PALS FINAL EXAM Q&A
What is considered inadequate perfusion when assessing/caring for a pediatric patient
with an arrhythmia? - 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? - 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 O2 saturation level. The provider interprets these findings as
indicating which condition? - 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 healthcare provider suspects that the child may be experiencing shock.
Which type of shock would the provider most likely suspect? - ANSWER -Hypovolemia
A 2-year-old child of unknown weight arrives at the emergency department in cardiac
arrest. When preparing to administer medications, which action would be appropriate for
the team to take? - ANSWER -Estimate weight using a length-based resuscitation tape.
An 11-year-old child develops ventricular tachycardia with a pulse with inadequate
perfusion. The PALS team would prepare the child for which intervention? - ANSWER -
Synchronized electrical cardioversion
A provider is assessing a child with suspected shock. Which statement correctly
describes hypotension and shock? - 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? - 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? - 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? - ANSWER -100 to 120 compressions per minute at a depth
of about 2 inches
A 5-year-old child with a history of a chronic neuromuscular disease is experiencing
respiratory distress. The child is breathing spontaneously and receiving supplemental
oxygen. Which additional intervention is a critical component of airway management for
this patient? - ANSWER -Airway clearance (e.g., suctioning)
Primary assessment of a 10-year-old child reveals septic shock. As part of the
secondary assessment, if not already done as part of initial sepsis care, laboratory
testing is completed to evaluate the child's status. Which laboratory tests would be
ordered for this child? - 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? - 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? - 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? - 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? - 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? -
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? - ANSWER -Compressing the chest about 2 inches
What is considered inadequate perfusion when assessing/caring for a pediatric patient
with an arrhythmia? - 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? - 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 O2 saturation level. The provider interprets these findings as
indicating which condition? - 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 healthcare provider suspects that the child may be experiencing shock.
Which type of shock would the provider most likely suspect? - ANSWER -Hypovolemia
A 2-year-old child of unknown weight arrives at the emergency department in cardiac
arrest. When preparing to administer medications, which action would be appropriate for
the team to take? - ANSWER -Estimate weight using a length-based resuscitation tape.
An 11-year-old child develops ventricular tachycardia with a pulse with inadequate
perfusion. The PALS team would prepare the child for which intervention? - ANSWER -
Synchronized electrical cardioversion
A provider is assessing a child with suspected shock. Which statement correctly
describes hypotension and shock? - 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? - 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? - 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? - ANSWER -100 to 120 compressions per minute at a depth
of about 2 inches
A 5-year-old child with a history of a chronic neuromuscular disease is experiencing
respiratory distress. The child is breathing spontaneously and receiving supplemental
oxygen. Which additional intervention is a critical component of airway management for
this patient? - ANSWER -Airway clearance (e.g., suctioning)
Primary assessment of a 10-year-old child reveals septic shock. As part of the
secondary assessment, if not already done as part of initial sepsis care, laboratory
testing is completed to evaluate the child's status. Which laboratory tests would be
ordered for this child? - 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? - 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? - 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? - 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? - 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? -
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? - ANSWER -Compressing the chest about 2 inches
