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AHA Pediatric Advanced Life Support Exam / PALS Exam (answered)

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AHA Pediatric Advanced Life Support Exam / PALS Exam (answered) A 6-month-old infant is unresponsive. You begin checking for breathing at the same time you check for the infant's pulse. Which is the maximum time you should spend when trying to simultaneously check for breathing and palpate the infant's pulse before starting CPR? -10 seconds /.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. Which condition is most consistent with your assessment? Disordered control of breathing /.An 8-year-old child is brought to the emergency department with a 2-day history of lethargy and polyuria. The child has new-onset rapid, deep, and labored breathing. Which diagnostic test should you order first? 12-lead ECG Arterial blood gases Blood glucose /.After rectal administration of diazepam, an 8-year-old boy with a history of seizures is now unresponsive to painful stimulation. His respirations are shallow, at a rate of 10/min. His oxygen saturation is 94% on 2.L of nasal cannula oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. Which action should you take next? . Reposition the patient, and insert an oral airway - /.After rectal administration of diazepam, an 8-year-old boy with a history of seizures is now unresponsive to painful stimulation. His respirations are shallow, at a rate of 10/min. His oxygen saturation is 94% on 2.L of nasal cannula oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. If the patient continues to deteriorate after your initial intervention, which next step is most appropriate? - Answer- /.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. Which compression-to-ventilation ratio do you use? . 15:2 /.n postresuscitation management after cardiac arrest, extra care should be taken to avoid reperfusion injury. What should the ideal oxygen saturation range most likely be'? . 94% to 99% /.A3-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 administration of the shock, what should you say to your team members? "Resume compressions ." /.Use this scenario to answer the next 2 questions: 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. Which dosage range should you use for initial defibrillation? 2to4 Jikg /.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. Which dosage range should you use for initial defibrillation? . 40J /.You are the team leader during a pediatric resuscitation attempt. Which action is an element of high- quality CPR? Allowing complete chest wall recoil after each compression

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ENPC EXAM 6TH UNIT QUESTIONS WITH CORRECT
DETAILED ANSWERS

A 5-year-old child presents with hives, swelling of the lips and face, and stridor that
developed about an hour after eating lunch. The child has no known allergies. Which of
the following is the priority intervention?
A. Administer intramuscular epinephrine
B. Auscultate bilateral breath sounds
C. Insert an intravenous catheter
D. Administer inhaled albuterol - Answer-A. Administer intramuscular epinephrine

/.An adolescent is awaiting ICU admission for pneumonia. During reassessment, which
of the following findings would be most indicative that respiratory failure is developing?
A. SpO2 of 94 % on room air
B. Widened pulse pressure
C. Extreme lethargy
D. Flash capillary refill - Answer-A. SpO2 of 94 % on room air

/.A 3-year-old has a two-day history of runny nose, low-grade fever, and a "barky"
cough at night. The child is awake and alert with noted stridor. Pulse oximetry is 96% on
room air. Which of the following interventions would be the most appropriated for this
child?
A. Delivery of humidified oxygen by nasal cannula
B. Administration of nebulized epinephrine
C. Suctioning secretions from the oropharynx
D. Administration of albuterol with a spacer - Answer-B. Administration of nebulized
epinephrine

/.A 14-year-old patient had a reduction of a temporomandibular joint dislocation in the
ED. Which of the following should be included in the discharge instructions?
A. Practice yawning three to four times a day
B. Resume eating a regular diet later today
C. Apply hot packs to the joint area for pain control
D. Use a nonsteroidal anti-inflammatory for pain control - Answer-D. Use a nonsteroidal
anti-inflammatory for pain control

/.Which of the following parameters would indicate that appropriate post resuscitation
interventions were successfully carried out in the pediatric patient?
A. Pulse oximetry reading of 96%
B. Temperature of 99.8°F (37.6°C)
C. Capillary refill of < 1 second
D. Capnography reading of 60 mm Hg - Answer-A. Pulse oximetry reading of 96%

, /.An anxious 12-year-old child presents to the emergency department with a sudden
onset of nausea, diarrhea, abdominal cramping, flushing, and hypotension. Symptoms
started about 60 minutes after lunch. Which of the following conditions is the most likely
cause of these symptoms?
A. Anaphylaxis
B. Renal colic
C. Crohn's Disease
D. Menarche - Answer-A. Anaphylaxis

/.An 8-year-old trauma patient suddenly develops increased respiratory distress with a
rise in heart rate from 112 beats/minute to 142 beats/minute associated with an abrupt
hypotensive event. Distention of the jugular veins is noted. Which of the following
emergent interventions should be anticipated first?
A. High flow oxygen
B. Drug assisted intubation
C. Chest tube insertion
D. Needle decompression - Answer-D. Needle decompression

/.A 4-week-old infant born prematurely is brought to the emergency department due to
the rapid onset of abdominal distention, vomiting, bloody stools, and exhibiting signs of
shock. Based on these findings, what condition should the nurse suspect?
A. Necrotizing enterocolitis
B. Pyloric stenosis
C. Megacolon
D. Congenital diaphragmatic hernia - Answer-A. Necrotizing enterocolitis

/.A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry
mucous membranes. Vital signs reveal deep respirations at 44 breaths per minute, BP
of 70/44 mm Hg, and HR of 144 beats per minute. Which of the following laboratory
values would be most expected in this child?
A. Hypoglycemia
B. Severe anemia
C. Low pH level
D. Elevated serum bicarbonate - Answer-C. Low pH level

/.Which of the following pathologic processes would most likely be attributed to a
primary diagnosis of cystic fibrosis?
A. Hypernatremia
B. Constipation
C. Obesity
D. Epiglottitis - Answer-B. Constipation

/.Which of the following is the highest priority intervention for a well-appearing 2-month-
old with a fever?
A. Lumbar puncture
B. Urine culture

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