The child has a narrow-complex tachycardia (likely SVT) with signs of instability (hypotension, lethargy, hypoxemia, poor perfusion). In unstable SVT, cardioversion is indicated before adenosine. Fluids and epinephrine are not first-line for unstable SVT. Conclusion The Prova Teorica PALS is a demanding but passable exam if you approach it systematically. Focus on the Evaluate–Identify–Intervene framework, master the recognition of respiratory failure and shock, and drill the cardiac arrest algorithms until they become reflex. Combine that with quality practice questions, and you will enter the exam room confident and prepared.

For pediatric healthcare providers—from emergency physicians and pediatric nurses to paramedics and respiratory therapists—the certification is a non-negotiable credential. At its core lies the Prova Teorica PALS (PALS theoretical exam), a rigorous assessment of the cognitive knowledge required to manage critically ill or injured children.

A) Administer adenosine 0.1 mg/kg rapid IV push B) Perform immediate synchronized cardioversion at 0.5–1 J/kg C) Give a fluid bolus of 20 mL/kg normal saline D) Start an epinephrine infusion at 0.1 mcg/kg/min

B – Synchronized cardioversion.

By Dr. A. Rossi, Pediatric Emergency Medicine Consultant

This article is for educational purposes and follows AHA/ERC PALS guidelines. Always refer to the latest official provider manual for your region.