PALS Exam Questions: Pediatric Advanced Life Support Review, Exams of Nursing

A series of questions and answers related to pediatric advanced life support (pals) guidelines and protocols. It covers various emergency scenarios, assessment techniques, and interventions relevant to pediatric patients experiencing cardiac arrest, respiratory distress, and shock. The content includes ecg interpretation, medication administration, and critical decision-making in pediatric emergencies. It is useful for healthcare providers seeking to enhance their knowledge and skills in pediatric resuscitation and emergency care. Practical insights into the management of pediatric emergencies, making it a valuable resource for medical professionals involved in pediatric care. It is designed to improve the readiness and effectiveness of healthcare teams in managing critical pediatric cases.

Typology: Exams

2024/2025

Available from 07/09/2025

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PALS FINAL RED CROSS
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? -
sudden infant death syndrome is the most common cause in infants younger than 6 โ˜‘๏ธ๎˜‚
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? -
End-tidal carbon dioxide level between 15 and 20 mmHgโ˜‘๏ธ๎˜‚
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? -
The primary therapeutic goal in shock, regardless of cause, is to restore a favorable โ˜‘๏ธ๎˜‚
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? -
Decreased level of consciousness, Hypotension, Difficulty breathing, Mottlingโ˜‘๏ธ๎˜‚
A child is experiencing shock. The emergency response team prepares for imminent cardiac arrest
when assessment reveals which finding(s)? -
Hypotension, Bradycardia, Diminished central pulsesโ˜‘๏ธ๎˜‚
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? -
Albuterol plus ipratropium bromideโ˜‘๏ธ๎˜‚
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? -
Ensuring adequate mean arterial pressureโ˜‘๏ธ๎˜‚
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? -
pulseless ventricular tachycardia (pVT)โ˜‘๏ธ๎˜‚
Which action would the PALS resuscitation team initiate to minimize increased intracranial
pressure after cardiac arrest? -
Maintain the head in midline position with 30-degree elevationโ˜‘๏ธ๎˜‚
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? -
Rapid assessmentโ˜‘๏ธ๎˜‚
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PALS FINAL RED CROSS

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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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)? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ pulseless ventricular tachycardia (pVT) Which action would the PALS resuscitation team initiate to minimize increased intracranial pressure after cardiac arrest? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ Bronchiolitis A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest. For which rhythm(s) would this action be appropriate? - โ˜‘๏ธ 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? - โ˜‘๏ธ Deliver 1 BVM ventilation every 3 to 5 seconds 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? - โ˜‘๏ธ Summary of the event, including what actions were taken, Discussion of the pros and cons of the interventions, Identification of ways to improve, Evaluation of the objective data gathered during the event An advanced airway was placed in a 5-year-old child. Which action(s) would be most appropriate for the team to take to confirm correct placement? - โ˜‘๏ธ Auscultate over the lungs and epigastrium for air movement, Observe for bilateral chest rise, Evaluate results of capnography. 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? - โ˜‘๏ธ Sinus tachycardia 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? - โ˜‘๏ธ Supraventricular tachycardia A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the provider administer? - โ˜‘๏ธ Corticosteroids, Racemic epinephrine

A provider is assessing a child with suspected shock. Which statement correctly describes hypotension and shock? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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)? - โ˜‘๏ธ 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? - โ˜‘๏ธ 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

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 and is not breathing and has no pulse. The nurse initiates CPR. At what rate and depth would the nurse deliver compressions to this child? - โ˜‘๏ธ 100 to 120 compressions per minute at a depth of about 2 inches An unresponsive 7-year-old child with no pulse is brought to the pediatric urgent care center by his parents and CPR is initiated. The cardiac monitor reveals ventricular fibrillation. Which action would the PALS team take first? - โ˜‘๏ธ Initiate defibrillation with 2 J/kg. Following a cardiac arrest, a child is experiencing post-cardiac arrest hemodynamic instability. The PALS resuscitation team would administer which element to restore intravascular volume and optimize preload? - โ˜‘๏ธ Isotonic fluid boluses A child experiencing unstable bradycardia is receiving CPR. Despite efforts with CPR, the child's status remains unchanged. Which medication would the emergency response team expect to administer next? - โ˜‘๏ธ Epinephrine An 11-year-old child develops unstable wide complex tachycardia. Assessment reveals signs of significant hemodynamic compromise, but the child has a pulse. The PALS team would prepare the child for which intervention? - โ˜‘๏ธ Synchronized cardioversion 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 provider administers oxygen by nasal cannula with the goal of improving the child's oxygen saturation to at least what percentage? - โ˜‘๏ธ 94% A child is experiencing stable supraventricular tachycardia (SVT) and is to receive treatment. Which initial treatment would the provider administer? - โ˜‘๏ธ Vagal maneuvers 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 rapid assessment of the child, the provider hears audible inspiratory stridor. Which diagnosis would the provider most likely suspect? Select the correct answer to this - โ˜‘๏ธ Croup 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? - โ˜‘๏ธ Lactate