PALS TEST QUESTIONS WITH CORRECT SOLUTIONS GRADED TO PASS

In which of the following situations may IO access be used? - 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? - It is Hypotensive You are caring for patients in the emergency department. Which two year old requires immediate interventions? - 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? - 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? - Ask for a new task or role. You are the team lead during a pediatric resuscitation attempt. Which action is high quality CPR? - 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? - 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? - 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? - 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? - 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? - Oxygen Saturation 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. What medication would be most appropriate? - Antibiotics During a resuscitation attempt, the Team Leader asks you to administer an initial dose of epinephrine at 0.1 mg/kg to be given IO. How should you respond? - I think the correct dose is 0.01 mg/kg. Should I give that dose instead?' A 6-month-old infant is unresponsive. You begin checking for breathing at the same time you check for the infant's pulse. What is the maximum time you should spend trying to simultaneously check for breathing and palpate the infant's pulse before starting CPR? - 10 seconds A 10-year-old child is being evaluated for a headache. What is a normal finding for this 10-year-old child? - Heart rate of 88 bpm A 6-year-old boy is being evaluated for difficulty breathing. What finding would suggest this child has respiratory distress? - Audible inspiratory stridor A 4-year-old child in cardiac arrest is brought to the emergency department by ambulance. High-quality CPR is being performed. The cardiac monitor displays the rhythm strip shown here. The estimated weight of the child is 20 kg. What dosage range should you use for initial defibrillation? - 2 to 4 J/kg A 4-year-old child in cardiac arrest is brought to the emergency department by ambulance. High-quality CPR is being performed. The cardiac monitor displays the rhythm strip shown here. The estimated weight of the child is 20 kg. As the Team Leader, how many joules do you tell your team member to use to perform initial defibrillation? - 40J You respond to an infant who is unresponsive, is not breathing, and does not have a pulse. You do not have a mobile device, and you shout for nearby help but no one arrives. What action should you take next? - Begin CPR for 2 minutes before leaving to activate the emergency response system What ratio for compressions to breaths should be used for 1-rescuer infant CPR? - Give 30 compressions to 2 breaths A 3-year-old boy is brought to the emergency department by his mother. He is lethargic, with retractions and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk capillary refill. Which immediate life-threatening condition could this child's condition most likely progress to if left untreated? - Respiratory Failure You are evaluating a 10-year-old child who is febrile and tachycardic. The child's capillary refill time is 5 seconds. What parameter will determine if the child is in compensated shock? - Blood Pressure An 18-month old has had vomiting and diarrhea for the past 2 days; the mother brings him to the emergency department because he is becoming more lethargic. What diagnostic test should you order first? - Blood Glucose You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and diarrhea. His parents state that he has been sleeping much more. His heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg. 24. What assessment finding indicates that the infant has hypotensive shock? - Blood Pressure You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and diarrhea. His parents state that he has been sleeping much more. His heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg. On the basis of this infant's presentation, what type of shock does this infant have? - Hypovolemic Shock You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and diarrhea. His parents state that he has been sleeping much more. His heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg. You have decided that this infant needs fluid resuscitation. How much fluid should you administer? - 20 ml/kg normal saline What abnormality helps identify children with acute respiratory distress caused by lung tissue disease? - Crackles You are caring for a 9-month-old girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infant's SpOz is 94%. On auscultation, the lungs are clear bilaterally. What is the most likely cause of this infant's respiratory distress? - Upper airway obstruction You are caring for a 9-month-old girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infant's SpOz is 94%. On auscultation, the lungs are clear bilaterally. What medication should you administer first? - Epinephrine, nebulized What condition is characterized by a prolonged expiratory phase and wheezing? - Lower airway obstruction A 5-year-old child is brought to the emergency department by ambulance after being involved in a motor vehicle collision. You are using the primary assessment to evaluate the child. When assessing the child's neurologic status, you note that he has spontaneous eye opening, is fully oriented, and is able to follow commands. How would you document this child's AVPU (Alert, Voice, Painful, Unresponsive) Pediatric Response Scale finding? - Alert A 4-year-old child is brought to the emergency department for seizures. The seizures stopped a few minutes ago, but the child continues to have slow and irregular respirations. What condition is most consistent with your assessment? - Disordered control of breathing You are evaluating a 1-year-old child for respiratory distress. His heart rate is 168/min, and his respiratory rate has decreased from 65/min to 30/min. He now appears more lethargic and continues to have severe subcostal retractions. On the basis of your assessment, what is the most likely reason for this change in the child's condition? - The child has signs of respiratory failure.