PALS Final Exam
A 10-year-old child has collapsed in the gym of the elementary school. The school nurse arrives
and determines that the child is unresponsive. The school nurse then simultaneously checks for
breathing and a central pulse, limiting this assessment to which time frame? - ANS-No more
than 10 seconds
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? - ANS-Second-degree
atrioventricular (AV) block, type I
A 12-year-old is being treated in the urgent care clinic. The mother reports that the child came
home from school yesterday with a high fever, vomiting and multiple episodes of watery
diarrhea. The healthcare provider obtains a rhythm strip and notes the following waveform. The
provider interprets this as which type of arrhythmia? - ANS-Sinus tachycardia
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? - ANS-First-degree atrioventricular (AV) block
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? -
ANS-Compressing the chest about 2 inches
Providing ventilations that last about 1 second each
Giving 2 ventilations to every 15 compressions
Allowing the chest to recoil fully after each compression
A 2-year-old child is brought to the pediatric urgent care clinic by the parent who says that the
child has had a barking cough for two days. During the rapid assessment of the child, the
provider hears audible inspiratory stridor. Which common cause of partial upper airway
obstruction in children would the provider most likely suspect? - ANS-Croup
A 2-year-old child of unknown weight arrives at the emergency department in cardiac arrest.
When preparing to administer medications, which action would be appropriate for the team to
take? - ANS-Estimate weight using a length-based resuscitation tape.
A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the
provider administer? - ANS-Nebulized epinephrine
Corticosteroids
, 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? - ANS-Deliver 1 BVM ventilation every 2 to 3 seconds.
A 4-year-old child suddenly collapses in the playroom of the facility. A healthcare provider
observes the event and hurries over to assess the child. The healthcare provider completes
which assessment first? - ANS-Rapid assessment
A 4-year-old patient presents with tachycardia, tachypnea, cold extremities and weak pulses.
Assessment also reveals an enlarged liver and neck vein distension. The provider interprets
these assessment findings as suggesting which type of shock? - ANS-Cardiogenic
A 5-year-old child with a history of a chronic neuromuscular disease is experiencing respiratory
distress. The child is breathing spontaneously and receiving supplemental oxygen. Which
additional intervention is a critical component of airway management for this patient? -
ANS-Airway clearance (e.g., suctioning)
A 6-year-old child is brought to the emergency department. The child has been experiencing
extremely watery stools over the past several days. After completing the assessment, the
healthcare provider suspects that the child may be experiencing shock. Which type of shock
would the provider most likely suspect? - ANS-Hypovolemia
A 6-year-old patient is brought to the emergency department after a bicycle accident.
Assessment reveals chest pain on inspiration, diminished breath sounds on the right side, and
respiratory distress. The provider suspects obstructive shock caused by what condition? -
ANS-Tension pneumothorax
A 7-year-old child collapses on the playground at school. The school nurse is called to the
scene and determines that the child is unresponsive and is not breathing and has no pulse. The
nurse initiates CPR. At what rate and depth would the nurse deliver compressions to this child?
- ANS-100 to 120 compressions per minute at a depth of about 2 inches
A 7-year-old patient with septic shock has received three balanced/buffered crystalloid fluid
boluses (60-mL/kg) and reassessment reveals capillary refill of 3 seconds, diminished pulses,
narrow pulse pressure and cool, mottled extremities. The emergency response team interprets
these findings as indicating which type of septic shock? - ANS-Fluid-refractory
A 9-year-old child is brought to the emergency department because the child suddenly
collapsed at school. The child's ECG reveals the following waveform, and primary assessment
findings indicate that the child has inadequate perfusion. Which primary assessment findings
indicate this? - ANS-Signs of shock
Acutely altered mental status
Hypotension
A 10-year-old child has collapsed in the gym of the elementary school. The school nurse arrives
and determines that the child is unresponsive. The school nurse then simultaneously checks for
breathing and a central pulse, limiting this assessment to which time frame? - ANS-No more
than 10 seconds
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? - ANS-Second-degree
atrioventricular (AV) block, type I
A 12-year-old is being treated in the urgent care clinic. The mother reports that the child came
home from school yesterday with a high fever, vomiting and multiple episodes of watery
diarrhea. The healthcare provider obtains a rhythm strip and notes the following waveform. The
provider interprets this as which type of arrhythmia? - ANS-Sinus tachycardia
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? - ANS-First-degree atrioventricular (AV) block
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? -
ANS-Compressing the chest about 2 inches
Providing ventilations that last about 1 second each
Giving 2 ventilations to every 15 compressions
Allowing the chest to recoil fully after each compression
A 2-year-old child is brought to the pediatric urgent care clinic by the parent who says that the
child has had a barking cough for two days. During the rapid assessment of the child, the
provider hears audible inspiratory stridor. Which common cause of partial upper airway
obstruction in children would the provider most likely suspect? - ANS-Croup
A 2-year-old child of unknown weight arrives at the emergency department in cardiac arrest.
When preparing to administer medications, which action would be appropriate for the team to
take? - ANS-Estimate weight using a length-based resuscitation tape.
A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the
provider administer? - ANS-Nebulized epinephrine
Corticosteroids
, 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? - ANS-Deliver 1 BVM ventilation every 2 to 3 seconds.
A 4-year-old child suddenly collapses in the playroom of the facility. A healthcare provider
observes the event and hurries over to assess the child. The healthcare provider completes
which assessment first? - ANS-Rapid assessment
A 4-year-old patient presents with tachycardia, tachypnea, cold extremities and weak pulses.
Assessment also reveals an enlarged liver and neck vein distension. The provider interprets
these assessment findings as suggesting which type of shock? - ANS-Cardiogenic
A 5-year-old child with a history of a chronic neuromuscular disease is experiencing respiratory
distress. The child is breathing spontaneously and receiving supplemental oxygen. Which
additional intervention is a critical component of airway management for this patient? -
ANS-Airway clearance (e.g., suctioning)
A 6-year-old child is brought to the emergency department. The child has been experiencing
extremely watery stools over the past several days. After completing the assessment, the
healthcare provider suspects that the child may be experiencing shock. Which type of shock
would the provider most likely suspect? - ANS-Hypovolemia
A 6-year-old patient is brought to the emergency department after a bicycle accident.
Assessment reveals chest pain on inspiration, diminished breath sounds on the right side, and
respiratory distress. The provider suspects obstructive shock caused by what condition? -
ANS-Tension pneumothorax
A 7-year-old child collapses on the playground at school. The school nurse is called to the
scene and determines that the child is unresponsive and is not breathing and has no pulse. The
nurse initiates CPR. At what rate and depth would the nurse deliver compressions to this child?
- ANS-100 to 120 compressions per minute at a depth of about 2 inches
A 7-year-old patient with septic shock has received three balanced/buffered crystalloid fluid
boluses (60-mL/kg) and reassessment reveals capillary refill of 3 seconds, diminished pulses,
narrow pulse pressure and cool, mottled extremities. The emergency response team interprets
these findings as indicating which type of septic shock? - ANS-Fluid-refractory
A 9-year-old child is brought to the emergency department because the child suddenly
collapsed at school. The child's ECG reveals the following waveform, and primary assessment
findings indicate that the child has inadequate perfusion. Which primary assessment findings
indicate this? - ANS-Signs of shock
Acutely altered mental status
Hypotension
