ESTUDY
PALS VERSION A EXAM REVIEW
1. You are caring for a child who was resuscitated after a drowning event. The child is
intubated and ventilated with 100% oxygen with equal breath sounds and exhaled CO2
detected. The heart rate is slow and the monitor shows sinus bradycardia. The skin is
cool, mottled, and moist; distal pulses are not palpable and the central pulses are weak.
Intravenous access has been established. The core temperature is 37.3oC. Based on the
PALS bradycardia algorithm, which of the following should be provided first?
A) Epinephrine IV B) Transcutaneous pacing C) Atropine IV D) Dobutamine IV infusion
Answer: Epinephrine IV
2. You are caring for a 5-year-old patient with supraventricular tachycardia (heart rate =
220/min). The child is lethargic. The skin is pale and cool with delayed capillary refill.
Distal pulses are not palpable. Which of the following would be the best treatment to
provide without delay?
A) Place cold packs on the distal upper and lower extremities B) Ask the child to blow through a
small straw C) Exert light pressure on the eyes bilaterally D) Provide synchronized cardioversion
at 0.5 to 1 J/kg
Answer: Provide synchronized cardioversion at 0.5 to 1 J/kg
3. You are initiating treatment for a child with septic shock and hypotension. While
administering high-flow oxygen you determine that the child's respirations are adequate
and SpO2 is 100%. You have just established vascular access and obtained blood
samples. Which of the following is the next most appropriate therapy to support systemic
perfusion?
A) Administer repeated fluid boluses of isotonic colloid B) Administer repeated fluid boluses of
isotonic crystalloid C) Begin immediate dopamine infusion D) Begin immediate dobutamine
infusion
Answer: Administer repeated fluid boluses of isotonic crystalloid
4. You are treating an 8-year-old with ventricular tachycardia with pulses and adequate
perfusion. You attempted synchronized cardioversion without success. While seeking
expert consultation, it would be most appropriate to:
A) Administer a loading dose of milrinone B) Consider possible metabolic and toxicologic
causes C) Initiate overdrive pacing transcutaneously D) Deliver an unsynchronized shock
