PALS Test Anwer Key

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PALS test answer key and terms to learn

Chest Compression depth: Infant
1.5 inch or 4 cm (1/3 AP Diameter)
Chest Compression depth: Child
2 inches or 5 cm (1/3 AP Diameter)
Maximum Compression depth: Infant
2.4 in or 6cm
Infant/children/adolescent compression rate
100-120 compressions a minute
Ratio for single rescuer
30 compressions 2 breaths
Ratio for 2 rescuer
15 compressions 2 breaths
Rate of rescue breathing
1 breath every 6-8 seconds or 8-10 breaths/min
Isotonic Crystalloids 2 examples
NS & Lactated Ringers
Fluid challenge is how much (in hypotension)?
20mL/kg (18kg gets 260 mL)
BP parameters for PALS (minimum systolic in 4 age groups)
0-1month old= min 60 systolic
1 month-1 year= min 70 systolic
1 year-10 year= min 70+(2xage) systolic
over 10 years= min 90 systolic
Atropine dose pre-intubation
Atropine 0.02 mg/kg
Med: Shock refractory VF or pulseless Tachycardia
Lidocaine or Amiodarone (used in field had better chance of survival but in hospital, either drug has same outcome)
Amiodarone dosage
Epinephrine in Cardiac Arrest Indication
all pulseless arrests, hypotensive shock, anaphylaxis, asthma, croup
Targeted Temperature management post cardiac arrest
5 days of normothermia (36C-37.5C or 96.8F-99.5F)- NOT HYPOTHERMIA
Inotrope drugs (3)
Dopamine, Dobutamine, epinephrine (epi also vasopressor)
Normoxemia is what %?
94% or above oxygenation
6 roles in PALS:
team leader
Oxygen saturation level goals
Fluid bolus during post cardiac arrest care
5-10 mL/kg over 10-20 minutes
Causes of Secondary Brain Injury
Defibrillation Joules (initial and refractory)
2J and then if refractory 4J
Temp & timing for Permissive hypothermia post-cardiac arrest… how many days of normothermia after?
32C-34C (89.6-98.2) for 2 days followed by 3 days of normothermia
4 Spots for IO
proximal tibia
medial malleolus
distal femur
How to evaluate alert/awake/responsive?
Appearance, Breathing, Circulation
What should always follow IO?
NS flush 5-10mL



PALS 2019 Test Questions

Q:1-Clinical signs of respiratory distress may include all of the following EXCEPT:
Mark one answer:

  • Rapid respiratory rate
  • Grunting respirations
  • Warm, pink skin
  • Diminished level of consciousness

Q:2-Late and ominous signs of respiratory failure include all of the following EXCEPT:
Mark one answer:

  • Rapid respiratory rate
  • Cyanosis
  • Bradycardia
  • Diminished level of consciousness

Q:3-The 8-year-old child you are treating has a palpable pulse and a heart rate of 200. You look at the monitor and see a rapid rhythm with narrow QRS complexes. There are no discernible P waves on the monitor. The rhythm is probably:
Mark one answer:

  • Sinus tachycardia
  • Supraventricular tachycardia
  • Sinus rhythm
  • Ventricular tachycardia

Q:4-You are doing CPR on a child with symptomatic bradycardia. An intravenous line is in place. What is the first drug of choice for the patient?
Mark one answer:

  • Atropine
  • Epinephrine
  • Sodium bicarbonate
  • Dopamine

Q:5-High-quality CPR for young children includes:
Mark one answer:

  • Compress to a depth of at least one third of the child’s chest diameter
  • Compress at a rate between 100 and 120 compressions per minute
  • Minimize interruptions to chest compressions
  • All of the above

Q:6-You are the team leader on a team resuscitating a child without a pulse or respirations. When you look at the monitor, you see a disorganized rhythm with chaotic electrical activity. This rhythm is most likely:
Mark one answer:

  • Asystole
  • PEA
  • Ventricular fibrillation
  • Ventricular tachycardia

Q:7-The goal of the PALS team in the treatment of shock is to:
Mark one answer:

  • Improve oxygen delivery
  • Prevent organ injury
  • Stop the progression to cardiopulmonary failure
  • All of the above

Q:8-When evaluating a child’s bradycardia, it is important to consider the child’s:
Mark one answer:

  • Baseline rate
  • Level of activity
  • Clinical condition
  • All of the above

Q:9-For asystole, the team should do CPR until IV or IO access is achieved. The drug of choice for asystole is:
Mark one answer:

  • Amiodarone
  • Epinephrine
  • Lidocaine
  • Atropine

Q:10-In school age children and infants, the two most common initial rhythms seen in pediatric cardiac arrest are:
Mark one answer:

  • Asystole and PEA
  • Asystole and VF
  • PEA and VF
  • Pulseless VT and VF

Tips For Passing The PALS Certification Exam

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