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A study guide or practice exam for the pediatric advanced life support (pals) certification exam. It covers a wide range of topics related to pediatric emergency care, including assessment, recognition of arrhythmias, shock management, airway management, and post-cardiac arrest care. Multiple-choice questions with detailed explanations of the correct answers, which could be useful for healthcare providers preparing for the pals exam or reviewing their knowledge of pediatric emergency care. The content is comprehensive and covers key concepts that are essential for providing high-quality, evidence-based care to critically ill or injured children. This document could serve as a valuable resource for medical students, nursing students, paramedics, and other healthcare professionals who work with pediatric patients in emergency or critical care settings.
Typology: Exams
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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? - ✔✔Lactate 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? - ✔✔Appearance 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? - ✔✔Supraventricular tachycardia 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? - ✔✔Estimate weight using a length-based resuscitation tape. 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? - ✔✔Respiratory failure 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? - ✔✔Airway clearance An 8-year-old child being treated in the emergency department has significant respiratory distress. The child also exhibits hives, wheezing, angioedema, tachycardia and tachypnea. The parents state that the child, who is allergic to peanuts, had eaten some popcorn that had peanuts in it. The team initiates care, preparing to administer which agent first? - ✔✔Epinephrine 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? - ✔✔Fifth intercostal space at midclavicular line, left side
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? - ✔✔At least 5 seconds, but no more than 10 A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the provider administer? - ✔✔1. Racemic epinephrine
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? - ✔✔1. Identification of ways to improve
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? - ✔✔Ensure adequate mean arterial pressure. 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 mmHg A child requires cardiac monitoring. A three-electrode system is being used. At which location would the provider place the red electrode? - ✔✔On the lower left abdomen 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? - ✔✔Sinus tachycardia 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? - ✔✔100 to 120 compressions per minute at a depth of about 2 inches 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? - ✔✔Restore balance between oxygen delivery and demand. 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? - ✔✔1. Allowing the chest to recoil fully after each compression
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? - ✔✔Tension pneumothorax 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? - ✔✔Initiate defibrillation with 2 J/kg. 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? - ✔✔1. Prolonged prothrombin time (PT)
suspects that the child may be experiencing shock. Which type of shock would the provider most likely suspect? - ✔✔Hypovolemic 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? - ✔✔94% 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 assessment 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? - ✔✔1. Decreased level of consciousness