PALS 2021 QUESTIONS WITH CORRECT SOLUTIONS GRADED TO PASS
A 2 week old infant is being evaluated for irritability and poor feeding. His BP is 55/40 mmHg, and cap refill time is 5 seconds. Which statement best describes your assessment of this infants BP? A. Hypotensive B. Normal C. Hypertensive D. Compensated - A. Hypotensive A 3 year old boy is brought to the ED by his mother. His is lethargic, with retractions and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk cap refill. To which immediate life treating condition could this Childs condition most likely progress if left untreated? A. Respiratory distress B. Respiratory arrest C. Respiratory failure D. Disordered control of breathing - C. Respiratory failure A 3 year old child is brought to the emergency department by his mother. Which is a normal finding for a 3 year old child? - Respiratory rate of 24/min A 3 year old child is having difficulty breathing. Which finding would most likely lead you to suspect an upper airway obstruction in this child? - Increased inspiratory effort with retractions A 3 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 you team members? A. Resume CPR, beginning with chest compressions B. Check for a pulse C. Analyze the rhythm D. Administer epinephrine - A. Resume CPR, beginning with chest compressions 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. As the team leader, how many joules do you tell your team member to use to perform initial Defib? a. 100 Joules b. 40 Joules c. 140 Joules d. 10 Joules - b. 40 Joules 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. What dose range should you use for the initial defibrillation? a. 4-6 J/kg b. 6-8 J/kg c. 0.5-2 J/kg d. 2-4 J/kg - D. 2-4 J/kg 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? A. Vascular resistance B. Pulse rate C. Lung compliance D. Disordered Control of breathing - D. Disordered Control of Breathing A 5 year old child is brought to the emergency department by ambulance after being involved in a MVC. You are using the primary assessment to evaluate the child. When assessing the Childs neurological status, you note that he has spontaneous eye opening, is fully oriented, and is able to follow command. How would you document this Childs AVPU pediatric response scale finding? - Alert and fully oriented A 6 month old infant is being evaluated for bradycardia. Which is the most likely cause of bradycardia? - Hypoxia A 6 month old infant is unresponsive. You begin checking for breathing at the same time you check for the infants pulse. Which is the maximum time you should spend when trying to simultaneously check for breathing and palpate the infants pulse before starting CPR? a. 10 seconds b. 15 seconds c. 20 seconds d. 1 min - a. 10 seconds A 6 year old boy is being evaluated for difficulty breathing. Which finding would suggest this child has respiratory distress? a. O2 75% b. Respiration Rate 8 c. Decreased effort d. Audible inspiratory stridor - d. Audible inspiratory stridor A 6 year old child is found unresponsive, not breathing, and without a pulse. one health care worker leaves to activate the emergency response system and get the resuscitation equipment. You and another healthcare provider immediatly begin CPR. Which compression to ventilation ratio do you use? a. 15:2 b. 30:2 c. 15:1 d. 30:1 - a. 15:2 A 7 year old child in cardiac arrest is brought to the ED by ambulance. No palpable pulses are detected. The Childs ECG is shown here. How would you characterize this Childs rhythm? A. Ventricular escape rhythm B. Ventricular tachycardia C. Pulseless electrical activity D. Sinus bradycardia - C. Pulseless Electrical Activity A 10 year old child is being evaluated for a head ache. Which is a normal finding for this 10 year old child? - Heart rate of 88/min A 10 year old child is brought to the ED for fever and cough. You obtain an O2 sat on the child. Which oxygen saturation would indicate that immediate intervention is needed? - 88% on 4L of Nasal oxygen A team member is unable to perform an assigned task because it is beyond the team members scope of practice. Which action should the team member take? - Ask for a new task or role After rectal administration of diazepam, an 8 year old boy with a history of seizures is no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. After repositioning the patient and you insert an Oral airway, the patient continues to deteriorate. What next step is the most appropriate? - Provide bag mask ventilation After rectal administration of diazepam, an 8 year old boy with a history of seizures is no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. What action should you take next? - Reposition the patient, and insert an oral airway An 8 year (or 18 months or toddler) old child is brought to the emergency department with a 2 day history of (vomiting and diarrhea.) lethargy and polyuria. The child has new onset rapid, deep, and labored breathing. Which diagnostic test should you order first? A. Arterial blood gas B. Serum potassium concentration C. Glucose D. A 12-lead ECG - C. blood glucose An 8 year old child is brought to the ED by ambulance after being involved in a MVC. Which finding would suggest that immediate intervention is needed? - Decreased level of consciousness An 8 year old child is brought to the ED by his mother for difficulty breathing. He has a history of asthma and nut allergies. He's mother tells you that he recently ate a cookie at a family picnic. Which condition is most likely to be present in this child? a. upper airway obstruction b. lower airway obstruction c. lung tissue disorder - a. upper airway obstruction An unresponsive 9 year old boy is pale and cool to the touch his blood pressure is 70/45 mmHg, heart rate is 190/min and respiratory rate is 12/min. The SpO2 is not detectable Cap refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. If initial treatment is unavailable or delayed, which intervention is indicated? a. 20 mL/kg of isotonic crystalloid b. High quality CPR c. Defibrillation d. Syncronized cardioversion. - d. Syncronized cardioversion
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