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2020 Pals Exam A 49Questions with 100%
correct answers
In which of the following situations may IO access be used? A. An extremity with signs of infection B. An extremity with a sign of a crush injury C. An extremity with a previous unsuccessful IO attempt
D. An extremity with slow a capillary refill time - Correct answer D. An extremity
with slow a capillary refill time A 2 week old infant is being evaluated for irritability and poor feeding. His BP is 55/ mmHg, and cap refill time is 5 seconds. Which statement best describes your assessment of this infants BP? A. It represents compensated shock B. It is hypertensive C. It is Hypotensive
D. It is normal - Correct answer C. It is Hypotensive
You are caring for patients in the emergency department. Which 2 year old child requires immediate intervention? A. A child who is grunting B. A child with an Sp02 of 95% on room air C. A child with a systolic blood pressure of 92 mm Hg
D. A child with a temperature of 37.4 C (99.3 F) - Correct answer A. A child who is
grunting A 3 year old child is having difficulty breathing. Which finding would most likely lead you to suspect an upper airway obstruction in this child? A. Expiratory breath sounds B. Decreased expiratory effort C. Increased inspiratory effort with retractions
D. Normal inspiratory sounds - Correct answer C. Increased inspiratory effort with
retractions A team member is unable to perform an assigned task because it is beyond the team members scope of practice. Which action should the team member take?
A. Ask for a new task or role B. Refuse to perform the task C. Do it anyway
D. Seek expert consultation - Correct answer A. Ask for a new task or role
You are the team leader during a pediatric resuscitation attempt. which action is an element of high quality CPR? A. Providing a compression depth of one fourth the depth of the chest B. Providing a compression rate of 80 to 100/min C. Allowing complete chest wall recoil after each compression
D. Performing pulse checks every minute - Correct answer C. Allowing complete
chest wall recoil after each compression An 8 year old child is brought to the ED by his mother for difficulty breathing. He has a history of asthma and nut allergies. He's mother tells you that he recently ate a cookie at a family picnic. Which condition is most likely to be present in this child? A. Disordered control of breathing B. Hypovolemic shock C. Lung tissue disease
D. upper airway obstruction - Correct answer D. upper airway obstruction
An 8 year old child is brought to the ED by ambulance after being involved in a MVC. Which finding would suggest that immediate intervention is needed? A. Decreased level of consciousness B. Systolic blood pressure of 106 mm Hg C. Temperature of 38.1 C (100.5 F)
D. Warm, moist skin - Correct answer A. Decreased level of consciousness
A 6 year old child is found unresponsive, not breathing, and without a pulse. one health care worker leaves to activate the emergency response system and get the resuscitation equipment. You and another healthcare provider immediatly begin CPR. Which compression to ventilation ratio do you use? A. 15: B. 30: C. 15:
D. 30:2 - Correct answer C. 15:
A 3 year old child is in cardiac arrest, and high quality CPR is in progress. You are the team leader. The first rhythm check reveals the rhythm shown here. Defibrillation is
A. 10 seconds B. 15 seconds C. 30 seconds
D. 60 seconds - Correct answer A. 10 seconds
A 10 year old child is being evaluated for a head ache. Which is a normal finding for this 10 year old child? A. Blood pressure of 60/50 mm Hg B. Heart rate of 88/min C. Respiratory of 8/min
D. Temperature of 39.6 C (103.2 F) - Correct answer B. Heart rate of 88/min
A 6 year old boy is being evaluated for difficulty breathing. Which finding would suggest this child has respiratory distress? A. Audible inspiratory stridor B. Decreased respiratory effort C. Oxygen saturation of 95%
D. Respiratory rate of 8/min - Correct answer A. Audible inspiratory stridor
A 4 year old child in cardiac arrest is brought to the emergency department by ambulance. High quality CPR is being performed. The cardiac monitor displays the rhythm strip shown here. The estimated weight of the child is 20 kg. What dose range should you use for the initial defibrillation? A. 0.5 to 2 J/kg B. 4 to 6 J/kg C. 6 to 8 J/kg
D. 2-4 J/kg - Correct answer D. 2-4 J/kg
A 4 year old child in cardiac arrest is brought to the emergency department by ambulance. High quality CPR is being performed. The cardiac monitor displays the rhythm strip shown here. The estimated weight of the child is 20 kg. As the team leader, how many joules do you tell your team member to use to perform initial Defib? A. 10 Joules B. 40 Joules C. 100 Joules
D. 140 Joules - Correct answer B. 40 Joules
You respond to an infant who is unresponsive, in not breathing, and doe not have a pulse. You shout for nearby help, but no one arrives. What action should you take next?
A Begin CPR for 2 mins before leaving to activate the emergency response system. B. Begin CPR for 1 minute before leaving to activate the emergency response system C. Activate the emergency response system after giving CPR for 10 minutes
D. Activate the emergency response system after giving CPR for 5 minutes - Correct
answer A Begin CPR for 2 mins before leaving to activate the emergency response
system. What ratio for compressions to breaths should be used for 1 rescuer infant CPR A. Give 30 compressions to 2 breaths B. Give 5 compressions to 1 breath C. Give 20 compressions to 2 breaths
D. Give 15 compressions to 2 breaths - Correct answer A. Give 30 compressions
to 2 breaths A 3 year old boy is brought to the ED by his mother. His is lethargic, with retractions and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk cap refill. To which immediate life treating condition could this Childs condition most likely progress if left untreated? A. Cardiogenic shock B. Hypovolemic shock C. Respiratory distress
D. Respiratory failure - Correct answer D. Respiratory failure
You are evaluating a 10 year old child who is febrile and tachycardia. The Childs cap refill times 5 seconds. which parameter will determine if the child is in compensated shock? A. Blood pressure B. Chest movement C. Respiratory effort
D. Respiratory rate - Correct answer A. Blood pressure
Anb18-month old has had vomiting and diarrhea for the past 2 days; the mother brings him to the emergency department because he is becoming more lethargic. What diagnostic test should you order first? A. 12-lead ECG B. Arterial blood gases C. Blood glucose
D. Serum potassium - Correct answer C. Blood pressure
C. Stridor
D. Wheezes - Correct answer A. Crackles
You are Caring for a 9 month old girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infants SpO2 is 94% On auscultation, the lungs are clear bilaterally. Which is the most likely cause of this infants respiratory distress? A. Disordered control of breathing B. Lower airway obstruction C. Parenchymal lung disease
D. Upper airway obstruction - Correct answer D. Upper airway obstruction
You are Caring for a 9 month old girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infants SpO2 is 94% On auscultation, the lungs are clear bilaterally. Which medication should you administer first? A. Albuterol, nebulizer B. Celtraxone, IV C. Dexamethasone, PO/IM
D. Epinephrine, nebulized - Correct answer D. Epinephrine, nebulized
What condition is characterized by a prolonged expiratory phase and wheezing? A. Disordered control of breathing B. Hypovolemic shock C. Lower airway obstruction
D. Upper airway obstruction - Correct answer C. Lower airway obstruction
A 5 year old child is brought to the emergency department by ambulance after being involved in a MVC. You are using the primary assessment to evaluate the child. When assessing the Childs neurological status, you note that he has spontaneous eye opening, is fully oriented, and is able to follow command. How would you document this Childs AVPU pediatric response scale finding? A. Alert B. Voice C. Painful
D. Unresponsive - Correct answer Alert
A 4 year old child is brought to the emergency department for seizures. The seizures stopped a few minutes ago, but the child continues to have slow and irregular respirations. Which condition is most consistent with your assessment?
A. Disordered Control of Breathing B. Lower airway obstruction C. Lung tissue disease
D. Upper airway obstruction - Correct answer A. Disordered Control of Breathing
You are evaluating a 1 yer old child for respiratory distress. His HR is 168/min, and his respiratory rate has decreased from 65/min to 30/min. He now appears more lethargic and continues to have severe subcostal retractions. On the basis of your assessment, which is the most likely reason for this change in the Childs condition. A. The child has a neurologic problem rather than a respiratory problem B. The child has signs of probable respiratory failure C. The child likely has arrhythmia rather than a respiratory problem
D. The child status is improving - Correct answer B. The child has signs of
probable respiratory failure A 7 year old child in cardiac arrest is brought to the ED by ambulance. No palpable pulses are detected. The Childs ECG is shown here. How would you characterize this Childs rhythm? A. Pulseless Electrical Activity B. Sinus bradycardia C. Ventricular escape rhythm
D. Ventricular tachycardia - Correct answer A. Pulseless Electrical Activity
After rectal administration of diazepam, an 8 year old boy with a history of seizures is no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. What action should you take next? A. Administer naloxone B. Perform endotracheal intubation C. Increase nasal cannula flow
D. Reposition the patient, and insert an oral airway - Correct answer D.
Reposition the patient, and insert an oral airway After rectal administration of diazepam, an 8 year old boy with a history of seizures is no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. If the patient continues to snore and exhibit poor chest rise and poor air entry bilaterally after your initial intervention what next step is most appropriate?
Auscultation of the lungs reveals bilateral crackles. Which medication would be most
appropriate? - Correct answer an antibiotic
A 10 year old child is brought to the ED for fever and cough. You obtain an O2 sat on the child. Which oxygen saturation would indicate that immediate intervention is
needed? - Correct answer 88% on 4L of Nasal oxygen
An unresponsive 9 year old boy is pale and cool to the touch his blood pressure is 70/ mmHg, heart rate is 190/min and respiratory rate is 12/min. The SpO2 is not detectable Cap refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm
shown here. What rhythm is seen on the patient cardiac monitor? - Correct
answer Supraventricular tachycardia
An unresponsive 9 year old boy is pale and cool to the touch his blood pressure is 70/ mmHg, heart rate is 190/min and respiratory rate is 12/min. The SpO2 is not detectable Cap refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. If initial treatment is unavailable or delayed, which intervention is
indicated? - Correct answer Syncronized cardioversion
The parents of a 7 year old child who is undergoing chemotherapy report that the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals that the child is difficult to arouse and her skin color is pale. The Childs HR is 160/min, respiratory rate is 38/min, blood pressure is 76/45 mmHg, cap refill time is 5 to 6 seconds, and temp is 39.4 degrees C (103 F). IV access has been established, and blood cultures have been obtained. which action should you perform
next? - Correct answer Administer 20 ml/kg of isotonic crystalloid over 5 to 10
mins An unresponsive 9 year old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His BP is 80/40 mmHg, HR is 45/min, respiratory rate is 6/min, and SpO2 is 60% no room air. He is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here. Which rhythm is most consistent with this patients
presentation and ECG findings? - Correct answer Sinus Bradycardia
A 6 month old infant is being evaluated for bradycardia. Which is the most likely cause
of bradycardia? - Correct answer Hypoxia
A 3 year old child is brought to the emergency department by his mother. Which is a
normal finding for a 3 year old child? - Correct answer Respiratory rate of 24/min
