Pediatric Advanced Life Support Exam | PALS Test Exam 2024 with Questions and 100% Correct Answers
- In which of the following situations may IO access be used?
- An extremity with signs of infection
- An extremity with signs of a crush injury
- An extremity with a previous unsuccessful IO attempt
- An extremity with slow a capillary refill time
- A 2-week-old infant is being evaluated for irritability and poor feeding. His blood pressure is 55/40 mm Hg,
- It represents compensated shock.
- It is hypertensive.
- It is hypotensive.
- It is normal.
- You are caring for clients in the emergency department. Which 2-year-old child requires immediate
- A child who is grunting
- A child with an SpO2 of 95% on room air
- A child with a systolic blood pressure of 92 mm Hg
- A child with a temperature of 37.4°C (99.3°F)
Correct Answer D. Intraosseous (IO) cannulation is a relatively simple and effective method of rapidly establishing vascular access for emergency fluids or medications. It provides access to a noncollapsible marrow venous plexus, which serves as a rapid, safe, and reliable route for administration of drugs, crystalloids, colloids, and blood during resuscitation. IO access can be achieved in children of all ages, often in about 30 to 60 seconds.In certain circumstances (eg, cardiac arrest or severe shock with severe vasoconstriction), it may be considered for the initial vascular access attempted. [PALS Provider Manual, Part 10: Managing Shock > Resources for Managing Circulatory Emergencies > Intraosseous Access; page 223]
and capillary refill time is 5 seconds. Which statement best describes your assessment of this infant’s blood pressure?
Correct Answer C. The normal blood pressure for a 2-week-old infant should be within the systolic range of 67 to 84 mm Hg and a diastolic range of 35 to 53 mm Hg. [PALS Provider Manual, Part 4: Systematic Approach to the Seriously Ill or Injured Child > Primary Assessment > Circulation > Blood Pressure; page 57]
intervention?
Correct Answer A. Grunting produces early glottic closure during expiration. Grunting is a compensatory mechanism to maintain positive airway pressure and prevent collapse of the alveoli and small airways. Grunting is a serious sign and may indicate respiratory distress or respiratory failure. [PALS Provider Manual, Part 4: Systematic Approach to the Seriously Ill or Injured Child > Primary Assessment > Breathing > Lung and Airway Sounds > Grunting; page 50] 1 / 4
- A 3-year-old child is having difficulty breathing. What finding would most likely lead you to suspect an upper
- Expiratory breath sounds
- Decreased expiratory effort
- Increased inspiratory effort with retractions
- Normal inspiratory sounds
- A team member is unable to perform an assigned task because it is beyond the team member’s scope of
- Ask for a new task or role
- Refuse to perform the task
- Do it anyway
- Seek expert consultation
- You are the Team Leader during a pediatric resuscitation attempt. What action is an element of high-quality
- Providing a compression depth of one fourth the depth of the chest
- Providing a compression rate of 80 to 100/min
- Allowing complete chest wall recoil after each compression
- Performing pulse checks every minute
airway obstruction in this child?
Correct Answer C. The major clinical signs typically occur during the inspiratory phase of the respiratory cycle, such as stridor, hoarseness, or a change in voice or cry. Inspiratory retractions, use of accessory muscles, and nasal flaring are often present. The respiratory rate is often only mildly elevated because upper airway obstruction is worse with faster breathing. Examples include foreign body obstruction, croup, and epiglottitis. [PALS Provider Manual, Part 7: Recognizing Respiratory Distress and Failure > Identifying Respiratory Problems by Type > Upper Airway Obstruction > Signs of Upper Airway Obstruction; page 120]
practice. What action should the team member take?
Correct Answer A. Not only should everyone on the team know their own limitations and capabilities, but the Team Leader should also be aware of them. This allows the Team Leader to evaluate team resources and call for backup from team members when assistance is needed. High-performance team members should anticipate situations in which they might require assistance and inform the Team Leader. [PALS Provider Manual, Part 6: Effective High-Performance Team Dynamics > Elements of Effective High-Performance Team Dynamics > Knowing Your Limitations; page 105]
CPR?
Correct Answer C. During CPR, push fast (100 to 120 compressions per minute), push hard (at least one third the depth of the anteroposterior diameter of the chest, or about 2 inches for a child or about 1½ inches for an infant), allow complete chest recoil after each compression, minimize interruptions in chest compressions, and avoid excessive ventilation. [PALS Provider Manual, Part 5: Recognizing and Managing Cardiac Arrest > Managing Cardiac Arrest > Monitoring for CPR Quality; page 82] 2 / 4
- An 8-year-old child is brought to the emergency department by his mother for difficulty breathing. He has a
- Disordered control of breathing
- Hypovolemic shock
- Lung tissue disease
- Upper airway obstruction
- An 8-year-old child is brought to the emergency department by ambulance after being involved in a motor
- Decreased level of consciousness
- Systolic blood pressure of 106 mm Hg
- Temperature of 38.1°C (100.5°F)
- Warm, moist skin
- A 6-year-old child is found unresponsive, not breathing, and without a pulse. One healthcare worker leaves to
history of asthma and nut allergies. His mother tells you that he recently ate a cookie at a family picnic. What condition is most likely to be present in this child?
Correct Answer D. Common causes of upper airway obstruction are foreign-body aspiration (eg, food or a small object), infection, and swelling of the airway (eg, anaphylaxis, tonsillar hypertrophy, croup, or epiglottitis). [PALS Provider Manual, Part 7: Recognizing Respiratory Distress and Failure > Identifying Respiratory Problems by Type > Upper Airway Obstruction > Causes of Upper Airway Obstruction; page 119]
vehicle collision. What finding would suggest that immediate intervention is needed?
Correct Answer A. Signs of a life-threatening condition that would require immediate intervention include complete or severe airway obstruction (Airway); apnea, significant increased work of breathing, or bradypnea (Breathing); weak or absent pulses, poor perfusion, hypotension, or bradycardia (Circulation); unresponsiveness or decreased level of consciousness (Disability); and significant hypothermia, significant bleeding, petechiae, or purpura consistent with septic shock or coagulation problem (Exposure). [PALS Provider Manual, Part 5: Recognizing and Managing Cardiac Arrest > Life-Threatening Problems; page 73]
activate the emergency response system and get the resuscitation equipment. You and another healthcare provider immediately begin performing CPR. What compression-to-ventilation ratio do you use?
A. 15:1
B. 30:1
C. 15:2
D. 30:2
Correct Answer C. If 2 rescuers are present for the resuscitation attempt of an infant or a child, use a compression-to-ventilation ratio of 15:2. [PALS Provider Manual, Part 2: Review of BLS and AED for Infants and Children > BLS for Infants and Children > Infant/Child Chest Compressions > Compression Rate and Compression-to-Ventilation Ratio; page 18] 3 / 4
- A 3-year-old child is in cardiac arrest, and high-quality CPR is in progress. You are the Team Leader. The first
rhythm check reveals the rhythm shown here. Defibrillation is attempted with a shock dose of 2 J/kg. After shock administration, what should you say to your team members?
- “Check for a pulse.”
- “Give epinephrine 0.01 mg/kg.”
- “Let’s check the rhythm.”
- “Resume compressions.”
Correct Answer D. When attempting defibrillation, provide compressions until the defibrillator is charged, deliver 1 shock, and immediately resume CPR, starting with chest compressions. [PALS Provider Manual, Part 5: Recognizing and Managing Cardiac Arrest > Managing Cardiac Arrest > PALS in Cardiac Arrest > Defibrillation; page 85]
Use this scenario to answer the next 2 questions:
You are caring for a 5-year-old boy with a 4-day history of high fever and cough. He is having increasing lethargy, grunting, and sleepiness. Now he is difficult to arouse and is unresponsive to voice commands. His oxygen saturation is 72% on room air and 89% when on a nonrebreathing oxygen mask. He has shallow respirations with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles.
- What assessment finding is consistent with respiratory failure in this child?
- Cough
- Fever
- Oxygen saturation
- Respiratory rate
- / 4
Correct Answer C. Signs of probable respiratory failure include very rapid or inadequate respiratory rate; possible apnea; significant, inadequate, or absent respiratory effort; absent distal air movement; extreme tachycardia (bradycardia often indicates life-threatening deterioration); low oxygen saturation (hypoxemia) despite high-flow supplemental oxygen; decreased level of consciousness; and cyanosis. [PALS Provider Manual, Part 4: Systematic Approach to the Seriously Ill or Injured Child > Primary Assessment > Breathing > Oxygen Saturation by Pulse Oximetry > Caution in Interpreting Pulse Oximetry Readings; page 53]