PALS Final Review exam 2025 with precise detailed
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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: |- |correct |answer | |Respiratory |distress
The |proper |site |for |a |peripheral |pulse |assessment |in |the |infant |patient |is: |- |correct |answer | |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? |- |correct |answer | |compensate |shock?
A |mnemonic |that |aids |in |performing |a |primary |assessment |is: |- |correct |answer | |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: |- |correct |answer | |Extracorporeal |membrane |
oxygenation |(ECMO)
Which |of |the |following |is |the |correct |meaning |for |one |of |the |individual |letters |in |the |AVPU |scale? |- |
correct |answer | |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: |- |correct |answer | |
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: |- |correct |answer | |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? |- |correct |answer | |IV
Which |of |the |following |cannot |be |administered |through |an |ETT? |- |correct |answer | |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? |- |correct |answer | |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'? |- |correct |answer | |higher
Children's |demand |for |oxygen |is |___________ |adults. |- |correct |answer | |greater
Which |of |the |following |must |you |monitor |while |fluid |resuscitating |a |patient? |- |correct |answer | |Urine |
output
What |type |of |pressure |is |monitored |to |obtain |right |ventricular |cardiac |preload? |- |correct |answer | |
Central |venous |pressure |(CVP)
Define |shock: |- |correct |answer | |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 |
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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: |- |correct |answer | |Respiratory |distress
The |proper |site |for |a |peripheral |pulse |assessment |in |the |infant |patient |is: |- |correct |answer | |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? |- |correct |answer | |compensate |shock?
A |mnemonic |that |aids |in |performing |a |primary |assessment |is: |- |correct |answer | |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: |- |correct |answer | |Extracorporeal |membrane |
oxygenation |(ECMO)
Which |of |the |following |is |the |correct |meaning |for |one |of |the |individual |letters |in |the |AVPU |scale? |- |
correct |answer | |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: |- |correct |answer | |
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: |- |correct |answer | |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? |- |correct |answer | |IV
Which |of |the |following |cannot |be |administered |through |an |ETT? |- |correct |answer | |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? |- |correct |answer | |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'? |- |correct |answer | |higher
Children's |demand |for |oxygen |is |___________ |adults. |- |correct |answer | |greater
Which |of |the |following |must |you |monitor |while |fluid |resuscitating |a |patient? |- |correct |answer | |Urine |
output
What |type |of |pressure |is |monitored |to |obtain |right |ventricular |cardiac |preload? |- |correct |answer | |
Central |venous |pressure |(CVP)
Define |shock: |- |correct |answer | |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 |
