PALS Bradycardia With a Pulse 4

Question 1

A 9-year-old athlete has a resting heart rate of 48 bpm with no symptoms and normal BP. What is the most appropriate management?

Accepted Answer

Observation — this is likely physiologic bradycardia

Answer

Well-trained athletes commonly have sinus bradycardia at rest due to high vagal tone; without symptoms or hemodynamic compromise, no intervention is needed.

Question 2

Which of the following signs indicates that bradycardia is causing hemodynamic compromise in a pediatric patient?

Accepted Answer

Mottled skin, hypotension, and decreased consciousness

Answer

Mottling, hypotension, and altered mental status are clinical signs of poor perfusion indicating hemodynamically significant bradycardia.

Question 3

A 2-year-old ingested an unknown medication and presents with bradycardia, miosis, excessive secretions, and bronchospasm. Which antidote is indicated?

Accepted Answer

Atropine

Answer

This is a classic cholinergic toxidrome (organophosphate or carbamate poisoning); atropine reverses muscarinic effects including bradycardia.

Question 4

In the PALS bradycardia algorithm, what is the correct sequence after identifying bradycardia with a pulse AND cardiopulmonary compromise?

Accepted Answer

Airway/Oxygenation → Drugs → CPR if unresponsive → Pacing

Answer

PALS bradycardia sequence is: support airway and oxygenation first, then drugs (atropine/epinephrine), then CPR if needed, then consider pacing.

Question 5

A 12-year-old presents with bradycardia following a head injury with increased intracranial pressure. Which triad of findings should be recognized?

Accepted Answer

Bradycardia, hypertension, and irregular respirations (Cushing's triad)

Answer

Cushing's triad (bradycardia, hypertension, irregular respirations) signals severely elevated ICP and impending herniation.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Bradycardia With a Pulse 4