PALS RED CROSS FINAL EXAM

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 (e.g., suctioning)

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 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)? - Hypotension, fever,

hyperglycemia

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 immediately? - Albuterol

with or without ipratropium bromide

After ROSC, a child is experiencing post-cardiac arrest hypoperfusion. The PALS

resuscitation team would administer which element to restore intravascular volume and

optimize preload? - Isotonic fluid boluses

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 4-year-old child is brought to the emergency department by the parents. Assessment

reveals that the child has only gasping respirations and the pulse rate is 65 beats per

minute. Which action would the provider initiate first? - Deliver 1 BVM ventilation every 2

to 3 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? - Discussion of the pros

and cons of the interventions

Evaluation of the objective data gathered during the event, Summary of the event,

including what actions were taken, Identification of ways to improve

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? - Torsades

de pointes

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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 (e.g., suctioning) 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 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)? - Hypotension, fever, hyperglycemia 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 immediately? - Albuterol with or without ipratropium bromide After ROSC, a child is experiencing post-cardiac arrest hypoperfusion. The PALS resuscitation team would administer which element to restore intravascular volume and optimize preload? - Isotonic fluid boluses 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 4-year-old child is brought to the emergency department by the parents. Assessment reveals that the child has only gasping respirations and the pulse rate is 65 beats per minute. Which action would the provider initiate first? - Deliver 1 BVM ventilation every 2 to 3 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? - Discussion of the pros and cons of the interventions Evaluation of the objective data gathered during the event, Summary of the event, including what actions were taken, Identification of ways to improve 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? - Torsades de pointes

What is the correct IV/IO dose of epinephrine for a pediatric patient in cardiac arrest? - 0.01 mg/kg every 3 to 5 min (max single dose 1 mg) 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? - Bronchiolitis A child is experiencing supraventricular tachycardia (SVT) with adequate perfusion and is to receive treatment. Which initial treatment would the provider administer? - Vagal maneuvers A healthcare provider notices petechiae on the arms and legs while performing a rapid skin assessment of a child with a high fever and respiratory distress. Based on this assessment, which condition should the provider consider? - Life-threatening systemic infection A 7-year-old patient with septic shock has received three balanced/buffered crystalloid fluid boluses (60-mL/kg) and reassessment reveals capillary refill of 3 seconds, diminished pulses, narrow pulse pressure and cool, mottled extremities. The emergency response team interprets these findings as indicating which type of septic shock? - Fluid-refractory A 30-month old child has been diagnosed with moderate croup. Which medication(s) would the provider administer? - Nebulized epinephrine, Corticosteroids A child exhibiting a narrow-complex tachycardia with adequate perfusion is to receive adenosine. The provider would be alert for which result after administering this medication? - Transient asystole A child experiencing bradycardia with inadequate perfusion despite supporting oxygenation and ventilation is receiving compressions. Despite these efforts, the child's status remains unchanged. Which medication would the emergency response team expect to administer next? - Epinephrine A child in the pediatric intensive care unit displays the following ECG waveform. The child has no pulse. The resuscitation team interprets this as which arrhythmia? - Monomorphic pulseless ventricular tachycardia 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? - First-degree atrioventricular (AV) block

between tissue perfusion and metabolic demand with a focus on what? - Oxygen delivery and oxygen demand A 9-year-old patient is presenting with diminished breath sounds, bradycardia, slowed respiratory rate and a low O2 saturation level. The provider interprets these findings as indicating which condition? - Respiratory failure An 11-year-old child develops ventricular tachycardia with a pulse with inadequate perfusion. The PALS team would prepare the child for which intervention? - Synchronized electrical cardioversion A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest. For which rhythm(s) would this action be appropriate? - pVT, VF 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 perfusion and oxygen delivery? - Lactate 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, after assuring adequate oxygenation and ventilation? - Ensure adequate mean arterial pressure. A provider is forming an initial impression of a child using the Pediatric Assessment Triangle (PAT). For which part of the PAT may the provider use the mnemonic TICLS to assess the patient? - Appearance 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 common cause of partial upper airway obstruction in children would the provider most likely suspect? - Croup 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 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 6-year-old patient is brought to the emergency department after a bicycle accident. Assessment reveals chest pain on inspiration, diminished breath sounds on the right side, and respiratory distress. 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. 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? - Second- degree atrioventricular (AV) block, type I While performing a rapid assessment and formulating an initial impression using the Pediatric Assessment Triangle (PAT), the provider assesses the child's circulation. Which information would be important to consider? - Flushing of the skin Evidence of bleeding Skin pallor (or gray/dusky color) The PALS resuscitation team is providing care to an intubated child in cardiac arrest. Which of the following can be used to monitor the adequacy of the team's chest compressions? - End-tidal carbon dioxide levels Presence of an arterial waveform or arterial blood pressure in patients with indwelling arterial catheters An 8-year-old child being treated in the emergency department has significant respiratory distress. The child also exhibits hives, wheezing, angioedema, tachycardia and dyspnea. 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 provider is assessing a child with suspected shock. Which statement correctly describes hypotension and shock? - Hypotension is not a consistent feature of shock presentation in children. 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 what percentage range? - 94% to 99% What is considered inadequate perfusion when assessing/caring for a pediatric patient with an arrhythmia? - Diminished peripheral pulses Acutely altered mental status Hypotension

PALS RED CROSS FINAL EXAM, Exams of Advanced Education

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PALS RED CROSS FINAL EXAM