PALS Certification Practice Test

Which of the following is the most appropriate first step in the management of a child with bradycardia and poor perfusion despite oxygenation and ventilation?*

Administer epinephrine IV/IO immediately

Begin chest compressions if heart rate remains <60/min with signs of poor perfusion

Apply a defibrillator and deliver a shock

Initiate synchronized cardioversion

What is the preferred method for confirming endotracheal tube placement in a pediatric patient?*

Auscultation of bilateral breath sounds

Observation of chest rise

Continuous waveform capnography

Colorimetric CO₂ detector

Which of the following signs is most consistent with compensated shock in a pediatric patient?*

Hypotension

Altered mental status

Bounding peripheral pulses

Tachycardia with cool extremities

Epinephrine should be administered via the endotracheal tube if IV or IO access is unavailable.*

True

False

Which of the following rhythms is most likely to respond to defibrillation in a pediatric cardiac arrest?*

Pulseless electrical activity

Asystole

Ventricular fibrillation

Sinus bradycardia

In pediatric advanced life support, what is the initial fluid bolus for a child in septic shock?*

60 mL/kg over 5 minutes

20 mL/kg over 5–10 minutes

10 mL/kg over 30 minutes

5 mL/kg over 1 hour

Which of the following actions is most important when managing an unresponsive child with a pulse and inadequate breathing?*

Provide chest compressions immediately

Give high-flow oxygen via non-rebreather mask

Begin rescue breathing at a rate of 1 breath every 3–5 seconds

Initiate synchronized cardioversion

Which of the following is the most appropriate energy dose for the first defibrillation attempt in a child with ventricular fibrillation?*

0.5 J/kg

1 J/kg

2 J/kg

4 J/kg

Bag-mask ventilation is the preferred initial method of airway management in a pediatric resuscitation unless advanced airway is immediately available.*

True

False

A child presents with anaphylaxis and respiratory compromise. Which medication should be administered first?*

Diphenhydramine IM

Epinephrine IM

Albuterol via nebulizer

Methylprednisolone IV

What is the most appropriate intervention for a child in pulseless electrical activity (PEA)?*

Synchronized cardioversion

Defibrillation

CPR and epinephrine administration

Amiodarone bolus

Which of the following best describes the role of amiodarone in pediatric advanced life support?*

First-line for bradycardia with poor perfusion

Used in shock-refractory pulseless VT or VF

Indicated for SVT in stable patients

Administered before epinephrine in cardiac arrest

What is the recommended dose of epinephrine during pediatric cardiac arrest?*

0.01 mg/kg IV/IO of 1:10,000 concentration every 3–5 minutes

0.1 mg/kg IV/IO of 1:1,000 concentration every 10 minutes

0.01 mg/kg IM of 1:1,000 concentration every 3 minutes

0.1 mg/kg IO of 1:10,000 concentration every 5 minutes

Which rhythm is least likely to require defibrillation?*

Ventricular fibrillation

Pulseless ventricular tachycardia

Asystole

Torsades de pointes

Capnography can help evaluate the quality of CPR in a pediatric arrest.*

True

False

Which of the following best describes the primary goal in post–cardiac arrest care in children?*

Administer additional doses of epinephrine

Monitor for re-arrest only

Optimize ventilation and perfusion

Place in Trendelenburg position

Which of the following is the best method to prevent deterioration in a child with respiratory distress?*

Administer sedatives

Delay intervention until apnea occurs

Recognize and treat early with oxygen and airway support

Wait for pulse oximeter to drop below 85%

What is the most reliable sign of effective chest compressions during CPR?*

Pupil response

Presence of a femoral pulse during compressions

Oxygen saturation above 90%

Heart rate over 60 bpm

Which of the following is an acceptable alternative to amiodarone in pediatric pulseless VT/VF?*

Lidocaine

Atropine

Adenosine

Procainamide

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