PALS UPDATED FINAL EXAM
A 12-year-old child being evaluated in the pediatric intensive care unit displays the
following ECG waveform. The team interprets this as which arrhythmia?
second degree
Laboratory tests are ordered for a child who has been vomiting for 3 days and is
diaphoretic, tachypneic, lethargic and pale. Which test would the provider use to
determine the adequacy of oxygen delivery?
Lactate
A 9-year-old patient is presenting with decreased breath sounds, bradycardia, slowed
respiratory rate and a low O2 saturation level. The provider interprets these findings as
indicating which condition?
Respiratory failure
A 4-year-old child is brought to the emergency department by the parents. Assessment
reveals that the child has only gasping respirations and the pulse rate is 65 beats per
minute. Which action would the provider initiate first?
Deliver 1 BVM ventilation every 3 to 5 seconds.
A 15-year-old patient is being evaluated during a follow-up visit after being diagnosed with
Lyme disease 2 months ago. A rhythm strip is obtained as shown below. The provider
interprets this rhythm as indicating which arrhythmia?
First-degree atrioventricular (AV) block
A child in cardiac arrest experiences return of spontaneous circulation but is exhibiting
signs of post–cardiac arrest syndrome (PCAS). The PALS resuscitation team determines
that the child is experiencing a systemic response to ischemia/reperfusion. The team bases
this determination on which finding(s)?
Hypotension
Fever
Hyperglycemia
A 2-year-old child arrives at the emergency department with the parents. The child is
unresponsive, is not breathing and has no pulse. Two emergency department providers
begin high-quality CPR. Which action(s) by the providers demonstrates high-quality CPR?
Allowing the chest to recoil fully after each compression
Providing ventilations that last about 1 second each
Compressing the chest about 2 inches
, Giving 2 ventilations to every 15 compressions
A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest.
For which rhythm(s) would this action be appropriate?
VF and pVT are shockable cardiac arrest rhythms.
A provider is assessing a child with suspected shock. Which statement correctly describes
hypotension and shock?
Hypotension is not a consistent feature of shock;
A provider is caring for a 4-year-old child in the urgent care clinic. Primary assessment
reveals difficulty breathing and an oxygen saturation of 91%. The provider administers
oxygen by nasal cannula with the goal of improving the child’s oxygen saturation above
what percentage?
Supplemental oxygen should be administered as needed to maintain an oxygen saturation
above 94%.
An 11-year-old soccer player is brought to the emergency department. After a quick
assessment, the team realizes this patient is experiencing a severe asthma exacerbation.
Which medication would the team administer first?
Albuterol plus ipratropium bromid
A child in the pediatric step-down unit is exhibiting signs of respiratory distress. When
assessing this child, which circulation finding might be present?
Pallor is a circulation finding that may be seen in patients with respiratory distress.
A healthcare provider is performing a primary assessment of a child in respiratory distress.
The provider documents increased work of breathing when which findings are observed?
Nasal flaring, use of accessory muscles to breathe and intercostal, substernal or suprasternal
retractions are all indicators of increased work or effort of breathing. Grunting and
inspiratory stridor are abnormal breath sounds.
An 11-year-old child develops unstable wide-complex tachycardia. Assessment reveals
signs of significant hemodynamic compromise, but the child has a pulse. The PALS team
would prepare the child for which intervention?
First-line treatment for unstable wide-complex tachycardias consists of synchronized
electrical cardioversion, particularly when signs of hemodynamic compromise are apparent.
A 4-month old infant is brought to the emergency department in cardiac arrest. Which
condition would the team identify as the most common cause of cardiac arrest in an infant
of this age?
Sudden infant death syndrome
A 12-year-old child being evaluated in the pediatric intensive care unit displays the
following ECG waveform. The team interprets this as which arrhythmia?
second degree
Laboratory tests are ordered for a child who has been vomiting for 3 days and is
diaphoretic, tachypneic, lethargic and pale. Which test would the provider use to
determine the adequacy of oxygen delivery?
Lactate
A 9-year-old patient is presenting with decreased breath sounds, bradycardia, slowed
respiratory rate and a low O2 saturation level. The provider interprets these findings as
indicating which condition?
Respiratory failure
A 4-year-old child is brought to the emergency department by the parents. Assessment
reveals that the child has only gasping respirations and the pulse rate is 65 beats per
minute. Which action would the provider initiate first?
Deliver 1 BVM ventilation every 3 to 5 seconds.
A 15-year-old patient is being evaluated during a follow-up visit after being diagnosed with
Lyme disease 2 months ago. A rhythm strip is obtained as shown below. The provider
interprets this rhythm as indicating which arrhythmia?
First-degree atrioventricular (AV) block
A child in cardiac arrest experiences return of spontaneous circulation but is exhibiting
signs of post–cardiac arrest syndrome (PCAS). The PALS resuscitation team determines
that the child is experiencing a systemic response to ischemia/reperfusion. The team bases
this determination on which finding(s)?
Hypotension
Fever
Hyperglycemia
A 2-year-old child arrives at the emergency department with the parents. The child is
unresponsive, is not breathing and has no pulse. Two emergency department providers
begin high-quality CPR. Which action(s) by the providers demonstrates high-quality CPR?
Allowing the chest to recoil fully after each compression
Providing ventilations that last about 1 second each
Compressing the chest about 2 inches
, Giving 2 ventilations to every 15 compressions
A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest.
For which rhythm(s) would this action be appropriate?
VF and pVT are shockable cardiac arrest rhythms.
A provider is assessing a child with suspected shock. Which statement correctly describes
hypotension and shock?
Hypotension is not a consistent feature of shock;
A provider is caring for a 4-year-old child in the urgent care clinic. Primary assessment
reveals difficulty breathing and an oxygen saturation of 91%. The provider administers
oxygen by nasal cannula with the goal of improving the child’s oxygen saturation above
what percentage?
Supplemental oxygen should be administered as needed to maintain an oxygen saturation
above 94%.
An 11-year-old soccer player is brought to the emergency department. After a quick
assessment, the team realizes this patient is experiencing a severe asthma exacerbation.
Which medication would the team administer first?
Albuterol plus ipratropium bromid
A child in the pediatric step-down unit is exhibiting signs of respiratory distress. When
assessing this child, which circulation finding might be present?
Pallor is a circulation finding that may be seen in patients with respiratory distress.
A healthcare provider is performing a primary assessment of a child in respiratory distress.
The provider documents increased work of breathing when which findings are observed?
Nasal flaring, use of accessory muscles to breathe and intercostal, substernal or suprasternal
retractions are all indicators of increased work or effort of breathing. Grunting and
inspiratory stridor are abnormal breath sounds.
An 11-year-old child develops unstable wide-complex tachycardia. Assessment reveals
signs of significant hemodynamic compromise, but the child has a pulse. The PALS team
would prepare the child for which intervention?
First-line treatment for unstable wide-complex tachycardias consists of synchronized
electrical cardioversion, particularly when signs of hemodynamic compromise are apparent.
A 4-month old infant is brought to the emergency department in cardiac arrest. Which
condition would the team identify as the most common cause of cardiac arrest in an infant
of this age?
Sudden infant death syndrome
