Download Pediatric Advanced Life Support (PALS) Final Exam Questions and Answers and more Quizzes Pediatrics in PDF only on Docsity!
AHA PALS- PEDIATRIC ADVANCED LIFE SUPPORT
FINAL EXAM QUESTIONS WITH ANSWERS 100%
VERIFIED RATED A+ GUARANTEED PASS
"A 6-year-old child is brought to the emergency department. The child has been experiencing extremely watery stools over the past several days. After completing the assessment, the healthcare provider suspects that the child may be experiencing shock. Which type of shock would the provider most likely
suspect? - CORRECT ANSWER=> Hypovolemic"
"An oxygen saturation of ≥ _____% while a child is breathing room air usually indicates that oxygenation is adequate.
- 90%
- 92%
- 94%
4. 98% - CORRECT ANSWER=> 3."
"Heart rate and rhythm, pulses, capillary refill time, skin color and temperature, and blood pressure are all direct indicators of circulatory status. Which of the following are indirect indicators of circulatory status? (Choose all correct answers)
- Urine output
- Oxygen saturation
- Level of consciousness
4. Respiratory rate - CORRECT ANSWER=> 1, 3."
"What is the most common cause of bradycardia in children?
- Sepsis
- Drug overdose
- Hypoxia
4. Complete heart block - CORRECT ANSWER=> 3."
"(True or False) Tachycardia is a normal physiologic response in the critically ill child?
- True
2. False - CORRECT ANSWER=> 1."
"An observed decrease in systolic blood pressure of ________ mm Hg from baseline should prompt serial evaluations for additional signs of shock.
- 5 mm Hg
- 10 mm Hg
- 15 mm Hg
4. 20 mm Hg - CORRECT ANSWER=> 2."
"The second box of the PALS systematic approach algorithm contains a question. (Fill in the blank to complete the question.)
Is the child ____________ or is immediate intervention needed? - CORRECT ANSWER=> unresponsive"
"In the PALS systematic approach algorithm, if the child is determined to be unresponsive or immediate intervention is needed what will be your next step?
- Start CPR
- Apply breathing with a bag valve mask
- Activate emergency response
4. Check for a pulse - CORRECT ANSWER=> 3."
"After the emergency response is activated, the next intervention is to ____________.
- Lightly shake the child's shoulders.
- Look, listen, and feel.
- Open the airway.
4. Check for breathing and a pulse - CORRECT ANSWER=> 4."
"After it is determined that the child has no pulse, what should be done?
- Call for help
- Begin CPR
- Provide 2 rescue breaths
4. Start an IV - CORRECT ANSWER=> 2."
"A child is unresponsive and is not breathing. You have activated the emergency response system and your pulse check reveals that the child has a pulse. What should you do now?
- Perform a brief head to toe assessment.
- Place the child in the recovery position.
- Give epinephrine 1mg IV push
4. Open the airway and provide ventilations and oxygen. - CORRECT ANSWER=> 4."
"A child is unresponsive and is not breathing. Emergency response was activated and now a pulse check shows that the child does have a pulse. You then open the airway, provide age-appropriate ventilations, and 100% oxygen with a bag valve mask. The child's pulse is < 60/min, and the child has signs of poor perfusion. What is your next intervention?
- Begin CPR
- Provide a 500ml NS bolus
- Perform an ABG.
4. Intubate the patient. - CORRECT ANSWER=> 1."
”The PALS systemic approach algorithm begins with the initial impression. This is an assessment of which
3 characteristics? - CORRECT ANSWER=> 1. Consciousness
- Breathing
"A consistent respiratory rate less than 10 or more than _____ breaths per minute in a child of any age is abnormal and suggests the presence of a potentially serious problem.
- 40
- 50
- 60
4. 70 - CORRECT ANSWER=> 3."
"The primary objective of the Airway assessment in the ABCDE model is to assess airway _________.
- effort of breathing
- rate of breathing
- disease
4. patency - CORRECT ANSWER=> 4."
"Within the EVALUATE portion of the evaluate-identify-intervene sequence, The primary assessment uses the ABCDE model for a hands-on evaluation of the critically ill child. What does ABCDE stand for? (Fill in the blanks) A B C D
E - CORRECT ANSWER=> Airway
Breathing Circulation Disability Exposure" "Simple measures for maintaining airway patency include all of the following EXCEPT which intervention?
- Continuous positive airway pressure
- Head tilt chin lift
- Jaw thrust
4. Nasopharyngeal airway - CORRECT ANSWER=> 1."
"Assessment of Breathing includes evaluation of:
- Respiratory rate and effort
- Chest expansion in air movement
- Lung and airway sounds
- O2 saturation
5. All of the above - CORRECT ANSWER=> 5."
"Tachypnea can have both respiratory and non-respiratory causes. Select all of the non-respiratory cause of tachypnea.
- Croup
- Pneumonia
- Bronchiolitis
- High Fever
- Asthma
- Severe pain
7. Anemia - CORRECT ANSWER=> 4, 6, 7"
"(True or False) Stridor is a sign of lower airway problem.
- True
2. False - CORRECT ANSWER=> 2."
"(True or False) Grunting is often a sign of lung tissue disease resulting from small airway collapse, alveolar collapse or both.
- True
2. False - CORRECT ANSWER=> 1."
"Match each lung and airway sound with the appropriate definition. (drag and drop) A. Coarse, usually higher pitched breathing sound typically heard on inspiration B. High-pitched or low-pitched whistling or sighing sound heard most often during expiration C. Bubbling sound heard during inspiration or expiration D. Short, low pitched breathing sound heard during expiration
E. Also known as rales and typically associated with pneumonia - CORRECT ANSWER=> A. Stridor
B. Wheezing C. Gurgling D. Grunting E. Crackles" "In healthy children, the heart rate may fluctuate with the respiratory cycle. The heart rate __________ with inspiration and __________ with expiration. (fill in each blank with a
single word) - CORRECT ANSWER=> increases, decreases"
"(True or False) When assessing circulation, it is only necessary to assess the central pulses.
- True
2. False - CORRECT ANSWER=> 2."
"What is a common cause of vasoconstriction and can result in a discrepancy between the peripheral and central pulses in children? (Choose all correct answers)
- hot environment
- cold environment
- environmental stress
4. tachyarrhythmias - CORRECT ANSWER=> 2."
"The AVPU scale is a scale used to evaluate cerebral cortex function and is used to rate a child's level of consciousness. What does the acronym AVPU stand for?
- Alert, Voice, Painful, Unresponsive
- Active, Verbal, Painful, Unresponsive
- Alert, Voice, Pupils, Unresponsive
4. Alive, Voice, Pulses, Understands - CORRECT ANSWER=> 1."
"The Glasgow coma scale is used to evaluate a child's level of consciousness and neurologic status. The child's best eye-opening, verbal, and motor responses are scored. If a child is intubated, unconscious, or preverbal, the most important part of this scale is _____________ response.
- Eye-opening
- Verbal
3. Motor - CORRECT ANSWER=> 3."
"Pupil response to light is a indicator of ______________ function.
- Cortex
- Hypothalamus
- Limbic
4. Brainstem - CORRECT ANSWER=> 4."
"The D(disability) of the primary assessment is a quick evaluation of neurologic function. Which standard evaluations are included in this assessment? (choose all correct answers)
- AVPU scale
- Glasgow coma scale
- Pupil response to light
- NIH stroke scale
5. Blood glucose test - CORRECT ANSWER=> 1, 2, 3, 5"
"The E of the ABCDE primary assessment acronym stands for ________________.
- Evidence
- Emergency
- Evaluate
4. Exposure - CORRECT ANSWER=> 4."
"After completion of the primary assessment, if the child does not have a life-threatening condition, the secondary assessment should be completed. The secondary assessment consists of which of the following components? (Choose all correct answers)
- General physical exam
- Family medical history
- Focused history
4. Focused physical exam - CORRECT ANSWER=> 3, 4"
"The final aspect of the evaluate component for the evaluate - identify - intervene sequence is diagnostic tests. What is the primary diagnostic test for assessing the severity of respiratory problems?
- Central venous oxygen saturation
- Hemoglobin concentration
- Arterial blood gas
4. Arterial lactate - CORRECT ANSWER=> 3."
"Within the evaluate-identify-intervene sequence, there are 3 clinical assessments that occur. The 3 clinical assessments are primary assessment, secondary assessment, and _________ tests. (fill in the
blank with the correct answer) - CORRECT ANSWER=> Diagnostic"
"An arterial blood gas is a diagnostic test that measures amounts of certain gasses and other constituents in the arterial blood. Match each result with the proper definition. A. This value tells us about the acid-base balance. B. This value tells us whether oxygenation is adequate. C. This value tells us whether ventilation is adequate. D. This value is used to determine if the source of an acid-base disturbance is respiratory or metabolic.
E. This value tells us the percentage of hemoglobin saturated with oxygen. - CORRECT ANSWER=> A.
pH (7.35-7.45) B. PaO2 (80-100) C. PaCO2 (35-45) D. HCO3 (22-26) E. SaO2 (80-100)" "(True or False) Hemoglobin concentration determines the oxygen-carrying capacity of the blood.
- True
2. False - CORRECT ANSWER=> 1."
"In the seriously ill or injured child, the arterial lactate level can __________ as a result of tissue hypoxia and anaerobic metabolism.
- Fall
2. Rise - CORRECT ANSWER=> 2."
"(True or False) Pediatric cardiac arrest typically has a primary cause that is related to respiratory failure or shock.
- True
2. False - CORRECT ANSWER=> 1."
"Pediatric cardiac arrest is typically the result of _________ resulting from respiratory failure and/or shock.
- coronary occlusion
- tissue hypoxia
- pulmonary embolism
4. hypovolemia - CORRECT ANSWER=> 2."
"(True or False) Outcomes for cardiac arrest in children is generally good.
“A 12-year-old child being evaluated in the pediatric intensive care unit displays the following ECG
waveform. The team interprets this as which arrhythmia? - CORRECT ANSWER=> Second degree
Second Degree Heart Block (Mobitz II) the picture shown is not the picture in the actual exam" "Laboratory tests are ordered for a child who has been vomiting for 3 days and is diaphoretic, tachypneic, lethargic and pale. Which test would the provider use to determine the adequacy of oxygen
delivery? - CORRECT ANSWER=> Lactate"
"A 9-year-old patient is presenting with decreased breath sounds, bradycardia, slowed respiratory rate and a low O2 saturation level. The provider interprets these findings as indicating which condition? -
CORRECT ANSWER=> Respiratory failure"
"A 4-year-old child is brought to the emergency department by the parents. Assessment reveals that the child has only gasping respirations and the pulse rate is 65 beats per minute. Which action would the
provider initiate first? - CORRECT ANSWER=> Deliver 1 BVM ventilation every 3 to 5 seconds."
"A 15-year-old patient is being evaluated during a follow-up visit after being diagnosed with Lyme disease 2 months ago. A rhythm strip is obtained as shown below. The provider interprets this rhythm as
indicating which arrhythmia? - CORRECT ANSWER=> First-degree atrioventricular (AV) block
the picture shown is not the picture in the actual exam" "A child in cardiac arrest experiences return of spontaneous circulation but is exhibiting signs of post- cardiac arrest syndrome (PCAS). The PALS resuscitation team determines that the child is experiencing a systemic response to ischemia/reperfusion. The team bases this determination on which finding(s)? -
CORRECT ANSWER=> Hypotension
Fever Hyperglycemia" "A 2-year-old child arrives at the emergency department with the parents. The child is unresponsive, is not breathing and has no pulse. Two emergency department providers begin high-quality CPR. Which
action(s) by the providers demonstrates high-quality CPR? - CORRECT ANSWER=> Allowing the chest to
recoil fully after each compression Providing ventilations that last about 1 second each Compressing the chest about 2 inches
Giving 2 ventilations to every 15 compressions (15:2)" "A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest. For which
rhythm(s) would this action be appropriate? - CORRECT ANSWER=> VF and pVT are shockable cardiac
arrest rhythms." "A provider is assessing a child with suspected shock. Which statement correctly describes hypotension
and shock? - CORRECT ANSWER=> Hypotension is not a consistent feature of shock;"
"A provider is caring for a 4-year-old child in the urgent care clinic. Primary assessment reveals difficulty breathing and an oxygen saturation of 91%. The provider administers oxygen by nasal cannula with the
goal of improving the child's oxygen saturation above what percentage? - CORRECT ANSWER=>
Supplemental oxygen should be administered as needed to maintain an oxygen saturation above 94%." "An 11-year-old soccer player is brought to the emergency department. After a quick assessment, the team realizes this patient is experiencing a severe asthma exacerbation. Which medication would the
team administer first? - CORRECT ANSWER=> Albuterol plus Ipratropium Bromid"
"A child in the pediatric step-down unit is exhibiting signs of respiratory distress. When assessing this
child, which circulation finding might be present? - CORRECT ANSWER=> Pallor is a circulation finding
that may be seen in patients with respiratory distress." "A healthcare provider is performing a primary assessment of a child in respiratory distress. The provider
documents increased work of breathing when which findings are observed? - CORRECT ANSWER=>
Nasal flaring, use of accessory muscles to breathe and intercostal, substernal or suprasternal retractions are all indicators of increased work or effort of breathing. Grunting and inspiratory stridor are abnormal breath sounds." "An 11-year-old child develops unstable wide-complex tachycardia. Assessment reveals signs of significant hemodynamic compromise, but the child has a pulse. The PALS team would prepare the child
for which intervention? - CORRECT ANSWER=> First-line treatment for unstable wide-complex
tachycardias consists of synchronized electrical cardioversion, particularly when signs of hemodynamic compromise are apparent." "A 4-month old infant is brought to the emergency department in cardiac arrest. Which condition would
the team identify as the most common cause of cardiac arrest in an infant of this age? - CORRECT
ANSWER=> Sudden infant death syndrome"
"A 9-year-old child is brought to the emergency department because the child suddenly collapsed at school. The child's ECG reveals the following waveform, and primary assessment findings indicate that
the child is hemodynamically unstable. Which primary assessment findings indicate this? - CORRECT
ANSWER=> Difficulty breathing
Hypotension
"Primary assessment of a 10-year-old child reveals septic shock. As part of the secondary assessment, laboratory testing is completed to evaluate the child's status. Which laboratory tests would be ordered
for this child? - CORRECT ANSWER=> Laboratory testing for the child in septic shock may include CBC,
blood cultures, blood gasses, coagulation panel, renal function tests, liver function panel and lactate level." "A 4-year-old patient presents with tachycardia, tachypnea, cold extremities and weak pulses. Assessment also reveals an enlarged liver and neck vein distension. The provider interprets these
assessment findings as suggesting which type of shock? - CORRECT ANSWER=> cardio"
"A 10-year-old child has collapsed in the gym of the elementary school. The school nurse arrives and determines that the child is unresponsive. The school nurse then simultaneously checks for breathing
and a central pulse, limiting this assessment to which time frame? - CORRECT ANSWER=> 5 seconds,
but no more than 10." "A child being cared for in the pediatric telemetry unit suddenly displays the following ECG waveform. The provider prepares to intervene because the child is demonstrating which type of arrhythmia? -
CORRECT ANSWER=> Supraventricular tachycardia"
"A 6-year-old patient is brought to the emergency department after a bicycle accident. Assessment reveals tracheal deviation to the left side, chest pain on inspiration and decreased breath sounds on the
right side. The provider suspects obstructive shock caused by what condition? - CORRECT ANSWER=>
Tension pneumothorax" "A child is experiencing stable supraventricular tachycardia (SVT) and is to receive treatment. Which
initial treatment would the provider administer? - CORRECT ANSWER=> Vagal"
"An unresponsive 7-year-old child with no pulse is brought to the pediatric urgent care center by his parents and CPR is initiated. The cardiac monitor reveals ventricular fibrillation. Which action would the
PALS team take first? - CORRECT ANSWER=> Initiate defibrillation with 2 J/kg."
"A child who is stable and exhibiting a narrow-complex tachycardia is to receive adenosine. The provider
would be alert for which result after administering this medication? - CORRECT ANSWER=> Patients
may have a brief period of "asystole" following the administration of adenosine. This is normal and typically self-limited." "An 8-year-old child being treated in the emergency department has significant respiratory distress. The child also exhibits hives, wheezing, angioedema, tachycardia and dyspnea. The parents state that the child, who is allergic to peanuts, had eaten some popcorn that had peanuts in it. The team initiates care,
preparing to administer which agent first? - CORRECT ANSWER=> epi"
"A 2-year-old child of unknown weight arrives at the emergency department in cardiac arrest. When preparing to administer medications, which action would be appropriate for the team to take? -
CORRECT ANSWER=> Tape"
"The PALS team is providing post-cardiac arrest care to an 8-year-old child in the pediatric intensive care unit. Which intervention would the team implement to achieve the primary goal of post-cardiac arrest
care? - CORRECT ANSWER=> ensure MAP"
"A 12-year-old is being treated in the urgent care clinic. The mother reports that the child came home from school yesterday with a high fever, vomiting and multiple episodes of watery diarrhea. The healthcare provider obtains a rhythm strip and notes the following waveform. The provider interprets
this as which type of arrhythmia? - CORRECT ANSWER=> sinus tahy"
"A child requires cardiac monitoring. A three-electrode system is being used. At which location would the
provider place the red electrode? - CORRECT ANSWER=> On the lower left abdomen"
"An advanced airway was placed in a 5-year-old child. Which action(s) would be most appropriate for the
team to take to confirm correct placement? - CORRECT ANSWER=> Auscultate over the lungs and
epigastrium for air movement, Observe for bilateral chest rise, Evaluate results of capnography." "A 12-lead ECG is ordered for a child complaining of a "racing heart." When placing the electrodes on the
child, at which location would the lead for V4 be placed? - CORRECT ANSWER=> Fifth intercostal space
at the midclavicular line on the patient's left side." "A 7-year-old child collapses on the playground at school. The school nurse is called to the scene and determines that the child is unresponsive and is not breathing and has no pulse. The nurse initiates CPR.
At what rate and depth would the nurse deliver compressions to this child? - CORRECT ANSWER=> 100
to 120 compressions per minute at a depth of about 2 inch" "Which action would the PALS team initiate to manage increased intracranial pressure in a pediatric
patient? - CORRECT ANSWER=> Maintain the head in midline position with 30-degree elevation"
"child is experiencing shock. The emergency response team prepares for imminent cardiac arrest when
assessment reveals which finding(s)? - CORRECT ANSWER=> Hypotension, Bradycardia, Diminished
central pulses" "A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the
provider administer? - CORRECT ANSWER=> Corticosteroids, Racemic epinephrine"
"After ROSC, a child is experiencing post-cardiac arrest hemodynamic instability. The PALS resuscitation team would administer which element to restore intravascular volume and optimize preload? -
CORRECT ANSWER=> Isotonic fluid boluses"
