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AHA PALS FINAL EXAM WITH ACCURATE
AND PROFESSOR VERIFIED ANSWERS
- A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer. What is the next most appropriate intervention C. Reassess breath sounds and clinical status
- The respiratory rate of a 1-year-old child with respiratory distress has decreased from 65/min to 30/min. The child is more lethargic and continues to have subcostal retractions. What does this change likely indicate B. Progression toward respiratory failure
- What is the most likely cause of head bobbing in infants A. Increased respiratory effort
- Several healthcare providers are participating in an attempted resuscitation. Which of the
following is most consistent with the responsibilities of the team leader of the resuscitation B. Assigns roles to team members
- Which of the following conditions is appropriate for use of an oropharyngeal airway C. Unconscious with no gag reflex
- A 10-year-old child had a sudden witnessed cardiac arrest and received immediate bystander CPR and defibrillation within 3 minutes. He had a return of spontaneous circulation. The child remains unresponsive and has an advanced airway in place. There is no history of trauma or signs of shock. What is the target range for oxygen saturation for this child C. 94% to 99%
- A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10 minutes after eating peanuts. What is the most appropriate initial medication for this child?A. Nebulized albuterolB. Epinephrine IMC. Isotonic crystalloid IVD. Methylprednisolone B. Epinephrine IM
this child C. Administer nebulized epinephrine
- Which of the following oxygen saturations indicates the need for additional intervention C. 93% on 4 L of oxygen
- A 3-year-old child presents with a 2-day history of nausea and vomiting. She is alert, with no increase in respiratory effort, and is pale in color. The child's heart rate is 160/min, respiratory rate is 40/min, and blood pressure is 100/70 mm Hg. Her extremities are cool, with sluggish capillary refill. Which term best describes this child's physiologic state A. Compensated shock
- A 3-year-old child presents with dehydration after a 2-day history of vomiting and diarrhea. The child after has received 2 fluid boluses of 20 mL/kg of normal saline. After the second bolus, the child is alert and interacting. Her heart rate is 110/min, respiratory rate is 30/min, and blood
pressure is 92/64 mm Hg. Her capillary refill time is 2 seconds, and oxygen saturation is 98% What is the most appropriate next intervention for this child C. Continue to monitor and reevaluate the child
- A 3-year-old child presents with a high fever and a petechial rash. The child is lethargic, has no signs of increased work of breathing, and is pale in color. His heart rate is 180/min, respiratory rate is 30/min, blood pressure is 80/68 mm Hg. Capillary refill time is 4 seconds, and oxygen saturation is 88%. Airway and lungs are clear. Peripheral pulses are diminished. Which of the following is the most appropriate initial intervention A. Provide 100% oxygen via a nonrebreathing mask
- You are examining a 2-year-old child who has a history of gastroenteritis. The initial impression reveals that the child is lethargic, with increased work of breathing and pale color. The child has a heart rate of 180/min, a respiratory rate of 40/min, a blood pressure of 80/60 mm Hg, a capillary refill time of 4 seconds, and an oxygen saturation of 96%. Central pulses are strong and peripheral pulses are weak, and the extremities are cool below the knee. What best describes the
Distal pulses are readily palpable. You give oxygen and establish IV access. What is the most appropriate vagal maneuver D. Ice to the face
- A 7-year-old child presents with a narrow-complex supraventricular tachycardia, lethargy, and poor perfusion. Pulses are weak and thready. Vascular access cannot be established. What is the most appropriate intervention B. Synchronized shock with 0.5 to 1 J/kg °
- A 3-month-old infant presents with lethargy and a 3-day history of vomiting, diarrhea, and poor feeding. The initial impression reveals lethargy, increased respiratory effort with retractions, and pale, mottled skin color. Vital signs are as follows: heart rate 210/min, respiratory rate 60/min, and blood pressure 60/40 mm Hg. Peripheral pulses are thready, and capillary refill time is 4 seconds. The cardiac monitor displays the rhythm below. After administration of oxygen and establishment of vascular access, what is the most appropriate intervention
D. IV fluid bolus of 20 mL/kg normal saline
- A 3-year-old child is unresponsive, gasping, and has no detectable pulse. CPR is initiated. A monitor is attached, and the rhythm is shown below. What is the appropriate next therapy A. Attempted defibrillation with 2 J/kg
- A 2-year-old child is in pulseless arrest. The child has received high-quality CPR, 2 shocks, and a dose of IV epinephrine. The next rhythm check reveals the rhythm shown below. What would be an appropriate energy dose for the third defibrillation attempt C. 4 J/kg or greater
- A 12-year-old child suddenly collapses while playing sports. He is unresponsive and not breathing. Emergency response is activated. The child has no pulse, and CPR is initiated. An AED arrives. What is the most appropriate next intervention D. Use the AED
palpable pulse. A cardiac monitor is applied, and sinus bradycardia at a rate of 42/min is noted. CPR is resumed, and vascular access is obtained. Which of the following is the most appropriate intervention A. Epinephrine 0.01 mg/kg IO/IV
- During a pediatric resuscitation attempt, what is most likely to contribute to high- quality CPR D. Allowing the chest wall to recoil completely between compressions
- While you are performing CPR on an infant in cardiac arrest at a doctor's office, a second rescuer arrives with an AED. Which of the following best describes the use of an AED on this infant D. If pediatric pads are unavailable, it is acceptable to use adult pads.
- A 5-year-old child is hit in the chest with a baseball and suddenly collapses. High- quality CPR is being performed. When the AED arrives, only adult AED pads are available. What should the rescuer do
A. Use the AED with adult pads
- A team is attempting to resuscitate a child who was brought to the emergency department by EMS after a traumatic injury. The family members arrive at the child's bedside and request to remain in the room during the resuscitation attempt. What does the American Heart Association recommend B. Allow the family to stay at the bedside with a staff member who is assigned to provide information and assistance
- Which of the following is most likely to produce a prolonged expiratory phase and wheezing C. Lower airway obstruction
- A 5-year-old child has had severe respiratory distress for 2 days. During assessment the child's heart rate decreases from 140/min to 90/min, and the child's respiratory rate decreases from 66/min to 8/min. Which of the following is the next appropriate intervention A. Rescue breaths at a rate of 12 to 20/min
55/40 mm Hg. What term describes this infant's blood pressure A. Hypotensive
- During a resuscitation attempt, the team leader orders an initial dose of epinephrine at 0. mg/kg to be given IO. What should the team member do C. Respectfully ask the team leader to clarify the dose °
- Which of the following is a characteristic of respiratory failure A. Inadequate oxygenation and/or ventilation
- Which of the following is most likely to produce a prolonged expiratory phase and wheezing C. Lower airway obstruction
- A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few minutes ago. Which of the following most likely to be abnormal D. Control of breathing
- What abnormality is most likely to be present in children with acute respiratory distress caused by lung tissue disease? A. Decreased oxygen saturation
- An alert 2-year-old child with an increased work of breathing and pink color is being evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would best describe this patient's condition A. Respiratory distress
- The parents of a 7-year-old child who is undergoing chemotherapy report that the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals the following: The child is difficult to arouse, with pale color. The child's heart rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is the most appropriate intervention B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
following vital signs: heart rate 168/min, respiratory rate 15/min, blood pressure 90/ mm Hg, and temperature 98.6°F (37°C). The child's capillary refill time is 4 seconds. After 2 IV boluses of normal saline (20 mL/kg each), the child's vital signs are now as follows: heart rate 130/min, respiratory rate 16/min, blood pressure 94/62 mm Hg, capillary refill 2 seconds, and temperature 98.6°F (37°C). The child's urine output is 1 to 2 mL/kg in the past hour. The child is still lethargic. What diagnostic tests or information should be obtained first C. Glucose
- A 15-year-old boy presents with acute onset of severe respiratory distress, with retractions and an oxygen saturation of 85%. His trachea is deviated to the right, and there are no breath sounds on the left. His heart rate is 140/min, his blood pressure is 84/60 mm Hg, and his capillary refill time is 3 seconds. What is the most appropriate intervention B. Perform needle decompression on the left chest
- A 4-year-old is being treated for hypovolemic shock and has received a single fluid bolus of 20
mL/kg of normal saline. On reevaluation the child remains anxious, with a heart rate of 140/min, a blood pressure of 84/54 mm Hg, and a capillary refill time of 4 seconds. What describes this patient's condition B. Compensated shock
- An 8-year-old child had a sudden onset of palpitations and light-headedness. At the time of evaluation the child is alert. His respiratory rate is 26/min, and his blood pressure is 104/70 mm Hg. A cardiac monitor is applied, and the rhythm below is noted. What is the most appropriate initial intervention B. Attempt vagal maneuvers
- A 10-year-old child had a sudden witnessed cardiac arrest and received immediate bystander CPR and defibrillation within 3 minutes. He had a return of spontaneous circulation. The child remains unresponsive and has an advanced airway in place. There is no history of trauma or signs of shock. What is the target range for oxygen saturation for this child C. 94% to 99%
D. Ice to the face
- A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10 minutes after eating peanuts. What is the most appropriate initial medication for this child B. Epinephrine IM
- A 2-year-old child was found submerged in a swimming pool. She is unresponsive, not breathing, and pulseless. In addition to performing high-quality CPR and establishing vascular access, which of the following is the most appropriate intervention C. Give epinephrine 0.01 mg/kg IO/IV
- A 3-year-old child is unresponsive, not breathing, and pulseless. High-quality CPR is in progress. A cardiac monitor is applied, and the rhythm below is noted. What is the next appropriate intervention A. Attempt defibrillation with a 2 J/kg shock
- A pulseless 6-week-old infant arrives in the emergency department, and high-quality CPR is in progress. The initial rhythm strip is shown below. CPR continues, and vascular access has been established. What is the next appropriate intervention C. Administer epinephrine 0.01 mg/kg IO/IV
- A 6-month-old infant is unresponsive and not breathing. What is the maximum time that should be spent trying to palpate the pulse before starting CPR A. 10 seconds
- What is the recommended location to check for a pulse in a 3-month-old infant C. Brachial
- A 7-year-old child presents in pulseless arrest. The child's ECG shows the rhythm below. Which of the following describes the patient's condition C. Pulseless electrical activity
