AHA PALS FINAL EXAM 2022/2023
1. 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?: Second degree
Second Degree Heart Block (Mobitz II)
the picture shown is not the picture in the actual e...
1. A 12-year-old child being evaluated in the pediatric intensive care unit displays the following
ECG waveform. The team interprets this as which ar- rhythmia?: Second degree
Second Degree Heart Block (Mobitz II)
the picture shown is not the picture in the actual exam
2. 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?: Lactate
3. A 9-year-old patient is presenting with decreased breath sounds, brady- cardia, slowed
respiratory rate and a low O2 saturation level. The provider interprets these findings as
indicating which condition?: Respiratory failure
4. 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?: Deliver 1 BVM ventilation every 3 to 5 seconds.
5. 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 arrhyth- mia?: First-degree atrioventricular (AV) block
the picture shown is not the picture in the actual exam
6. 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 re-
sponse to ischemia/reperfusion. The team bases this determination on which finding(s)?: Hypotensio
Fever Hyperglycemia
7. 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 de-
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partment providers begin high-quality CPR. Which action(s) by the providers demonstrates high-
quality CPR?: 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)
8. A PALS resuscitation team is preparing to defibrillate a child e cardiac arrest. Forxperiencing
which rhythm(s) would this action be appropr pVT are shockable cardiac arrestiate?: VF and
rhythms.
9. A provider is assessing a child with suspected shock. Which s correctly describes tatement
hypotension and shock?: Hypotension is not feature of shock; a consistent
10. 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?:
Supplemental oxygen should be administered as needed to maintain an oxygen saturation above 94%.
11. An 11-year-old soccer player is brought to the emergency d After a quick
assessment, the team realizes this patient is expe severe asthma exacerbation. epartment.
Which medication would the team a first?: Albuterol plus Ipratropium Bromid riencing a
12. A child in the pediatric step-down unit is exhibiting signs of respiratory distress. When
dminister
assessing this child, which circulation finding might be pre- sent?: Pallor is a circulation finding that
may be seen in patients with respiratory distress.
13. 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?: 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.
14. An 11-year-old child develops unstable wide-complex tachycardia. As- sessment reveals signs
of significant hemodynamic compromise, but the child has a pulse. The PALS team would prepare
the child for which in- tervention?: First-line treatment for unstable wide-complex tachycardias
consists
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, AHA PALS FINAL EXAM
of synchronized electrical cardioversion, particularly when signs of h emodynamic
compromise are apparent.
15. 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?: Sudden infant death syndrome
16. 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 hemo- dynamically unstable. Which primary assessment findings
indicate this?: Dif- ficulty breathing
Hypotension Mottling
Decreased level of consciousness
17. 2-year-old child is brought to the pediatric urgent care clinic by who says that the the parent
child has had a barking cough for two days. Dur rapid assessment of the child, theing the
provider hears audible inspirato Which common cause of partial upper airwayry stridor.
obstruction in childr the provider most likely suspect?: Croup en would
18. A 6-year-old child is brought to the emergency department. Th been experiencinge child has
extremely watery stools over the past several d completing the assessment, the ays. After
healthcare provider suspects that may be experiencing shock. Which type of shock the child
would the provi likely suspect?: Hypovolemic der most
19. 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?: When assessing the adequacy of circulation, consider skin color and visible
mucous mem- branes for pallor (or gray/dusky color), cyanosis, mottling or flushing and evidence of
any bleeding, including life-threatening bleeding.
20. Assessment of a 3-month-old infant admitted with respiratory d reveals fever,
grunting and a wet, "junky" cough. The infant's pare the child had a recent respiratory istress
infection with a fever. A rapid re syncytial virus (RSV) test is positive.Which condition nts said
would the pro likely suspect as the cause?: Bronchiolitis
spiratory
vider most
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