PALS Precourse Self-Assessment Answers » Quizzma Graded A 2025

Home » Quiz Answers » PALS Precourse Self Assessment Answers PALS Precourse Self Assessment Answers By Quizzma Team / Medicine, PALS We thoroughly check each answer to a question to provide you with the most correct answers. Found a mistake? Let us know about it through the REPORT button at the bottom of the page. Sinus bradycardia Sinus bradycardia – version 2 Normal sinus rhythm Asystole Wide complex tachycardia 2/45 infant responds only to painful stimulation. The infant’s respiratory rate is 40 breaths per minute, and SVT converting to sinus rhythm after adenosine administration Wide complex tachycardia – version 2 Torsades de pointes Supraventricular tachycardia VF with successful de b and resumption of organized rhythm Pulseless electrical activity Ventricular brillation Sinus tachycardia A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency department by her parents. During Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W 2-4 ml/kg IV your assessment, you nd that the 3/45 4/45 painful stimuli and has irregular breathing, faint central pulses, bruises over the abdomen, abdominal central pulses are rapid and weak. The infant has good bilateral breath sounds, cool extremities, and a capillary re ll time of more than 5 seconds. The infant’s blood pressure is 85/65 mmHg, and glucose is 30 mg/dL (1.65 mmol/L). You administer 100% oxygen via face mask and start an IV. Which treatment is most appropriate for this infant? A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. The patient is speaking in short phrases and tells you that he has asthma but does not carry an inhaler. He has nasal aring, severe suprasternal and intercostal retractions, and decreased air movement with prolonged expiratory time and wheezing. You administer 100% oxygen by a nonrebreathing mask. His spO2 is 92%. Which med do you prepare to give to this patient? Albuterol (duh) Paramedics are called to the home of a 1yo child. Their initial assessment reveals a child who responds only to Rapid bolus of 20ml/kg of isotonic crystalloid 5/45 use of calcium chloride in pediatric indicated during cardiac arrest patients? distention, and cyanosis. Bag-mask ventilation with 100% oxygen is initiated. The child’s heart rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the emergency department, the child is intubated and ventilated with 100% oxygen, and IV access is established. The heart rate is now 150/min with weak central pulses but no distal pulses. Systolic blood pressure is 74 mmHg. Which intervention should be provided next? Which statement is correct about the Routine administration is not 6/45 check, persistent ventricular brillation is present. You administer a 4 J/kg shock and resume CPR. Which statement is correct about endotracheal drug administration during resuscitative efforts for pediatric patients? It is the least desirable route of administration Initial impression of a 2yo girl shows her to be alert with mild breathing dif culty during inspiration and pale skin color. On primary assessment, she makes high-pitched inspiratory sounds (mild stridor) when agitated; otherwise, her breathing is quiet. Her spO2 is 92% on room air, and she has mild inspiratory intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with adequate distal breath sounds bilaterally. Which is the most appropriate initial intervention for this child? Humidi ed oxygen as tolerated You are part of a team attempting to resuscitate a child with ventricular brillation cardiac arrest. You delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of epinephrine, 0.01 mg/kg IO. At the next rhythm Amiodarone 5 mg/kg IO 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma Nonrebreathing face mask Which oxygen delivery system most Which drug and dose should be administered next? Which statement is correct about the effects of epinephrine during attempted resuscitation? Epinephrine stimulates spontaneous contractions when asystole is present A 10mo infant boy is brought to the emergency department. Your initial assessment reveals a lethargic, pale infant with slow respirations and slow, weak central pulses. One team member begins ventilation with a bag-mask device with 100% oxygen. A second team member attaches the monitor/de brillator and obtains vital signs while a third team member attempts to establish IV/IO access. The patient’s heart rate is 38/min with the rhythm shown here. The infant’s blood pressure is 58/38 mmHg, and capillary re ll is 4 seconds. His central pulses remain weak, and distal pulses Epinephrine 0.01 mg/kg IV/IO cannot be palpated. Chest compressions are started and IO 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma access is obtained. Which medication do you anticipate will be given next? You nd a 10yo boy to be unresponsive. You shout for help, and after nding that he is not breathing and has no pulse, you and a colleague begin CPR. Another colleague activates the emergency response system, brings the emergency equipment, and places the child on a cardiac monitor/de brillator, which reveals the rhythm shown here. You attempt de brillation at 2 J/kg and give 2 minutes of CPR. The rhythm persists at the second rhythm check, Lidocaine 1 mg/kg IV at which point you attempt de brillation with 4 J/kg. A fourth colleague arrives, starts an IV, and 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma While a colleague provides spinal administers 1 dose of epinephrine 0.01 mg/kg. If ventricular brillation or pulseless ventricular tachycardia persists after 2 minutes of CPR, you will administer another shock. Which drug and dose should be administered next? You are alone and witness a child suddenly collapse. There is no suspected head or neck injury. A colleague responded to your shout for help and is activating the emergency response system and is retrieving the resuscitation equipment, including a de brillator. Open the airway with a head tilt- chin lift maneuver and give 2 breaths After delivering 30 compressions, what would be your next action? 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma You and another rescuer begin CPR. Your colleague begins compressions, and you notice that the compression rate is too slow. What should you say to offer constructive feedback? “You need to compress at a rate of 100-120 per minute.” You are caring for a 6yo patient who is receiving positive-pressure mechanical ventilation via an endotracheal tube. The child begins to move his head and suddenly becomes cyanotic, and his heart rate decreases. His spO2 is 65%. You remove the child from the mechanical ventilator and begin to provide manual ventilation with a bag via the endotracheal tube. During manual ventilation with 100% oxygen, the child’s color and heart rate improve slightly and his BP remains adequate. Breath sounds and chest expansion are present and adequate on the right side and are present but consistently diminished on the left side. The trachea is not deviated, and the neck veins are not distended. a suction catheter passes easily beyond the tip of the Tracheal tube displacement into the right main bronchus endotracheal tube. Which of hte following is the most likely cause of this child’s acute deterioration? 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma You are giving chest compressions for a child in cardiac arrest? What is the proper depth of compressions for a child? Compress the chest at least one third the depth of the chest, about 2 inches (5 cm) A pale and very sleepy but arousable 3yo child with a hx of diarrhea is brought to the hospital. Primary assessment reveals a respiratory rate of 45/min with good breath sounds bilaterally. Heart rate is 150/min, BP is 90/64 mmHg, and spO2 is 92% on room air. Capillary re ll is 5 seconds, and peripheral pulses are weak. After placing the child on a nonrebreathing face mask (10L/min ow) with 100% oxygen and obtaining vascular access, which is the most appropriate immediate treatment for this child? Administer a bolus of 20 ml/kg isotonic crystalloid Why is allowing complete chest recoil The heart will re ll with blood important when performing high- 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma child CPR 30 compressions to 2 breaths quality CPR? between compressions An 8yo child was struck by a car. He arrives in the ED alert, anxious, and in respiratory distress. His cervical spine is immobilized, and he is receiving a 10L/min ow of 100% oxygen by nonrebreathing face mask. His respiratory rate is 60/min, HR 150/min, systolic BP 70 mmHg, and spO2 84%. Breath sounds are absent over the right chest but present over the left chest, and the trachea is deviated to the left. He has weak central pulses and absent distal pulses. Which intervention should be performed next? Perform needle decompression of the right chest Adequate bilateral breath sounds 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma A 4yo boy is in pulseless arrest in the Magnesium sulfate 25-50 mg/kg PICU. High-quality CPR is in progress. IV You quickly review his chart and nd You are caring for a 3yo with vomiting and diarrhea. You have established IV access. The child’s pulses are palpable but faint, and the child is now lethargic. The heart rate is variable (range, 44/min to 62/min). You begin bag-mask ventilation with 100% oxygen. When the heart rate does not improve, you begin chest compressions. The rhythm shown here is seen on the cardiac monitor. Which would be the most appropriate therapy to consider next? Atropine 0.02 mg/kg IV 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma capillary re ll is less than 2 seconds. Which are the most immediate interventions for this toddler? that his baseline-corrected QT interval on a 12-lead ECG is prolonged. The monitor shows recurrent episodes of the rhythm shown here. The patient has received 1 dose of epinephrine 0.01 mg/kg, but the rhythm shown here continues. If this rhythm persists at the next rhythm check, which medication would be most appropriate to administer at that time? An 18mo child has a 1 week hx of cough and runny nose. The child has diffuse cyanosis and is responsive only to painful stimulation with slow respirations and rapid central pulses. The child’s respiratory rate has decreased from 65/min to 10/min, severe inspiratory intercostal retractions are present, heart rate is 160/min, spO2 is 65% on room air, and Open the airway and provide positive-pressure ventilation using 100% oxygen and a bag- mask device 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma An 8mo infant is brought to the Give normal saline 20 ml/kg IO emergency department for rapidly evaluation of severe diarrhea and 1 breath every 3-5 seconds You need to provide rescue breaths to A child becomes unresponsive in the emergency department and is not breathing. You are uncertain if a faint pulse is present. You shout for help and provide ventilation with 100% oxygen. The rhythm shown here is seen on the cardiac monitor. What is your next action? Start high-quality CPR You are evaluating an irritable 6yo girl with mottled skin color. The patient is febrile (temperature 40C [104F]), and her extremities are cold with capillary re ll of 5 seconds. Distal pulses are absent and central pulses are weak. Heart rate is 180/min, respiratory rate is 45/min, and blood pressure is 98/56 mmHg. How would you categorize this child’s condition? Compensated shock associated with tachycardia and inadequate tissue perfusion 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma place the child on a cardiac monitor and see the rhythm shown here. The child has no history of congenital dehydration. On arrival to the emergency department, the infant becomes unresponsive, apneic, and pulseless. You shout for help and start CPR. Another provider arrives, at which point you switch to 2-rescuer CPR. The rhythm shown here is seen on the cardiac monitor. The infant is intubated and ventilated with with 100% oxygen. An IO line is established, and a dose of epinephrine is given. While continuing high-quality CPR, what do you do next? A 1yo boy is brought to the emergency department for evaluation of poor feeding, irritability, and sweating. The child is lethargic but arousable. He has labored breathing, very rapid pulses, and a dusky color. His respiratory rate is 68/min, heart rate 300/min, and blood pressure 70/45 mmHg. He has weak brachial pulses and absent radial pulses, a capillary re ll of 6 seconds, spO2 85% on room air, and good bilateral breath sounds. You administer high- ow oxygen and Administer adenosine 0.1 mg/kg IV rapid push 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma action should you take next? effective seal between the child’s face heart disease. IV access has been established. Which therapy is most appropriate for this child? A 3yo unresponsive, apneic child is brought to the emergency department. EMS personnel report that the child became unresponsive as they arrived at the hospital. The child is receiving CPR with bag-mask ventilation. The rhythm shown here is on the cardiac monitor. A biphasic manual de brillator is present. You quickly use the length from head to of the child on a color-coded length- based resuscitation tape to estimate the approximate weight as 15kg. Which therapy is most appropriate for this child at this time? Attempt de brillation at 30 J, and then resume CPR, beginning with compressions You nd an infant who is unresponsive, is not breathing, and does not have a pulse. You shout for nearby help, but no one arrives. What Provide CPR for about 2 minutes before leaving to activate the emergency response system 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma Parents of a 1-year-old female phoned EMS when they picked up their daughter from the babysitter. Paramedics perform an initial impression revealing an obtunded infant with irregular breathing, bruises over the abdomen, abdominal distension, and cyanosis. Assisted bag-mask ventilation with 100% oxygen is initiated. On primary assessment heart rate is 36/min, peripheral pulses cannot be palpated, and central pulses are barely palpable. Cardiac monitor shows sinus bradycardia. Chest compressions are started at 15:2. In the ED the infant is intubated and ventilated, and IV access is established. The heart rate is now up to 150/min, but there are weak central pulses and no distal pulses. Systolic BP is 74. Of the following, which would be most useful in management of this infant? A. Synchronized cardioversion B. Epinephrine 0.01 mg/kg (0.1 mL/kg of 1:10,000 dilution) IV C. Rapid bolus of 20 mL/kg of isotonic crystalloid D. C Atropine 0.02 mg/kg IV 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma You enter a room to perform an initial impression of a previously stable 10- year-old male and nd him unresponsive and apneic. A code is called and bag-mask ventilation is performed with 100% oxygen. The cardiac monitor shows a wide- complex tachycardia. The boy has no detectable pulses so compressions and ventilations are provided. As soon as the de brillator arrives you deliver an unsynchronized shock with 2 J/kg. The rhythm check after 2 minutes of CPR reveals VF. You then deliver a shock of 4 J/kg and resume immediate CPR beginning with compressions. A team member has established IO access, so you give a dose of epi, 0.01 mg/kg (0.1 mL/kg of 1:10,000 dilution) IO after second shock. At the next rhythm check, persistent VF is present. You administer another 4 J/kg shock and resume CPR. Based on the PALS Pulseless Arrest Algorithm, what is the next drug and dose to administer when CPR is restarted? A. Magnesium sulfate 25-50 mg/kg IO B. D Atropine 0.02 mg/kg IO C. Epinephrine 0.1 mg/kg of 1:10,000 dilution IO D. Amiodarone 5 mg/kg IO 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma the next medical therapy to provide to this patient? A. Adenosine 0.1 mg/kg B. Amiodarone 5 mg/kg IV/IO Which of the following statements about calcium is true? A. Calcium chloride 10% has the same bioavailability of elemental calcium as calcium gluconate in critically ill children B. The recommended dose is 1-2 mg/kg of calcium chloride. C. Indications for administration of calcium include hypercalcemia, hypokalemia, and hypomagnesemia. D. Routine administration of calcium is not indicated during cardiac arrest. D Initial impression of a 9-year-old male with increased work of breathing reveals the boy to be agitated and leaning forward on the bed with obvious respiratory distress. You administer 100% oxygen by nonrebreathing mask. The patient is speaking in short phrases and tells you that he has asthma but does not carry an inhaler. He has nasal aring, severe suprasternal and intercostal retractions, and decreased air movement with prolonged expiratory time and wheezing. His SpO2 is 96% (on nonrebreathing mask). What is C 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma (1.65 mmol/L). Which of the following is the most appropriate treatment to provide for this infant? A. Establish IV C. Albuterol by nebulization D. Procainamide 15 mg/kg IV/IO An infant with a history of vomiting and diarrhea arrives by ambulance. During your primary assessment the infant responds only to painful stimulation. The upper airway is patent, the repiratory rate is 40/min with good bilateral breath sounds, and 100% oxygen is being administered. The infant has cool extremities, weak pulses, and a cap re ll of more than 5 seconds. The infant’s BP is 85/65 mm Hg and glucose concentration is 30 mg/dL A 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma resuscitation because is results in predictable drug levels and drug effects. D. Intravenous drug doses for or IO access, administer 20 mL/kg isotonic crystalloid over 10 to 20 minutes, and simultaneously administer D25W 2 to 4 mL/kg in a separate infusion. B. Establish IV or IO access and administer 20 mL/kg D50 .45% sodium chloride bolus over 15 minutes. C. Establish IV or IO access and administer 20 mL/kg Lactated Ringer’s solution over 60 minutes. D. Perform endotracheal intubation and administer epinephrine 0.1 mg/kg 1:1,000 via the endotracheal tube. Which of the following statements about endotracheal drug administration is true? A. Endotracheal doses of resuscitation drugs in children have been well established and are supported by evidence from clinical trials. B. Endotracheal drug administration is the least desirable route of administration because of this route results in unpredictable drug levels and effects. C. Endotracheal drug administration is the preferred route of drug administration dring B 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma stridor) when agitated; otherwise, her breathing is quiet. Her SpO2 is 92% in room air, and she has mild inspiratory resuscitation drugs should be used whther you give the drugs by the IV, IO, or the endotracheal route. Which of the following statements B most accurately re ects the PALS recommendations for the use of magnesium sulfate in the treatment of cardiac arrest? A. Routine use of magnesium sulfate is indicated for shock-refractory monomorphic VT. B. Magnesium sulfate is indicated for torsades de pointes and VF/ pulseless VT associated with suspected hypomagnesemia. C. Magnesium sulfate is indicated for VF refractory to repeated shocks and amiodarone or lidocaine. D. Magnesium sulfate is contraindicated in VT associated with an abnormal QT interval during the preceding sinus rhythm. Initial impression of a 2-year-old female reveals her to be alert with mild breathing dif culty during inspiration and pale skin color. On primary assessment, she makes high- pitched inspiratory sounds (mild C 2/18/23, 5:22 PM PALS Precourse Self Assessment Answers » Quizzma intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with adequate distal breath sounds bilaterally. Which of the following is the most appropriate initial therapeutic intervention for this child? A. Administer an IV dose of dexamethasone B. Perform immediate endotracheal intubation C. Administer humidi ed supplementary oxygen as tolerated and continue evaluation D. Nebulize 2.5 mg of albuterol Which of the following statements about the effects of epinephrine during attempted resuscitation is true? A. Epinephrine decreases the peripheral vascular resistance and reduces myocardial afterload so that ventricular contractions are more effective B. Epinephrine is contraindicated in ventricular brillation because it increases myocardial irritability. C. Epinephrine improves coronary artery perfusion pressure and stimulates spontaneous C contractions when asystole is present. D. Epinephrine decreases myocardial oxygen consumption.