J/kg
Give adenosine 0.1 mg/kg rapid IV push
- An 8-month-old infant is being evaluated. The child's mother says the infant has not been feeding well. The infant is alert with rapid but unlabored breathing, and the infant's color is pale. A cardiac monitor is applied, and the rhythm below is noted. Distal pulses are readily palpable. You give oxygen and establish IV access. What is the most appropriate vagal maneuver?
A. Valsalva maneuver
- A 3-year-old child is unresponsive, gasping, and has no detectable pulse. CPR is initiated. A monitor is attached, and the rhythm is shown below. What is the appropriate next therapy?
A. Attempted defibrillation with 2 J/kg
B. Synchronized cardioversion with 0.5 to 1 J/kg
C. Epinephrine 0.01 mg/kg 10/IV
D. Amiodarone 5 mg/kg 1O/IV
Attempted defibrillation with 2 J/kg
- A 2-year-old child is in pulseless arrest. The child has received high-quality CPR, 2 shocks, and a dose of IV epinephrine. The next rhythm check reveals the rhythm shown below. What would be an appropriate energy dose for the third defibrillation attempt?
A. 2 J/kg
B. 2 to 4 J/kg
C. 4 J/kg or greater
D. Greater than 10 J/kg
4 J/kg or greater
- 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
Use the AED
- A 3-year-old child is in cardiac arrest, and high- quality CPR is in progress. The first rhythm check reveals the rhythm below. Defibrillation is attempted with a shock dose of 2 J/kg. After administration of the shock, what is the most appropriate next intervention?
A. Resume CPR, beginning with chest compressions
B. Check for a pulse
C. Analyze the rhythm
D. Administer epinephrine
Resume CPR, beginning with chest compressions
- 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
Inadequate oxygenation and/or ventilation
- A 3-year-old child is in cardiac arrest, and a resuscitation attempt is in progress. The child is in ventricular fibrillation and was given a shock at 2 J/kg, followed by immediate CPR. At the next rhythm check, ventricular fibrillation is again noted on the cardiac monitor. What is the most appropriate next intervention?
A. Attempt defibrillation with a 4 J/kg shock
B. Attempt defibrillation with a 2 J/kg shock
