Download PALS Final Review exam 2024/25 with 100% correct answers and more Exams Nursing in PDF only on Docsity!
PALS Final Review exam 2024/25 with 100%
correct 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 is alert and anxious with a heart rate of 145 beats per minute, a blood pressure of 76/48mmHg and a capillary refill time of 4 seconds. Which of the
following is the patient's clinical condition? - Correct answer hypotensive shock
To treat wheezing in a child, which medication is the most appropriate to administer? -
Correct answer Albuterol
You arrive on scene to assess a 9-year-old boy who was stung by a bee. The patient is found to be suffering from urticaria and is displaying respiratory distress with a
What medication should be administered for severe cases of croup with imminent
respiratory failure? - Correct answer Dexamethasone
Infection of the central nervous system (CNS) can cause hypoventilation or
__________. - Correct answer Apnea
During a resuscitation, it is important that all members of the team understand the
concept of: - Correct answer Each member of the team caring for a pediatric
patient must understand his role and the role of other members. In most pediatric resuscitation efforts, there is one team leader who will ensure that everything gets done by the right person at the right time. You are serving in the capacity of team leader during the resuscitation of a pediatric medical patient. Which of the items listed below is a responsibility of the team leader? -
Correct answer Assign roles to team members
The best vasoactive agent for a child in warm septic shock is: - Correct
answer NoE
Anemic hypoxia results from: - Correct answer Anemic hypoxia results from the
amount of functional hemoglobin is too small, and hence the capacity of the blood to carry oxygen is too low Which of the following is correct regarding post resuscitation management of the
pediatric patient? - Correct answer The goal of post resuscitation care are to
preserve neurologic function, prevent secondary organ injury and treat the cause of the illness. You and your team members are currently resuscitating a 7-year-old male patient who was found face down in a pool. EMS states the patient was in the water for an unknown amount of time. The patient is currently in asystole, is cyanotic with an advanced airway in place. Inline waveform capnography is showing a small peak upon mechanical ventilation with a ETCO2 of 12. Which of the following is the most appropriate care for
this patient? - Correct answer DOPE
You and your partner are providing high-quality CPR to a 7-year-old female. The correct
compression to ventilation ratio is: - Correct answer 15:
You decide that BLS ventilations are no longer effective in your pediatric patient resuscitation. You elect to place an endotracheal tube. The preferred method for
confirming and monitoring the placement of this ETT is: - Correct answer End-
tidal CO2 monitoring
A 7-month-old patient presents with supraventricular tachycardia. The patient is
hemodynamically stable. The best method of a vagal maneuver is: - Correct
answer Application of a cold stimulus to the face (e.g., a washcloth soaked in iced
water, cold pack, or crushed ice mixed with water in a plastic bag or glove) for up to 10 seconds.
Atropine is indicated for: - Correct answer Symptomatic bradycardia
Consideration for _____________ through devices such as BiPAP or CPAP is indicated
for infants or children with suspected lung tissue disease. - Correct
answer Continuous PEEP
An accepted initial therapy for a patient with suspected croup is: - Correct
answer Nebulized epinephrine
Which of the following is a sign of respiratory failure? - Correct answer Decrease
in ventilation and oxygenation Which of the statements about supraventricular tachycardia (SVT) is correct? -
Correct answer The clinical presentations demonstrate that children and infants
lack the ability to tolerate this rhythm well. The mother of a 9-year-old patient reports that her son was playing with a friend when he collapsed while running. At the patients side, you apply an AED and deliver one shock. The patient regains a pulse but remains unresponsive. you successfully place an ETT. There is no evidence of shock or trauma. Your target range for SpO2 is: -
Correct answer 94% - 99%
Which of the following rhythms is non-shockable? - Correct answer asystole
You and your team are treating a 9-year-old patient who is tachycardic. She has a heart rate of 184 and is short of breath but still able to speak in full sentences and is able to follow commands. Emergency intervention for this patient intially is __________. -
Correct answer The patient is conscious, able to speak in full sentences and is
able to follow commands, attempting vagal maneuvers first is appropriate for this patient. If bradycardia is the result of a complete heart block or an abnormal sinus node
function, what therapy is recommended? - Correct answer cardiac pacing
fluids. The patient is most likely in what kind of shock due to the burns? - Correct
answer Hypovolemic shock
You are evaluating a 3-year-old female patient in the emergency department. Her parents brought her in for an evaluation of increasing cough, difficulty breathing, sputum and now increased irritability. On assessing your patient, you note a temperature of 100.4 F, respiratory rate of 38, and a room air SpO2 of 93%. With this information you
can infer that the patient's airway resistance is: - Correct answer increase?
A diagnostic test that shows acidosis, tissue hypoxia, anaerobic respiration, and/or high
glucose is: - Correct answer Arterial lactate
Septic shock is common in children because: - Correct answer They have an
underdeveloped immune system and have difficulty fighting infections
Which of the following are muscles involved in inspiration? - Correct
answer diaphragm
intercostals accessory muscles The parents of your patient indicate their child suffered a grand mal seizure for 3 minutes. On examination of the patient you note he is comatose and his breathing pattern is slow and irregular. This is referred to as _______________ and may cause
respiratory failure. - Correct answer Disordered regulation of breathing
Your patient is tachycardic with a blood pressure just above normal accepted values. The patient is alert to voice. In regards to oxygen therapy, which of the following is true?
- Correct answer high flow oxygen Which of the following chest retractions represent moderate breathing difficulty? -
Correct answer intercoastal
Which of the following is a goal of shock management? - Correct answer The goal
of shock management are to correct perfusion problems, improve perfusion/metabolic demand balance, restore organ function and prevent cardiac arrest. Which of the roles listed does data show have no impact on patient survival in an in-
hospital cardiac arrest? - Correct answer medical response team?
The most common cause of cardiac arrest in infants and children is: - Correct
answer Respiratory inadequacy causing hypoxia
You are assessing a 5-year-old patient with acute respiratory distress. You note a change in the patient's mental status as well as a decrease in the patients heart rate from 150 beats per minute to 66 beats per minute. You also note that the patients respiratory rate is currently 6 breaths per minute. Your immediate intervention is: -
Correct answer When an adult, child or infant has a pulse but is not breathing
effectively, rescuers should give breaths without chest compressions. For infant and children, give 1 breath every 3 to 5 seconds, about 12 to 20 breaths per minute. Which of the following statements is correct concerning respiratory management during
post-resuscitation? - Correct answer Appropriate PaCO2 level is relative to clinical
circumstances. For example, children with asthma and respiratory failure may respond poorly (increased morbidity) to rapid correction of PaCO2 with mechanical ventilation. A normal PaCO2 is preferred for patients with neurologic conditions.
Which of the following is suggested treatments for septic shock? - Correct
answer Aggressive fluid therapy
Which of the following statements concerning cardiac arrest is correct? - Correct
answer Uninterrupted CPR is critical when managing cardiac arrest
Cardiogenic shock results from: - Correct answer Poor heart contractions
Sinus tachycardia occurs in response to an increased need for oxygen and cardiac
output. A common cause of sinus tachycardia include: - Correct answer Tissue
hypoxia Which of the following statements about tachycardia is relative to the pediatric patient? -
Correct answer Sinus tachycardia (ST) is a tachycardic rhythm produced by an
increased rate of sinus node discharge. Sinus tachycardia occurs in response to an increased need for oxygen and cardiac output. Sinus tachycardia is not a constant rate, but instead varies as the need for oxygen varies. Sinus tachycardia occurs in response to an increased energy level, but is also a response to many common conditions. There is no indication that this rhythm may lead to cardiac arrest. Emergently using a paralytic agent such as succinylcholine for securing the airway in a pediatric patient may cause bradycardia. What medication and dose would you provide
as a premedication for the possible development of bradycardia? - Correct
answer Atropine 0.02 mg/kg IV
What may a provider expect to notice on a pediatric patient with a diagnosis of lung
tissue disease? - Correct answer tachypnea
tachycardia
Which of the following is an inclusion criterion for Systemic Inflammatory Response
Syndrome (SIRS)? - Correct answer Internal temperature above 38.0 C or below
36.0 C
You are treating a 9-year-old patient complaining of respiratory distress who presents with hives, stridorous breath sounds, and a fast heart rate after being stung by a bee.
Your first action is: - Correct answer E, IM
While performing a resuscitation of an 8-year-old boy, the parents ask if they can be in
the room. You should: - Correct answer Being present during cardiopulmonary
resuscitation (CPR) may help the family member understand that everything possible to bring the patient back to life has been implemented. In addition to quelling suspicion about behind-closed-doors resuscitation efforts and unrealistic expectations of such efforts, the family member's presence may offer the opportunity for a last goodbye and help that person grasp the reality of death, with the hope that the bereavement process will not be prolonged or complicated by pathologic mourning or post-traumatic stress disorder (PTSD) Which of the following statements is correct concerning the treatment of hypovolemic
shock? - Correct answer Aggressive fluid therapy within the first hour produces
the best outcomes Your patient presents unresponsive and in coarse ventricular fibrillation. CPR is being performed and the patient has been shocked once. Your patient remains in ventricular
fibrillation. The next dose for electrical therapy is: - Correct answer 4 J/kg
After administering two fluid boluses to a patient who was initially hypotensive, the
patient is still extremely lethargic. What would your next diagnostic test be? - Correct
answer glucose
Which of the following is a reversible cause of bradycardia? - Correct
answer Toxins/poisons/drugs
You are participating in the resuscitation of a 6-month-old patient weighing 7 kilograms who is in pulseless electrical arrest (PEA). High quality CPR is being administered, IV access has been obtained and BLS ventilations are working well. The team leader orders epinephrine 1:10,000 at a dose of 0.1 mg/kg IV with a 20ml saline flush. On receiving this order from the team leader as the person in charge of medications you
should: - Correct answer recheck order dosage (0.01mg/kg for pusless IV)
You should immediately start compressions if the pediatric patient has a heart rate below ___ beats per minute and is showing signs of cardiorespiratory compromise. -
Correct answer 60
Your patient presents in the emergency department with her parents. She is 4 years old and had eaten a cookie at the neighbor's house this morning. The patient has no medical history and a possible allergy to peanuts. The patient presents as anxious with her focus appearing to be on breathing. Her breathing effort is increased and labored with accessory muscle usage. The patient exhibits audible stridor. The patient further presents with peripheral cyanosis to the lips, hands and feet. What is the assessment
tool you used to find this presentation? - Correct answer PATs
While assessing a patient brought to you by very frantic parents, you note the patient to be alert to loud verbal stimuli only, tachypneic, tacyhcardic, exhibiting an increase in work of breathing, audible expiratory wheezing and pale. This patient is presenting
with the clinical signs of: - Correct answer respiratory distress
You are evaluating a 3-year-old female patient in the emergency department. Her parents brought her in for an evaluation of increasing cough, difficulty breathing, sputum and now increased irritability. On assessing your patient, you note a temperature of 100.4 F, respiratory rate of 38, and a room air SpO2 of 93%. With this information you
can infer that the patient's airway resistance is: - Correct answer increased
