PALS Final Exam Review | 100% Correct Answers | Verified | Latest 2024 Version, Exams of Nursing

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PALS Final Exam Review | 100% Correct

Answers | Verified | Latest 2024 Version

Mikey, a 2-year-old boy, is sitting upright on a hospital bed in room 3 of your emergency department. Your initial impression from the door does not raise immediate concern. On your entry to the room, you are able to look at Mikey more closely and notice on inhalation his nostrils are flaring. This is a sign of: - ✔✔Respiratory distress The proper site for a peripheral pulse assessment in the infant patient is: - ✔✔brachial You are called to the scene of a 3-year-old patient who was found anxious, cyanotic and lethargic after a fall down a flight of stairs. On assessing the patient, you find vital signs with a respiratory rate of 30, regular pulse rate of 130, regular capillary refill time of 4 seconds, and a blood pressure of 102/61. What kind of shock is the patient experiencing? - ✔✔compensate shock? A mnemonic that aids in performing a primary assessment is: - ✔✔ABCDE A consideration of treatment for a pediatric patient with acute fulminant myocarditis who is in cardiac arrest or at a high risk of cardiac arrest is: - ✔✔Extracorporeal membrane oxygenation (ECMO) Which of the following is the correct meaning for one of the individual letters in the AVPU scale? - ✔✔Alert - The child is alert and awake and responds to normal stimuli based upon age and environment The recommended route of vascular access on a hypotensive pediatric patient is: - ✔✔central IV You are called to the bedside of a 12-year-old male patient who was admitted after a week of persistent vomiting, diarrhea and limiting oral intake of both solids and liquids. The patient's airway is patent, ventilatory rate is within normal limits and the patient's circulatory status presents with tachycardia, a blood pressure of 70/40 and a capillary refill time of 5 seconds. The patient is speaking incoherently. The patient has no history of cardiac problems or congenital defects. The appropriate fluid administration dose for this patient is: - ✔✔20 ml/kg 0.9% NaCl over 10 minutes

You suspect your 8-year-old female patient of being hypovolemic. Her parents brought her to the emergency department with persistent vomiting and diarrhea for 5 days. The patient presents with mottled skin and reports of periods where "she just stopped breathing!" according to her parents. The patient is being managed with a BVM and supplemental oxygen. What is the best route of establishing vascular access for the purpose of fluid resuscitation? - ✔✔IV Which of the following cannot be administered through an ETT? - ✔✔Sodium bicarbonate You are examining the rhythm strip of a patient who presents with bradycardia. Which of the following characteristics may you notice in the rhythm? - ✔✔The most obvious sign of bradycardia on an ECG is slow heart rate. The characteristics of P-waves and the QRS complex may vary. When looking at an EKG, the following characteristics are seen with bradycardia patients: Slow heart rate, P-waves may not be noticeable, QRS complex may be wide or narrow, and P-waves and QRS complex may not be related to bradycardia. How do children's metabolic rates compare to adults'? - ✔✔higher Children's demand for oxygen is ___________ adults. - ✔✔greater Which of the following must you monitor while fluid resuscitating a patient? - ✔✔Urine output What type of pressure is monitored to obtain right ventricular cardiac preload? - ✔✔Central venous pressure (CVP) Define shock: - ✔✔When oxygen and nutrient supply to body tissue is insufficient compared to metabolic tissue needs Your 5-year-old patient is admitted to the PICU and is being treated by your team for hypovolemic shock. The team has administered one bolus of 20ml/kg of 0.9% NaCl. On re-evaluation the patient is alert and anxious with a heart rate of 145 beats per minute, a blood pressure of 76/48mmHg and a capillary refill time of 4 seconds. Which of the following is the patient's clinical condition? - ✔✔hypotensive shock To treat wheezing in a child, which medication is the most appropriate to administer? - ✔✔Albuterol

You arrive on scene to assess a 9-year-old boy who was stung by a bee. The patient is found to be suffering from urticaria and is displaying respiratory distress with a presentation of nasal flaring, tachypnea and accessory muscle use. The patient's mother relates he has never had an allergic reaction to a bee sting, but his father is gravely allergic to bee stings. The patient relates it is hard to breathe. While gathering your initial set of vital signs you note the patient has a room air SpO2 is 90%. This finding classifies the patient as: - ✔✔When the blood is insufficiently oxygenated, hypoxemia can occur. Hypoxemia is a decreased saturation of oxyhemoglobin (oxygenated hemoglobin) in the blood. A noninvasive method of estimating arterial oxygen saturation (SaO2) is pulse oximetry, which calculates the saturation of oxyhemoglobin (SpO2). In a normal child, a room air measurement below 94% indicates hypoxemia. You are called to the scene of a 7-month-old with altered mental status. On obtaining the patient's vital signs, you note a pulse of 58 beats per minute. The mother tells you the patient was born with an atrial ventricular defect. What kind of bradycardia is the patient in? - ✔✔primary brad Which of the following is an element of the mechanics of respiration? - ✔✔The mechanics of respiration are composed of: airway resistance (upper and lower), lung compliance, muscles of respiration, and central nervous system control of breathing. While caring for a child admitted to the Pediatric Intensive Care Unit (PICU), recently drawn lab values return with no issues noted in the CBE or chem panel. However, in the ABG you note a PaO2 of 40mmHg and a pH of 7.20. This patient is: - ✔✔Hypoxic and acidotic Which of the following is a form of distributive shock? - ✔✔Anaphylactic shock A child with an upper airway obstruction caused by infection-induced edema should not receive suction and instead be placed in a comfortable position and given what medication? - ✔✔Nebulized e While assessing a pediatric patient using the ABCDE algorithm, life-threatening conditions associated with the letter E for Exposure are: - ✔✔Severe hypothermia, substantial bleeding, petechiae, or purpura indicating septic shock The preferred initial method of removing a foreign body airway obstruction in a responsive patient less than one year of age is: - ✔✔Back blows and chest thrusts

What medication should be administered for severe cases of croup with imminent respiratory failure? - ✔✔Dexamethasone Infection of the central nervous system (CNS) can cause hypoventilation or __________. - ✔✔Apnea During a resuscitation, it is important that all members of the team understand the concept of: - ✔✔Each member of the team caring for a pediatric patient must understand his role and the role of other members. In most pediatric resuscitation efforts, there is one team leader who will ensure that everything gets done by the right person at the right time. You are serving in the capacity of team leader during the resuscitation of a pediatric medical patient. Which of the items listed below is a responsibility of the team leader? - ✔✔Assign roles to team members The best vasoactive agent for a child in warm septic shock is: - ✔✔NoE Anemic hypoxia results from: - ✔✔Anemic hypoxia results from the amount of functional hemoglobin is too small, and hence the capacity of the blood to carry oxygen is too low Which of the following is correct regarding post resuscitation management of the pediatric patient? - ✔✔The goal of post resuscitation care are to preserve neurologic function, prevent secondary organ injury and treat the cause of the illness. You and your team members are currently resuscitating a 7-year-old male patient who was found face down in a pool. EMS states the patient was in the water for an unknown amount of time. The patient is currently in asystole, is cyanotic with an advanced airway in place. Inline waveform capnography is showing a small peak upon mechanical ventilation with a ETCO2 of 12. Which of the following is the most appropriate care for this patient? - ✔✔DOPE You and your partner are providing high-quality CPR to a 7-year-old female. The correct compression to ventilation ratio is: - ✔✔15:

You decide that BLS ventilations are no longer effective in your pediatric patient resuscitation. You elect to place an endotracheal tube. The preferred method for confirming and monitoring the placement of this ETT is: - ✔✔End-tidal CO2 monitoring A 7-month-old patient presents with supraventricular tachycardia. The patient is hemodynamically stable. The best method of a vagal maneuver is: - ✔✔Application of a cold stimulus to the face (e.g., a washcloth soaked in iced water, cold pack, or crushed ice mixed with water in a plastic bag or glove) for up to 10 seconds. Atropine is indicated for: - ✔✔Symptomatic bradycardia Consideration for _____________ through devices such as BiPAP or CPAP is indicated for infants or children with suspected lung tissue disease. - ✔✔Continuous PEEP An accepted initial therapy for a patient with suspected croup is: - ✔✔Nebulized epinephrine Which of the following is a sign of respiratory failure? - ✔✔Decrease in ventilation and oxygenation Which of the statements about supraventricular tachycardia (SVT) is correct? - ✔✔The clinical presentations demonstrate that children and infants lack the ability to tolerate this rhythm well. The mother of a 9-year-old patient reports that her son was playing with a friend when he collapsed while running. At the patients side, you apply an AED and deliver one shock. The patient regains a pulse but remains unresponsive. you successfully place an ETT. There is no evidence of shock or trauma. Your target range for SpO2 is: - ✔✔94% - 99% Which of the following rhythms is non-shockable? - ✔✔asystole You and your team are treating a 9-year-old patient who is tachycardic. She has a heart rate of 184 and is short of breath but still able to speak in full sentences and is able to follow commands. Emergency intervention for this patient intially is __________. - ✔✔The patient is conscious, able to speak in full sentences and is able to follow commands, attempting vagal maneuvers first is appropriate for this patient.

If bradycardia is the result of a complete heart block or an abnormal sinus node function, what therapy is recommended? - ✔✔cardiac pacing The correct IV epinephrine dose for the symptomatic bradycardia patient is: - ✔✔Administration of epinephrine for continuing symptomatic bradycardia via IV/IO is 0.01 mg/kg (1:10,000: 0.1 ml/kg). You arrive on scene to a 4-year-old child who presents pulseless and apneic with high-quality CPR being performed and vascular access established. Which is your next intervention? - ✔✔epinephrine Define tachypnea: - ✔✔Tachypnea is defined as an elevated breathing rate for age What is the most common pre-arrest rhythm in children? - ✔✔Bradyarrhythmia Which of the following is a lower airway obstruction? - ✔✔bronchiolitis You are called to the bedside of a patient admitted to the pediatric intensive care unit (PICU) for a 22- month-old patient in severe respiratory distress. The patient has a patent airway, is tachypneic with an increased work of breathing, has as a pulse rate of 150 beats per minute, with no neurologic deficits, and is normothermic. What mnemonic should be used to aid the performance of a secondary assessment? - ✔✔SAMPLE The chief purpose of the respiratory system is to: - ✔✔exchange gases Treatment of obstructive shock includes which of the following? - ✔✔Look for and treat causes of obstructive shock You are administering a bolus of normal saline to a 16 kg child. The appropriate volume is: - ✔✔320 (20 x

What can cause head-bobbing in the infant patient? - ✔✔Increased respiratory effort

Hypoxemic ischemia results from: - ✔✔caused by arterial or arteriolar obstruction or vasoconstriction Your patient is a 4-year-old boy who pulled the handle of a pot of hot oil from the top of the stove causing the contents to cover him. You note that the patient is being given iv fluids. The patient is most likely in what kind of shock due to the burns? - ✔✔Hypovolemic shock You are evaluating a 3-year-old female patient in the emergency department. Her parents brought her in for an evaluation of increasing cough, difficulty breathing, sputum and now increased irritability. On assessing your patient, you note a temperature of 100.4 F, respiratory rate of 38, and a room air SpO2 of 93%. With this information you can infer that the patient's airway resistance is: - ✔✔increase? A diagnostic test that shows acidosis, tissue hypoxia, anaerobic respiration, and/or high glucose is: - ✔✔Arterial lactate Septic shock is common in children because: - ✔✔They have an underdeveloped immune system and have difficulty fighting infections Which of the following are muscles involved in inspiration? - ✔✔diaphragm intercostals accessory muscles The parents of your patient indicate their child suffered a grand mal seizure for 3 minutes. On examination of the patient you note he is comatose and his breathing pattern is slow and irregular. This is referred to as _______________ and may cause respiratory failure. - ✔✔Disordered regulation of breathing Your patient is tachycardic with a blood pressure just above normal accepted values. The patient is alert to voice. In regards to oxygen therapy, which of the following is true? - ✔✔high flow oxygen Which of the following chest retractions represent moderate breathing difficulty? - ✔✔intercoastal

Which of the following is a goal of shock management? - ✔✔The goal of shock management are to correct perfusion problems, improve perfusion/metabolic demand balance, restore organ function and prevent cardiac arrest. Which of the roles listed does data show have no impact on patient survival in an in-hospital cardiac arrest? - ✔✔medical response team? The most common cause of cardiac arrest in infants and children is: - ✔✔Respiratory inadequacy causing hypoxia You are assessing a 5-year-old patient with acute respiratory distress. You note a change in the patient's mental status as well as a decrease in the patients heart rate from 150 beats per minute to 66 beats per minute. You also note that the patients respiratory rate is currently 6 breaths per minute. Your immediate intervention is: - ✔✔When an adult, child or infant has a pulse but is not breathing effectively, rescuers should give breaths without chest compressions. For infant and children, give 1 breath every 3 to 5 seconds, about 12 to 20 breaths per minute. Which of the following statements is correct concerning respiratory management during post- resuscitation? - ✔✔Appropriate PaCO2 level is relative to clinical circumstances. For example, children with asthma and respiratory failure may respond poorly (increased morbidity) to rapid correction of PaCO2 with mechanical ventilation. A normal PaCO2 is preferred for patients with neurologic conditions. Which of the following is suggested treatments for septic shock? - ✔✔Aggressive fluid therapy Which of the following statements concerning cardiac arrest is correct? - ✔✔Uninterrupted CPR is critical when managing cardiac arrest Cardiogenic shock results from: - ✔✔Poor heart contractions Sinus tachycardia occurs in response to an increased need for oxygen and cardiac output. A common cause of sinus tachycardia include: - ✔✔Tissue hypoxia

Which of the following statements about tachycardia is relative to the pediatric patient? - ✔✔Sinus tachycardia (ST) is a tachycardic rhythm produced by an increased rate of sinus node discharge. Sinus tachycardia occurs in response to an increased need for oxygen and cardiac output. Sinus tachycardia is not a constant rate, but instead varies as the need for oxygen varies. Sinus tachycardia occurs in response to an increased energy level, but is also a response to many common conditions. There is no indication that this rhythm may lead to cardiac arrest. Emergently using a paralytic agent such as succinylcholine for securing the airway in a pediatric patient may cause bradycardia. What medication and dose would you provide as a premedication for the possible development of bradycardia? - ✔✔Atropine 0.02 mg/kg IV What may a provider expect to notice on a pediatric patient with a diagnosis of lung tissue disease? - ✔✔tachypnea tachycardia rise in respiratory effort grunting hypoxemia crackles reduced breath sounds Distributive shock results from: - ✔✔abnormal distribution of blood Your 4-year-old patient is unresponsive and has no spontaneous ventilations. CPR is being provided and you notice the patient is in a pulseless wide complex tachycardia at a rate of 200 on the monitor. Your next treatment is: - ✔✔Per the 2015 AHA guidelines, a patient presenting in cardiac arrest with a ventricular rhythm after two minutes of CPR, should receive defibrillation at 2 J/kg for the first defibrillation and 4 J/kg for the 2nd shock. A sign of congestive heart failure with SVT is: - ✔✔Distended jugular veins indicate congestive heart failure. The goal of the assessment phase of PALS is to recognize: - ✔✔is to recognize respiratory distress, respiratory arrest, and shock.

An effective, non-invasive method of detecting hypoxia is _____________. - ✔✔pulse oximetry Your patient is in cardiac arrest after being unrestrained in a head-on motor vehicle collision. Which of the following is the most appropriate intervention? - ✔✔Minimize movement of the cervical spine The appropriate dose for a fluid bolus in a patient with cardiac compromise is: - ✔✔20mL/kg Your patient was diagnosed with leukemia 3 months ago and was just involved in a motor vehicle collision with an arterial laceration to her upper right arm. Despite high-flow oxygen therapy, your patient's SpO2 remains 85%. This patient's hypoxic state is referred to as: - ✔✔anemic hypoxia The use of Pediatric Early Warning Scores (PEWS) may: - ✔✔The use of PEWS may be considered, but its effectiveness in the in-hospital setting is not well established. Which of the following is an inclusion criterion for Systemic Inflammatory Response Syndrome (SIRS)? - ✔✔Internal temperature above 38.0 C or below 36.0 C You are treating a 9-year-old patient complaining of respiratory distress who presents with hives, stridorous breath sounds, and a fast heart rate after being stung by a bee. Your first action is: - ✔✔E, IM While performing a resuscitation of an 8-year-old boy, the parents ask if they can be in the room. You should: - ✔✔Being present during cardiopulmonary resuscitation (CPR) may help the family member understand that everything possible to bring the patient back to life has been implemented. In addition to quelling suspicion about behind-closed-doors resuscitation efforts and unrealistic expectations of such efforts, the family member's presence may offer the opportunity for a last goodbye and help that person grasp the reality of death, with the hope that the bereavement process will not be prolonged or complicated by pathologic mourning or post-traumatic stress disorder (PTSD) Which of the following statements is correct concerning the treatment of hypovolemic shock? - ✔✔Aggressive fluid therapy within the first hour produces the best outcomes

Your patient presents unresponsive and in coarse ventricular fibrillation. CPR is being performed and the patient has been shocked once. Your patient remains in ventricular fibrillation. The next dose for electrical therapy is: - ✔✔4 J/kg After administering two fluid boluses to a patient who was initially hypotensive, the patient is still extremely lethargic. What would your next diagnostic test be? - ✔✔glucose Which of the following is a reversible cause of bradycardia? - ✔✔Toxins/poisons/drugs You are participating in the resuscitation of a 6-month-old patient weighing 7 kilograms who is in pulseless electrical arrest (PEA). High quality CPR is being administered, IV access has been obtained and BLS ventilations are working well. The team leader orders epinephrine 1:10,000 at a dose of 0.1 mg/kg IV with a 20ml saline flush. On receiving this order from the team leader as the person in charge of medications you should: - ✔✔recheck order dosage (0.01mg/kg for pusless IV) You should immediately start compressions if the pediatric patient has a heart rate below ___ beats per minute and is showing signs of cardiorespiratory compromise. - ✔✔ 60 Your patient presents in the emergency department with her parents. She is 4 years old and had eaten a cookie at the neighbor's house this morning. The patient has no medical history and a possible allergy to peanuts. The patient presents as anxious with her focus appearing to be on breathing. Her breathing effort is increased and labored with accessory muscle usage. The patient exhibits audible stridor. The patient further presents with peripheral cyanosis to the lips, hands and feet. What is the assessment tool you used to find this presentation? - ✔✔PATs While assessing a patient brought to you by very frantic parents, you note the patient to be alert to loud verbal stimuli only, tachypneic, tacyhcardic, exhibiting an increase in work of breathing, audible expiratory wheezing and pale. This patient is presenting with the clinical signs of: - ✔✔respiratory distress You are evaluating a 3-year-old female patient in the emergency department. Her parents brought her in for an evaluation of increasing cough, difficulty breathing, sputum and now increased irritability. On assessing your patient, you note a temperature of 100.4 F, respiratory rate of 38, and a room air SpO2 of 93%. With this information you can infer that the patient's airway resistance is: - ✔✔increased