PALS Precourse Test with 100% Correct Verified Answers and Questions, Exams of Nursing

Download PALS Precourse Test with 100% Correct Verified Answers and Questions and more Exams Nursing in PDF only on Docsity! PALS PRECOURSE TEST WITH 100% CORRECT VERIFIED ANSWERS AND QUESTIONS A COMPLETE SOLUTION BEST GRADED TO SCORE A+ FOR SUCCESS Initial impression of a 10-year-old male shows him to be unresponsive. You shout for help, check breathing or only gasping. After finding that he is pulseless, you begin CPR. A colleague arrives and places the child on a cardiac monitor, revealing the above rhythm (V Tach). The two of you attempt defibrillation at 2 J/kg and give 2 minutes of CPR. The rhythm persists at the second rhythm check, at which point you attempt defibrillation using 4 J/kg. A third colleague establishes IO access and administers one dose of epinephrine 0.01 mg/kg (0.1 mL/kg of 1:10,0000) during the compressions following the second shock. If VF or pulseless VT persists after 2 minutes of CPR, what is the next drug/dose to administer? A. Adenosine 0.1 mg/kg IV B. Amiodarone 5 mg/kg IV C. Epinephrine 0.1 mg/kg (0.1 mL/kg of 1:1,000) IV D. Atropine 0.02 mg/kg IV - CORRECT ANSWERS B You are supervising another healthcare provider who is inserting an intraosseous (IO) needle into an infant's tibia. Which of the following signs should you tell the provider is the best indication of successful insertion of a needle into the bone marrow cavity? A. You are unable to aspirate any blood through the needle. B. Pulsatile blood flow will be present in the needle hub. C. Once inserted, the shaft of the needle moves easily in all directions within the bone. D. Fluids can be administered freely without local soft tissue swelling. - CORRECT ANSWERS D You are evaluating an irritable 6-year-old girl with mottled color. On primary assessment she is febrile ( temperature 104 F) and her extremities are cold (despite a warm ambient PALS PRECOURSE TEST WITH 100% CORRECT VERIFIED ANSWERS AND QUESTIONS A COMPLETE SOLUTION BEST GRADED TO SCORE A+ FOR SUCCESS temperature in the room) with cap refill of 5 seconds. Distal pulses are absent and central pulses are weak. Heart rate is 180/min, respiratory rate is 45/min, and blood pressure is 98/56. Which of the following most accurately describes the categorization of this chil's condition using the terminology taught in the PALS Provider Course? A. Hypotensive shock associated with inadequate tissue perfusion. B. Compensated shock associated with tachycardia and inadequate tissue perfusion. C. Hypotensive shock associated with inadequate tissue perfusion and significant hypotension. D. Compensated shock requiring no intervention. - CORRECT ANSWERS B You are caring for a 3-year-old with vomiting and diarrhea. You have established IV access. When you place an orogastric tube, the child begins gagging and continues to gag after the tube is placed. The child's color has deteriorated; pulses are palpable but faint and the child is now lethargic. The heart rate is variable (range 44/min to 62/min). You begin bag-mask ventilation with 100% oxygen. When the heart rate does not improve, you begin chest compressions. The cardiac monitor shows the above rhythm (Sinus Bradycardia at 50 bpm). Which of the following would be the most appropriate therapy to consider next. A. Cardiology consult for transcutaneous pacing. B. Epinephrine 0.1 mg/kg (0.1 mL/kg of 1:1,000) IV C. Atropine 0.02 mg/kg IV D. Attempt synchronized cardioversion at 0.5 J/kg - CORRECT ANSWERS C An 18-month-old child presents with a 1-week history of cough and runny nose. Your initial impression is a toddler responsive only to painful stimulation with slow respirations and PALS PRECOURSE TEST WITH 100% CORRECT VERIFIED ANSWERS AND QUESTIONS A COMPLETE SOLUTION BEST GRADED TO SCORE A+ FOR SUCCESS B. Amiodarone 5 mg/kg IV/IO C. Albuterol by nebulization D. Procainamide 15 mg/kg IV/IO - CORRECT ANSWERS C You are called to help resuscitate an infant with severe symptomatic bradycardia associated with respiratory distress. The bradycardia persists despite establishment of an effective airway, oxygenation, and ventilation. There is no heart block present. Which of the following is the first drug you should administer? A. Dopamine B. Adenosine C. Atropine D. Epinephrine - CORRECT ANSWERS D An infant with a history of vomiting and diarrhea arrives by ambulance. During your primary assessment the infant responds only to painful stimulation. The upper airway is patent, the repiratory rate is 40/min with good bilateral breath sounds, and 100% oxygen is being administered. The infant has cool extremities, weak pulses, and a cap refill of more than 5 seconds. The infant's BP is 85/65 mm Hg and glucose concentration is 30 mg/dL (1.65 mmol/L). Which of the following is the most appropriate treatment to provide for this infant? A. Establish IV or IO access, administer 20 mL/kg isotonic crystalloid over 10 to 20 minutes, and simultaneously administer D25W 2 to 4 mL/kg in a separate infusion. B. Establish IV or IO access and administer 20 mL/kg D50 .45% sodium chloride bolus over 15 minutes. PALS PRECOURSE TEST WITH 100% CORRECT VERIFIED ANSWERS AND QUESTIONS A COMPLETE SOLUTION BEST GRADED TO SCORE A+ FOR SUCCESS C. Establish IV or IO access and administer 20 mL/kg Lactated Ringer's solution over 60 minutes. D. Perform endotrachea - CORRECT ANSWERS A Which of the following statements about endotracheal drug administration is true? A. Endotracheal doses of resuscitation drugs in children have been well established and are supported by evidence from clinical trials. B. Endotracheal drug administration is the least desirable route of administration because of this route results in unpredictable drug levels and effects. C. Endotracheal drug administration is the preferred route of drug administration dring resuscitation because is results in predictable drug levels and drug effects. D. Intravenous drug doses for resuscitation drugs should be used whther you give the drugs by the IV, IO, or the endotracheal route. - CORRECT ANSWERS B Which of the following statements most accurately reflects the PALS recommendations for the use of magnesium sulfate in the treatment of cardiac arrest? A. Routine use of magnesium sulfate is indicated for shock-refractory monomorphic VT. B. Magnesium sulfate is indicated for torsades de pointes and VF/ pulseless VT associated with suspected hypomagnesemia. C. Magnesium sulfate is indicated for VF refractory to repeated shocks and amiodarone or lidocaine. PALS PRECOURSE TEST WITH 100% CORRECT VERIFIED ANSWERS AND QUESTIONS A COMPLETE SOLUTION BEST GRADED TO SCORE A+ FOR SUCCESS D. Magnesium sulfate is contraindicated in VT associated with an abnormal QT interval during the preceding sinus rhythm. - CORRECT ANSWERS B Initial impression of a 2-year-old female reveals her to be alert with mild breathing difficulty during inspiration and pale skin color. On primary assessment, she makes high-pitched inspiratory sounds (mild stridor) when agitated; otherwise, her breathing is quiet. Her SpO2 is 92% in room air, and she has mild inspiratory intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with adequate distal breath sounds bilaterally. Which of the following is the most appropriate initial therapeutic intervention for this child? A. Administer an IV dose of dexamethasone B. Perform immediate endotracheal intubation C. Administer humidified supplementary oxygen as tolerated and continue evaluation D. Nebulize 2.5 mg of albuterol - CORRECT ANSWERS C Which of the following statements about the effects of epinephrine during attempted resuscitation is true? A. Epinephrine decreases the peripheral vascular resistance and reduces myocardial afterload so that ventricular contractions are more effective B. Epinephrine is contraindicated in ventricular fibrillation because it increases myocardial irritability. C. Epinephrine improves coronary artery perfusion pressure and stimulates spontaneous contractions when asystole is present. D. Epinephrine decreases myocardial oxygen consumption. - CORRECT ANSWERS C PALS PRECOURSE TEST WITH 100% CORRECT VERIFIED ANSWERS AND QUESTIONS A COMPLETE SOLUTION BEST GRADED TO SCORE A+ FOR SUCCESS heart rate. Secondary assessment reveals no history of congenital heart disease. IV access has been established. Which of the following therapies is most appropriate for this infant? A. Adenosine 0.1 mg/kg IV rapidly; if adenosine is not immediately available, perform synchronized cardioversion. - CORRECT ANSWERS A You are preparing to use a manual defibrillator and paddles in the pediatric setting. When would it be most appropriate to use the smaller "pediatric" sized paddles for shock delivery? A. If the patient weighs less than approximately 10 kg or is less than 1 year of age. B. Whenever you can compress the victim's chest using only the heel of one hand C. To attempt synchronized cardioversion but not defibrillation D. If the patient weighs less than approximately 25 kg, or is less than 8 years of age. - CORRECT ANSWERS A You are transporting a 6-year-old endotracheally intubated patient who is receiving positive- pressure mechanical ventilation. The child begins to move his head and suddenly becomes cyanotic and bradycardic. SpO2 is 65% with good pulse signal. You remove the child from the mechanical ventilator circuit and provide manual ventilation with a bag via the endotracheal tube. During manual ventilation with 100% oxygen, the child's color and heart rate improve slightly and his blood pressure remains adequate. Breath sounds and chest expansion are present and adequate on the right side, but they are consistently diminished on the left side. The trachea is not deviated, and the neck veins are not distended. A suction catheter passes easily beyond the tip of the endotracheal tube. Which of the following is the most likely cause of this child's acute deterioration? A. Tracheal tube displacement into the right main bronchus B. - CORRECT ANSWERS A PALS PRECOURSE TEST WITH 100% CORRECT VERIFIED ANSWERS AND QUESTIONS A COMPLETE SOLUTION BEST GRADED TO SCORE A+ FOR SUCCESS A child becomes unresponsive in the emergency department and is not breathing. You provide ventilation with 100% oxygen. You are uncertain if a faint pulse is present with the above rhythm (asystole). What is your next action? A. Order transcutaneous pacing. B. Start high quality CPR, beginning with compressions. C. Start an IV and give atropine 0.01 mg/kg IV D. Start an IV and give epinephrine 0.01 mg/kg IV (0.1 mL/kg of 1:10,000) - CORRECT ANSWERS B You have just assisted with the elective endotracheal intubation of a child with respiratory failure and a perfusing rhythm. Which of the following provides the most reliable, prompt assessment of correct endotracheal tube placement in this child? A. Absence of audible breath sounds over the abdomen during positive-pressure ventilation. B. Auscultation of breath sounds over the lateral chest bilaterally plus presence of mist in the endotracheal tube. C. Clinical assessment of adequate bilateral breath sounds and chest expansion plus presence of exhaled CO2 in a colormetric detection device after delivery of 6 positive- pressure ventilations. D. Confirmation of appropriate oxygen and carbon dioxide tensions on arterial blood gas analysis. - CORRECT ANSWERS C PALS PRECOURSE TEST WITH 100% CORRECT VERIFIED ANSWERS AND QUESTIONS A COMPLETE SOLUTION BEST GRADED TO SCORE A+ FOR SUCCESS An 8-year-old child was struck by a car. He arrives in the emergency department alert, anxious, and in respiratory distress. His cervical spine is immobilized, and he is receiving a 10 L/min flow of 100% oxygen by nonrebreathing face mask. PRimary assessment reveals respiratory rate 60/min, heart rate 150/min, systolic blood pressure 70, and SpO2 84% on supplementary oxygen. Breath sounds are absent over the right chest, and the trachea is deviated to the left. He has weak central pulses and absent distal pulses. Which of the following is the most appropriate immediate intervention for this child? A. Provide bag-mask ventilation and call for a STAT chest x-ray B. Perform needle decompression of the right chest and assist ventilation with a bag and mask if necessary. C. Establish IV access and administer a 20 mL/kg normal saline fluid bolus D. Perform endotracheal intubation and call for a STAT chest x-ray - CORRECT ANSWERS B A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is ongoing. The child is intubated and vascular access is established. The ECG monitor reveals an organized rhythm, but a pulse check reveals no palpable pulses. Effective ventilations and compressions are resumed, and an initial IV dose of epinephrine is administered. Which of the following therapies should you perform next? A. Administer synchronized cardioversion at 1 J/kg B. Administer epinephrine 0.1 mg/kg IV (0.1 mL/kg of 1:1,000) C. Attempt defibrillation at 4 J/kg D. Attempt to identify and treat reversible causes (using the H's and T's as a memory aid) - CORRECT ANSWERS D