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A comprehensive set of questions and answers related to the pediatric advanced life support (pals) final exam. It covers a wide range of topics, including cardiac arrest, shock, respiratory distress, and arrhythmias. Designed to help healthcare professionals prepare for the pals exam and enhance their knowledge and skills in pediatric emergency care.
Typology: Exams
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A 4-month old infant is brought to the emergency department in cardiac arrest. Which condition would the team identify as the most common cause of cardiac arrest in an infant of this age? - Ans: sudden infant death syndrome is the most common cause in infants younger than 6 months of age. The PALS resuscitation team is providing care to an intubated child in cardiac arrest. Which result best determines the adequacy of the team's chest compressions? - Ans: End-tidal carbon dioxide level between 15 and 20 mmHg The emergency response team is providing care to a preschooler who is experiencing shock. Which therapeutic goal, common to all types of shock, does the team work to achieve? - Ans: The primary therapeutic goal in shock, regardless of cause, is to restore a favorable balance between oxygen delivery and oxygen demand. A 9-year-old child is brought to the emergency department because the child suddenly collapsed at school. The child's ECG reveals the following waveform, and primary assessment findings indicate that the child is hemodynamically unstable. Which primary assessment findings indicate this? - Ans: Decreased level of consciousness, Hypotension, Difficulty breathing, Mottling A child is experiencing shock. The emergency response team prepares for imminent cardiac arrest when assessment reveals which finding(s)? - Ans: Hypotension, Bradycardia, Diminished central pulses 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 first? - Ans: Albuterol plus ipratropium bromide 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? - Ans: Ensuring adequate mean arterial pressure
child in the pediatric intensive care unit displays the following ECG waveform and does not have a palpable central pulse. The resuscitation team interprets this as which arrhythmia? - Ans: pulseless ventricular tachycardia (pVT) Which action would the PALS resuscitation team initiate to minimize increased intracranial pressure after cardiac arrest? - Ans: Maintain the head in midline position with 30-degree elevation 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? - Ans: Rapid assessment A provider is forming an initial impression of a child using the Pediatric Assessment Triangle (PAT). During which step of the PAT may the provider use the mnemonic TICLS to assess the patient? - Ans: Appearance A 9-year-old patient is presenting with decreased breath sounds, bradycardia, slowed respiratory rate and a low O2 saturation level. The provider interprets these findings as indicating which condition? - Ans: Respiratory failure 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? - Ans: Bronchiolitis A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest. For which rhythm(s) would this action be appropriate? - Ans: Ventricular fibrillation (VF), Pulseless ventricular tachycardia (pVT), A 4-year-old child is brought to the emergency department by the parents. Assessment reveals that the child is gasping and the pulse rate is 65 beats per minute. Which action would the provider initiate first?
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? - Ans: 5 seconds, but no more than
A 12-lead ECG is ordered for a child complaining of a "racing heart." When placing the electrodes on the child, at which location would the lead for V4 be placed? - Ans: fifth intercostal space at the midclavicular line on the patient's left side. A child who is stable and exhibiting a wide-complex tachycardia is to receive adenosine. The provider would be alert for which result after administering this medication? - Ans: Transient asystole 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? - Ans: Torsades de pointes 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? - Ans: Estimate weight using a length-based resuscitation tape. 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? - Ans: Sternal retractions, Nasal flaring, Accessory muscle use Primary assessment of a 10-year-old child reveals septic shock. As part of the secondary assessment, laboratory testing is completed to evaluate the child's status. Which finding(s) would support the diagnosis? - Ans: Elevated creatinine level, Elevated lactate level, Prolonged prothrombin time (PT) A provider is assessing a child with suspected shock. Which statement correctly describes hypotension and shock? - Ans: Hypotension is not a consistent feature of shock in children. While formulating initial impressions using the Pediatric Assessment Triangle, the provider assesses the child's circulation. Which information would be important to consider? - Ans: Skin pallor (or gray/dusky color), Evidence of bleeding, Flushing of the skin
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? - Ans: Second-degree atrioventricular (AV) block, type I A 6-year-old patient is brought to the emergency department after a bicycle accident. Assessment reveals tracheal deviation to the left side, chest pain on inspiration and decreased breath sounds on the right side. The provider suspects obstructive shock caused by what condition? - Ans: Tension pneumothorax 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 shock. Which type of shock would the provider most likely suspect? - Ans: Hypovolemic shock 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? - Ans: Airway clearance 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? - Ans: First-degree AV block A child requires cardiac monitoring. A three-electrode system is being used. At which location would the provider place the red electrode? - Ans: On the lower left abdomen 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)? - Ans: Fever, Hyperglycemia, Hypotension 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? - Ans: Allowing the chest to recoil fully after each compression, Giving 2 ventilations to every 15 compressions, Providing ventilations that last about 1 second each, Compressing the chest about 2 inches
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 oxygen delivery? - Ans: Lactate