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PALS- PEDIATRIC ADVANCED LIFE SUPPORT
B+ QUESTIONS AND ANSWERS
1. The PALS systemic approach algorithm begins with the initial impression.
This is an assessment of which 3 characteristics? ANS 1. Consciousness
2. Breathing
3. Color
2. The right branch of the systemic approach algorithm focuses on what
sequence to prevent cardiopulmonary arrest? ANS Evaluate, Identify, Intervene
3. The evaluate portion of the sequence consists of three assessment tools
ANS-
ANS 1. Primary
2. Secondary
3. Diagnostic
4. What is included in the primary assessment of a patient?
ANS A B
C
D
E
Vitals
5. What is included in the secondary assessment of a patient?
ANS Focused history and a focused physical exam
6. The initial impression of the PALS systematic approach algorithm includes
which of the following characteristics? (Choose all correct answers.)
1. Appearance
2. Breathing
3. Restlessness
4. Color
- Pain ANS 1, 2, 4
7. 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? ANS unrespon- sive
8. 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?
1. Start CPR
2. Apply breathing with a bag valve mask
3. Activate emergency response
4. Check for a pulse
ANS 3.
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?
1. Begin CPR
2. Provide a 500ml NS bolus
3. Perform an ABG.
4. Intubate the patient.
ANS 1.
13. The right branch of the PALS systematic approach algorithm is a se-
quence of three actions. In the proper sequence, the three actions are ANS (Fill in the blanks) , , ANS evaluate, identify, intervene
14. The evaluate portion of the evaluate-identify-intervene sequence con-
sists of what clinical assessment tools? (Choose all correct answers)
1. Diagnostic tests
2. Pain assessment
3. Secondary assessment
4. Primary assessment
ANS 1, 3, 4
- (True or False) The sequence of evaluate-identify-intervene should be used before and after each intervention and should continue until the child is stable.
1. True
2. False
ANS 1.
16. 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
- 70 ANS 3.
17. The primary objective of the Airway assessment in the ABCDE model is to
assess airway.
1. effort of breathing
2. rate of breathing
3. disease
4. patency
ANS 4.
18. Within the EVALUATE portion of the evaluate-identify-intervene se-
quence, 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
2. Head tilt chin lift
3. Jaw thrust
4. Nasopharyngeal airway
ANS 1.
- Assessment of Breathing includes evaluation of ANS
1. Respiratory rate and effort
2. Chest expansion in air movement
3. Lung and airway sounds
4. O2 saturation
5. All of the above
ANS 5.
- Tachypnea can have both respiratory and non-respiratory causes. Select all of the non-respiratory cause of tachypnea.
1. Croup
2. Pneumonia
3. Bronchiolitis
4. High Fever
5. Asthma
6. Severe pain
7. Anemia
ANS 4, 6, 7
- (True or False) Stridor is a sign of lower airway problem.
1. True
2. False
ANS 2.
- (True or False) Grunting is often a sign of lung tissue disease resulting from small airway collapse, alveolar collapse or both.
1. True
2. False
ANS 1.
24. Match each lung and airway sound with the appropriate definition. (drag
and drop)
A. Coarse, usually higher pitched breathing sound typically heard on inspi-
ration
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
ANS A. Stridor
B. Wheezing
C. Gurgling
D. Grunting
E. Crackles
1. True
2. False
ANS 1.
- An observed decrease in systolic blood pressure of mm Hg from baseline should prompt serial evaluations for additional signs of shock.
1. 5 mm Hg
2. 10 mm Hg
3. 15 mm Hg
- 20 mm Hg ANS 2.
30. 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) ANS increases, decreases
31. (True or False) When assessing circulation, it is only necessary to assess
the central pulses.
1. True
2. False
ANS 2.
- What is a common cause of vasoconstriction and can result in a dis- crepancy between the peripheral and central pulses in children? (Choose all correct answers)
1. hot environment
2. cold environment
3. environmental stress
4. tachyarrhythmias
ANS 2.
- Normal capillary refill time in children is.
1. d 5 seconds
2. d 3 seconds
3. < 2 seconds
4. d 2 second
ANSs4.
34. Skin color can be an indication of tissue perfusion. Match the skin char-
acteristics with the correct definitions.
A. Irregular or patchy discoloration of the skin which may be caused hypox-
emia, hypovolemia, or shock.
B. Paleness, lack of normal color in the skin or mucous membrane.
C. Blue discoloration of the skin and mucous membranes
D. Bluish discoloration of the hands and feet commonly seen during the
newborn period.
E. Bluish discoloration of the hands and feet seen beyond the newborn
period.
1. Decreased level of consciousness
2. Loss of muscular tone
3. Generalized seizures
4. Pupil dilation
ANS 1, 2, 3, 4
- When cerebral hypoxia develops more gradually, the neurologic signs are the same as when severe cerebral hypoxia develops suddenly.
1. True
2. False
ANS 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?
1. Alert, Voice, Painful, Unresponsive
2. Active, Verbal, Painful, Unresponsive
3. Alert, Voice, Pupils, Unresponsive
4. Alive, Voice, Pulses, Understands
ANS 1.
- The Glasgow coma scale is used to evaluate a child's level of conscious- ness 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.
1. Eye-opening
2. Verbal
3. Motor
ANS 3.
- Pupil response to light is a indicator of function.
1. Cortex
2. Hypothalamus
3. Limbic
4. Brainstem
ANS 4.
- The D(disability) of the primary assessment is a quick evaluation of neurologic function. Which standard evaluations are included in this assess- ment? (choose all correct answers)
1. AVPU scale
2. Glasgow coma scale
3. Pupil response to light
4. NIH stroke scale
5. Blood glucose test
ANS 1, 2, 3, 5
- The E of the ABCDE primary assessment acronym stands for .
secondary assessment, and tests. (fill in the blank with the correct answer) ANS Diagnostic
47. 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.
ANS A. pH (7.35-7.45) B. PaO2 (80-100) C. PaCO2 (35-45) D. HCO3 (22-26) E. SaO2 (80-100)
48. (True or False) Hemoglobin concentration determines the oxygen-carry-
ing capacity of the blood.
1. True
2. False
ANS 1.
- In the seriously ill or injured child, the arterial lactate level can as a result of tissue hypoxia and anaerobic metabolism.
1. Fall
2. Rise
ANS 2.
- (True or False) Pediatric cardiac arrest typically has a primary cause that is related to respiratory failure or shock.
1. True
2. False
ANS 1.
- Pediatric cardiac arrest is typically the result of resulting from respiratory failure and/or shock.
1. coronary occlusion
2. tissue hypoxia
3. pulmonary embolism
4. hypovolemia
ANS 2.
- (True or False) Outcomes for cardiac arrest in children is generally good.
1. True
1. True
2. False
ANS 1.
- The correct location to palpate for a pulse in an unresponsive CHILD is . (choose all correct answers)
1. carotid
2. radial
3. femoral
4. brachial
ANS 1, 3
- (True or False) To ensure proper treatment of cardiac arrest, the rhythm must be identified before initiating CPR.
1. True
2. False
ANS 2.
- In children, a pulse check should be limited to.
1. no more than 5 seconds
2. no more than 10 seconds
3. no more than 15 seconds
4. no more than 20 seconds
ANS 2.
- Choose the scenarios that would require immediate CPR.
1. 3-year-old. not responsive, shallow breathing, weak pulse, HR 70
2. 7-year-old, not responsive, not breathing, weak pulse, poor perfusion, HR
3. 1-year-old, opens eyes, lethargic, rapid breathing, HR 55
4. 4-year-old, not responsive, agonal breathing, no pulse
ANS 2, 4
