PALS Updated Final Exam Questions And Verified Answers
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PALS Updated Final Exam
Questions And Verified Answers
Complete Solutions,
100% Correct
New Update
Complete A+ Guide
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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?
Answer second degree
*Explanation: Second-degree atrioventricular (AV) block is characterized by intermittent failure
of atrial impulses to conduct to the ventricles. On ECG, it appears as some P waves not followed
by QRS complexes. The description “second degree” typically refers to Mobitz type I
(Wenckebach) or type II, both of which are recognized by the pattern of dropped beats.
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?
Answer Lactate
*Explanation: Lactate levels reflect tissue hypoxia and inadequate oxygen delivery. In
conditions like shock or dehydration, elevated lactate indicates anaerobic metabolism due to
insufficient oxygen at the cellular level. It is a key marker of perfusion adequacy.
3. 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?
Answer Respiratory failure
*Explanation: The combination of inadequate oxygenation (low O2 saturation), decreased
breath sounds, bradycardia, and a slowed respiratory rate indicates that the respiratory system
is failing to maintain adequate gas exchange. This defines respiratory failure, often a pre-arrest
state.
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, 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?
Answer Deliver 1 BVM ventilation every 3 to 5 seconds.
*Explanation: Gasping is not effective breathing. With a pulse rate of 65 (bradycardia for a 4-
year-old), the priority is to support ventilation. Bag-valve-mask (BVM) ventilation at a rate of
12-20 breaths per minute (one every 3-5 seconds) is the immediate intervention before
considering chest compressions.
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 arrhythmia?
Answer First-degree atrioventricular (AV) block
*Explanation: Lyme disease can cause heart block. First-degree AV block is defined by a
prolonged PR interval (>0.20 seconds) without dropped beats. It is often asymptomatic and
detected on routine ECG.
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 response to ischemia/reperfusion. The team bases this
determination on which finding(s)?
Answer Hypotension, Fever, Hyperglycemia
*Explanation: Post-cardiac arrest syndrome (PCAS) includes a systemic inflammatory response
similar to sepsis. Common findings are hypotension (cardiovascular dysfunction), fever
(inflammatory response), and hyperglycemia (stress-induced metabolic changes). These reflect
ischemia-reperfusion injury.
Complete Solutions, 100% Correct | New Update | |
Complete A+ Guide
Geniusexpert stuvia
THIS DOCUMENT CONTAINS:
PALS Updated Final Exam
Questions And Verified Answers
Complete Solutions,
100% Correct
New Update
Complete A+ Guide
,https://www.stuvia.com/user/geniusexpert
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?
Answer second degree
*Explanation: Second-degree atrioventricular (AV) block is characterized by intermittent failure
of atrial impulses to conduct to the ventricles. On ECG, it appears as some P waves not followed
by QRS complexes. The description “second degree” typically refers to Mobitz type I
(Wenckebach) or type II, both of which are recognized by the pattern of dropped beats.
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?
Answer Lactate
*Explanation: Lactate levels reflect tissue hypoxia and inadequate oxygen delivery. In
conditions like shock or dehydration, elevated lactate indicates anaerobic metabolism due to
insufficient oxygen at the cellular level. It is a key marker of perfusion adequacy.
3. 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?
Answer Respiratory failure
*Explanation: The combination of inadequate oxygenation (low O2 saturation), decreased
breath sounds, bradycardia, and a slowed respiratory rate indicates that the respiratory system
is failing to maintain adequate gas exchange. This defines respiratory failure, often a pre-arrest
state.
https://www.stuvia.com/user/geniusexpert
, 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?
Answer Deliver 1 BVM ventilation every 3 to 5 seconds.
*Explanation: Gasping is not effective breathing. With a pulse rate of 65 (bradycardia for a 4-
year-old), the priority is to support ventilation. Bag-valve-mask (BVM) ventilation at a rate of
12-20 breaths per minute (one every 3-5 seconds) is the immediate intervention before
considering chest compressions.
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 arrhythmia?
Answer First-degree atrioventricular (AV) block
*Explanation: Lyme disease can cause heart block. First-degree AV block is defined by a
prolonged PR interval (>0.20 seconds) without dropped beats. It is often asymptomatic and
detected on routine ECG.
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 response to ischemia/reperfusion. The team bases this
determination on which finding(s)?
Answer Hypotension, Fever, Hyperglycemia
*Explanation: Post-cardiac arrest syndrome (PCAS) includes a systemic inflammatory response
similar to sepsis. Common findings are hypotension (cardiovascular dysfunction), fever
(inflammatory response), and hyperglycemia (stress-induced metabolic changes). These reflect
ischemia-reperfusion injury.
