PALS Practice Test

Note: This PALS Algorithm Practice Test Question covers 5 core PALS algorithms: Cardiac Arrest, Bradycardia, Tachycardia, Suspected Stroke and ROSC Post-Resuscitation Care Algorithm

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1. During pediatric cardiac arrest, after confirming CPR quality and attaching the monitor/defibrillator, what is the first recommended shock dose for ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT)?
A.

2 J/kg

B.

4 J/kg

C.

6 J/kg

D.

10 J/kg

Please select atleast one answer!

2. A 4-year-old is in cardiac arrest with VF on the monitor. You have delivered the first shock. What is the next immediate step?
A.

Administer epinephrine

B.

Resume high-quality CPR for 2 minutes

C.

Check for a pulse

D.

Deliver another shock immediately

Please select atleast one answer!
3. In the pediatric cardiac arrest algorithm, epinephrine is given every:
A.

1-2 minutes

B.

3-5 minutes

C.

6-8 minutes

D.

10 minutes

Please select atleast one answer!
4. Which drug and dose is recommended for the first dose of amiodarone in pediatric refractory VF/pVT?
A.

5 mg/kg IV/IO bolus

B.

2 mg/kg IV/IO bolus

C.

0.1 mg/kg IV/IO bolus

D.

1 mg/kg IV/IO bolus

Please select atleast one answer!
5. Which of the following is a reversible cause of pediatric cardiac arrest that should be considered during resuscitation?
A.

Hyperkalemia

B.

Hypoglycemia

C.

Tension pneumothorax

D.

All of the above

Please select atleast one answer!
6. In the PALS bradycardia algorithm, which finding indicates the need for immediate intervention?
A.

Heart rate <80/min in an infant

B.

Bradycardia with poor perfusion despite adequate oxygenation and ventilation

C.

Heart rate <100/min in a newborn

D.

Heart rate <60/min in a school-aged child without symptoms

Please select atleast one answer!
7. In a child with persistent bradycardia and poor perfusion despite adequate oxygenation and ventilation, what is the next recommended step?
A.

Give atropine immediately

B.

Begin chest compressions if HR <60/min

C.

Give amiodarone

D.

Observe and reassess in 5 minutes

Please select atleast one answer!
8. The recommended dose of epinephrine for bradycardia with poor perfusion is:
A.

0.1 mg/kg IV/IO (1:10,000)

B.

0.01 mg/kg IV/IO (1:10,000)

C.

1 mg/kg IV/IO (1:1,000)

D.

0.1 mcg/kg IV/IO

Please select atleast one answer!
9. Which drug is the first-line medication for bradycardia caused by increased vagal tone or primary AV block?
A.

Epinephrine

B.

Amiodarone

C.

Atropine

D.

Lidocaine

Please select atleast one answer!
10. In the PALS bradycardia algorithm, which underlying condition should be assessed and treated simultaneously while managing bradycardia?
A.

Hypoxia

B.

Hypothermia

C.

Hypovolemia

D.

All of the above

Please select atleast one answer!
11. In the PALS tachycardia algorithm, the first step after identifying a rapid heart rate is to:
A.

Give adenosine immediately

B.

Determine if the child is stable or unstable

C.

Start synchronized cardioversion

D.

Give amiodarone

Please select atleast one answer!
12. A 6-year-old presents with a narrow-complex tachycardia at 220/min, stable blood pressure, and no signs of shock. What is the first recommended treatment?
A.

Amiodarone

B.

Adenosine IV/IO

C.

Synchronized cardioversion

D.

Vagal maneuvers

Please select atleast one answer!
13. What is the initial dose of adenosine for pediatric supraventricular tachycardia (SVT)?
A.

0.05 mg/kg IV/IO rapid push (max 6 mg)

B.

0.1 mg/kg IV/IO rapid push (max 6 mg)

C.

0.2 mg/kg IV/IO rapid push (max 12 mg)

D.

0.5 mg/kg IV/IO rapid push (max 12 mg)

Please select atleast one answer!
14. In a child with unstable SVT (poor perfusion, hypotension, altered mental status), the first recommended intervention is:
A.

Give adenosine

B.

Perform synchronized cardioversion starting at 0.5–1 J/kg

C.

Give amiodarone 5 mg/kg IV/IO

D.

Administer epinephrine

Please select atleast one answer!
15. In pediatric wide-complex tachycardia with a pulse and poor perfusion, if the rhythm is regular and monomorphic, what is the recommended drug and dose?
A.

Adenosine 0.1–0.2 mg/kg IV/IO

B.

Epinephrine 0.01 mg/kg IV/IO

C.

Atropine 0.02 mg/kg IV/IO

D.

Lidocaine 0.1 mg/kg IV/IO

Please select atleast one answer!
16. In suspected pediatric stroke, the most important initial step is to:
A.

Give aspirin immediately

B.

Perform a rapid neurological assessment

C.

Start IV fluids

D.

Give alteplase

Please select atleast one answer!
17. Which acronym is commonly used to recognize possible signs of stroke?
A.

SAMPLE

B.

AVPU

C.

FAST

D.

OPQRST

Please select atleast one answer!
18. In suspected stroke, oxygen should be administered if:
A.

Oxygen saturation is <94%

B.

Any neurological symptom is present

C.

Heart rate is elevated

D.

The child is unresponsive

Please select atleast one answer!
19. What is the recommended time goal for obtaining brain imaging in suspected stroke?
A.

Within 10 minutes of arrival

B.

Within 25 minutes of arrival

C.

Within 60 minutes of arrival

D.

Within 3 hours of arrival

Please select atleast one answer!
20. In suspected ischemic stroke, which of the following is most critical for treatment decisions?
A.

Blood glucose level

B.

Blood pressure

C.

Time of symptom onset

D.

Temperature

Please select atleast one answer!
21. After achieving ROSC, the most important priority is to:
A.

Start IV fluids

B.

Optimize ventilation and oxygenation

C.

Give epinephrine

D.

Start antibiotics

Please select atleast one answer!
22. In post-ROSC care, oxygen saturation should be maintained at:
A.

85–90%

B.

90–94%

C.

94–99%

D.

100% at all times

Please select atleast one answer!
23. Which of the following is a recommended blood pressure goal after ROSC in children?
A.

Above the 25th percentile for age

B.

Above the 50th percentile for age

C.

Above the 5th percentile for age

D.

Above the 10th percentile for age

Please select atleast one answer!
24. What is the recommended target temperature range to avoid hyperthermia in pediatric post–cardiac arrest care?
A.

32–34°C

B.

34–36°C

C.

36–37.5°C

D.

>38°C

Please select atleast one answer!
25. Which of the following is not part of immediate post-ROSC management?
A.

Treating hypotension promptly

B.

Treating reversible causes

C.

Maintaining oxygen saturation at 100% continuously

D.

Providing seizure monitoring and management

Please select atleast one answer!
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