PALS UPDATED 2022 FINAL EXAM(Answered;graded
A+)
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+)
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.
