American Heart Association Training Center

American Heart Association Training Center

PALS Practice Quiz

Note: This PALS Algorithm Practice Test Question Covers 5 Core PALS Algorithms:

  1. Pediatric Post-Resuscitation Care Algorithm (ROSC)
  2. PALS Bradycardia Algorithm
  3. Pediatric Cardiac Arrest Algorithm
  4. PALS Tachycardia Algorithm
  5. Pediatric Septic Shock Algorithm
1. After achieving ROSC in a pediatric patient, what’s your priority?
A.

Administer a second dose of epinephrine

B.

Get a chest X-ray

C.

Support airway, breathing, and circulation

D.

Start chest compressions again

Please select atleast one answer!
  • Correct
  • Incorrect
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2. A child has ROSC but remains unresponsive. What’s the most appropriate action next?
A.

Start oral feedings

B.

Check blood glucose and monitor neurologic status

C.

Send them to the waiting room

D.

Discontinue oxygen support

Please select atleast one answer!
  • Correct
  • Incorrect
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3. After ROSC, a pediatric patient's oxygen saturation is 100% on high-flow oxygen. What’s the best next step?
A.

Increase oxygen to 100%

B.

Discontinue oxygen immediately

C.

Titrate oxygen to keep saturation between 94–99%

D.

Begin hyperventilation to reduce CO₂

Please select atleast one answer!
  • Correct
  • Incorrect
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4. After ROSC, a child’s systolic blood pressure is below the 5th percentile for age. What’s your first step?
A.

Administer a sedative

B.

Start an epinephrine infusion

C.

Watch and wait

D.

Begin fluid resuscitation

Please select atleast one answer!
  • Correct
  • Incorrect
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5. What is the goal of temperature management in a pediatric patient after ROSC?
A.

Induce a fever to boost immune function

B.

Maintain normothermia and avoid hyperthermia

C.

Allow passive cooling without monitoring

D.

Avoid any temperature changes

Please select atleast one answer!

  • Correct
  • Incorrect
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6. You're treating a 4-year-old with a heart rate of 48 bpm. She’s pale, lethargic, and has a weak pulse. What should you do first?
A.

Start chest compressions

B.

Give atropine 0.02 mg/kg IV

C.

Apply oxygen and support her airway

D.

Observe and recheck her heart rate in 5 minutes

Please select atleast one answer!
  • Correct
  • Incorrect
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7. You’ve provided oxygen and assisted ventilation, but the child’s heart rate is still 45 bpm, and she's showing signs of poor perfusion. What’s your next move?
A.

Administer epinephrine

B.

Start an IV line

C.

Recheck her temperature

D.

Call the cardiology team

Please select atleast one answer!
  • Correct
  • Incorrect
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8. What is the correct initial dose of IV/IO epinephrine in a pediatric bradycardia case?
A.

0.01 mg/kg (1:10,000)

B.

0.1 mg/kg (1:1000)

C.

1 mg/kg (1:10,000)

D.

0.02 mg/kg (1:1000)

Please select atleast one answer!
  • Correct
  • Incorrect
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9. In which situation is atropine the preferred first drug over epinephrine for a child with bradycardia?
A.

Suspected respiratory failure

B.

Hypovolemia

C.

Suspected increased vagal tone or primary AV block

D.

Sepsis

Please select atleast one answer!
  • Correct
  • Incorrect
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10. You’ve tried oxygen, CPR, and meds, but the bradycardia isn’t responding. What advanced intervention should you consider next?
A.

Switch to a pediatric AED

B.

Transcutaneous pacing

C.

Give another fluid bolus

D.

Intubate immediately

Please select atleast one answer!
  • Correct
  • Incorrect
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11. After the first shock in a pediatric cardiac arrest with a shockable rhythm, what drug and timing should you follow next?
A.

Give amiodarone every 10 minutes

B.

Give epinephrine every 3–5 minutes

C.

Give atropine once

D.

Wait to give drugs until after the second rhythm check

Please select atleast one answer!
  • Correct
  • Incorrect
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12. Secondary to respiratory failure or shock, pediatric cardiac arrest is typically the result of what condition?
A.

Myocardial infarction

B.

Ventricular fibrillation

C.

Tissue Hypoxia

D.

Congenital heart disease

Please select atleast one answer!
  • Correct
  • Incorrect
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13. You're using a manual defibrillator for a 20-kg child in cardiac arrest. What's the initial shock dose you should deliver?
A.

50 joules

B.

100 joules

C.

2 joules/kg

D.

10 joules/kg

Please select atleast one answer!
  • Correct
  • Incorrect
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14. What is the most common presenting rhythm in children experiencing cardiac arrest?
A.

Ventricular fibrillation

B.

PEA/asystole 

C.

Third Degree AV block 

D.

Pulseless ventricular tachycardia 

Please select atleast one answer!
  • Correct
  • Incorrect
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15. You walk into a room and find an unresponsive child. There’s no breathing and no pulse. What’s your priority?
A.

Attach the AED and deliver a shock

B.

Start CPR immediately

C.

Open the airway and give 2 rescue breaths

D.

Call the child’s parents

Please select atleast one answer!
  • Correct
  • Incorrect
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16. What is the first step in the PALS tachycardia algorithm when a child presents with a wide complex tachycardia and poor perfusion?
A.

Start CPR

B.

Administer adenosine

C.

Perform synchronized cardioversion

D.

Administer amiodarone

Please select atleast one answer!
  • Correct
  • Incorrect
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17. A 7-year-old child presents with the sudden onset of cyanosis, labored breathing, and a precursor to shock. Chest auscultation reveals decreased breath sounds on the right side. What is the most likely diagnosis?
A.

Congestive heart failure

B.

Tension pneumothorax

C.

Aspiration pneumonia

D.

Asthma exacerbation

Please select atleast one answer!
  • Correct
  • Incorrect
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18. What is the most common tachyarrhythmia in children?
A.

Supraventricular tachycardia (ST)

B.

Ventricular tachycardia (VT) 

C.

Sinus tachycardia (ST)

D.

Atrial Fibrillation 

Please select atleast one answer!
  • Correct
  • Incorrect
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19. What is the appropriate dose of adenosine for a child with narrow complex tachycardia and stable vitals in the PALS algorithm?
A.

0.1 mg/kg

B.

0.2 mg/kg

C.

0.3 mg/kg

D.

0.5 mg/kg

Please select atleast one answer!
  • Correct
  • Incorrect
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20. What is the normal QRS in a pediatric tachycardia?
A.

Less than  0.04 seconds

B.

Less than 0.07 seconds 

C.

Less than 0.09 seconds 

D.

Less than 0.10 seconds

Please select atleast one answer!
  • Correct
  • Incorrect
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21. A 6-year-old comes into the ER with fever, altered mental status, and cold extremities. You suspect septic shock. What’s the priority in managing this child?
A.

Start antibiotics immediately

B.

Give a fluid bolus of 60 mL/kg all at once

C.

Ensure airway, breathing, and circulation are stable

D.

Wait for lab results before taking action

Please select atleast one answer!
  • Correct
  • Incorrect
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22. A child in septic shock has warm extremities, bounding pulses, and hypotension. What type of shock does this likely indicate?
A.

Cardiogenic shock

B.

Distributive (warm) shock

C.

Obstructive shock

D.

Hypovolemic shock

Please select atleast one answer!
  • Correct
  • Incorrect
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23. What should be suspected in a kid who falls suddenly while receiving positive-pressure ventilation?
A.

Ductal-dependent lesion

B.

Pulmonary embolism

C.

Tension pneumothorax

D.

Cardiac tamponade

Please select atleast one answer!

  • Correct
  • Incorrect
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24. A kid in warm shock isn't responding to fluids and is still hypotensive. Which vasoactive drug should you start?
A.

Epinephrine

B.

Dopamine

C.

Norepinephrine

D.

Atropine

Please select atleast one answer!
  • Correct
  • Incorrect
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25. After three fluid boluses, a child with cold shock is still hypotensive. What’s the best next step?
A.

Give high-dose epinephrine

B.

Start norepinephrine infusion

C.

Start epinephrine infusion

D.

Administer more fluid boluses

Please select atleast one answer!
  • Correct
  • Incorrect
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