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PALS Final Exam 2025 Questions And
Correct Verified Answers
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 presentation in children. 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>>No more than 10 seconds 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 2 to 3 seconds. 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 inches
What is considered inadequate perfusion when assessing/caring for a pediatric patient with an arrhythmia? - Correct Answer>>Diminished peripheral pulses Acutely altered mental status Hypotension 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 has inadequate perfusion. Which primary assessment findings indicate this? - Correct Answer>>Signs of shock Acutely altered mental status Hypotension A 9-year-old patient is presenting with diminished breath sounds, bradycardia, slowed respiratory rate and a low O saturation level. The provider interprets these findings as indicating which condition? - Correct Answer>>Respiratory failure 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
evaluate the child's status. Which laboratory tests would be ordered for this child? - Correct Answer>>Complete blood count (CBC) Lactate level Blood cultures A 6-year-old patient is brought to the emergency department after a bicycle accident. Assessment reveals chest pain on inspiration, diminished breath sounds on the right side, and respiratory distress. The provider suspects obstructive shock caused by what condition? - Correct Answer>>Tension pneumothorax A child exhibiting a narrow-complex tachycardia with adequate perfusion is to receive adenosine. The provider would be alert for which result after administering this medication? - Correct Answer>>Transient asystole The emergency response team is providing care to a preschooler who is experiencing shock. The primary goal, common to all types of shock, is to restore a favorable balance between tissue perfusion and metabolic demand with a focus on what? - Correct Answer>>Oxygen delivery and oxygen demand
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>>Epinephrine A child in the pediatric intensive care unit displays the following ECG waveform. The child has no pulse. The resuscitation team interprets this as which arrhythmia? - Correct Answer>>Monomorphic pulseless ventricular tachycardia 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>>Compressing the chest about 2 inches Providing ventilations that last about 1 second each Giving 2 ventilations to every 15 compressions Allowing the chest to recoil fully after each compression A 15-year-old patient is being evaluated during a follow-up visit after being diagnosed with Lyme disease 2 months ago. A
saturation to what percentage range? - Correct Answer>>94% to 99% While performing a rapid assessment and formulating an initial impression using the Pediatric Assessment Triangle (PAT), the provider assesses the child's circulation. Which information would be important to consider? - Correct Answer>>Flushing of the skin Evidence of bleeding Skin pallor (or gray/dusky color) A child is experiencing shock. The emergency response team prepares for imminent cardiac arrest when assessment reveals which finding(s)? - Correct Answer>>Bradycardia Diminished central pulses Hypotension 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 Intercostal, substernal or suprasternal retractions Accessory muscle use
A 2-year-old child is brought to the pediatric urgent care clinic by the parent who says that the child has had a barking cough for two days. During the rapid assessment of the child, the provider hears audible inspiratory stridor. Which common cause of partial upper airway obstruction in children would the provider most likely suspect? - Correct Answer>>Croup A child experiencing bradycardia with inadequate perfusion despite supporting oxygenation and ventilation is receiving compressions. Despite these efforts, the child's status remains unchanged. Which medication would the emergency response team expect to administer next? - Correct Answer>>Epinephrine 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 immediately? - Correct Answer>>Albuterol with or without ipratropium bromide 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 atrioventricular (AV) block, type I
may the provider use the mnemonic TICLS to assess the patient? - Correct Answer>>Appearance 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 perfusion and oxygen delivery? - Correct Answer>>Lactate The PALS resuscitation team notes the following ECG waveform and the child does not have a pulse. The team prepares to intervene to address which arrhythmia? - Correct Answer>>Torsades de pointes Assessment of a 3-month-old infant admitted with respiratory distress reveals fever, grunting and a wet, "junky" cough. The infant's parents said the child had a recent respiratory infection with a fever. A rapid respiratory syncytial virus (RSV) test is positive. Which condition would the provider most likely suspect as the cause? - Correct Answer>>Bronchiolitis A 7-year-old patient with septic shock has received three balanced/buffered crystalloid fluid boluses (60-mL/kg) and reassessment reveals capillary refill of 3 seconds, diminished pulses, narrow pulse pressure and cool, mottled extremities. The emergency response team interprets these findings as
indicating which type of septic shock? - Correct Answer>>Fluid- refractory A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the provider administer? - Correct Answer>>Nebulized epinephrine Corticosteroids A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest. For which rhythm(s) would this action be appropriate? - Correct Answer>>pVT VF A 4-year-old child suddenly collapses in the playroom of the facility. A healthcare provider observes the event and hurries over to assess the child. The healthcare provider completes which assessment first? - Correct Answer>>Rapid assessment The PALS team leader is conducting a debriefing session with the team. Which topic(s) would the team leader most likely address during the session? - Correct Answer>>Discussion of the pros and cons of the interventionsEvaluation of the objective data gathered during the event, Summary of the event, including what actions were taken, Identification of ways to improve
Which action would the PALS team initiate to manage increased intracranial pressure in a pediatric patient? - Correct Answer>>Maintain the head in midline position. What is the correct IV/IO dose of epinephrine for a pediatric patient in cardiac arrest? - Correct Answer>>0.01 mg/kg every 3 to 5 min (max single dose 1 mg) 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. The PALS resuscitation team is providing care to an intubated child in cardiac arrest. Which of the following can be used to monitor the adequacy of the team's chest compressions? - Correct Answer>>End-tidal carbon dioxide levels Presence of an arterial waveform or arterial blood pressure in patients with indwelling arterial catheters
