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Pals Exam A Test Questions and Answers Graded A+

In which of the following situations may IO access be

used?

A. An extremity with signs of infection

B. An extremity with a sign of a crush injury

C. An extremity with a previous unsuccessful IO

attempt

D. An extremity with slow a capillary refill time -

ANSWER -D. An extremity with slow a capillary

refill time

A 2 week old infant is being evaluated for irritability

and poor feeding. His BP is 55/40 mmHg, and cap

refill time is 5 seconds. Which statement best

describes your assessment of this infants BP?

A. It represents compensated shock

B. It is hypertensive

C. It is Hypotensive

D. It is normal - ANSWER -C. It is Hypotensive

You are caring for patients in the emergency

department. Which 2 year old child requires

immediate intervention?

A. A child who is grunting

B. A child with an Sp02 of 95% on room air

C. A child with a systolic blood pressure of 92 mm Hg

D. A child with a temperature of 37.4 C (99.3 F) -

ANSWER -A. A child who is grunting

A 3 year old child is having difficulty breathing. Which

finding would most likely lead you to suspect an

upper airway obstruction in this child?

A. Expiratory breath sounds

B. Decreased expiratory effort

C. Increased inspiratory effort with retractions

D. Normal inspiratory sounds - ANSWER -C.

Increased inspiratory effort with retractions

A team member is unable to perform an assigned

task because it is beyond the team members scope

of practice. Which action should the team member

take?

A. Ask for a new task or role

B. Refuse to perform the task

C. Do it anyway

D. Seek expert consultation - ANSWER -A. Ask

for a new task or role

You are the team leader during a pediatric

resuscitation attempt. which action is an element of

high quality CPR?

A. Providing a compression depth of one fourth the

depth of the chest

B. Providing a compression rate of 80 to 100/min

C. Allowing complete chest wall recoil after each

compression

D. Performing pulse checks every minute -

ANSWER -C. Allowing complete chest wall

recoil after each compression

An 8 year old child is brought to the ED by his mother

for difficulty breathing. He has a history of asthma

and nut allergies. He's mother tells you that he

recently ate a cookie at a family picnic. Which

condition is most likely to be present in this child?

A. Disordered control of breathing

B. Hypovolemic shock

C. Lung tissue disease

D. upper airway obstruction - ANSWER -D.

upper airway obstruction

An 8 year old child is brought to the ED by

ambulance after being involved in a MVC. Which

finding would suggest that immediate intervention is

needed?

A. Decreased level of consciousness

B. Systolic blood pressure of 106 mm Hg

C. Temperature of 38.1 C (100.5 F)

D. Warm, moist skin - ANSWER -A. Decreased

level of consciousness

A 6 year old child is found unresponsive, not

breathing, and without a pulse. one health care

worker leaves to activate the emergency response

system and get the resuscitation equipment. You and

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In which of the following situations may IO access be used? A. An extremity with signs of infection B. An extremity with a sign of a crush injury C. An extremity with a previous unsuccessful IO attempt D. An extremity with slow a capillary refill time - ANSWER - D. An extremity with slow a capillary refill time A 2 week old infant is being evaluated for irritability and poor feeding. His BP is 55/40 mmHg, and cap refill time is 5 seconds. Which statement best describes your assessment of this infants BP? A. It represents compensated shock B. It is hypertensive C. It is Hypotensive D. It is normal - ANSWER - C. It is Hypotensive You are caring for patients in the emergency department. Which 2 year old child requires immediate intervention? A. A child who is grunting B. A child with an Sp02 of 95% on room air C. A child with a systolic blood pressure of 92 mm Hg D. A child with a temperature of 37.4 C (99.3 F) - ANSWER - A. A child who is grunting A 3 year old child is having difficulty breathing. Which finding would most likely lead you to suspect an upper airway obstruction in this child? A. Expiratory breath sounds B. Decreased expiratory effort C. Increased inspiratory effort with retractions D. Normal inspiratory sounds - ANSWER - C. Increased inspiratory effort with retractions A team member is unable to perform an assigned task because it is beyond the team members scope of practice. Which action should the team member take? A. Ask for a new task or role B. Refuse to perform the task C. Do it anyway D. Seek expert consultation - ANSWER - A. Ask for a new task or role You are the team leader during a pediatric resuscitation attempt. which action is an element of high quality CPR? A. Providing a compression depth of one fourth the depth of the chest B. Providing a compression rate of 80 to 100/min C. Allowing complete chest wall recoil after each compression D. Performing pulse checks every minute - ANSWER - C. Allowing complete chest wall recoil after each compression An 8 year old child is brought to the ED by his mother for difficulty breathing. He has a history of asthma and nut allergies. He's mother tells you that he recently ate a cookie at a family picnic. Which condition is most likely to be present in this child? A. Disordered control of breathing B. Hypovolemic shock C. Lung tissue disease D. upper airway obstruction - ANSWER - D. upper airway obstruction An 8 year old child is brought to the ED by ambulance after being involved in a MVC. Which finding would suggest that immediate intervention is needed? A. Decreased level of consciousness B. Systolic blood pressure of 106 mm Hg C. Temperature of 38.1 C (100.5 F) D. Warm, moist skin - ANSWER - A. Decreased level of consciousness A 6 year old child is found unresponsive, not breathing, and without a pulse. one health care worker leaves to activate the emergency response system and get the resuscitation equipment. You and

another healthcare provider immediatly begin CPR. Which compression to ventilation ratio do you use? A. 15: B. 30: C. 15: D. 30:2 - ANSWER - C. 15: A 3 year old child is in cardiac arrest, and high quality CPR is in progress. You are the team leader. The first rhythm check reveals the rhythm shown here. Defibrillation is attempted with a shock dose of 2 J/kg. after administration of the shock, what should you say to you team members? A. Check for a pulse B. Give epinephrine 0.01 mg/kg C. Let's check the rhythm D. Resume compressions - ANSWER - D. Resume compressions You are caring for a 5 year old boy with a 4 day history of high fever and cough. He is having increasing lethargy, grunting, and sleepiness. Now he is difficult to arouse and is unresponsive to voice commands. His O2 sat is 72% on room air and 89% when on a NRB O2 mask. He has shallow respirations, with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles. Which assessment finding is consistent with respiratory failure in this child? A. Cough B. Fever C. Oxygen saturation D. Respiratory rate - ANSWER - C. Oxygen saturation You are caring for a 5 year old boy with a 4 day history of high fever and cough. He is having increasing lethargy, grunting, and sleepiness. Now he is difficult to arouse and is unresponsive to voice commands. His O2 sat is 72% on room air and 89% when on a NRB O2 mask. He has shallow respirations, with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles. Which medication would be most appropriate? A. A bronchodilator B. An antibiotic C. A cortcosteroid D. A vasopressor - ANSWER - B. An antibiotic During a resuscitation attempt, the team leader asks you to administer an initial dose of Epinephrine at 0. mg/kg to be given IO. How should you respond? A. "I can't administer the drug at the dose you ordered B. "OK, but will administer epinephrine 0.01 mg/kg" C. "OK, I will administer epinephrine 0.1 mg/kg D. "I think the correct dose is 0.01 mg/kg. should I give that dose instead?" - ANSWER - D. "I think the correct dose is 0.01 mg/kg. should I give that dose instead?" A 6 month old infant is unresponsive. You begin checking for breathing at the same time you check for the infants pulse. Which is the maximum time you should spend when trying to simultaneously check for breathing and palpate the infants pulse before starting CPR? A. 10 seconds B. 15 seconds C. 30 seconds D. 60 seconds - ANSWER - A. 10 seconds A 10 year old child is being evaluated for a head ache. Which is a normal finding for this 10 year old child? A. Blood pressure of 60/50 mm Hg B. Heart rate of 88/min C. Respiratory of 8/min D. Temperature of 39.6 C (103.2 F) - ANSWER - B. Heart rate of 88/min A 6 year old boy is being evaluated for difficulty breathing. Which finding would suggest this child has respiratory distress? A. Audible inspiratory stridor

You are caring for a 3 month old boy with a 2 day history of fever, vomiting and diarrhea. His parents state that he has been sleeping much more. His HR is 190/min, temp is 38.3 degrees C (101 F) blood pressure is 59/29 mmHg, Resp rate is 70/min and shallow, and oxygen sat is 94% on 100% oxygen. His capillary refills time is 4-5 seconds, and he has mottled, cool extremities. The infant weighs 6 Kg. What assessment finding indicates that the infant has hypotensive shock? A. Blood pressure B. Capillary refill time C. Heart rate D. Tachypnea - ANSWER - A. Blood pressure You are caring for a 3 month old boy with a 2 day history of fever, vomiting and diarrhea. His parents state that he has been sleeping much more. His HR is 190/min, temp is 38.3 degrees C (101 F) blood pressure is 59/29 mmHg, Resp rate is 70/min and shallow, and oxygen sat is 94% on 100% oxygen. His capillary refills time is 4-5 seconds, and he has mottled, cool extremities. The infant weighs 6 Kg. On the basis of this infant's presentation, what type of shock does this infant have? A. Cardiogenic B. Distributive C. Hypovolemic D. Obstructive - ANSWER - C. Hypovolemic You are caring for a 3 month old boy with a 2 day history of fever, vomiting and diarrhea. His parents state that he has been sleeping much more. His HR is 190/min, temp is 38.3 degrees C (101 F) blood pressure is 59/29 mmHg, Resp rate is 70/min and shallow, and oxygen sat is 94% on 100% oxygen. His capillary refills time is 4-5 seconds, and he has mottled, cool extremities. The infant weighs 6 Kg. You have decided that this infant needs fluid resuscitation. How much fluid should you administered? A. 10 mL/kg lactated Ringer's B. 15 mL/kg 5% dextrose in 0.45% normal saline C. 20 mL/kg normal saline D. 20 mL/kg 0.45% normal saline - ANSWER - C. 20mL/kg normal saline Which abnormality helps identify children with acute respiratory distress caused by lung tissue disease? A. Crackles B. Prolonged inspiratory saline C. Stridor D. Wheezes - ANSWER - A. Crackles You are Caring for a 9 month old girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infants SpO2 is 94% On auscultation, the lungs are clear bilaterally. Which is the most likely cause of this infants respiratory distress? A. Disordered control of breathing B. Lower airway obstruction C. Parenchymal lung disease D. Upper airway obstruction - ANSWER - D. Upper airway obstruction You are Caring for a 9 month old girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infants SpO2 is 94% On auscultation, the lungs are clear bilaterally. Which medication should you administer first? A. Albuterol, nebulizer B. Celtraxone, IV C. Dexamethasone, PO/IM D. Epinephrine, nebulized - ANSWER - D. Epinephrine, nebulized What condition is characterized by a prolonged expiratory phase and wheezing? A. Disordered control of breathing B. Hypovolemic shock C. Lower airway obstruction

D. Upper airway obstruction - ANSWER - C. Lower airway obstruction A 5 year old child is brought to the emergency department by ambulance after being involved in a MVC. You are using the primary assessment to evaluate the child. When assessing the Childs neurological status, you note that he has spontaneous eye opening, is fully oriented, and is able to follow command. How would you document this Childs AVPU pediatric response scale finding? A. Alert B. Voice C. Painful D. Unresponsive - ANSWER - Alert A 4 year old child is brought to the emergency department for seizures. The seizures stopped a few minutes ago, but the child continues to have slow and irregular respirations. Which condition is most consistent with your assessment? A. Disordered Control of Breathing B. Lower airway obstruction C. Lung tissue disease D. Upper airway obstruction - ANSWER - A. Disordered Control of Breathing You are evaluating a 1 yer old child for respiratory distress. His HR is 168/min, and his respiratory rate has decreased from 65/min to 30/min. He now appears more lethargic and continues to have severe subcostal retractions. On the basis of your assessment, which is the most likely reason for this change in the Childs condition. A. The child has a neurologic problem rather than a respiratory problem B. The child has signs of probable respiratory failure C. The child likely has arrhythmia rather than a respiratory problem D. The child status is improving - ANSWER - B. The child has signs of probable respiratory failure A 7 year old child in cardiac arrest is brought to the ED by ambulance. No palpable pulses are detected. The Childs ECG is shown here. How would you characterize this Childs rhythm? A. Pulseless Electrical Activity B. Sinus bradycardia C. Ventricular escape rhythm D. Ventricular tachycardia - ANSWER - A. Pulseless Electrical Activity After rectal administration of diazepam, an 8 year old boy with a history of seizures is no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. What action should you take next? A. Administer naloxone B. Perform endotracheal intubation C. Increase nasal cannula flow D. Reposition the patient, and insert an oral airway - ANSWER - D. Reposition the patient, and insert an oral airway After rectal administration of diazepam, an 8 year old boy with a history of seizures is no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. If the patient continues to snore and exhibit poor chest rise and poor air entry bilaterally after your initial intervention what next step is most appropriate? A. Increase nasal cannula flow B. Provide bag mask ventilation C. Subcostal retractions D. Wheezing - ANSWER - B. Provide bag mask ventilation You are performing the airway component of the primary assessment. Which finding would lead you to conclude that the child has an upper airway obstruction? - ANSWER - inspiratory stridor

ANSWER - Administer 20 ml/kg of isotonic crystalloid over 5 to 10 mins An unresponsive 9 year old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His BP is 80/40 mmHg, HR is 45/min, respiratory rate is 6/min, and SpO2 is 60% no room air. He is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here. Which rhythm is most consistent with this patients presentation and ECG findings? - ANSWER - Sinus Bradycardia A 6 month old infant is being evaluated for bradycardia. Which is the most likely cause of bradycardia? - ANSWER - Hypoxia A 3 year old child is brought to the emergency department by his mother. Which is a normal finding for a 3 year old child? - ANSWER - Respiratory rate of 24/min

PALS Exam A: Practice Test Questions and Answers, Exams of Nursing

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