PALS - Pediatric Advanced Life Support Bradycardia With a Pulse Questions and Answers

Question 1

An 8-month-old infant is found apneic with a brachial pulse of 45/min and signs of poor perfusion.
Despite effective bag-mask ventilation with 100% oxygen, the heart rate remains 45/min and perfusion is poor.
What is the most appropriate immediate action?

Accepted Answer

Begin high-quality chest compressions and continue assisted ventilations.

Answer

Provide rescue breaths only and recheck the pulse in 2 minutes.

Answer

Administer IV epinephrine 0.01 mg/kg.

Answer

Attach an AED and wait for rhythm analysis.

Question 2

A 4-year-old child presents with symptomatic bradycardia. After ensuring a patent airway and providing effective oxygenation and ventilation, the child's heart rate remains 55/min with hypotension. An IV is in place. Which medication is the most appropriate first-line pharmacologic intervention?

Accepted Answer

Epinephrine 0.01 mg/kg IV

Answer

Amiodarone 5 mg/kg IV

Answer

Adenosine 0.1 mg/kg IV

Answer

Sodium Bicarbonate 1 mEq/kg IV

Question 3

Which of the following is considered the MOST common cause of bradycardia in infants and children?

Accepted Answer

Hypoxia

Answer

Congenital heart block

Answer

Drug overdose

Answer

Hypothermia

Question 4

A 6-year-old with a known third-degree AV block develops symptomatic bradycardia with a heart rate of 50/min. The child is hypotensive and lethargic despite a patent airway and adequate breathing. According to the PALS algorithm, which medication should be administered FIRST?

Accepted Answer

Atropine 0.02 mg/kg

Answer

Epinephrine 0.01 mg/kg

Answer

Dopamine infusion at 5 mcg/kg/min

Answer

Calcium Chloride 20 mg/kg

Question 5

You are managing a 5-year-old with persistent symptomatic bradycardia. Initial steps of supporting oxygenation and ventilation were ineffective. IV epinephrine and atropine have been administered without improvement. The child remains hypotensive with poor perfusion. Which of the following interventions should be considered next?

Accepted Answer

Transcutaneous pacing

Answer

Synchronized cardioversion

Answer

Administering a fluid bolus of 20 mL/kg

Answer

Administering a dose of amiodarone

Question 6

What is the correct IV/IO dose of atropine for a pediatric patient with symptomatic bradycardia according to the PALS guidelines?

Accepted Answer

0.02 mg/kg, with a maximum single dose of 0.5 mg

Answer

0.1 mg/kg, with no minimum dose

Answer

0.5 mg fixed dose, may repeat once

Answer

0.01 mg/kg, with a maximum total dose of 1 mg