PALS 2025 QUESTIONS WITH CORRECT ANSWERS.
What is the role of the diaphragm during normal breathing in infants? - pulls the ribs slightly
inward
S/S mild respiratory distress - - mild tachypnea
- mild increase in respiratory effort (nasal flaring, retractions)
- abnormal airway sounds (stridor, wheezing, grunting)
S/S Severe respiratory distress - - marked tachypnea
- marked increase in respiratory effort
- paradoxical throacoabdominal breathing (seesaw breathing)
- accessory muscle use (head bobbing)
- abnormal airway sounds (grunting)
- decreased level of consciousness
S/S Impending respiratory arrest - - bradypnea, apnea, respiratory pauses
- low oxygen saturation (hypoxemia) despite high-flow supplemental oxygen
- inadequate respiratory effort (shallow respirations)
- decreased level of consciousness (unresponsive)
- bradycardia
What steps should be taken as part of initial management of a child in respiratory distress? - -
monitor O2 sat by pulse ox
- monitor HR, rhythm, and, BP
- support an open airway
Stridor - high-pitched breathing during inspirations
Crackles - breath sounds heart during expirations
How should 1-rescuer infant compressions be delivered? - - two fingers or two thumbs
- rate of 100-120
- single rescuer (30:2)
- two rescuer (15:2)
How should 1-rescurer child compressions be delivered? - either one or two hands
- compress at least 1/3 the chest diameter (approximately 2 inches)
Guidelines for rescue breathing for infants and children - - give 1 breath every 2-3 seconds
(about 20-30/min)
- given each breath in 1 second
- visible chest rise
- check pulse every 2 minutes
- use oxygen as soon as it is available
, 2-person bag mask ventilation may be necessary when: - - making a seal is difficult
- the provider's hands are too small
- significant airway resistance (asthma) or poor lung compliance)
- restricting spinal motion is necessary
Best position to maintain an open airway - - infant: place padding underneath shoulders
- child: place padding underneath occiput
Evaluate-Identify-Intervene Sequence - evaluate (primary assessment, secondary assessment,
diagnostic assessment)
Evaluate - Primary Assessment - a rapid hands-on ABCDE approach to evaluate respiratory,
cardiac, and neurologic function; includes assessment of vital signs and pulse ox
Evaluate - Secondary Assessment - a focused medical history and focused physical exam
Evaluate - Diagnostic Assessment - laboratory, radiographic, and other advanced tests that help
to identify the child's physiologic condition and diagnosis
The evaluate-identify-intervene sequence should be continued until - the child is stable
Flow rate for pediatric nebulizer - 5-6 L/min
Causes of upper airway obstruction - - foreign body aspiration
- airway swelling (anaphylaxis, tonsillar hypertrophy, coup, epiglottitis)
- masses
- thick secretion
- congenital airway abnormality
- poor control of upper airway due to decreased level of consciousness
S/S of Upper Airway Obstruction - - stridor
- hoarseness
- change in voice or cry
- inspiratory retractions
- use of accessory muscles
- nasal flaring
- increased respiratory rate and effort
- drooling, snoring, gurgling sounds
- poor chest rise
What is chest compression fraction? - the proportion of time that chest compressions are
performed during a cardiac arrest
Mild Croup - S/S:
- occasional barking cough
What is the role of the diaphragm during normal breathing in infants? - pulls the ribs slightly
inward
S/S mild respiratory distress - - mild tachypnea
- mild increase in respiratory effort (nasal flaring, retractions)
- abnormal airway sounds (stridor, wheezing, grunting)
S/S Severe respiratory distress - - marked tachypnea
- marked increase in respiratory effort
- paradoxical throacoabdominal breathing (seesaw breathing)
- accessory muscle use (head bobbing)
- abnormal airway sounds (grunting)
- decreased level of consciousness
S/S Impending respiratory arrest - - bradypnea, apnea, respiratory pauses
- low oxygen saturation (hypoxemia) despite high-flow supplemental oxygen
- inadequate respiratory effort (shallow respirations)
- decreased level of consciousness (unresponsive)
- bradycardia
What steps should be taken as part of initial management of a child in respiratory distress? - -
monitor O2 sat by pulse ox
- monitor HR, rhythm, and, BP
- support an open airway
Stridor - high-pitched breathing during inspirations
Crackles - breath sounds heart during expirations
How should 1-rescuer infant compressions be delivered? - - two fingers or two thumbs
- rate of 100-120
- single rescuer (30:2)
- two rescuer (15:2)
How should 1-rescurer child compressions be delivered? - either one or two hands
- compress at least 1/3 the chest diameter (approximately 2 inches)
Guidelines for rescue breathing for infants and children - - give 1 breath every 2-3 seconds
(about 20-30/min)
- given each breath in 1 second
- visible chest rise
- check pulse every 2 minutes
- use oxygen as soon as it is available
, 2-person bag mask ventilation may be necessary when: - - making a seal is difficult
- the provider's hands are too small
- significant airway resistance (asthma) or poor lung compliance)
- restricting spinal motion is necessary
Best position to maintain an open airway - - infant: place padding underneath shoulders
- child: place padding underneath occiput
Evaluate-Identify-Intervene Sequence - evaluate (primary assessment, secondary assessment,
diagnostic assessment)
Evaluate - Primary Assessment - a rapid hands-on ABCDE approach to evaluate respiratory,
cardiac, and neurologic function; includes assessment of vital signs and pulse ox
Evaluate - Secondary Assessment - a focused medical history and focused physical exam
Evaluate - Diagnostic Assessment - laboratory, radiographic, and other advanced tests that help
to identify the child's physiologic condition and diagnosis
The evaluate-identify-intervene sequence should be continued until - the child is stable
Flow rate for pediatric nebulizer - 5-6 L/min
Causes of upper airway obstruction - - foreign body aspiration
- airway swelling (anaphylaxis, tonsillar hypertrophy, coup, epiglottitis)
- masses
- thick secretion
- congenital airway abnormality
- poor control of upper airway due to decreased level of consciousness
S/S of Upper Airway Obstruction - - stridor
- hoarseness
- change in voice or cry
- inspiratory retractions
- use of accessory muscles
- nasal flaring
- increased respiratory rate and effort
- drooling, snoring, gurgling sounds
- poor chest rise
What is chest compression fraction? - the proportion of time that chest compressions are
performed during a cardiac arrest
Mild Croup - S/S:
- occasional barking cough
