AHA Pediatric Advanced Life Support Exam / PALS
Exam (answered)
You are assisting in the elective intubation of an average-sized 4 yo
child with respiratory failure. Colleague is retrieving the color-coded
length- based tape from the resuscitation chart. What is likely to be the
estimated size of the uncuffed endotracheal tube for this child? -
ANSWERS>>>>>*5- mm tube*
What oxygen delivery system most reliably delivers a high (90% of
greater) concentration of inspired oxygen to a 7-year-old child? -
ANSWERS>>>>>Nonrebreathing face mask
You are called to help treat an infant with severe symptomatic
bradycardia (heart rate 66/min) associated with respiratory distress.
Bradycardia persists despite establishment of an effective airway,
oxygenation, and ventilation. There is no heart block present. What first
drug should you administer? - ANSWERS>>>>>*Epinephrine*
You are part of a team attempting to resuscitate a child with ventricular
fibrillation cardiac arrest. You deliver 2 unsynchronized shocks. A team
member established IO access, so you give a dose of epinephrine, 0.01
mg/kg IO. At next rhythm check, persistent ventricular fibrillation is
present. You administer a 4-J/kg shock and resume CPR. What drug and
dose should be administered next? - ANSWERS>>>>>*Amiodarone 5
mg/kg IO*
- can be used for shock-refractory VF or pVT
You are caring for a 6-year-old patient who is receiving positive-
pressure mechanical ventilation via an endotracheal tube. Child begins
to move his head and suddenly becomes cyanotic, and his heart rate
decreases. His SpO2 is 65%. You remove child from mechanical
ventilator and begin to provide manual ventilation with a bag via
,endotracheal tube. During manual ventilation with 100% oxygen, child's
color and heart rate improve slightly and his BP remains adequate.
Breath sounds and chest expansion are present and adequate on right
side and are present but consistently diminished on left side. Trachea not
deviated, and neck veins are not distended. Suction catheter passes
easily beyond tip of the endotracheal tube. Most likely cause of this
child's acute deterioration? - ANSWERS>>>>>*Tracheal tube
displacement into right main bronchus*
You are giving chest compressions for a child in cardiac arrest. What
is the proper depth of compressions for a child? -
ANSWERS>>>>>*Compress the chest at least one third the depth of the
chest, about 2 inches (5 cm)*
During PALS, you and another rescuers begin CPR. Your colleague
begins compressions, and you noticed that the compression rate is too
slow.
What should you say to offer constructive feedback? -
ANSWERS>>>>>*You need to compress at a rate of 100 to 120 per
minute*
You are preparing to use a manual defibrillator in the pediatric setting.
What best describes when it is appropriate to use the smaller
pediatric-
,sized paddles? - ANSWERS>>>>>*If the child weighs less than 10 kg or is
less than 1 year old*
You need to provide rescue breaths to a child victim with a pulse. What
is the appropriate rate for delivering breaths? - ANSWERS>>>>>*1 breath
every 3 to 5 seconds*
You find an infant who is unresponsive, is not breathing, and does not
have a pulse. You shout for nearby help, but no one arrives. What action
should you take next? - ANSWERS>>>>>*Provide CPR for about 2 minutes
before leaving to activate the emergency response system*
3 yo boy presents with multiple-system trauma. Child was an
unrestrained passenger in a high-speed MVC. On primary assessment,
he is unresponsive to voice or painful stimulation. His RR is 5/min, HR
and pulses are 170/min, systolic BC is 60 mmHg, capillary refill is 5
seconds, and SpO2 is 75% on room air. What action should you take first?
- ANSWERS>>>>>*While a colleague provides spinal motion restriction,
open the airway with a jaw thrust and provide bag-mask ventilation*
Initial impression of a 2-year-old girl shows her to be alert with mild
breathing difficulty during inspiration and pale skin color. On primary
assessment, she makes high-pitched inspiratory sounds (mild stridor)
when agitated; otherwise, her breathing is quiet. Her SpO2 is 92% on
room air, and she has mild inspiratory intercostal retractions. Lung
auscultation reveals transmitted upper airway sounds with adequate
distal breath sounds bilaterally. Most appropriate initial intervention for
this child? - ANSWERS>>>>>*Humidified oxygen as tolerated*
7-year-old boy found unresponsive, apneic, and pulseless. CPR is
ongoing. Child is intubated, and vascular access is established. ECG
monitor shows organized rhythm with heart rate of 45/min, but a pulse
, check reveals no palpable pulses. High-quality CPR is resumed, and an
initial IV dose of epinephrine is administered. What intervention should
you perform next? - ANSWERS>>>>>*Identify and treat reversible causes*
Exam (answered)
You are assisting in the elective intubation of an average-sized 4 yo
child with respiratory failure. Colleague is retrieving the color-coded
length- based tape from the resuscitation chart. What is likely to be the
estimated size of the uncuffed endotracheal tube for this child? -
ANSWERS>>>>>*5- mm tube*
What oxygen delivery system most reliably delivers a high (90% of
greater) concentration of inspired oxygen to a 7-year-old child? -
ANSWERS>>>>>Nonrebreathing face mask
You are called to help treat an infant with severe symptomatic
bradycardia (heart rate 66/min) associated with respiratory distress.
Bradycardia persists despite establishment of an effective airway,
oxygenation, and ventilation. There is no heart block present. What first
drug should you administer? - ANSWERS>>>>>*Epinephrine*
You are part of a team attempting to resuscitate a child with ventricular
fibrillation cardiac arrest. You deliver 2 unsynchronized shocks. A team
member established IO access, so you give a dose of epinephrine, 0.01
mg/kg IO. At next rhythm check, persistent ventricular fibrillation is
present. You administer a 4-J/kg shock and resume CPR. What drug and
dose should be administered next? - ANSWERS>>>>>*Amiodarone 5
mg/kg IO*
- can be used for shock-refractory VF or pVT
You are caring for a 6-year-old patient who is receiving positive-
pressure mechanical ventilation via an endotracheal tube. Child begins
to move his head and suddenly becomes cyanotic, and his heart rate
decreases. His SpO2 is 65%. You remove child from mechanical
ventilator and begin to provide manual ventilation with a bag via
,endotracheal tube. During manual ventilation with 100% oxygen, child's
color and heart rate improve slightly and his BP remains adequate.
Breath sounds and chest expansion are present and adequate on right
side and are present but consistently diminished on left side. Trachea not
deviated, and neck veins are not distended. Suction catheter passes
easily beyond tip of the endotracheal tube. Most likely cause of this
child's acute deterioration? - ANSWERS>>>>>*Tracheal tube
displacement into right main bronchus*
You are giving chest compressions for a child in cardiac arrest. What
is the proper depth of compressions for a child? -
ANSWERS>>>>>*Compress the chest at least one third the depth of the
chest, about 2 inches (5 cm)*
During PALS, you and another rescuers begin CPR. Your colleague
begins compressions, and you noticed that the compression rate is too
slow.
What should you say to offer constructive feedback? -
ANSWERS>>>>>*You need to compress at a rate of 100 to 120 per
minute*
You are preparing to use a manual defibrillator in the pediatric setting.
What best describes when it is appropriate to use the smaller
pediatric-
,sized paddles? - ANSWERS>>>>>*If the child weighs less than 10 kg or is
less than 1 year old*
You need to provide rescue breaths to a child victim with a pulse. What
is the appropriate rate for delivering breaths? - ANSWERS>>>>>*1 breath
every 3 to 5 seconds*
You find an infant who is unresponsive, is not breathing, and does not
have a pulse. You shout for nearby help, but no one arrives. What action
should you take next? - ANSWERS>>>>>*Provide CPR for about 2 minutes
before leaving to activate the emergency response system*
3 yo boy presents with multiple-system trauma. Child was an
unrestrained passenger in a high-speed MVC. On primary assessment,
he is unresponsive to voice or painful stimulation. His RR is 5/min, HR
and pulses are 170/min, systolic BC is 60 mmHg, capillary refill is 5
seconds, and SpO2 is 75% on room air. What action should you take first?
- ANSWERS>>>>>*While a colleague provides spinal motion restriction,
open the airway with a jaw thrust and provide bag-mask ventilation*
Initial impression of a 2-year-old girl shows her to be alert with mild
breathing difficulty during inspiration and pale skin color. On primary
assessment, she makes high-pitched inspiratory sounds (mild stridor)
when agitated; otherwise, her breathing is quiet. Her SpO2 is 92% on
room air, and she has mild inspiratory intercostal retractions. Lung
auscultation reveals transmitted upper airway sounds with adequate
distal breath sounds bilaterally. Most appropriate initial intervention for
this child? - ANSWERS>>>>>*Humidified oxygen as tolerated*
7-year-old boy found unresponsive, apneic, and pulseless. CPR is
ongoing. Child is intubated, and vascular access is established. ECG
monitor shows organized rhythm with heart rate of 45/min, but a pulse
, check reveals no palpable pulses. High-quality CPR is resumed, and an
initial IV dose of epinephrine is administered. What intervention should
you perform next? - ANSWERS>>>>>*Identify and treat reversible causes*
