PALS Tachycardia With a Pulse 2

Question 1

A 3-year-old presents with a heart rate of 220 bpm, poor perfusion, and altered mental status. The rhythm is narrow-complex and regular. What is the most appropriate next intervention?

Accepted Answer

Synchronized cardioversion at 1 J/kg

Answer

Unstable SVT with signs of poor perfusion requires immediate synchronized cardioversion starting at 1 J/kg.

Question 2

Which ECG feature best distinguishes sinus tachycardia from SVT in a pediatric patient?

Accepted Answer

P-waves present before every QRS with a normal axis

Answer

Sinus tachycardia shows upright P-waves with a normal axis preceding each QRS, unlike SVT which often shows absent or retrograde P-waves.

Question 3

A 6-year-old with SVT receives adenosine 0.1 mg/kg IV without conversion. What is the next dose of adenosine?

Accepted Answer

0.2 mg/kg IV

Answer

If the first dose of adenosine (0.1 mg/kg) fails, the second dose is doubled to 0.2 mg/kg (max 12 mg).

Question 4

In a child with wide-complex tachycardia and a pulse who is hemodynamically stable, which drug is preferred?

Accepted Answer

Amiodarone 5 mg/kg IV over 20–60 minutes

Answer

Amiodarone is the preferred antiarrhythmic for stable wide-complex tachycardia in pediatric patients per PALS guidelines.

Question 5

Which scenario is MOST consistent with sinus tachycardia rather than SVT?

Accepted Answer

Heart rate that gradually decreases with fluid administration for dehydration

Answer

Sinus tachycardia has an identifiable cause (e.g., fever, dehydration) and responds to treatment of that cause, often showing gradual rate change.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Tachycardia With a Pulse 2