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2022-2024 PALS Updated Final Exam with Answers (149 Solved Questions)

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    PALS Updated FINAL EXAM LATEST 2022 - 2024 REAL EXAM 150 QUESTIONS AND CORRECT ANSWERS(VERIFIED ANSWERS) A GRADE 1. 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 fo r this patient? - ANSWER - Airway clearance (e.g., suctioning) 2. 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? - ANSWER - Supraventricular tachycardia 3. 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

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    determination on which finding(s)? - ANSWER - Hypotension, fever, hyperglycemia 4. An 11 - year - old soccer player is brought to the emergency departm ent. After a quick assessment, the team realizes this patient is experiencing a severe asthma exacerbation. Which medication would the team administer immediately? - ANSWER - Albuterol with or without ipratropium bromide 5. 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? - ANSWER - Isotonic fluid boluses 6. 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

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    appropriate for the team to take? - ANSWER - Estimate weight using a length - based resuscitation tape. 7. 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 woul d the provider initiate first? - ANSWER - Deliver 1 BVM ventilation every 2 to 3 seconds. 8. 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? - ANSWER - 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 9. 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? - ANSWER - Torsades de pointes 10. What is the correct IV/IO dose of epinephrine for a pediatric patient in cardiac arrest? - ANSWER - 0.01 mg/kg every 3 to 5 min (max single dos e 1 mg)

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    11. 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? - ANSWER - Bronchiolitis 12. A child is experiencing supraventricular tachycardia (SVT) with adequate perfusion and is to receive treatment. Which initial treatment wo uld the provider administer? - ANSWER - Vagal maneuvers 13. 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? - ANSWER - Life - threatening systemic infection 14. 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.

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    The emergency response team interprets these findings as indicating which type of septic shock? - ANSWER - Fluid - refractory 15. A 30 - month o ld child has been diagnosed with moderate croup. Which medication(s) would the provider administer? - ANSWER - Nebulized epinephrine, Corticosteroids 16. A child exhibiting a narrow - complex tachycardia with adequate perfusion is to receive adenosine. The provider would be alert for which result after administering this medication? - ANSWER - Transient asystole 17. A child experiencing bradycardia with inadequat e perfusion despite supporting oxygenation and ventilation is receiving compressions. Despite these efforts, the child's status remains unchanged. Which medication would the emergency response team expect to administer next? - ANSWER - Epinephrine 18. A child i n the pediatric intensive care unit displays the following ECG waveform. The child has no pulse. The resuscitation team interprets this as which arrhythmia? - ANSWER - Monomorphic pulseless ventricular tachycardia

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    19. 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? - ANSWER - First - degree at rioventricular (AV) block 20. 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? - ANSWER - Nasal flaring Intercostal, substernal or suprasternal retractions Accessory muscle use 21. A 4 - year - old patient presents with tachycardia, tachypnea, cold extremities and weak pulses. Assessment also reveals an enlarged liver and neck vein distension. The provider interprets these assessment findings as suggesting which type of shock? - ANSWER - Cardiogenic 22. 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

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    shock. Which type of shock would the provider most likely suspect? - ANSWER - Hypovolemic 23. A child is experiencing shock. The emergency response team prepares for imminent cardiac arrest when assessment reveals which finding(s)? - ANSWER - Bradycardia Diminished central pulses Hypotension 24. Primary assessment of a 10 - year - old child reveals septic shock. As part of the secondary assessment, if not already done as part of initial sepsis care, laboratory testing is completed to evaluate the child's status. Which laboratory tests would be ordered for this child? - ANSWER - Complete blood count (CBC) Lactate level Blood cultures 25. A 10 - year - old child has collapsed in the gym of the elementary school. The school nurse arrives and determines that the child is unresponsive. The school nurse then simultaneously checks for breathing and a central pulse, limiting this assessment to which time frame? - ANSWER - No more than 10 seconds

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    26. 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? - ANSWER - Compressing the chest about 2 inches Providing ventilations that last about 1 second each Giving 2 ventilations to every 15 compressions Allowing the chest to recoil fully after each compression 27. The emergency response team is providing care to a preschooler who is experiencing shock. The primary goal, common to all types of shock, is to restore a favorable balance between tissue perfusion and metabolic demand with a focus on what? - ANSWER - Oxygen delivery and oxygen demand 28. A 9 - year - old patient is presenting with diminished breath sounds, bradycardia, slowed respiratory rate and a low O2 saturatio n level. The provider interprets these findings as indicating which condition? - ANSWER - Respiratory failure

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    29. An 11 - year - old child develops ventricular tachycardia with a pulse with inadequate perfusion. The PALS team would prepare the child for which intervention? - ANSWER - Synchronized electrical cardioversion 30. A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest. For which rhythm(s) would this action be appropriate? - ANSWER - pVT, VF 31. 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 perfusion and oxygen delivery? - ANSWER - Lactate 32. The PALS team is providing post - cardiac arrest care to an 8 - year - old child in the pediatric intensive care unit. Which intervention would the team implement to achieve the primary goal of post - cardiac arrest care, after assuring adequate oxygenation and ventilation? - ANSWER - Ensure adequate mean arterial pressure. 33. A provider is forming an initial impression of a child using the Pediatric Assessment Triangle (PAT). For which part of the PAT may the provider use the mnemonic TICLS to assess the patient? - ANSWER - Appearance

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    34. A 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 rap id 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? - ANSWER - Croup 35. A 4 - year - old child suddenly collapses in the playroom of the facility. A healthcare provider observes the event and hurries over to assess the child. The healthcare provider completes which assessment first? - ANSWER - Rapid assessment 36. A 12 - year - old is being treated in the urgent care clinic. The mother reports that the child came home from school yesterday with a high fever, vomiting and multiple episodes of watery diarrhea. The healthcare provider obtains a rhythm strip and notes the following waveform. The provider interprets this as which type of arrhythmia? - ANSWER - Sinus tachycardia 37. A 6 - year - old patient is brought to the emergency department after a bicycle accident. Assessment reveals chest pain on inspiration, diminished breath sounds

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    on the right side, and respiratory distress. The provider suspects obstructive shock caused by what condition? - ANSWER - Tension pneumothorax 38. An unresponsive 7 - year - old child with no pulse is brought to the pediatric urgent care center by his parents and C PR is initiated. The cardiac monitor reveals ventricular fibrillation. Which action would the PALS team take first? - ANSWER - Initiate defibrillation with 2 J/kg. 39. 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? - ANSWER - Second - degree atrioventricular (AV) block, type I 40. While performing a rapid assessment and formulating an initial impression using the Pediatric Assessment Triangle (PAT), the provider assesses the child's circulation. Which information would be important to consider? - ANSWER - Flushing of the skin Evidence of bleeding Skin pallor (or gray/dusky color)

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    41. The PALS resuscitation team is providing care to an intubated child in cardiac arrest. Which of the following can be used to monitor the adequacy of the team's chest compressions? - ANSWER - End - tidal carbon dioxide levels Presence of an arterial waveform or arterial blood pressure in patients with indwelling arterial catheters 42. An 8 - year - old child being treated in the emergency department has significant respiratory distress. The child also exhibits hives, wheezing, angioedema, tachycardia and dyspnea. The parents state that the child, who is allergic to peanuts, had eaten some popcorn that had peanuts in it. The team initiates care, preparing to administer which agent first? - ANSWER - Epinephrine 43. A provider is assessing a child with suspected shock. Which statement correctly describes hypotension and shock? - ANSWER - Hypotension is not a consistent feature of shock presentation in ch ildren. 44. 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

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    provider administers oxygen by nasal cannula with the goal of improving the child's oxygen saturation to what percentage range? - ANSWER - 94% to 99% 45. What is considered inadequate perfusion when assessing/caring for a pediatric patient with an arrhythmia? - ANSWER - Diminished peripheral pulses Acutely altered mental status Hypotension 46. A 7 - year - old child collapses on the playground at school. The school nurse is called to the scene and determines that the child is unresponsive a nd is not breathing and has no pulse. The nurse initiates CPR. At what rate and depth would the nurse deliver compressions to this child ? - ANSWER - 100 to 120 compressions per minute at a depth of about 2 inches 47. A child in the pediatric step - down unit is exhibiting signs of respiratory distress. When assessing this child, which circulation finding might be present? - ANSWER - Pallor 48. A 9 - year - old child is brought to the emergency department because the child suddenly collapsed at school. The child's ECG rev eals the

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