PALS FINAL EXAM SUMMER 2023;SOLVED
CORRECTLY
A 12-year-old child being evaluated in the pediatric intensive care unit displays
the following ECG waveform. The team interprets this as which arrhythmia?
second degree
Laboratory tests are ordered for a child who has been vomiting for 3 days and is
diaphoretic, tachypneic, lethargic and pale. Which test would the provider use to
determine the adequacy of oxygen delivery?
Lactate
A 9-year-old patient is presenting with decreased breath sounds, bradycardia,
slowed respiratory rate and a low O2 saturation level. The provider interprets
these findings as indicating which condition?
Respiratory failure
A 4-year-old child is brought to the emergency department by the parents.
Assessment reveals that the child has only gasping respirations and the pulse
rate is 65 beats per minute. Which action would the provider initiate first?
Deliver 1 BVM ventilation every 3 to 5 seconds.
A 15-year-old patient is being evaluated during a follow-up visit after being
diagnosed with Lyme disease 2 months ago. A rhythm strip is obtained as shown
below. The provider interprets this rhythm as indicating which arrhythmia?
First-degree atrioventricular (AV) block
A child in cardiac arrest experiences return of spontaneous circulation but is
exhibiting signs of post–cardiac arrest syndrome (PCAS). The PALS resuscitation
team determines that the child is experiencing a systemic response to
ischemia/reperfusion. The team bases this determination on which finding(s)?
Hypotension
Fever
Hyperglycemia
A 2-year-old child arrives at the emergency department with the parents. The
child is unresponsive, is not breathing and has no pulse. Two emergency
department providers begin high-quality CPR. Which action(s) by the providers
demonstrates high-quality CPR?
Allowing the chest to recoil fully after each compression
Providing ventilations that last about 1 second each
Compressing the chest about 2 inches
Giving 2 ventilations to every 15 compressions
A PALS resuscitation team is preparing to defibrillate a child experiencing
cardiac arrest. For which rhythm(s) would this action be appropriate?
VF and pVT are shockable cardiac arrest rhythms.
A provider is assessing a child with suspected shock. Which statement correctly
describes hypotension and shock?
Hypotension is not a consistent feature of shock;
A provider is caring for a 4-year-old child in the urgent care clinic. Primary
assessment reveals difficulty breathing and an oxygen saturation of 91%. The
, provider administers oxygen by nasal cannula with the goal of improving the
child’s oxygen saturation above what percentage?
Supplemental oxygen should be administered as needed to maintain an oxygen
saturation above 94%.
An 11-year-old soccer player is brought to the emergency department. After a
quick assessment, the team realizes this patient is experiencing a severe asthma
exacerbation. Which medication would the team administer first?
Albuterol plus ipratropium bromid
A child in the pediatric step-down unit is exhibiting signs of respiratory distress.
When assessing this child, which circulation finding might be present?
Pallor is a circulation finding that may be seen in patients with respiratory distress.
A healthcare provider is performing a primary assessment of a child in
respiratory distress. The provider documents increased work of breathing when
which findings are observed?
Nasal flaring, use of accessory muscles to breathe and intercostal, substernal or
suprasternal retractions are all indicators of increased work or effort of breathing.
Grunting and inspiratory stridor are abnormal breath sounds.
An 11-year-old child develops unstable wide-complex tachycardia. Assessment
reveals signs of significant hemodynamic compromise, but the child has a pulse.
The PALS team would prepare the child for which intervention?
First-line treatment for unstable wide-complex tachycardias consists of synchronized
electrical cardioversion, particularly when signs of hemodynamic compromise are
apparent.
A 4-month old infant is brought to the emergency department in cardiac arrest.
Which condition would the team identify as the most common cause of cardiac
arrest in an infant of this age?
Sudden infant death syndrome
A 9-year-old child is brought to the emergency department because the child
suddenly collapsed at school. The child’s ECG reveals the following waveform,
and primary assessment findings indicate that the child is hemodynamically
unstable. Which primary assessment findings indicate this?
Difficulty breathing
Hypotension
Mottling
Decreased level of consciousnes
2-year-old child is brought to the pediatric urgent care clinic by the parent who
says that the child has had a barking cough for two days. During the rapid
assessment of the child, the provider hears audible inspiratory stridor. Which
common cause of partial upper airway obstruction in children would the provider
most likely suspect?
croup
A 6-year-old child is brought to the emergency department. The child has been
experiencing extremely watery stools over the past several days. After
completing the assessment, the healthcare provider suspects that the child may
be experiencing shock. Which type of shock would the provider most likely
suspect?
CORRECTLY
A 12-year-old child being evaluated in the pediatric intensive care unit displays
the following ECG waveform. The team interprets this as which arrhythmia?
second degree
Laboratory tests are ordered for a child who has been vomiting for 3 days and is
diaphoretic, tachypneic, lethargic and pale. Which test would the provider use to
determine the adequacy of oxygen delivery?
Lactate
A 9-year-old patient is presenting with decreased breath sounds, bradycardia,
slowed respiratory rate and a low O2 saturation level. The provider interprets
these findings as indicating which condition?
Respiratory failure
A 4-year-old child is brought to the emergency department by the parents.
Assessment reveals that the child has only gasping respirations and the pulse
rate is 65 beats per minute. Which action would the provider initiate first?
Deliver 1 BVM ventilation every 3 to 5 seconds.
A 15-year-old patient is being evaluated during a follow-up visit after being
diagnosed with Lyme disease 2 months ago. A rhythm strip is obtained as shown
below. The provider interprets this rhythm as indicating which arrhythmia?
First-degree atrioventricular (AV) block
A child in cardiac arrest experiences return of spontaneous circulation but is
exhibiting signs of post–cardiac arrest syndrome (PCAS). The PALS resuscitation
team determines that the child is experiencing a systemic response to
ischemia/reperfusion. The team bases this determination on which finding(s)?
Hypotension
Fever
Hyperglycemia
A 2-year-old child arrives at the emergency department with the parents. The
child is unresponsive, is not breathing and has no pulse. Two emergency
department providers begin high-quality CPR. Which action(s) by the providers
demonstrates high-quality CPR?
Allowing the chest to recoil fully after each compression
Providing ventilations that last about 1 second each
Compressing the chest about 2 inches
Giving 2 ventilations to every 15 compressions
A PALS resuscitation team is preparing to defibrillate a child experiencing
cardiac arrest. For which rhythm(s) would this action be appropriate?
VF and pVT are shockable cardiac arrest rhythms.
A provider is assessing a child with suspected shock. Which statement correctly
describes hypotension and shock?
Hypotension is not a consistent feature of shock;
A provider is caring for a 4-year-old child in the urgent care clinic. Primary
assessment reveals difficulty breathing and an oxygen saturation of 91%. The
, provider administers oxygen by nasal cannula with the goal of improving the
child’s oxygen saturation above what percentage?
Supplemental oxygen should be administered as needed to maintain an oxygen
saturation above 94%.
An 11-year-old soccer player is brought to the emergency department. After a
quick assessment, the team realizes this patient is experiencing a severe asthma
exacerbation. Which medication would the team administer first?
Albuterol plus ipratropium bromid
A child in the pediatric step-down unit is exhibiting signs of respiratory distress.
When assessing this child, which circulation finding might be present?
Pallor is a circulation finding that may be seen in patients with respiratory distress.
A healthcare provider is performing a primary assessment of a child in
respiratory distress. The provider documents increased work of breathing when
which findings are observed?
Nasal flaring, use of accessory muscles to breathe and intercostal, substernal or
suprasternal retractions are all indicators of increased work or effort of breathing.
Grunting and inspiratory stridor are abnormal breath sounds.
An 11-year-old child develops unstable wide-complex tachycardia. Assessment
reveals signs of significant hemodynamic compromise, but the child has a pulse.
The PALS team would prepare the child for which intervention?
First-line treatment for unstable wide-complex tachycardias consists of synchronized
electrical cardioversion, particularly when signs of hemodynamic compromise are
apparent.
A 4-month old infant is brought to the emergency department in cardiac arrest.
Which condition would the team identify as the most common cause of cardiac
arrest in an infant of this age?
Sudden infant death syndrome
A 9-year-old child is brought to the emergency department because the child
suddenly collapsed at school. The child’s ECG reveals the following waveform,
and primary assessment findings indicate that the child is hemodynamically
unstable. Which primary assessment findings indicate this?
Difficulty breathing
Hypotension
Mottling
Decreased level of consciousnes
2-year-old child is brought to the pediatric urgent care clinic by the parent who
says that the child has had a barking cough for two days. During the rapid
assessment of the child, the provider hears audible inspiratory stridor. Which
common cause of partial upper airway obstruction in children would the provider
most likely suspect?
croup
A 6-year-old child is brought to the emergency department. The child has been
experiencing extremely watery stools over the past several days. After
completing the assessment, the healthcare provider suspects that the child may
be experiencing shock. Which type of shock would the provider most likely
suspect?
