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

Question 1

A 3-year-old child presents with a regular, narrow-complex tachycardia at a rate of 230/min.
The child is irritable but has strong peripheral pulses, a capillary refill of 2 seconds, and normal blood pressure for age.
According to the PALS algorithm, which of the following is the most appropriate initial intervention?

Accepted Answer

Attempt vagal maneuvers, such as applying ice to the face.

Answer

Perform synchronized cardioversion at 0.5 J/kg.

Answer

Administer adenosine 0.1 mg/kg rapid IV push.

Answer

Administer amiodarone 5 mg/kg IV over 20 minutes.

Question 2

A 6-year-old child is lethargic with cool, mottled skin. The monitor shows a regular, wide-complex tachycardia with a QRS duration of 0.12 seconds and a rate of 190/min. The blood pressure is 68/40 mmHg. What is the most critical and immediate intervention?

Accepted Answer

Perform immediate synchronized cardioversion.

Answer

Obtain a 12-lead ECG to confirm the diagnosis.

Answer

Administer a 20 mL/kg bolus of isotonic crystalloid.

Answer

Consult pediatric cardiology before proceeding.

Question 3

When analyzing a pediatric ECG, which QRS duration is the threshold that differentiates a narrow-complex from a wide-complex tachycardia according to PALS guidelines?

Accepted Answer

Greater than 0.09 seconds

Answer

Greater than 0.12 seconds

Answer

Less than 0.08 seconds

Answer

Exactly 0.10 seconds

Question 4

A 4-year-old with a history of fever and vomiting presents with a heart rate of 170/min. The ECG shows a narrow QRS complex and visible P waves before each QRS. The heart rate decreases when the child's fever is treated. Which of the following is the most likely rhythm?

Accepted Answer

Sinus Tachycardia

Answer

Supraventricular Tachycardia (SVT)

Answer

Ventricular Tachycardia

Answer

Atrial Flutter

Question 5

You are preparing to administer the initial dose of adenosine to a 10 kg infant with stable SVT that was unresponsive to vagal maneuvers. What is the correct dose and administration technique?

Accepted Answer

1 mg (0.1 mg/kg) as a rapid IV push, followed by a saline flush.

Answer

2 mg (0.2 mg/kg) as a slow IV push over 1 minute.

Answer

0.5 mg (0.05 mg/kg) as a rapid IV push.

Answer

6 mg (standard adult dose) as a slow IV infusion.

Question 6

A 7-year-old child in the PICU develops an unstable narrow-complex tachycardia. You are preparing for synchronized cardioversion. What is the recommended initial energy dose?

Accepted Answer

0.5 to 1 J/kg

Answer

4 J/kg

Answer

10 J/kg

Answer

20 J/kg