PALS RED CROSS FINAL EXAM QUESTIONS
and ANSWERS (GRADED A+)
A 5-year-old child with a history of a chronic neuromuscular disease is experiencing respiratory
distress. The child is breathing spontaneously and receiving supplemental oxygen. Which additional
intervention is a critical component of airway management for this patient?
Airway clearance (e.g., suctioning)
Airway clearance (e.g., suctioning) is a critical component of airway management in patients with
neuromuscular disorders. Advanced airway and assisted ventilation may be necessary if distress
progresses but suctioning should always be a first action.
A child being cared for in the pediatric telemetry unit suddenly displays the following ECG waveform.
The provider prepares to intervene because the child is demonstrating which type of arrhythmia?
Supraventricular tachycardia
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
Systemic response to ischemia/reperfusion reflects impaired tissue oxygenation causing systemic
inflammation, vascular instability, and increased coagulation along with adrenal suppression and a
lowered resistance to infection. Clinical manifestations include: fever, hypotension, hyperglycemia,
infection, multiorgan failure.
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 immediately?
Albuterol with or without ipratropium bromide
.After ROSC, a child is experiencing post-cardiac arrest hypoperfusion. The PALS resuscitation team
would administer which element to restore intravascular volume and optimize preload?
Isotonic fluid boluses
A 2-year-old child of unknown weight arrives at the emergency department in cardiac arrest. When
preparing to administer medications, which action would be appropriate for the team to take?
Estimate weight using a length-based resuscitation tape.
In children, medications administered during cardiac arrest are typically dosed based on weight. If a
child's weight is not known or cannot be quickly and easily measured, use a length-based
resuscitation tape (e.g., Broselow) to estimate the child's weight. The tape also provides
predetermined medication doses correlating with the color block corresponding to the patient's
length.
.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 2 to 3 seconds.
, .The PALS team leader is conducting a debriefing session with the team. Which topic(s) would the
team leader most likely address during the session?
Discussion of the pros and cons of the interventions
Evaluation of the objective data gathered during the event, Summary of the event, including what
actions were taken, Identification of ways to improve
The PALS resuscitation team notes the following ECG waveform and the child does not have a pulse.
The team prepares to intervene to address which arrhythmia?
Torsades de pointes
What is the correct IV/IO dose of epinephrine for a pediatric patient in cardiac arrest?
0.01 mg/kg every 3 to 5 min (max single dose 1 mg)
Assessment of a 3-month-old infant admitted with respiratory distress reveals fever, grunting and a
wet, "junky" cough. The infant's parents said the child had a recent respiratory infection with a fever.
A rapid respiratory syncytial virus (RSV) test is positive. Which condition would the provider most
likely suspect as the cause?
Bronchiolitis
Bronchiolitis is a lower respiratory tract infection that primarily affects infants and young children.
Affected infants are typically between the ages of 2 and 4 months. It typically presents after a
prodrome of upper respiratory tract infection and fever and is characterized by grunting and a wet,
"junky" cough. It is most often caused by respiratory syncytial virus (RSV).
.A child is experiencing supraventricular tachycardia (SVT) with adequate perfusion and is to receive
treatment. Which initial treatment would the provider administer?
Vagal maneuvers
.A healthcare provider notices petechiae on the arms and legs while performing a rapid skin
assessment of a child with a high fever and respiratory distress. Based on this assessment, which
condition should the provider consider?
Life-threatening systemic infection
.A 7-year-old patient with septic shock has received three balanced/buffered crystalloid fluid boluses
(60-mL/kg) and reassessment reveals capillary refill of 3 seconds, diminished pulses, narrow pulse
pressure and cool, mottled extremities. The emergency response team interprets these findings as
indicating which type of septic shock?
Fluid-refractory
Septic shock that does not respond to fluid therapy is called fluid-refractory septic shock
.A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the
provider administer?
Nebulized epinephrine, Corticosteroids
The child is exhibiting signs of moderate croup. Therefore, neublized epinephrine and corticosteroids
would be indicated. Administration of nebulized epinephrine reduces inflammation and edema of the
airway. Administration of corticosteroids reduces the inflammation and helps to prevent the
progression to respiratory failure.
and ANSWERS (GRADED A+)
A 5-year-old child with a history of a chronic neuromuscular disease is experiencing respiratory
distress. The child is breathing spontaneously and receiving supplemental oxygen. Which additional
intervention is a critical component of airway management for this patient?
Airway clearance (e.g., suctioning)
Airway clearance (e.g., suctioning) is a critical component of airway management in patients with
neuromuscular disorders. Advanced airway and assisted ventilation may be necessary if distress
progresses but suctioning should always be a first action.
A child being cared for in the pediatric telemetry unit suddenly displays the following ECG waveform.
The provider prepares to intervene because the child is demonstrating which type of arrhythmia?
Supraventricular tachycardia
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
Systemic response to ischemia/reperfusion reflects impaired tissue oxygenation causing systemic
inflammation, vascular instability, and increased coagulation along with adrenal suppression and a
lowered resistance to infection. Clinical manifestations include: fever, hypotension, hyperglycemia,
infection, multiorgan failure.
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 immediately?
Albuterol with or without ipratropium bromide
.After ROSC, a child is experiencing post-cardiac arrest hypoperfusion. The PALS resuscitation team
would administer which element to restore intravascular volume and optimize preload?
Isotonic fluid boluses
A 2-year-old child of unknown weight arrives at the emergency department in cardiac arrest. When
preparing to administer medications, which action would be appropriate for the team to take?
Estimate weight using a length-based resuscitation tape.
In children, medications administered during cardiac arrest are typically dosed based on weight. If a
child's weight is not known or cannot be quickly and easily measured, use a length-based
resuscitation tape (e.g., Broselow) to estimate the child's weight. The tape also provides
predetermined medication doses correlating with the color block corresponding to the patient's
length.
.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 2 to 3 seconds.
, .The PALS team leader is conducting a debriefing session with the team. Which topic(s) would the
team leader most likely address during the session?
Discussion of the pros and cons of the interventions
Evaluation of the objective data gathered during the event, Summary of the event, including what
actions were taken, Identification of ways to improve
The PALS resuscitation team notes the following ECG waveform and the child does not have a pulse.
The team prepares to intervene to address which arrhythmia?
Torsades de pointes
What is the correct IV/IO dose of epinephrine for a pediatric patient in cardiac arrest?
0.01 mg/kg every 3 to 5 min (max single dose 1 mg)
Assessment of a 3-month-old infant admitted with respiratory distress reveals fever, grunting and a
wet, "junky" cough. The infant's parents said the child had a recent respiratory infection with a fever.
A rapid respiratory syncytial virus (RSV) test is positive. Which condition would the provider most
likely suspect as the cause?
Bronchiolitis
Bronchiolitis is a lower respiratory tract infection that primarily affects infants and young children.
Affected infants are typically between the ages of 2 and 4 months. It typically presents after a
prodrome of upper respiratory tract infection and fever and is characterized by grunting and a wet,
"junky" cough. It is most often caused by respiratory syncytial virus (RSV).
.A child is experiencing supraventricular tachycardia (SVT) with adequate perfusion and is to receive
treatment. Which initial treatment would the provider administer?
Vagal maneuvers
.A healthcare provider notices petechiae on the arms and legs while performing a rapid skin
assessment of a child with a high fever and respiratory distress. Based on this assessment, which
condition should the provider consider?
Life-threatening systemic infection
.A 7-year-old patient with septic shock has received three balanced/buffered crystalloid fluid boluses
(60-mL/kg) and reassessment reveals capillary refill of 3 seconds, diminished pulses, narrow pulse
pressure and cool, mottled extremities. The emergency response team interprets these findings as
indicating which type of septic shock?
Fluid-refractory
Septic shock that does not respond to fluid therapy is called fluid-refractory septic shock
.A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the
provider administer?
Nebulized epinephrine, Corticosteroids
The child is exhibiting signs of moderate croup. Therefore, neublized epinephrine and corticosteroids
would be indicated. Administration of nebulized epinephrine reduces inflammation and edema of the
airway. Administration of corticosteroids reduces the inflammation and helps to prevent the
progression to respiratory failure.
