1. 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? Ans- second degree 2. Laboratory tests are ordered for a child who has been vomiting for 3 daysand is diaphoretic, tachypneic, lethargic and pale. Which test would the provider use to determine the adequacy of oxygen delivery? Ans- Lactate 3. 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? Ans- Respiratory failure 4. 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 pulserate is 65 beats per minute. Which action would the provider initiate first? Ans- Deliver 1 BVM ventilation every 3 to 5 seconds. 5. 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? Ans- First-degree atrioventricular (AV) block 6. A child in cardiac arrest experiences return of spontaneous circulation but isexhibiting 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)? Ans- Hypotension Fever Hyperglycemia 7. A 2-year-old child arrives at the emergency department with the parents. Thechild 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? Ans- Allowing the chest to recoil fully after each compression Providing ventilations that last about 1 second each Compressing the chest about 2 inches Giving 2 ventilations to every 15 compressions 8. A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac arrest. For which rhythm(s) would this action be appropriate? Ans- VF and pVT are shockable cardiac arrest rhythms. 9. A provider is assessing a child with suspected shock. Which statementcorrectly describes hypotension and shock? Ans- Hypotension is not a consistent feature of shock; 10.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 ofimproving the child's oxygen saturation above what percentage? Ans- Supplemental oxygen should be administered as needed to maintain anoxygen saturation above 94%. 11.An 11-year-old soccer player is brought to the emergency department. Aftera quick assessment, the team realizes this patient is experiencing a severe asthma exacerbation. Which medication would the team administer first? Ans- Albuterol plus ipratropium bromid 12.A child in the pediatric step-down unit is exhibiting signs of respiratory distress. When assessing this child, which circulation finding might be present? Ans- Pallor is a circulation finding that may be seen in patients with respiratory distress

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