PALS QUESTIONS WITH CORRECT SOLUTIONS RATED A+

How long should assessing for breathing and a pulse take? A) no longer than 20 seconds B) no longer than 10 seconds C) no longer than 15 seconds D) no longer than 5 seconds - B) no longer than 10 seconds What should you do to check for breathing? A) look for chest rise and fall B) place your hand on the chest C) look at the nose to check for nasal flaring D) listen for lung sounds - A) look for chest rise and fall Where do you check a pulse on an infant and child? - Infant: brachial Child: femoral or carotid If the child does not have normal breathing and a pulse of 64 bpm is present, you will need to: A) begin CPR B) monitor C) provide rescue breathing - C) provide rescue breathing For an unwitnessed cardiac arrest, what should you do after determining unresponsiveness and there is no breathing and no pulse? A) shout for help B) perform high quality CPR for 2 minutes C) provide rescue breaths D) activate the emergency response system - B) perform high quality CPR for 2 minutes The appropriate rate for compressions for children is 100-120/min. What is the correct depth for children? A) approximately 2 inches (one third the AP diameter) B) approximately 3 inches (one half AP diameter) C) approximately 4 inches (two thirds AP diameter) - A) approximately 2 inches (one third the AP diameter) What is the compression to ventilation ratio for 1- and 2-rescuer CPR for children and infants? A) 15:2 for both B) 30:2 for both C) single rescuer 15:2, 2 rescuers 30:2 D) single rescuer 30:2, 2 rescuers 15:2 - D) single rescuer 30:2, 2 rescuers 15:2 How should 1-rescuer infant compressions be delivered? A) with 2 fingers or 2 thumbs B) with 1 finger or 2 thumbs C) with 2 hands or 2 fingers D) with 1 hand or 2 fingers - A) with 2 fingers or 2 thumbs What is the preferred technique for infant compressions when there are 2 or more rescuers present? A) 1 finger technique B) 1 thumb encircling hands technique C) 2 thumb encircling hands technique D) 2 finger technique - C) 2 thumb encircling hands technique If the AED indicates no shock advised, what should be the next action? A) start chest compressions B) call for help C) remove AED pads D) give 2 rescue breaths - A) start chest compressions When is the Pediatric Assessment Triangle (PAT) performed to make an initial assessment? A) during the "from the doorway" observation B) during the primary assessment C) during the transfer of care D) during the secondary assessment - A) during the "from the doorway" observation The evaluate-identify-intervene sequence should be continued until: A) the child is stable B) the child is ready for transport C) the child is ready for discharge D) interventions are provided for the child - A) the child is stable In the primary assessment, how should you open the airway of a child who is not suspected of having a c-spine injury? A) with ET intubation B) with a jaw thrust C) by flexing the neck D) with a head tilt-chin lift - D) with a head tilt-chin lift Hypotension for children 1-10 years of age is a SBP of less than: A) 50 + (2 x age in years) B) 40 + (2 x age in years) C) 70 + (2 x age in years) D) 60 + (2 x age in years) - C) 70 + (2 x age in years) What does a prolonged capillary refill time indicate? A) low cardiac rate B) increased stroke volume C) increased cardiac output D) low cardiac output - D) low cardiac output What pulses should be assessed to monitor systemic perfusion in a child? A) carotid and brachial B) pedal and radial C) peripheral and central D) femoral and carotid - C) peripheral and central What do weak central pulses indicate a need for immediate intervention to prevent? A) hypovolemia B) sepsis C) respiratory arrest D) cardiac arrest - D) cardiac arrest Which resuscitation strategy will result in an improved chest compression fraction? A) hovering over the chest during compression pauses B) switching compressors every 2 minutes C) implementing physiologic monitoring devices D) adhering to recommended drug dosing intervals - A) hovering over the chest during compression pauses What is one way to increase chest compression fraction during a code? A) switching the airway and compressor roles during CPR B) starting an IV/IO during rhythm analysis C) charging the defibrillator 15 seconds before a rhythm check D) giving epinephrine during a rhythm analysis - C) charging the defibrillator 15 seconds before a rhythm check What is chest compression fraction? A) proportion of time that compression are not performed B) proportion of time that compressions are performed C) proportion of time that recoil is adequate in compressions D) proportion of time that depth is adequate in compressions - B) proportion of time that compressions are performed Children develop hypoxemia and tissue hypoxia more quickly than adults because of their: A) lower respiratory rate B) higher HGB C) higher metabolic rate D) lower oxygen demand - C) higher metabolic rate Which of the following describes laminar or normal airflow? A) low airway resistance and a small driving pressure B) smaller airways need increased airways resistance C) larger airways need increased airway resistance D) high airway resistance and low driving pressure - A) low airway resistance and a small driving pressure Which of the following is true about airway resistance? A) the smaller the airway, the lower the airway resistance B) impedance to airflow is decreased when the airways constrict C) airway resistance decreases as lung volume remains unchanged D) when airway resistance increases, work of breathing increases - D) when airway resistance increases, work of breathing increases What do central chemoreceptors respond to? A) CO2 in the CSF B) serum pH C) CO2 in the bloodstream D) hydrogen ions in the CSF - D) hydrogen ions in the CSF What is the function of the nonrebreathing outlet valve of a self-inflating bag? A) keeps exhaled gases contained B) opens when the child exhales C) prevents rebreathing of CO2 D) allows the child to exhale - C) prevents rebreathing of CO2 Which of the following is required to appropriately ventilate a child with a self-inflating bag? A) the oxygen flow rate must remain constant B) face masks do not need to be fitted to the child C) tidal volume needs to be delivered at the correct rate D) the outlet control valve must not be changed - C) tidal volume needs to be delivered at the correct rate How is sniffing position achieved in an infant or child? A) place the infant in a prone position B) flex the neck behind the level of the shoulder C) hyperextend the neck D) ensure the external ear canal is anterior to the shoulder - D) ensure the external ear canal is anterior to the shoulder Which of these factors can override brainstem control of breathing in an infant? A) turbulent airflow B) breathing normally C) laminar airflow D) breath holding - D) breath holding What does the EC clamp technique include? A) using the thumb and index finger of the same hand to hold the face mask B) pressing on the soft tissue under the chin to lift the jaw C) using the third, fourth, and fifth fingers of one hand along the jaw to lift it forward D) using the second and third fingers of one hand to hold the face mask - A and C What should you do to help reduce the risk of hypoxemia during suctioning? A) never interrupt suctioning B) suction the back of the oropharynx C) withdraw the catheter in a twisting motion D) limit suction attempts to 10 seconds or less - D) limit suction attempts to 10 seconds or less What can happen if the OPA is too large? A) it can push the tongue to the back of the throat B) it can block the airway C) it may cause vomiting D) it will open the airway - B) it can block the airway Which are appropriate interventions for an apneic child? A) provide a breath every 2-3 seconds B) provide a breath every 2 seconds C) provide a breath every 3-5 seconds D) watch for chest rise - A and D Which of the following should be included in rescue breathing for an infant? A) provide a breath every 6 seconds B) check for a pulse every 5 minutes C) start chest compressions D) use oxygen as soon as it is available - D) use oxygen as soon as it is available What should you do before suctioning a child who has an upper airway obstruction? A) give nebulized epinephrine B) give corticosteroids C) determine the underlying cause of the obstruction D) determine if there is blood or debris in the airway - C) determine the underlying cause of the obstruction In a less severe case of upper airway obstruction in a child, what can relieve obstruction caused by the tongue? A) suction B) decide if a surgical airway is needed C) insert an oral airway D) minimize agitation - C) insert an oral airway Where may padding be required under when properly positioning a child older than 2 years of age to maintain a patent airway? A) the shoulders B) the occiput C) the upper torso D) padding is not required for children older than 2 years of age - B) the occiput A responsive infant presents with severe foreign body airway obstruction. What is the appropriate management? A) perform abdominal thrusts B) lay the infant on a hard surface and begin CPR C) perform a blind finger sweep D) give 5 back blows followed by 5 chest thrusts - D) give 5 back blows followed by 5 chest thrusts A responsive child presents with severe foreign body airway obstruction is unable to speak. You determine that the child: A) should be lowered to the floor and CPR should be initiated B) should receive abdominal thrusts C) needs no intervention; call for help and allow the child to clear the obstruction D) has a severe airway obstruction; give 5 back blows and 5 chest thrusts - B) should receive abdominal thrusts What is the treatment for mild allergic reaction? A) consider an antihistamine B) remove the offending agent C) monitor for wheezing D) use an epinephrine autoinjector D) give an albuterol treatment - A and B What are the common causes of lower airway obstruction? A) bronchiolitis B) asthma C) epiglottitis D) foreign body airway obstruction - A and B How can small airways be obstructed in lower airway obstruction? A) increased expiratory flow B) decreased volume of gas in the lungs C) smooth muscle bronchial constriction D) decreased intrapleural pressure E) mucus plugging - C and E How do infants initially respond to lower airway obstruction? A) increased tidal volumes B) increased respiratory rate C) decreased respiratory rate D) decreased intrapleural pressure - D) decreased intrapleural pressure BVM ventilation has been used on a child with a lower airway obstruction. Which complications may occur? A) increased venous return to the heart B) decreased blood supply to the heart C) risk of lung collapse D) increased oxygenation - B and C Which of the following are typical signs of lung tissue disease? A) bradypnea and hypercarbia B) tachypnea and hypoxemia C) normal respiratory rate and hypoxemia D) tachypnea and hypercarbia - B) tachypnea and hypoxemia How would you estimate the size of a cuffed or uncuffed ET tube to use for a patient that is 7 kg and 6 months old? - cuffed: (age in years)/4 + 3.5 uncuffed: (age in years)/4 + 4 How does the clinical presentation of distributive shock compare to hypovolemic shock? A) distributive shock has completely different presenting characteristics than those of hypovolemic shock B) distributive shock presents with bradycardia while hypovolemic shock presents with tachycardia C) distributive shock has a more variable presentation than that of hypovolemic shock D) distributive shock always presents the same as hypovolemic shock - C) distributive shock has a more variable presentation than that of hypovolemic shock When is distributive shock present? A) when there is excessive blood flow to all tissue beds B) when there is adequate blood flow to some tissue beds but too much to others C) when there is inadequate blood flow to all tissue beds D) when there is inadequate blood flow to some tissue beds but too much to others - D) when there is inadequate blood flow to some tissue beds but too much to others What is the focus of the initial management of distributive shock? A) filling expanded dilated vascular space B) stopping additional fluid loss C) decreasing extravascular volume D) expanding intravascular volume E) correcting hypovolemia - A, D, E You are dispatched to the home of a 7 y/o male who presents with a 1-day history of runny nose and progressive lethargy and fever. He has a decreased LOC and a rash on his trunk and legs. He is hot to the touch. The first responders report that the scene is safe. The patient's vital signs are HR 178 bpm, BP 61/38, RR 32/min, SpO2 95%, and temperature 102.9 degrees. When you arrive at the house, the patient is sitting on the couch in the living room. Given the status of the patient, what immediate steps should you take to stabilize him? A) insert an OPA B) monitor and support ABCs C) establish IV/IO access D) monitor HR, BP, and SpO2 E) obtain chest XR - You establish an IV in your 7 y/o patient with septic shock. What is the next most appropriate intervention? A) administer fluid bolus B) consider medical control consult C) initiate and titrate vasoactive drugs D) administer an antipyretic - A) administer fluid bolus Ongoing assessment of your 7 y/o septic shock patient must be done while administering fluid boluses. What are some of the adverse effects that indicate that you should stop rapid fluid bolus administration? A) increased urinary output B) hepatomegaly C) mental status improvement D) rales E) respiratory distress - B, D, E What is the most appropriate vasoactive drug to use in fluid-refractory septic shock? A) epinephrine or norepinephrine B) vasopressin C) milrinone D) phenylephrine - A) epinephrine or norepinephrine What is the recommendation for fluid bolus of isotonic crystalloids in cardiogenic shock? A) 40 mL/kg over 20-30 mins B) 10-20 mL/kg over 10-15 mins C) 5-10 mL/kg over 10-20 mins D) 20 mL/kg over 5-10 mins - C) 5-10 mL/kg over 10-20 mins