PALS UPDATED 2023 FINAL EXAM(Answered;graded A+)

PALS UPDATED 2023 FINAL EXAM

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?

Correct answer- second degree

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?

Correct answer- Lactate

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?

Correct answer- Respiratory failure

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?

Correct answer- Deliver 1 BVM ventilation every 3 to 5 seconds.

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?

Correct answer- First-degree atrioventricular (AV) block

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)?

Correct answer- Hypotension

Fever

Hyperglycemia

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?

Correct answer- 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

A PALS resuscitation team is preparing to defibrillate a child experiencing cardiac

arrest. For which rhythm(s) would this action be appropriate?

Correct answer- VF and pVT are shockable cardiac arrest rhythms.

A provider is assessing a child with suspected shock. Which statement correctly

describes hypotension and shock?

Correct answer- Hypotension is not a consistent feature of shock;

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 above

what percentage?

Correct answer- Supplemental oxygen should be administered as needed to maintain

an oxygen saturation above 94%.

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 first?

Correct answer- Albuterol plus ipratropium bromid

A child in the pediatric step-down unit is exhibiting signs of respiratory distress. When

assessing this child, which circulation finding might be present?

Correct answer- Pallor is a circulation finding that may be seen in patients with

respiratory distress.

A healthcare provider is performing a primary assessment of a child in respiratory

distress. The provider documents increased work of breathing when which findings are

observed?

Correct answer- Nasal flaring, use of accessory muscles to breathe and intercostal,

substernal or suprasternal retractions are all indicators of increased work or effort of

breathing. Grunting and inspiratory stridor are abnormal breath sounds.

An 11-year-old child develops unstable wide-complex tachycardia. Assessment reveals

signs of significant hemodynamic compromise, but the child has a pulse. The PALS

team would prepare the child for which intervention?

Correct answer- First-line treatment for unstable wide-complex tachycardias consists of

synchronized electrical cardioversion, particularly when signs of hemodynamic

compromise are apparent.