PALS All Questions.docx

PALS ALL QUESTIONS 2024/2025 WITH 100% CORRECT
ANSWERS




You are caring for a child who was resuscitated after a drowning event. The child is intubated and ventilated
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with 100% oxygen with equal breath sounds and exhaled CO2 detected. The heart rate is slow and the monitor
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shows sinus bradycardia. The skin is cool, mottled, and moist; distal pulses are not palpable and the central
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pulses are weak. Intravenous access has been established. The core temperature is 37.3oC. Based on the PALS
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bradycardia algorithm, which of the following should be provided first?
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Epinephrine IV r




Transcutaneous pacing r




Atropine IV r




Dobutamine IV infusion - correct answer Epinephrine IV
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You are caring for a 5-year-old patient with supraventricular tachycardia (heart rate = 220/min). The child is
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lethargic. The skin is pale and cool with delayed capillary refill. Distal pulses are not palpable. Which of the
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following would be the best treatment to provide without delay?
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,Place cold packs on the distal upper and lower extremities
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Ask the child to blow through a small straw
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Exert light pressure on the eyes bilaterally
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Provide synchronized cardioversion at 0.5 to 1 J/kg - correct answer Provide synchronized cardioversion at 0.5
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to 1 J/kg
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You are initiating treatment for a child with septic shock and hypotension. While administering high-flow
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oxygen you determine that the child's respirations are adequate and SpO2 is 100%. You have just established
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vascular access and obtained blood samples. Which of the following is the next most appropriate therapy to
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support systemic perfusion? r r




Administer repeated fluid boluses of isotonic colloid r r r r r r




Administer repeated fluid boluses of isotonic crystalloid r r r r r r




Begin immediate dopamine infusion
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Begin immediate dobutamine infusion - correct answer Administer repeated fluid boluses of isotonic
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crystalloid



You are treating an 8-year-old with ventricular tachycardia with pulses and adequate perfusion. You attempted
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synchronized cardioversion without success. While seeking expert consultation, it would be most appropriate
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to:



Administer a loading dose of milrinone r r r r r




Consider possible metabolic and toxicologic causes
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Initiate overdrive pacing transcutaneously
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Deliver an unsynchronized shock - correct answer Consider possible metabolic and toxicologic causes
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You are caring for a 2-year-old unconscious patient who is intubated and receiving mechanical ventilation. The
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child's heart rate suddenly drops to 40/min and his color becomes mottled. You should respond to these
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changes by: r




Increasing the ventilator rate r r r




Increasing tidal volume r r

, Increasing positive end-expiratory pressure (PEEP) r r r r




Using a resuscitation bag provide manual ventilation with 100% oxygen - correct answer Using a resuscitation
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bag provide manual ventilation with 100% oxygen
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You are caring for a 9-month-old patient with pronounced respiratory distress. You initiated high-flow oxygen
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using a nonrebreathing mask about 10 minutes ago and established intravenous access. Initially the infant's
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heart rate was in the 150/min range with strong pulses. Suddenly the infant's respiratory rate falls to 6/min
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with significant intercostals retractions, and little air movement is heard. The infant becomes cyanotic and the
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heart rate decreases to 95/min. Which of the following treatments would be best for you to provide now?
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Administer epinephrine IV r r




Provide bag-mask ventilation r r




Administer magnesium sulfate IV r r r




Intubate and ventilate - correct answer Provide bag-mask ventilation
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Which of the following is likely to be the most helpful technique to identify potentially reversible metabolic and
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toxic causes during the attempted resuscitation of a young child in cardiac arrest?
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Obtaining a urine sample for toxicology screen r r r r r r




Obtaining chest and abdominal radiographs r r r r




Soliciting a history from the caregiver or family r r r r r r r




Obtaining a venous blood gas - correct answer Soliciting a history from the caregiver or family
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You are caring for a patient who developed a tension pneumothorax after several hours of positive-pressure
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ventilation. Which of the following would be the most appropriate site for needle decompression?
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Over the third rib at the midclavicular line
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Under the eighth rib at the midaxillary line
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Over the fifth rib at the sternal border
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Under the sixth rib at the midclavicular line - correct answer Over the third rib at the midclavicular line
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