PALS Final Review exam 2024 with
100% correct answers
Mikey, a 2-year-old boy, is sitting upright on a hospital bed in room 3 of your emergency
department. Your initial impression from the door does not raise immediate concern. On your
entry to the room, you are able to look at Mikey more closely and notice on inhalation his
nostrils are flaring. This is a sign of: - ANS-Respiratory distress
The proper site for a peripheral pulse assessment in the infant patient is: - ANS-brachial
You are called to the scene of a 3-year-old patient who was found anxious, *cyanotic* and
lethargic after a fall down a flight of stairs. On assessing the patient, you find vital signs with a
respiratory rate of 30, regular pulse rate of 130, regular capillary refill time of 4 seconds, and a
blood pressure of 102/61. What kind of shock is the patient experiencing? - ANS-compensate
shock?
A mnemonic that aids in performing a primary assessment is: - ANS-ABCDE
A consideration of treatment for a pediatric patient with acute fulminant myocarditis who is in
cardiac arrest or at a high risk of cardiac arrest is: - ANS-Extracorporeal membrane oxygenation
(ECMO)
Which of the following is the correct meaning for one of the individual letters in the AVPU scale?
- ANS-Alert - The child is alert and awake and responds to normal stimuli based upon age and
environment
The recommended route of vascular access on a hypotensive pediatric patient is: - ANS-central
IV
You are called to the bedside of a 12-year-old male patient who was admitted after a week of
persistent vomiting, diarrhea and limiting oral intake of both solids and liquids. The patient's
airway is patent, ventilatory rate is within normal limits and the patient's circulatory status
presents with tachycardia, a blood pressure of 70/40 and a capillary refill time of 5 seconds. The
patient is speaking incoherently. The patient has no history of cardiac problems or congenital
defects. The appropriate fluid administration dose for this patient is: - ANS-20 ml/kg 0.9% NaCl
over 10 minutes
You suspect your 8-year-old female patient of being hypovolemic. Her parents brought her to
the emergency department with persistent vomiting and diarrhea for 5 days. The patient
presents with *mottled skin* and reports of periods where "she just stopped breathing!"
according to her parents. The patient is being managed with a BVM and supplemental oxygen.
, What is the best route of establishing vascular access for the purpose of fluid resuscitation? -
ANS-IV
Which of the following cannot be administered through an ETT? - ANS-Sodium bicarbonate
You are examining the rhythm strip of a patient who presents with bradycardia. Which of the
following characteristics may you notice in the rhythm? - ANS-The most obvious sign of
bradycardia on an ECG is slow heart rate. The characteristics of P-waves and the QRS complex
may vary. When looking at an EKG, the following characteristics are seen with bradycardia
patients: Slow heart rate, P-waves may not be noticeable, QRS complex may be wide or narrow,
and P-waves and QRS complex may not be related to bradycardia.
How do children's metabolic rates compare to adults'? - ANS-higher
Children's demand for oxygen is ___________ adults. - ANS-greater
Which of the following must you monitor while fluid resuscitating a patient? - ANS-Urine output
What type of pressure is monitored to obtain right ventricular cardiac preload? - ANS-Central
venous pressure (CVP)
Define shock: - ANS-When oxygen and nutrient supply to body tissue is insufficient compared to
metabolic tissue needs
Your 5-year-old patient is admitted to the PICU and is being treated by your team for
hypovolemic shock. The team has administered one bolus of 20ml/kg of 0.9% NaCl . On
re-evaluation the patient is alert and anxious with a heart rate of 145 beats per minute, a blood
pressure of 76/48mmHg and a capillary refill time of 4 seconds. Which of the following is the
patient's clinical condition? - ANS-hypotensive shock
To treat wheezing in a child, which medication is the most appropriate to administer? -
ANS-Albuterol
You arrive on scene to assess a 9-year-old boy who was stung by a bee. The patient is found to
be suffering from urticaria and is displaying respiratory distress with a presentation of nasal
flaring, tachypnea and accessory muscle use. The patient's mother relates he has never had an
allergic reaction to a bee sting, but his father is gravely allergic to bee stings. The patient relates
it is hard to breathe. While gathering your initial set of vital signs you note the patient has a
room air SpO2 is 90%. This finding classifies the patient as: - ANS-When the blood is
insufficiently oxygenated, hypoxemia can occur. Hypoxemia is a decreased saturation of
oxyhemoglobin (oxygenated hemoglobin) in the blood. A noninvasive method of estimating
arterial oxygen saturation (SaO2) is pulse oximetry, which calculates the saturation of
oxyhemoglobin (SpO2). In a normal child, a room air measurement below 94% indicates
hypoxemia.
100% correct answers
Mikey, a 2-year-old boy, is sitting upright on a hospital bed in room 3 of your emergency
department. Your initial impression from the door does not raise immediate concern. On your
entry to the room, you are able to look at Mikey more closely and notice on inhalation his
nostrils are flaring. This is a sign of: - ANS-Respiratory distress
The proper site for a peripheral pulse assessment in the infant patient is: - ANS-brachial
You are called to the scene of a 3-year-old patient who was found anxious, *cyanotic* and
lethargic after a fall down a flight of stairs. On assessing the patient, you find vital signs with a
respiratory rate of 30, regular pulse rate of 130, regular capillary refill time of 4 seconds, and a
blood pressure of 102/61. What kind of shock is the patient experiencing? - ANS-compensate
shock?
A mnemonic that aids in performing a primary assessment is: - ANS-ABCDE
A consideration of treatment for a pediatric patient with acute fulminant myocarditis who is in
cardiac arrest or at a high risk of cardiac arrest is: - ANS-Extracorporeal membrane oxygenation
(ECMO)
Which of the following is the correct meaning for one of the individual letters in the AVPU scale?
- ANS-Alert - The child is alert and awake and responds to normal stimuli based upon age and
environment
The recommended route of vascular access on a hypotensive pediatric patient is: - ANS-central
IV
You are called to the bedside of a 12-year-old male patient who was admitted after a week of
persistent vomiting, diarrhea and limiting oral intake of both solids and liquids. The patient's
airway is patent, ventilatory rate is within normal limits and the patient's circulatory status
presents with tachycardia, a blood pressure of 70/40 and a capillary refill time of 5 seconds. The
patient is speaking incoherently. The patient has no history of cardiac problems or congenital
defects. The appropriate fluid administration dose for this patient is: - ANS-20 ml/kg 0.9% NaCl
over 10 minutes
You suspect your 8-year-old female patient of being hypovolemic. Her parents brought her to
the emergency department with persistent vomiting and diarrhea for 5 days. The patient
presents with *mottled skin* and reports of periods where "she just stopped breathing!"
according to her parents. The patient is being managed with a BVM and supplemental oxygen.
, What is the best route of establishing vascular access for the purpose of fluid resuscitation? -
ANS-IV
Which of the following cannot be administered through an ETT? - ANS-Sodium bicarbonate
You are examining the rhythm strip of a patient who presents with bradycardia. Which of the
following characteristics may you notice in the rhythm? - ANS-The most obvious sign of
bradycardia on an ECG is slow heart rate. The characteristics of P-waves and the QRS complex
may vary. When looking at an EKG, the following characteristics are seen with bradycardia
patients: Slow heart rate, P-waves may not be noticeable, QRS complex may be wide or narrow,
and P-waves and QRS complex may not be related to bradycardia.
How do children's metabolic rates compare to adults'? - ANS-higher
Children's demand for oxygen is ___________ adults. - ANS-greater
Which of the following must you monitor while fluid resuscitating a patient? - ANS-Urine output
What type of pressure is monitored to obtain right ventricular cardiac preload? - ANS-Central
venous pressure (CVP)
Define shock: - ANS-When oxygen and nutrient supply to body tissue is insufficient compared to
metabolic tissue needs
Your 5-year-old patient is admitted to the PICU and is being treated by your team for
hypovolemic shock. The team has administered one bolus of 20ml/kg of 0.9% NaCl . On
re-evaluation the patient is alert and anxious with a heart rate of 145 beats per minute, a blood
pressure of 76/48mmHg and a capillary refill time of 4 seconds. Which of the following is the
patient's clinical condition? - ANS-hypotensive shock
To treat wheezing in a child, which medication is the most appropriate to administer? -
ANS-Albuterol
You arrive on scene to assess a 9-year-old boy who was stung by a bee. The patient is found to
be suffering from urticaria and is displaying respiratory distress with a presentation of nasal
flaring, tachypnea and accessory muscle use. The patient's mother relates he has never had an
allergic reaction to a bee sting, but his father is gravely allergic to bee stings. The patient relates
it is hard to breathe. While gathering your initial set of vital signs you note the patient has a
room air SpO2 is 90%. This finding classifies the patient as: - ANS-When the blood is
insufficiently oxygenated, hypoxemia can occur. Hypoxemia is a decreased saturation of
oxyhemoglobin (oxygenated hemoglobin) in the blood. A noninvasive method of estimating
arterial oxygen saturation (SaO2) is pulse oximetry, which calculates the saturation of
oxyhemoglobin (SpO2). In a normal child, a room air measurement below 94% indicates
hypoxemia.
