PALS 2025 VERIFIED EXAM WITH COMPLETE QUESTION TEST BANK 100% CORRECT
ANSWERS
Which pulses should be assessed to monitor systemic perfusion in a child?
peripheral and central
What should the first rescuer arriving on the scene of an unresponsive infant or child do?
(in order)
1. verify scene safety
2. check for responsiveness
3. shout for help
4. activate the emergency response system
Why may excessive ventilation during CPR be harmful?
- it increases intrathoracic pressure
- it impedes venous return
If you cannot achieve effective ventilation (ie, the chest does not rise), do the following:
- reposition/reopen the airway (sniffing position)
- verify mask size and ensure a tight face-mask seal
- suction the airway if needed
- check the O2 source
- check the ventilation bag and mask
- treat gastric inflation (NG/OG)
,- consider 2-person bag-mask ventilation and inserting an OPA
Ventilation rate
1 breath every 2-3 seconds delivered over 1 second (20-30 breaths per minute)
Early signs of tissue hypoxia
- tachypnea
- increased respiratory effort (nasal flaring, retractions)
- tachycardia
- pallor, mottling, cyanosis
- agitation, anxiety, irritability
Late signs of tissue hypoxia
- bradypnea, inadequate respiratory effort, apnea
- increased respiratory effort (head bobbing, seesaw respirations, grunting)
- bradycardia
- pallor, mottling, cyanosis
- decreased level of consciousness
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
ANSWERS
Which pulses should be assessed to monitor systemic perfusion in a child?
peripheral and central
What should the first rescuer arriving on the scene of an unresponsive infant or child do?
(in order)
1. verify scene safety
2. check for responsiveness
3. shout for help
4. activate the emergency response system
Why may excessive ventilation during CPR be harmful?
- it increases intrathoracic pressure
- it impedes venous return
If you cannot achieve effective ventilation (ie, the chest does not rise), do the following:
- reposition/reopen the airway (sniffing position)
- verify mask size and ensure a tight face-mask seal
- suction the airway if needed
- check the O2 source
- check the ventilation bag and mask
- treat gastric inflation (NG/OG)
,- consider 2-person bag-mask ventilation and inserting an OPA
Ventilation rate
1 breath every 2-3 seconds delivered over 1 second (20-30 breaths per minute)
Early signs of tissue hypoxia
- tachypnea
- increased respiratory effort (nasal flaring, retractions)
- tachycardia
- pallor, mottling, cyanosis
- agitation, anxiety, irritability
Late signs of tissue hypoxia
- bradypnea, inadequate respiratory effort, apnea
- increased respiratory effort (head bobbing, seesaw respirations, grunting)
- bradycardia
- pallor, mottling, cyanosis
- decreased level of consciousness
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
