Pediatric Advanced Life Support (PALS)Exit
Exam with: Questions & 100% Correct Answers |
Comprehensive Predictor Exit Exam with NGN Q
& A: Latest Actual Exam Version
,Topic: PALS Systematic Approach & Assessment
1. Question: What is the correct sequence of the PALS systematic approach algorithm?
Answer: Initial impression → Primary assessment → Secondary assessment → Diagnostic tests.
Rationale: The systematic approach begins with a rapid initial impression (consciousness, breathing, color) to identify life
threats, followed by the primary assessment (ABCDE), secondary assessment (focused history and physical exam), and
appropriate diagnostic tests.
2. Question: During the initial impression, a child appears limp, pale, and is not making any sounds. What category of
pathophysiology should you immediately suspect?
Answer: Cardiopulmonary failure or arrest.
Rationale: The initial impression evaluates consciousness, breathing, and color. A limp, pale, silent child has collapsed
circulation and/or respiratory failure, indicating a pre-arrest or arrest state requiring immediate intervention.
3. Question: What does the mnemonic “AVPU” stand for in the primary assessment?
,Answer: Alert, Verbal, Painful, Unresponsive.
Rationale: AVPU is a rapid method to assess a child’s level of consciousness, ranging from fully Alert, responsive to Voice,
responsive only to Painful stimuli, to completely Unresponsive, which indicates a need for immediate airway support.
4. Question: What is the most common cause of cardiac arrest in the pediatric population?
Answer: Respiratory failure or shock leading to progressive tissue hypoxia and acidosis.
Rationale: Unlike adults, primary cardiac events are rare in children. Cardiac arrest is usually the end result of
decompensated respiratory failure or shock (asphyxial arrest).
5. Question: You are performing a primary assessment on a 4-year-old with stridor. What is the first and most critical
intervention you should prepare for?
Answer: Opening the airway (head tilt-chin lift or jaw thrust) and preparing for possible advanced airway management.
Rationale: Stridor indicates upper airway obstruction. In the primary assessment, the “A” (Airway) is the first priority.
Maintaining a patent airway takes precedence over all other actions.
6. Question: A 6-month-old is responsive only to painful stimuli, has circumoral cyanosis, and respiratory rate is 10/min.
What is the immediate action?
Answer: Open the airway, provide bag-mask ventilation with 100% oxygen, and activate the emergency response system.
, Rationale: Unresponsive or obtunded children with inadequate breathing require immediate airway opening and assisted
ventilation. Cyanosis and bradypnea confirm respiratory failure.
7. Question: In the primary assessment, what does the “D” stand for, and what does it evaluate?
Answer: Disability; evaluates neurological function via rapid assessment of level of consciousness (AVPU) and pupillary
response.
Rationale: After managing ABCs (Airway, Breathing, Circulation), the provider assesses neurological Disability to identify
brain injury or inadequate cerebral perfusion.
8. Question: You assess a child’s circulation during the primary assessment. Which two signs are the most sensitive early
indicators of compensated shock?
Answer: Persistent tachycardia and delayed capillary refill.
Rationale: Tachycardia is the earliest vital sign change in shock. Delayed capillary refill (>2 seconds) indicates reduced
peripheral perfusion. Blood pressure is maintained until late (decompensated) shock.
9. Question: What is the priority after delivering a shock for ventricular fibrillation during a pediatric cardiac arrest?
Answer: Immediately resume high-quality CPR for 2 minutes, starting with chest compressions, before rechecking the
rhythm.
Exam with: Questions & 100% Correct Answers |
Comprehensive Predictor Exit Exam with NGN Q
& A: Latest Actual Exam Version
,Topic: PALS Systematic Approach & Assessment
1. Question: What is the correct sequence of the PALS systematic approach algorithm?
Answer: Initial impression → Primary assessment → Secondary assessment → Diagnostic tests.
Rationale: The systematic approach begins with a rapid initial impression (consciousness, breathing, color) to identify life
threats, followed by the primary assessment (ABCDE), secondary assessment (focused history and physical exam), and
appropriate diagnostic tests.
2. Question: During the initial impression, a child appears limp, pale, and is not making any sounds. What category of
pathophysiology should you immediately suspect?
Answer: Cardiopulmonary failure or arrest.
Rationale: The initial impression evaluates consciousness, breathing, and color. A limp, pale, silent child has collapsed
circulation and/or respiratory failure, indicating a pre-arrest or arrest state requiring immediate intervention.
3. Question: What does the mnemonic “AVPU” stand for in the primary assessment?
,Answer: Alert, Verbal, Painful, Unresponsive.
Rationale: AVPU is a rapid method to assess a child’s level of consciousness, ranging from fully Alert, responsive to Voice,
responsive only to Painful stimuli, to completely Unresponsive, which indicates a need for immediate airway support.
4. Question: What is the most common cause of cardiac arrest in the pediatric population?
Answer: Respiratory failure or shock leading to progressive tissue hypoxia and acidosis.
Rationale: Unlike adults, primary cardiac events are rare in children. Cardiac arrest is usually the end result of
decompensated respiratory failure or shock (asphyxial arrest).
5. Question: You are performing a primary assessment on a 4-year-old with stridor. What is the first and most critical
intervention you should prepare for?
Answer: Opening the airway (head tilt-chin lift or jaw thrust) and preparing for possible advanced airway management.
Rationale: Stridor indicates upper airway obstruction. In the primary assessment, the “A” (Airway) is the first priority.
Maintaining a patent airway takes precedence over all other actions.
6. Question: A 6-month-old is responsive only to painful stimuli, has circumoral cyanosis, and respiratory rate is 10/min.
What is the immediate action?
Answer: Open the airway, provide bag-mask ventilation with 100% oxygen, and activate the emergency response system.
, Rationale: Unresponsive or obtunded children with inadequate breathing require immediate airway opening and assisted
ventilation. Cyanosis and bradypnea confirm respiratory failure.
7. Question: In the primary assessment, what does the “D” stand for, and what does it evaluate?
Answer: Disability; evaluates neurological function via rapid assessment of level of consciousness (AVPU) and pupillary
response.
Rationale: After managing ABCs (Airway, Breathing, Circulation), the provider assesses neurological Disability to identify
brain injury or inadequate cerebral perfusion.
8. Question: You assess a child’s circulation during the primary assessment. Which two signs are the most sensitive early
indicators of compensated shock?
Answer: Persistent tachycardia and delayed capillary refill.
Rationale: Tachycardia is the earliest vital sign change in shock. Delayed capillary refill (>2 seconds) indicates reduced
peripheral perfusion. Blood pressure is maintained until late (decompensated) shock.
9. Question: What is the priority after delivering a shock for ventricular fibrillation during a pediatric cardiac arrest?
Answer: Immediately resume high-quality CPR for 2 minutes, starting with chest compressions, before rechecking the
rhythm.
