PALS Final Exam
Pediatric Advanced Life Support — Realistic Clinical Scenario Review
This set reviews core PALS life-saving skills through realistic clinical scenarios,
including pediatric assessment, high-quality CPR, airway management, shock
recognition, arrhythmia recognition, and post-resuscitation care.
, Q1. You walk into a room and see a 4-year-old sitting upright, leaning
forward, drooling, with noisy breathing but making eye contact with a
parent. Using the Pediatric Assessment Triangle (PAT), what is your initial
impression, and what should you avoid doing?
Answer:
The PAT looks at Appearance, Work of Breathing, and Circulation (skin)
from across the room before touching the child. Here, work of breathing is
clearly abnormal (drooling, tripod-like positioning, noisy breathing) suggesting
a possible upper airway obstruction (e.g., epiglottitis or a foreign body).
Appearance is not severely abnormal (child is alert and interactive). You
should avoid agitating the child — do not force them to lie down, do not
examine the mouth/throat with a tongue depressor, and keep the child in a
position of comfort (usually with the caregiver) while arranging urgent
evaluation, since agitation can precipitate complete airway obstruction.
Q2. What is the correct sequence of the Primary Assessment in PALS,
and why does it matter?
Answer:
The Primary Assessment follows the ABCDE sequence: Airway, Breathing,
Circulation, Disability (neurologic status), Exposure. It matters because life
threats are addressed in the order most likely to cause imminent death — an
obstructed airway kills faster than a breathing problem, which kills faster than
a circulation problem, and so on. Any abnormality found at one step should
generally be addressed before moving to the next, unless doing so would
delay a higher-priority intervention.
Q3. A 2-year-old is brought in after a febrile seizure. She is now postictal:
eyes closed, breathing but not responding to voice. Using the AVPU or
GCS approach, how would you classify her level of consciousness, and
what is your next assessment priority?
Answer:
Using AVPU, a child who does not respond to voice but may respond to
painful stimuli would be classified as 'P' (responsive to Pain) or, if
Pediatric Advanced Life Support — Realistic Clinical Scenario Review
This set reviews core PALS life-saving skills through realistic clinical scenarios,
including pediatric assessment, high-quality CPR, airway management, shock
recognition, arrhythmia recognition, and post-resuscitation care.
, Q1. You walk into a room and see a 4-year-old sitting upright, leaning
forward, drooling, with noisy breathing but making eye contact with a
parent. Using the Pediatric Assessment Triangle (PAT), what is your initial
impression, and what should you avoid doing?
Answer:
The PAT looks at Appearance, Work of Breathing, and Circulation (skin)
from across the room before touching the child. Here, work of breathing is
clearly abnormal (drooling, tripod-like positioning, noisy breathing) suggesting
a possible upper airway obstruction (e.g., epiglottitis or a foreign body).
Appearance is not severely abnormal (child is alert and interactive). You
should avoid agitating the child — do not force them to lie down, do not
examine the mouth/throat with a tongue depressor, and keep the child in a
position of comfort (usually with the caregiver) while arranging urgent
evaluation, since agitation can precipitate complete airway obstruction.
Q2. What is the correct sequence of the Primary Assessment in PALS,
and why does it matter?
Answer:
The Primary Assessment follows the ABCDE sequence: Airway, Breathing,
Circulation, Disability (neurologic status), Exposure. It matters because life
threats are addressed in the order most likely to cause imminent death — an
obstructed airway kills faster than a breathing problem, which kills faster than
a circulation problem, and so on. Any abnormality found at one step should
generally be addressed before moving to the next, unless doing so would
delay a higher-priority intervention.
Q3. A 2-year-old is brought in after a febrile seizure. She is now postictal:
eyes closed, breathing but not responding to voice. Using the AVPU or
GCS approach, how would you classify her level of consciousness, and
what is your next assessment priority?
Answer:
Using AVPU, a child who does not respond to voice but may respond to
painful stimuli would be classified as 'P' (responsive to Pain) or, if
