PALS Test exam 2024 GRADED A
EXAM
In which of the following situations may IO access be used? - CORRECT ANSWER
An extremity with slow capillary refill time.
A 2 - week old infant is being evaluated irritability and poor feeding. His blood
pressure is 55/40 mm Hg and capillary refill time i...
In which of the following situations may IO access be used? - CORRECT ANSWER
An extremity with slow capillary refill time.
A 2 - week old infant is being evaluated irritability and poor feeding. His blood
pressure is 55/40 mm Hg and capillary refill time is 5 seconds. Which statement
best describes your assessment of this infants blood pressure? - CORRECT
ANSWER It is Hypotensive
You are caring for patients in the emergency department. Which two year old
requires immediate interventions? - CORRECT ANSWER A child who is grunting
A 3 year old child is having difficulty breathing. What finding would most likely
lead you to expect an upper airway obstruction in this child? - CORRECT ANSWER
Increased inspiratory effort with retractions
A team member is unable to perform an assigned task because it is beyond the
team member's scope of practice. What action should the team member take? -
CORRECT ANSWER Ask for a new task or role.
You are the team lead during a pediatric resuscitation attempt. Which action is
high quality CPR? - CORRECT ANSWER Allow complete chest wall recoil after
each compression.
A 8 year old child is brought to the emergency department by his mother for
difficultly breathing. He has a history is asthma and nut allergies. His mother tells
you that he has recently ate a cookie at a family picnic. Which condition is most
likely present with this child? - CORRECT ANSWER Upper airy way obstruction
An 8-year-old child is brought to the emergency department by ambulance after
being involved in a motor vehicle collision. What finding would suggest that
immediate intervention is needed? - CORRECT ANSWER Decreased level of
consciousness
,A 6-year-old child is found unresponsive, not breathing, and without a pulse. One
healthcare worker leaves to activate the emergency response system and get the
resuscitation equipment. You and another healthcare provider immediately begin
performing CPR. What compression-to-ventilation -ratio do you use? - CORRECT
ANSWER 15:2
A 3-year-old child is in cardiac arrest, and high-quality CPR is in progress. You are
the Team Leader. The first rhythm check reveals the rhythm shown here.
Defibrillation is attempted with a shock dose of 2 J/kg. After shock
administration, what should you say to your team members? - CORRECT ANSWER
Resume compressions
You are caring for a 5-year-old boy with a 4-day history of high fever and cough.
He is having increasing lethargy, grunting, and sleepiness. Now he is difficult to
arouse and is unresponsive to voice commands. His oxygen saturation is 72% on
room air and 89% when on a nonrebreathing oxygen mask. He has shallow
respirations with a respiratory rate of 38/min. Auscultation of the lungs reveals
bilateral crackles.
11. What assessment finding is consistent with respiratory failure in this child? -
CORRECT ANSWER Oxygen Saturation
compression to breath ratio children with 1 rescuer - CORRECT ANSWER 30:2
2 rescuer compression to breath ratio? - CORRECT ANSWER 15:2
Initial impression of a 2-year old girl shows her to be alert with mild breathing
difficulty during inspiration and pale skin color. On primary assessment, she
makes high pitched inspiratory sound (mild stridor) when agitated; otherwise,
intercoastal retractions. Lung auscultation reveals transmitted upper airway
sounds with adequate distal breath sounds bilaterally. Which is the most
appropriate initial intervention for this child? - CORRECT ANSWER humidified
oxygen as tolerated
Which statement is correct about use of calcium chloride in pediatric? - CORRECT
ANSWER Routine administration is not indicated during cardiac arrest
Which statement is correct about endotracheal drug administration during
resuscitative efforts for pediatric patients? - CORRECT ANSWER It is the least
desirable route of administration
You are a part of a team attempting to resuscitate a child with ventricular
fibrillation cardiac arrest. You delivered 2 unsynchronized shocks. A team
member established IO access, so you give a dose of epinephrine, 0.01 mg/kg IO.
,At the next rhythm check, persistent ventricular fibrillation is present. You
administer a 4-J/kg shock and resume CPR. Which drug and dose should be
administered next? - CORRECT ANSWER Amiodarone 5 mg/kg
You are called to help treat an infant with severe symptomatic bradycardia (HR
66/min) associated with respiratory distress. The bradycardia persists despite
establishment of an effective airway, oxygenation, and ventilation. There is no
heart block present. Which is the first drug you should administer? - CORRECT
ANSWER Epinephrine
Which statement is correct about the effects of epinephrine during attempted
resuscitation? - CORRECT ANSWER Epinephrine stimulates spontaneous
contractions when asystole is present
Paramedics are called to the home of a 1yo child. Their initial assessment reveals
a child who responds only to painful stimuli and has irregular breathing, faint
central pulses, bruises over the abdomen, abdominal distention, and cyanosis.
Bag-mask ventilation with 100% oxygen is initiated. The child's heart rate is
36/min. Peripheral pulses cannot be palpated, and central pulses are barely
palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is
started. Upon arrival to the emergency department, the child is intubated and
ventilated with 100% oxygen, and IV access is established. The heart rate is now
150/min with weak central pulses but no distal pulses. Systolic blood pressure is
74 mmHg. Which intervention should be provided next? - CORRECT ANSWER
Rapid bolus of 20 ml/kg of isotonic crystalloid
A 9-year old boy is agitated and leaning forward on the bed in obvious respiratory
distress. The patient is speaking in short phrases and tells you that he has
asthma but does not carry an inhaler. He has nasal flaring, severe suprasternal
and intercoastal retractions, and decreased air movement with prolonged
expiratory time and wheezing. You administer 100% oxygen by a NRB mask. His
SpO2 is 92%. Which medication do you prepare to give to this patient? - CORRECT
ANSWER Albuterol
A previously healthy infant with a history of vomiting and diarrhea is brought to
the ER by her parents. During your assessment, you find that the infant responds
only to painful stimulation. The infant's RR is 40/min, and central pulses are rapid
and weak. The infant has good bilateral breath sounds, cool extremities, and a
capillary refill time of ore than 5 seconds. The infant's blood pressure is 85/65
mmHg, and glucose is 30 mg/dL (1.56 mmol/L). You administer 100% oxygen via
facemsk and start an IV. Which treatment is the most appropriate for this infant?
, - CORRECT ANSWER Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20
minutes, and also give D25W to 4 ml/kg IV
How can rescuers ensure that they are providing effective breaths when using a
bag-mask device? - CORRECT ANSWER By observing the chest rise with each
breath
You need to provide rescue breaths to a child victim with a pulse. What is the
appropriate rate for delivering breaths? - CORRECT ANSWER 1 breath every 3 to 5
seconds
You just assisted with elective endotracheal intubation of a child with respiratory
failure and perfusing rhythm. Which provide reliable , prompt assessment of
correct endotracheal tube placement in this child? - CORRECT ANSWER Adequate
bilateral breath sounds and chest expansion plus detection of ETCO2 with
waveform capnography.
An 18 month-old child has 1 week history of cough and runny nose. The child has
diffuse cyanosis and responsive only to painful stimulation with slow respirations
and rapid central pulses. The child's respiratory has decreased from 65/min to
10/min, severe inspiratory intercoastal retractions are present, HR is 160/min,
SPO2 is 65% on RA, and capillary refill is less than2 seconds. Which are the most
appropriate immediate interventions for this toddler? - CORRECT ANSWER Open
the airway and provide positive-pressure ventilation using 100% O2 and a bag-
mask device.
You find an infant who is unresponsive, is not breathing, and does not have a
pulse. You shout for nearby help, but no one arrives. What action should you take
next? - CORRECT ANSWER Provide CPR about 2 minutes before leaving to
activate the emergency response system
You are caring for a 3 year old with vomitting and diarrhea. The child's pulses are
palpable but faint, and the child is now lethargic. The HR is variable (range,
44/min to 62/min). You begin bag-mask ventilation with 100% oxygen. When the
HR does not improve, you begin chest comnpressions. The rhythm shown here is
seen on the cardiac monitor (bradycardia). Which would be the most appropriate
therapy to consider next? - CORRECT ANSWER Atropine 0.02 mg/kg IV
The Secretary of the Commonwealth is authorized to appoint and commission
notaries public for a term of ______ years from the date of appointment. - CORRECT
ANSWER 4 years
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