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1 / 1.In which of the following situations may IO access be used? Answer> An extremity with slow capillary refill time. 2.A 2 - week old infant is being evaluated irritability and poor feeding. His blood pressure is 55/40 mm Hg and capillary refill time is 5 seconds. Which statement best describes your assessment of this infants blood pressure? Answer> It is Hypotensive 3.You are caring for patients in the emergency department. Which two year old requires immediate interventions? Answer> A child who is grunting 4.A 3 year old child is having difficulty breathing. What finding would most likely lead you to expect an upper airway obstruction
PALS TEST QU
2 / in this child? Answer> Increased inspiratory effort with retractions 5.A team member is unable to perform an assigned task because it is beyond the team member's scope of practice. What action should the team member take? Answer> Ask for a new task or role. 6.You are the team lead during a pediatric resuscitation attempt. Which action is high quality CPR? Answer> Allow complete chest wall recoil after each compression. 7.A 8 year old child is brought to the emergency department by his mother for difficultly breathing. He has a history is asthma and nut allergies. His mother tells you that he has recently ate a cookie at a family picnic. Which condition is most likely present with this child? Answer> Upper airy way obstruction 8.An 8-year-old child is brought to the emergency department by ambulance after being involved in a motor vehicle collision. What finding would suggest that immediate intervention is needed? Answer> Decreased level of consciousness
4 / lungs reveals bilateral crackles.
- What assessment finding is consistent with respiratory failure in this child? Answer> Oxygen Saturation 12.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 oxygen satu- ration is 72% on room air and 89% when on a nonrebreathing oxygen mask. He has shallow respirations with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles. What medication would be most appropriate? Answer> Antibiotics 13.During a resuscitation attempt, the Team Leader asks you to administer an initial dose of epinephrine at 0.1 mg/kg to be given IO. How should you respond? Answer> I think the correct dose is 0.01 mg/kg. Should I give that dose instead?' 14.A 6-month-old infant is unresponsive. You begin checking for
5 / breathing at the same time you check for the infant's pulse. What is the maximum time you should spend trying to simultaneously check for breathing and palpate the infant's pulse before starting CPR? Answer> 10 seconds 15.A 10-year-old child is being evaluated for a headache. What is a normal finding for this 10-year-old child? Answer> Heart rate of 88 bpm 16.A 6-year-old boy is being evaluated for difficulty breathing. What finding would suggest this child has respiratory distress? Answer> Audible inspiratory stridor
- A 4-year-old child in cardiac arrest is brought to the emergency department by ambulance. High-quality CPR is being performed. The cardiac monitor displays the rhythm strip shown here. The estimated weight of the child is 20 kg. What dosage range should you use for initial defibrillation? Answer> 2 to 4 J/kg
- A 4-year-old child in cardiac arrest is brought to the emergency department by ambulance. High-quality CPR is being
7 / life-threatening condition could this child's condition most likely progress to if left untreated? Answer> Respiratory Failure 22.You are evaluating a 10-year-old child who is febrile and tachycardic. The child's capillary refill time is 5 seconds. What parameter will determine if the child is in compensated shock? Answer> Blood Pressure 23.An 18-month old has had vomiting and diarrhea for the past 2 days; the mother brings him to the emergency department because he is becoming more lethargic. What diagnostic test should you order first? Answer> Blood Glucose 24.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 heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 5 seconds, and he has
8 / mottled, cool extremities. The infant weighs 6 kg.
- What assessment finding indicates that the infant has hypotensive shock?- Answer> Blood Pressure 25.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 heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 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? Answer> Hypovolemic Shock 26.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 heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is
10 / 18 What is the most likely cause of this infant's respiratory distress? Answer> Upper airway obstruction 29.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 infant's SpOz is 94%. On auscultation, the lungs are clear bilaterally. What medication should you administer first? Answer> Epinephrine, nebulized 30.What condition is characterized by a prolonged expiratory phase and wheezing? Answer> Lower airway obstruction 31.A 5-year-old child is brought to the emergency department by ambulance after being involved in a motor vehicle collision. You are using the primary assessment to evaluate the child. When assessing the child's neurologic status, you note that he has spontaneous eye opening, is fully oriented, and is able to follow commands. How would you document this child's AVPU (Alert, Voice, Painful, Unresponsive) Pediatric Response Scale finding?
11 / 18 Answer> Alert 32.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. What condition is most consistent with your assessment? Answer> Disordered control of breathing 33.You are evaluating a 1-year-old child for respiratory distress. His heart rate 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, what is the most likely reason for this change in the child's condition? Answer> The child has signs of respiratory failure. 34.A 7-year-old child in cardiac arrest is brought to the emergency department by ambulance. No palpable pulses are detected. The child's ECG is shown here. How would you characterize this child's rhythm? Answer> Pulseless electrical activity 35.After rectal administration of diazepam, an 8-year-old boy with
13 / 18 37.You are performing the airway component of the primary assessment. What finding would lead you to conclude that the child has an upper airway obstruction? Answer> Inspiratory strides 38.In management of post-cardiac arrest patients, extra care should be taken to avoid reperfusion injury. What should the ideal oxygen saturation range most likely be? Answer> 94%- 99% 39.You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is responsive, but she does not feel well and appears to be flushed. Her temperature is 39°C (102.2°F), heart rate is 118/min, respiratory rate is 36/min, blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air. Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% oxygen by nonrebreathing mask. Laboratory studies document lactic acidosis. On the basis of the patient's clinical assessment and history, what type of shock does this patient most likely have?
14 / 18 Answer> Distributive, septic 40.You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is responsive, but she does not feel well and appears to be flushed. Her temperature is 39°C (102.2°F), heart rate is 118/min, respiratory rate is 36/min, blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air. Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% oxygen by nonrebreathing mask. What assessment finding is most important in your determination of the severity of the patient's condition? Answer> Blood pressure 41.You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is responsive, but she does not feel well and appears to be flushed. Her temperature is 39°C (102.2°F), heart rate is 118/min, respiratory rate is 36/min, blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air. Your assessment reveals mild increase in work of breathing and
16 / 18 additional early intervention should you provide to this patient? Answer> Antibiotic administration 43.A 10-year-old child is brought to the emergency department for fever and cough. You obtain an oxygen saturation on the child. What oxygen saturation would indicate that immediate intervention is needed? Answer> 88% on 4 L/min of nasal oxygen 44.An unresponsive 14-year-old girl is pale and cool to the touch. Her blood pressure is 70/45 mm Hg, heart rate is 190/min, and respiratory rate is 12/min. The Spoz is not detectable. Capillary refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. Answer> Supraventricular tachycardia 45.If pharmacological interventions are unavailable or delayed, what interven- tion is indicated? Answer> Synchronized cardioversion 46.The parents of a 7-year-old child who is undergoing
17 / 18 chemotherapy report that the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals that the child is difficult to arouse, and her skin color is pale. The child's heart rate is 160/min, respiratory rate is 38/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds, and tem- perature is 39.4°C (103°F). I access has been established, and blood cultures have been obtained. What is the most appropriate intervention? Answer> Administer 10 to 20 mL/kg of isotonic crystalloid over 5 to 10 minutes 47.An unresponsive 9-year-old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His blood pressure is 80/40 mm Hg, heart rate is 45/min, respiratory rate is 6/min, and Spoz is 60% on room air. He is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here. Answer> Sinus Bradycardia 48.An unresponsive 9-year-old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His blood pressure is 80/40 mm Hg, heart rate is 45/min, respiratory rate is
