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AHA PALS Practice exam 63Questions with 100% correct answers, Exams of Nursing

AHA PALS Practice exam 63Questions with 100% correct answersAHA PALS Practice exam 63Questions with 100% correct answers

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2024/2025

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AHA PALS Practice exam 63Questions with
100% correct answers
1. A 5-year-old child presents with lethargy, increased work of breathing, and pale color.
The primary assessment reveals that the airway is open and the respiratory rate is
30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of
95% and a pulse rate of 93/min. On the basis of this information, which of the following
provides the best interpretation of the oxygen saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary oxygen
should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered - Correct
answerUnreliable; supplementary oxygen should be administered
2. A 3-year-old child was recently diagnosed with leukemia and has been treated with
chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min,
respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is less
than 2 seconds. What is the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock - Correct answerSeptic shock
3. A 2-week-old infant presents with irritability and a history of poor feeding. Blood
pressure is 55/40 mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated - Correct answerHypotensive
4. During a resuscitation attempt, the team leader orders an initial dose of epinephrine
at 0.1 mg/kg to be given 10. What should the team member do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug - Correct answerRespectfully ask the team
leader to clarify the dose
5. Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
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AHA PALS Practice exam 63Questions with

100% correct answers

  1. A 5-year-old child presents with lethargy, increased work of breathing, and pale color. The primary assessment reveals that the airway is open and the respiratory rate is 30/min, with crackles heard on auscultation. The cardiac monitor shows sinus tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of 95% and a pulse rate of 93/min. On the basis of this information, which of the following provides the best interpretation of the oxygen saturation of 95% by pulse oximetry? A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary oxygen should be administered C. Unreliable; no supplementary oxygen is indicated

D. Unreliable; supplementary oxygen should be administered - Correct

answer Unreliable; supplementary oxygen should be administered

  1. A 3-year-old child was recently diagnosed with leukemia and has been treated with chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min, respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is less than 2 seconds. What is the child's most likely condition? A. Septic shock B. Hypovolemic shock C. Significant bradycardia

D. Cardiogenic shock - Correct answer Septic shock

  1. A 2-week-old infant presents with irritability and a history of poor feeding. Blood pressure is 55/40 mm Hg. What term describes this infant's blood pressure? A. Hypotensive B. Normal C. Hypertensive

D. Compensated - Correct answer Hypotensive

  1. During a resuscitation attempt, the team leader orders an initial dose of epinephrine at 0.1 mg/kg to be given 10. What should the team member do? A. Administer the drug as ordered B. Administer 0.01 mg/kg of epinephrine C. Respectfully ask the team leader to clarify the dose

D. Refuse to administer the drug - Correct answer Respectfully ask the team

leader to clarify the dose

  1. Which of the following is a characteristic of respiratory failure? A. Inadequate oxygenation and/or ventilation

B. Hypotension C. An increase in serum pH (alkalosis)

D. Abnormal respiratory sounds - Correct answer Inadequate oxygenation and/or

ventilation

  1. Which of the following is most likely to produce a prolonged expiratory phase and wheezing? A. Disordered control of breathing B. Hypovolemic shock C. Lower airway obstruction

D. Upper airway obstruction - Correct answer Lower airway obstruction

  1. A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few minutes ago. Which of the following most likely to be abnormal? A. Vascular resistance B. Pulse rate C. Lung compliance

D. Control of breathing - Correct answer Control of breathing

  1. What abnormality is most likely to be present in children with acute respiratory distress caused by lung tissue disease? A. Decreased oxygen saturation B. Stridor C. Normal respiratory rate

D. Decreased respiratory effort - Correct answer Decreased oxygen saturation

  1. An alert 2-year-old child with an increased work of breathing and pink color is being evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would best describe this patient's condition? A. Respiratory distress B. Respiratory arrest C. Respiratory failure

D. Disordered control of breathing - Correct answer Respiratory distress

  1. The parents of a 7-year-old child who is undergoing chemotherapy report that the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals the following: The child is difficult to arouse, with pale color. The child's heart rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is the most appropriate intervention? A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30 minutes B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
  1. A 15-year-old boy presents with acute onset of severe respiratory distress, with retractions and an oxygen saturation of 85%. His trachea is deviated to the right, and there are no breath sounds on the left. His heart rate is 140/min, his blood pressure is 84/60 mm Hg, and his capillary refill time is 3 seconds. What is the most appropriate intervention? A. Obtain a chest x-ray B. Perform needle decompression on the left chest C. Insert a chest tube on the left side

D. Insert an IV and administer 20 mL/kg of normal saline - Correct

answer Perform needle decompression on the left chest

  1. A 4-year-old is being treated for hypovolemic shock and has received a single fluid bolus of 20 mL/kg of normal saline. On reevaluation the child remains anxious, with a heart rate of 140/min, a blood pressure of 84/54 mm Hg, and a capillary refill time of 4 seconds. What describes this patient's condition? A. Hypotensive shock B. Compensated shock C. No longer in shock

D. Cardiogenic shock - Correct answer Compensated shock

  1. An 8-year-old child had a sudden onset of palpitations and light-headedness. At the time of evaluation the child is alert. His respiratory rate is 26/ min, and his blood pressure is 104/70 mm Hg. A cardiac monitor is applied, and the rhythm below is noted. What is the most appropriate initial intervention? A. Provide synchronized cardioversion at 0.5 to 1 J/kg B. Attempt vagal maneuvers C. Administer adenosine 0.1 mg/kg over 5 minutes D. Administer amiodarone 5 mg/kg

over 20 minutes - Correct answer Attempt vagal maneuvers

  1. A 10-year-old child had a sudden witnessed cardiac arrest and received immediate bystander CPR and defibrillation within 3 minutes. He had a return of spontaneous circulation. The child remains unresponsive and has an advanced airway in place. There is no history of trauma or signs of shock. What is the target range for oxygen saturation for this child? A. 92% to 100% B. 92% to 99% C. 94% to 99%

D. 94% to 100% - Correct answer 94% to 99%

  1. A 3-month-old infant with bronchiolitis is suctioned to remove upper airway secretions. The infant's heart rate decreases from 155/min to 65/min as shown below. The infant remains alert, with easily palpable pulses. Capillary refill time is 1 second. What is the most appropriate initial intervention? A. Administer oxygen and ensure adequate ventilation; be prepared to intervene further if heart rate does not increase

B. Establish IV/IO access and administer epinephrine 0.01 mg/kg IV C. Establish IV/IO access and administer atropine 0.02 mg/kg IV D. Call for help and prepare to provide transthoracic pacing/transvenous pacing -

Correct answer Administer oxygen and ensure adequate ventilation; be prepared

to intervene further if heart rate

  1. A 3-month-old infant with bronchiolitis is intubated for management of respiratory failure. During transport, the infant develops bradycardia with a heart rate of 60/min, and the infant's oxygen saturation decreases to 75%. There are breath sounds on the right side, but no air entry is heard on the left side. What is the most appropriate initial intervention? A. Administer epinephrine 0.01 mg/kg IV B. Place a chest tube on the left C. Verify the endotracheal tube position

D. Aggressively suction the endotracheal tube - Correct answer Verify the

endotracheal tube position

  1. For a 6-month-old infant with supraventricular tachycardia and adequate perfusion, which of the following is the preferred vagal maneuver? A. Ocular pressure B. Carotid pressure C. Valsalva maneuver

D. Ice to the face - Correct answer Ice to the face

  1. A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10 minutes after eating peanuts. What is the most appropriate initial medication for this child? A. Nebulized albuterol B. Epinephrine IM C. Isotonic crystalloid IV

D. Methylprednisolone - Correct answer Epinephrine IM

  1. A 2-year-old child was found submerged in a swimming pool. She is unresponsive, not breathing, and pulseless. In addition to performing high-quality CPR and establishing vascular access, which of the following is the most appropriate intervention? A. Give atropine 0.02 mg/kg lIO/IV B. Apply cricoid pressure C. Give epinephrine 0.01 mg/kg IO/IV

D. Provide transthoracic pacing - Correct answer Give epinephrine 0.01 mg/kg

IO/IV

  1. A 3-year-old child is unresponsive, not breathing, and pulseless. High-quality CPR is in progress. A cardiac monitor is applied, and the rhythm below is noted. What is the next appropriate intervention?
  1. A 6-year-old child is found unresponsive, not breathing, and pulseless. What is the correct compression-to-ventilation ratio when 2 or more healthcare providers are

present to perform CPR? - Correct answer 15:

  1. A 5-year-old child has had severe respiratory distress for 2 days. During assessment the child's heart rate decreases from 140/min to 90/min, and the child's respiratory rate decreases from 66/min to 8/min. What intervention is most appropriate? A. Provide rescue breaths at a rate of 12 to 20/min B. Provide rescue breaths at a rate of 6 to 10/min C. Initiate chest compressions at a rate of at least 100/min

D. Initiate chest compressions at a rate of 60/min - Correct answer Provide rescue

breaths at a rate of 12 to 20/min

  1. A 7-year-old child presents with a narrow-complex supraventricular tachycardia, lethargy, and poor perfusion. Pulses are weak and thready. Vascular access cannot be established. What is the most appropriate intervention? A. Unsynchronized shock with 0.5 to 1 J/kg B. Synchronized shock with 0.5 to 1 J/kg C. Unsynchronized shock with 2 J/kg

D. Synchronized shock with 2 J/kg - Correct answer Synchronized shock with 0.

to 1 J/kg

  1. A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer. What is the next most appropriate intervention? A. Administer 0.1 mg/kg of adenosine B. Obtain a blood sample to evaluate arterial or venous blood gases C. Reassess breath sounds and clinical status

D. Repeat the albuterol treatment - Correct answer Reassess breath sounds and

clinical status

  1. The respiratory rate of a 1-year-old child with respiratory distress has decreased from 65/min to 30/min. The child is more lethargic and continues to have subcostal retractions. What does this change likely indicate? A. Respiratory distress is unchanged B. Progression toward respiratory failure C. Improved respiratory status

D. Neurologic impairment - Correct answer Progression toward respiratory failure

  1. What is the most likely cause of head bobbing in infants? A. Increased respiratory effort B. Improving respiratory status C. Decompensated shock

D. Brain injury - Correct answer Increased respiratory effort

  1. Several healthcare providers are participating in an attempted resuscitation. Which of the following is most consistent with the responsibilities of the team leader of the resuscitation? A. Records medications and interventions B. Assigns roles to team members C. Administers defibrillation shocks

D. Provides compressions - Correct answer Assigns roles to team members

  1. Which of the following conditions is appropriate for use of an oropharyngeal airway? A. Conscious with no gag reflex B. Unconscious with a gag reflex C. Unconscious with no gag reflex

D. Conscious with a gag reflex - Correct answer Unconscious with no gag reflex

  1. A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10 minutes after eating peanuts. What is the most appropriate initial medication for this child? A. Nebulized albuterol B. Epinephrine IM C. Isotonic crystalloid IV

D. Methylprednisolone IV - Correct answer Epinephrine IM

  1. A mother brings her 7-year-old child to the emergency department. The mother states that the child has had a fever for the past 4 days and has had little to eat or drink during the past 24 hours. Your initial impression reveals a lethargic child with increased respiratory rate and pale color. Heart rate is 160/min, respiratory rate is 38/min, and blood pressure is 86/48 mm Hg. Capillary refill is 4 seconds. Which of the following is the most appropriate intervention for this child? A. Fluid bolus of 10 mL/kg of isotonic crystalloid B. Fluid bolus of 20 mL/kg of isotonic crystalloid C. Maintenance fluid infusion of isotonic crystalloid at 10 mL/h

D. Maintenance fluid infusion of 5% dextrose and water at 20 mL/h - Correct

answer Fluid bolus of 20 mL/kg of isotonic crystalloid

  1. An intubated 5-year-old child who was in a motor vehicle collision becomes increasingly more difficult to ventilate. The child has diminished breath sounds and chest expansion on the right side of the chest, with audible breath sounds and visible chest expansion on the left. The endotracheal tube insertion depth has not changed. What is the most appropriate intervention? A. Deflate the cuff and pull the tube back B. Perform needle decompression on the right chest

C. Perform needle decompression on the left chest D. Insert a gastric tube - Correct

answer Perform needle decompression on the right chest

C. Administer dopamine

D. Administer an antibiotic - Correct answer Provide 100% oxygen via a

nonrebreathing mask

  1. An alert toddler presents with a barking cough, moderate stridor, and moderate retractions. The child's color is pink. What is the most appropriate initial intervention? A. Obtain a chest radiograph B. Administer nebulized epinephrine C. Prepare for a surgical airway

D. Use an epinephrine autoinjector - Correct answer Administer nebulized

epinephrine

  1. The initial impression of a 4-year-old child reveals a lethargic child who is diaphoretic, with no increased work of breathing and pink color. Her heart rate is 220/min, respiratory rate is 24/min, blood pressure is 84/46 mm Hg, and capillary refill time is 5 seconds. IV access has been established. The rhythm below is seen on the cardiac monitor. What is the most appropriate initial intervention? A. Give adenosine 0.1 mg/kg rapid IV push B. Perform carotid sinus massage C. Perform synchronized cardioversion at 0.5 J/kg D. Attempt defibrillation at 2 J/kg -

Correct answer Give adenosine 0.1 mg/kg rapid IV push

  1. An 8-month-old infant is being evaluated. The child's mother says the infant has not been feeding well. The infant is alert with rapid but unlabored breathing, and the infant's color is pale. A cardiac monitor is applied, and the rhythm below is noted. Distal pulses are readily palpable. You give oxygen and establish IV access. What is the most appropriate vagal maneuver? A. Valsalva maneuver B. Carotid massage C. Ocular pressure

D. Ice to the face - Correct answer Ice to the face

  1. A 7-year-old child presents with a narrow-complex supraventricular tachycardia, lethargy, and poor perfusion. Pulses are weak and thready. Vascular access cannot be established. What is the most appropriate intervention? A. Unsynchronized shock with 0.5 to 1 J/kg B. Synchronized shock with 0.5 to 1 J/kg C. Unsynchronized shock with 2 J/kg

D. Synchronized shock with 2 J/kg - Correct answer Synchronized shock with 0.

to 1 J/kg

  1. A 3-month-old infant presents with lethargy and a 3-day history of vomiting, diarrhea, and poor feeding. The initial impression reveals lethargy, increased respiratory effort with retractions, and pale, mottled skin color. Vital signs are as follows: heart rate 210/min, respiratory rate 60/min, and blood pressure 60/40 mm Hg. Peripheral pulses

are thready, and capillary refill time is 4 seconds. The cardiac monitor displays the rhythm below. After administration of oxygen and establishment of vascular access, what is the most appropriate intervention? A. Adenosine O.1 mg/kg IV rapid push B. Vagal maneuvers C. Synchronized shock at 0.5 to 1 J/kg

D. IV fluid bolus of 20 mL/kg normal saline - Correct answer IV fluid bolus of 20

mL/kg normal saline

  1. A 3-year-old child is unresponsive, gasping, and has no detectable pulse. CPR is initiated. A monitor is attached, and the rhythm is shown below. What is the appropriate next therapy? A. Attempted defibrillation with 2 J/kg B. Synchronized cardioversion with 0.5 to 1 J/kg C. Epinephrine 0.01 mg/kg 10/IV

D. Amiodarone 5 mg/kg 1O/IV - Correct answer Attempted defibrillation with 2

J/kg

  1. A 2-year-old child is in pulseless arrest. The child has received high-quality CPR, 2 shocks, and a dose of IV epinephrine. The next rhythm check reveals the rhythm shown below. What would be an appropriate energy dose for the third defibrillation attempt? A. 2 J/kg B. 2 to 4 J/kg C. 4 J/kg or greater

D. Greater than 10 J/kg - Correct answer 4 J/kg or greater

  1. A 12-year-old child suddenly collapses while playing sports. He is unresponsive and not breathing. Emergency response is activated. The child has no pulse, and CPR is initiated. An AED arrives. What is the most appropriate next intervention? A. Contact the child's family B. Provide CPR for 2 minutes C. Drive the child to the hospital

D. Use the AED - Correct answer Use the AED

  1. A 3-year-old child is in cardiac arrest, and high- quality CPR is in progress. The first rhythm check reveals the rhythm below. Defibrillation is attempted with a shock dose of 2 J/kg. After administration of the shock, what is the most appropriate next intervention? A. Resume CPR, beginning with chest compressions B. Check for a pulse C. Analyze the rhythm

D. Administer epinephrine - Correct answer Resume CPR, beginning with chest

compressions

  1. Which of the following is a characteristic of respiratory failure? A. Inadequate oxygenation and/or ventilation

A. Use the AED with adult pads B. Wait for pediatric AED pads and use them as soon as they are available C. Continue the steps of CPR for 2 minutes before using the AED

D. Await arrival of a manual defibrillator - Correct answer Use the AED with adult

pads

  1. A team is attempting to resuscitate a child who was brought to the emergency department by EMS after a traumatic injury. The family members arrive at the child's bedside and request to remain in the room during the resuscitation attempt. What does the American Heart Association recommend? A. Allow the family to stay at the bedside alone, but they should not talk to anyone B. Allow the family to stay at the bedside with a staff member who is assigned to provide information and assistance C. Escort the family to an assigned family room where they can be given regular updates D. Take the family to the chapel or an assigned quiet room so they can receive expert

consultation. - Correct answer Allow the family to stay at the bedside with a staff

member who is assigned to provide information and assistance

  1. Which of the following is most likely to produce a prolonged expiratory phase and wheezing? A. Disordered control of breathing B. Hypovolemic shock C. Lower airway obstruction

D. Upper airway obstruction - Correct answer Lower airway obstruction

  1. A 5-year-old child has had severe respiratory distress for 2 days. During assessment the child's heart rate decreases from 140/min to 90/min, and the child's respiratory rate decreases from 66/min to 8/min. Which of the following is the next appropriate intervention? A. Rescue breaths at a rate of 12 to 20/min B. Rescue breaths at a rate of 6 to 10/min C. Chest compressions at a rate of at least 100/min D. Chest compressions at a rate of

60/min - Correct answer Rescue breaths at a rate of 12 to 20/min