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Heartcode PALS updated revision test /answered, Exams of Nursing

Cheyney University of PennsylvaniaNursing

Heartcode PALS updated revision test /answered

Typology: Exams

2025/2026

Available from 01/31/2026

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Heartcode PALS updated revision test
/answered
1. The infant is placed on the ambulance stretcher and responds
with a groan when stimulated and has a temperature of 36.3 C (97.3 F):
-Monitor and support ABCs
-Establish
IV/IO
access
-Monitor
heart
rate,
blood
pressure,
and
pulse
oximetry
-Call
for
assistance
if
needed
2.
When you evaluate the patient, you find the lungs are clear, skin
is cool and mottled, glucose is 97 mg/dL and capillary refill time is 5
seconds. What are the warning signs that the patient is progressing
from compensated shock to
hypotensive shock?: -Hypotension (late sign)
-Increasing
tachycardia
3.
The patient still has a blood pressure of
58/38 mm Hg. Her condition would be classified as
shock.:
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pf4
pf5
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pf9
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Heartcode PALS updated revision test

/answered

  1. The infant is placed on the ambulance stretcher and responds with a groan when stimulated and has a temperature of 36.3 C (97.3 F): -Monitor and support ABCs -Establish IV/IO access -Monitor heart rate, blood pressure, and pulse oximetry -Call for assistance if needed
  2. When you evaluate the patient, you find the lungs are clear, skin is cool and mottled, glucose is 97 mg/dL and capillary refill time is 5 seconds. What are the warning signs that the patient is progressing from compensated shock to hypotensive shock?: -Hypotension (late sign) -Increasing tachycardia
  3. The patient still has a blood pressure of 58/38 mm Hg. Her condition would be classified as shock.:

2 / 21 Hypotensive

  1. What should be included in the initial treatment for this patient?: - Rapid fluid bolus administration -Establishing IV/IO access
  2. The mother does not recall the infant's most recent weight. What is the most appropriate way to rapidly determine her weight and calculate correct medication?: Measure her by using color-coded length-based tape
  3. You measure the infant to be 7 kg and prepare to administer a fluid bolus of what type?: Normal saline 20 mL/kg
  4. What is the most appropriate method of delivering rapid fluid boluses to this patient?: A syringe and 3-way stopcock
  5. After the first fluid bolus is administered, the child is reassessed and her vital signs are HR 167, BP 58/44 mm Hg, RR 56/min and SpO2 92%. Her skin is still cool and pale and she is still lethargic and weak. What should be the next intervention?: Deliver a second fluid bolus of 20 mL/kg and reassess

4 / 21 -Heart rate -Systemic perfusion -Blood pressure -Clinical signs of end-organ perfusion

  1. When should antibiotics be administered in septic shock?: Within the first hour
  2. What are the initial assessment findings for septic shock?: - Fever
  • Hypothermia -Normal, elevated or decreased WBC
  1. For septic shock, how soon should fluid resuscitation begin?: Within 10 to 15 minutes after recognizing shock
  2. What is the recommendation for fluid bolus of isotonic crystalloids in cardio- genic shock?: 5 to 10 mL/kg over 10 to 20 minutes
  3. What is the focus of the initial management of distributive shock?: -Correcting hypovolemia -Filling expanded dilated vascular space -Expanding intravascular volume
  4. What are causes of obstructive shock?: -Pulmonary embolus

5 / 21 -Tension pneumothorax -Congenital heart defects -Cardiac tamponade

  1. What signs are present as obstructive shock progresses?: - Increased respiratory ettort
  • Cyanosis -Signs of vascular congestion
  1. Most patients in cardiogenic shock will need inotropic support with medica- tions. Which of the following could be used?: - Milrinone
  • Epinephrine
  1. What is the main objective of managing obstructive shock?: - Correct the cause of cardiac output obstruction -Restore tissue perfusion
  2. Why is it important to immediately identify obstructive shock?: Obstructive shock can rapidly progress to cardiopulmonary failure and then cardiac arrest
  3. What is an assessment finding unique to tension pneumothorax?: Tracheal deviation

7 / 21 -Cardiac surgery -Infection of the percardium

  1. In the setting of impending or actual pulseless arrest when there is a strong suspicion of pericardial tamponade, what is the appropriate management?: - Emergency pericardiocentesis
  2. Pulmonary embolisms are in children.: Rare
  3. What is definitive treatment for most children with pulmonary embolism who are not in shock?: Anticoagulants
  4. In children with severe cardiovascular compromise from pulmonary em- bolism, what treatment should be considered?: Fibrinolytic agents
  5. What findings help distinguish pulmonary embolism from hypovolemic shock?: Systemic venous congestion and right heart failure
  6. What circulation findings are specific to pericardial tamponade?:
    • Tachycardia -Narrowed pulse pressures -Muffled or diminished heart sounds

8 / 21

  1. The child is awake, responsive and anxious. Her initial vitals signs are HR 168/min, BP 61/43 mm Hg, RR 44/min, SpO 66%. What is the initial priority in treatment for this patient?: Administer oxygen (nonrebreating mask)
  2. Based on the child's blood pressure, what type of shock is the patient in?: Hy- potensive
  3. Ausculating the patient's lungs demonstrates clear lung sounds on the left but absent lung sounds on the right. What is the most likely diagnosis for this patient?: Tension pneumothorax
  4. Treatment for tension pneumothorax should not be delayed. Based on the child's assessment, what immediate intervention should be per- formed?: Needle decompression

10 / 21 children?: Tissue hypoxia

  1. How is bradycardia defined in pediatric patients?: A heart rate that is slow in comparison with a normal heart rate range for the child's age, level of activity and clinical condition.
  2. What causes primary bradycardia?: Congenital or acquired heart conditions
  3. Whenever a child has an abnormal heart rate of rhythm, what must be done quickly?: Determine if the arrhythmia is causing hemodynamic instability or other signs of deterioration.
  4. What is the priority in initially managing arrhythmias?: Support the airway, breathing and circulation
  5. What are the causes of secondary bradycardia?: - Hypoxia
  • Acidosis
  • Hypotension
  • Hypothermia
  • Drugs
  1. What are the electrocardiographic characteristics of bradycardia?: -Heart rate slow compared with normal heart rate for age -P wave and QRS complex may be unrelrated

11 / 21 -QRS complex may be narrow or wide

  1. What is a THIRD-degree atrioventricular block?: None of the atrial impulses conduct to the ventricles
  2. What is a FIRST-degree atrioventricular block: A prolonged PR interval representing slowed conduction through the atrioventricular node
  3. Why do children with cardiac tamponade improve temporarily with fluid administration?: Fluids augment cardiac and tissue perfusion until pericardial drainage can be performed
  4. What is the initial dose of epinephrine in the treatment of symptomatic bradycardia?: 0.01 mg/kg IV/IO
  5. In which patients would bradycardia be an expected finding and not be considered problematic?: -A healthy child who is sleeping This is due to reduced metabolic demand -A well-conditioned athlete This is due to high stroke volume and increased vagal tone
  6. What is the IV/IO dose of atropine for pediatric bradycardia?: 0.02 mg/kg
  7. What should your next steps be?: -Maintains a patent airway

13 / 21 -Obtain expert consultation -Support ABC's -Identify and treat underlying causes

  1. What clinical findings may be presented in a child with a tachyarrhythmia?- : - Palpitations -Light-headedness
  • Syncope
  1. How is tachycardia defined in pediatric patients?: A heart rate that is fast compared with the normal heart rate for the child's age
  2. Where do tacharrhythmias originate?: Atria or ventricles
  3. How are tachycardia and tacharrhythmias classifed?: By the width of the QRS complex
  4. What is initial treatment for pediatric bradycardia with cardiopulmonary compromise?: Provide bag-mask ventilation with 100% oxygen
  5. if bradycardia persists after initial treatment and the heart rate remains less than 60/min, what action should be taken next?: Begin CPR

14 / 21

  1. What are the characteristics of ventricular tachycardia?: -It is a wide QRS complex generated within the ventricles -The rapid rate may deteriorate into pulseless ventricular tachycardia or ventricular fibrillation -A rapid rate compromises ventricular filling
  2. Why does sinus tachycardia typically develop?: The body needs increased cardiac output
  3. What is characteristic feature of supraventricular tachycardia?: An abrupt increase in heart rate that does not vary with activity
  4. In what conditions is atropine preferred over epinephrine as the first-choice treatment of symptomatic bradycardia?: -Increased vagal tone -Cholinergic drug toxicity (orgranophosphates) -Atrioventricular block due to primary bradycardia
  5. What is heart rate is consistent with sinus tachycardia?: Infant: Less than 220/min Child: Less than 180/min
  6. What are the characteristics of atrial flutter?: -Atrial rate can exceed 300/min and ventricular rate is slow -Can develop in children with congenital heart disease

16 / 21

  1. If amiodarone or procainamide does not terminate the rapid rhythm, why should adenosine be considered?: A wide-complex tachycardia could be supraventricular tachycardia with aberrant ventricular conduction
  2. What is considered an initial management priority in managing tach- yarrhythmias?: -Assess and support the airway, oxygenation and ventiliation -Obtain a 12-lead electrocardiogram if practical -Attach a continuous electrocardiographic monitor/defibrillator and a pulse oximeter
  3. Which signs and symptoms are consistent with supraventricular tachycar- dia?: -Absent or abnormal P waves -Heart rate 220/min or greater in an infant or 180/min or greater in a child -Heart rate does not vary with activity or stimulation
  4. For stable patients with a regular wide complex, and monomorphic tachy- cardia consider:: Adenosine
  5. Which of the following should be considered for stable supraventricular tachycardia?: -Ask an older child to try to blow through an obstructed straw -Place a bag with ice water over the upper half of the infant's face

17 / 21

  1. What is the initial dose of denosine?: 0.1 mg/kg IV/IO
  2. Your initial assessment indicates that the child is irritable and breathing rapidly. Which of the following is the most appropriate initial intervention?: Maintain patent airway; administer oxygen
  3. What is the most likely rhythm? (IMG_8681): Supraventricular tachycardia
  4. The patient has characteristics of supraventricular tachycardia, including a heart rate of more than 220/in. How would P waves appear on an ECG in a supraventricular tachycardia?: -Ab- normal
  • Absent
  1. Vagal maneuvers are indicated for an infant with supraventricular tachy- cardia who is stable and they should be performed while preparations are being made for admistering adenosine and synchronized cardioversion (if necessary). Ice for the face is vagal maneuver that can be performed in infants and children of all ages.

19 / 21 What is the recommended energy selection?: 12 J

  1. What is the appropriate initial dose if synchronized cardioversion is needed?- : 0.5 to 1 J/kg
  2. The most common cause of cardiac arrest in infants, children and adoles- cents is , which is the end result of progressive hypoxia and acido- sis.: hypoxic/asphyxial arrest
  3. What are the common initial rhythms in both in-hospital and out-of-hospital pediatric cardiac arrest, especially in children younger than 12 years?: -Asystole
  • PEA
  1. When is present,m the heart has no organized rhythm and no coordi- nated contractions: VF
  2. What are signs of cardiac arrest in children?: - Unresponsiveness -Agonal gasps -No pulse felt
  3. When treating persistent VF/pVT during cardiac arrest, administer epineph- rine: Every 3 to 5 minutes

20 / 21

  1. What are initial steps of treating asystole/PEA?: -Provide CPR -Establish IV/IO access -Administer epinephrine -Consider advanced airway
  2. What is considered part of the post-cardiac arrest care?: - Providing adequate oxy- genation and ventilation -Correcting acid-base and electrolyte imbalances -Ensuring adequate analgesia and sedation
  3. What is included in the SECOND phase of post-cardiac arrest management?- : Provide broad multiorgan supportive care
  4. What is included in the FIRST phase of post-cardiac arrest management?: - Continued advanced life support for immediate life-threatening conditions
  5. What are the initial steps of the VF/pVT pathway of the Pediatric Cardiac Arrest Algorithm?: -Perform CPR -Deliver ONE shock