Pals Exam

Front 1

A 4 year old child presents with seizures and irregular respirations. The seizures stopped a few minutes ago. Which of the following is most likely to be abnormal?

Back 1

Control of breathing

Front 2

The partents of a 7 yearold who is undergoing chemotherapy report that the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals the following:Dificult to arouse, pale. HR is 160/min, resp is 30/min, BP is 76/45. CAP refill is 5 to 6 sec, temp is 103 F. What is the most appropriate intervention?

Back 2

Obtain vascular access and administer 20mL/kg of isotonic crystaloid over 5 to 10 minutes

Front 3

An alert toddler presents with a barking cough, moderate stridor, moderate retractions. The child's color is pink. What is the most appropriate initial intervention?

Back 3

Administer Epinephrine

Front 4

A 2 year old child was found submerged in a swimming pool. She is unresponsive, not breathing, and pulseless. In addition to performing CPR and establishing Vascular access, which of the following is the most appropriate Intervention?

Back 4

Give Epinephrine 0.01mg/kg IO/IV

Front 5

An 8 yearold child presents with history of vomoting and diarrhea. The child has the following vital signs: HR 168/min, resp rate of 15/min, BP of 90/60, and a temp of 98.6 F. CAP refill is 4 sec. After 2 IV boluses of NS, the child has the following Vtals: HR 130/min, resp 16/min, BP 94/62, CAP refill less that 2 sec, temp of 98.6 F. Urine output is 1 to 2 mL/kg. The Child is still lethargic. What diagnostic tests or information should be obtained first

Back 5

Glucose

Front 6

Which of the following is a characteristic of respiratory failure?

Back 6

Inadequate oxygenation and/or ventilation

Front 7

A 12 year old child suddenly collapses while playing sports. He is unresponsive and not breathing. EMS is activated. The child has no pulse, and CPR is initiated. An AED arrives. What is the most appropriate next intervention

Back 7

Use the AED

Front 8

A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10 minutes after eating peanuts. What is the most appropriate initial medication for this child

Back 8

Epinephrine IM

Front 9

While you are performing CPR on an infant in cardiac arrest at a doctors office, a second rescuer arrives with an AED. Which of the following best describes the use of an AED on this infant?

Back 9

If pediatric pads are unavailable, it is acceptable to use adult pads

Front 10

A 15 year old boy presents with acute onset of severe respiratory distress, with retractions and an O2 Sat of about 85%. His trachea is deviated to the right, and there are no breath sounds on the left. His HR is 140/min, his BP is 84/60, and hi CAP refill time is 3 sec. What is the most appropriate intervention?

Back 10

Perform needle decompression on the left chest

Front 11

What abnormality is most likely to be present in children with acute respiratory distress caused by lung tissue disease?

Back 11

Decreased Oxygen saturation

Front 12

A 5 year old child presents with lethargy, increased work of breathing, and pale color. The primary assessment reveals that the airway is open and the respiratory rate is 30/min, with crackles. the cardiac monitor shows sinus-Tach at 165/min. The Pulse Ox displays an O2 sap of 95% and a pulse rate of 93/min. On the basis of this information, which of the following provides the best interpretation of the oxygen sat of 95% by Pulse Ox?

Back 12

Unreliable: Supplementary Oxygen should be administered.

Front 13

A 2 week old infant presents with irritability and a history of poor feeding. BP is 55/40. What term describes this infant's blood pressure?

Back 13

Hypotensive

Front 14

A 4 year old is being treated for hypovolemic shock and has received a single fluid bolus of 20mL/kg of NS. On reevaluation the child remains anxious, with a HR of 140/min, a BP of 84/54, and a CAP refilltime of 4 seconds. What describes this patient's condition?

Back 14

Compensated shock

Front 15

An 8 year old child had a sudden onset of palpitations and light-headedness. At the time of evaluation the child is alert. His resp rate is 26/min, BP is 104/70. A cardiac monitor is applied, that SVT is noted. What is the most appropriate initial intervention?

Back 15

Attempt vagal maneuvers

Front 16

What is the appropriate fluid bolus to administer for a child with hypovolemic shock with adequate myocardial finction?

Back 16

20mL/kg Normal Saline

Front 17

For a 6 Month Old infant with Supraventricular Tachycardia and adequate perfusion, which of the following is the preferred vagal maneuver?

Back 17

Ice to face

Front 18

A 3 month old infant with bronchiolitis is suctioned to remove upper airway secretions. Te infant's HR decreases from 155/min to 65/min as shown above. The infant remains alert, with easily palpable pulses. CAP refill time is 1 sec. What is the most appropriate initial intervention?

Back 18

Administer oxygen and ensure ventolation; be prepared to intervene further if Heart rate does not increase.

Front 19

During resuscitation attempt, the team leader orders an initial dose of epinephrine at 0.1mg/kg to be given IO. What should the team member do?

Back 19

Respectfully ask the team leader to clairfy the dose.

Front 20

A 7 year od child presents in pulseless arrest. The child's ECG shows a normal rhythm above. Which if the following describes the patient's condition?

Back 20

Pulsless electrical activity

Front 21

A 2 year old child presents with a 4-day history of vomiting. The initial impression reveals an unresponsive child with intermittent apnea and mottled color. HR is 166/min, Respiratory rate is now being supported with BVM ventolation, CAP refill time is 5 to 6 seconds, and temp is 102 F. What is the best method of establishing vascular access?

Back 21

Place an Intraosseous line

Front 22

a 10 year old child had a sudden witnesses cardiac arrest and received immediate bystandard CPR and defibrilation within 3 minutes. He had a return of spontaneous circulation. The child remains unresponsive and has an advanced airway in place. there is no history of trauma or signs os shock. What is the target range for oxygen saturation for this child?

Back 22

94% to 99%

Front 23

a 3 year old child was reciently diagnosed with leukemia and has been treated with chemotherapy. the child presents with lethargy and a high fever. HR is 195/min, resp rate is 36/min, BP is 85/40, and CAP refill time is less than 2 seconds. What is the child's most likely condition?

Back 23

Septic shock

Front 24

1 6 month old infant is unresponsive and not breathing. What is the maximum time that should be spent trying to palpate the pulse before starting CPR?

Back 24

10 Seconds

Front 25

A pulseless 6 week old infant arrives in the emergency department, and high-quality CPR is in progress. The initial strip is shows above. CPR continues, and vascular access has been established. What is the next appropriate intervention?

Back 25

Administer Epinephrine 0.01mg/kg IO/IV

Front 26

A 3-year old child is unresponsive, not breathing, and pulseless. High-Quality CPR is in progress. A cardiac monitor is aplied, and the rhythm above is noted. What is the next appropriate intervention?

Back 26

Attempt defibrilation with 2 J/kg shock

Front 27

A 6-year-old child is found unresponsive, not breathing, and pulseless. What is the correct compression-to-ventolation ratio when 2 or more healthcare providers are present to perform CPR?

Back 27

15:2

Front 28

Which of the following is most likely to produce a prolonged expiratory phase and wheezing?

Back 28

Lower airway obstruction

Front 29

What is the recomended location to check for a pulse in a 3-month-old infant?

Back 29

Brachial

Front 30

An alert 2-year-old child with an increased work of breathing and pink color is being evaluated. HR is 110/min, and resp rate is 30/min. What would best describe this patient's condition?

Back 30

Respiratory Distress

Front 31

A 5-year-old child has had Severe respiratory distress for 2 days. During assessment the child's HR decreases from 150/min to 90/min, and the child's respiratory rate decreases from 66/min to 8/min. What intervention is most appropriate?

Back 31

Provide rescue breaths at a rate of 12 to 20/min

Front 32

A 7-year-old child presents with a narrow-complex supraventricular tachycardia, lethargy, and poor perfusion. Pulses are weak and thready. Vascular access cannot be established. What is the most appropriate intervention?

Back 32

Synchronized shock with 0.5 to 1 J/kg

Front 33

a 3-mont-old infant with bronchiolitis is intubated for management of respiratory failure. During transport, the infant develops bradycardia with a HR of 60/min, and the infant's oxygen saturation decreases to 75%. There are breath sounds on the right side, but no air entry is heard on the left side. What is the most approipriate initial intervention?

Back 33

Verify endotracheal tube position