RQI PALS ENTRY EXAM QUESTIONS WITH PRECISE
AND FULLY SOLVED ANSWERS.
1) You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
diarrhea.
− His parents state that he has been sleeping much more.
_ _ _ _ _ _ _ _ _
− HR 190/min _
− Temp 38.3 C (101 F) _ _ _ _
− BP 59/29 mm Hg _ _ _
− RR 70/min and shallow _ _ _
− O2 94% on 100% oxygen _ _ _ _
− Capillary refill 4-5 seconds _ _ _
− He has mottled, cool extremities _ _ _ _
− Weight 6 kg _ _
On the basis of this infant's presentation, what type of shock does this infant have?
_ _ _ _ _ _ _ _ _ _ _ _ _ _
A) Cardiogenic
B) Hypovolemic
C) Distributive
D) Obstructive -- Correct Answer ✔✔ Hypovolemic _ _ _ _ _
2) The parents of a 7-year-old child who is undergoing chemotherapy report that the
_ _ _ _ _ _ _ _ _ _ _ _ _
child has been febrile and has not been feeling well, with recent onset of lethargy.
_ _ _ _ _ _ _ _ _ _ _ _ _ _
− Difficult to arouse _ _
− Pale
− HR 160/min _
− RR 38/min _
− BP 76/45 mm Hg _ _ _
− Cap refill 5-6 seconds _ _ _
− Temp 39.4 C (103 F) _ _ _ _
, − IV access established, Blood Culture obtained
_ _ _ _ _
What is the most appropriate intervention?
_ _ _ _ _
A) Administer 5-10 mL/kg of PRBCs _ _ _ _
B) Obtain chest x-ray _ _
C) Administer 20-30 mL/kg of isotonic crystalloid over 30 min _ _ _ _ _ _ _ _
D) Administer 10-20 mL/kg of isotonic crystalloid over 5-10min -- Correct _ _ _ _ _ _ _ _ _ _
Answer ✔✔ Administer 10-20 mL/kg of isotonic crystalloid over 5-10min
_ _ _ _ _ _ _ _ _
3) 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. What condition is most consistent with your assessment?
_ _ _ _ _ _ _ _
A) Lung tissue disease _ _
B) Upper airway obstruction _ _
C) Lower airway obstruction _ _
D) Disordered control of breathing -- Correct Answer ✔✔ Disordered _ _ _ _ _ _ _ _ _
control of breathing _ _
4) You are caring for a 9-month-ol girl who has increased work of breathing, a fever,
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
and a cough. On assessment, you find an alert infant with stridor and retractions. The
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
infant's SpO2 is 94%. On auscultation, the lings are clear bilaterally. What is the most
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
likely cause of this infants distress?
_ _ _ _ _
A) Upper airway obstruction _ _
B) Lower airway obstruction _ _
C) Disordered control of breathing _ _ _
D) Parenchymal lung disease -- Correct Answer ✔✔ Upper airway _ _ _ _ _ _ _ _ _
obstruction
5) A 3-year-old boy is brought to the emergency department by his mother.
_ _ _ _ _ _ _ _ _ _ _
He is lethargic, with retractions and nasal flaring.
_ _ _ _ _ _ _
He has a respiratory rate of 70/min, with warm extremities and brisk capillary
_ _ _ _ _ _ _ _ _ _ _ _ _
refill.
AND FULLY SOLVED ANSWERS.
1) You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
diarrhea.
− His parents state that he has been sleeping much more.
_ _ _ _ _ _ _ _ _
− HR 190/min _
− Temp 38.3 C (101 F) _ _ _ _
− BP 59/29 mm Hg _ _ _
− RR 70/min and shallow _ _ _
− O2 94% on 100% oxygen _ _ _ _
− Capillary refill 4-5 seconds _ _ _
− He has mottled, cool extremities _ _ _ _
− Weight 6 kg _ _
On the basis of this infant's presentation, what type of shock does this infant have?
_ _ _ _ _ _ _ _ _ _ _ _ _ _
A) Cardiogenic
B) Hypovolemic
C) Distributive
D) Obstructive -- Correct Answer ✔✔ Hypovolemic _ _ _ _ _
2) The parents of a 7-year-old child who is undergoing chemotherapy report that the
_ _ _ _ _ _ _ _ _ _ _ _ _
child has been febrile and has not been feeling well, with recent onset of lethargy.
_ _ _ _ _ _ _ _ _ _ _ _ _ _
− Difficult to arouse _ _
− Pale
− HR 160/min _
− RR 38/min _
− BP 76/45 mm Hg _ _ _
− Cap refill 5-6 seconds _ _ _
− Temp 39.4 C (103 F) _ _ _ _
, − IV access established, Blood Culture obtained
_ _ _ _ _
What is the most appropriate intervention?
_ _ _ _ _
A) Administer 5-10 mL/kg of PRBCs _ _ _ _
B) Obtain chest x-ray _ _
C) Administer 20-30 mL/kg of isotonic crystalloid over 30 min _ _ _ _ _ _ _ _
D) Administer 10-20 mL/kg of isotonic crystalloid over 5-10min -- Correct _ _ _ _ _ _ _ _ _ _
Answer ✔✔ Administer 10-20 mL/kg of isotonic crystalloid over 5-10min
_ _ _ _ _ _ _ _ _
3) 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. What condition is most consistent with your assessment?
_ _ _ _ _ _ _ _
A) Lung tissue disease _ _
B) Upper airway obstruction _ _
C) Lower airway obstruction _ _
D) Disordered control of breathing -- Correct Answer ✔✔ Disordered _ _ _ _ _ _ _ _ _
control of breathing _ _
4) You are caring for a 9-month-ol girl who has increased work of breathing, a fever,
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
and a cough. On assessment, you find an alert infant with stridor and retractions. The
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
infant's SpO2 is 94%. On auscultation, the lings are clear bilaterally. What is the most
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
likely cause of this infants distress?
_ _ _ _ _
A) Upper airway obstruction _ _
B) Lower airway obstruction _ _
C) Disordered control of breathing _ _ _
D) Parenchymal lung disease -- Correct Answer ✔✔ Upper airway _ _ _ _ _ _ _ _ _
obstruction
5) A 3-year-old boy is brought to the emergency department by his mother.
_ _ _ _ _ _ _ _ _ _ _
He is lethargic, with retractions and nasal flaring.
_ _ _ _ _ _ _
He has a respiratory rate of 70/min, with warm extremities and brisk capillary
_ _ _ _ _ _ _ _ _ _ _ _ _
refill.
