Download AHA PALS Post Test Exam Q & As (Version A and B) 2024-2025 A+ Graded and more Exams Nursing in PDF only on Docsity!
2024 - 2025 A+ Graded
AHA PALS Practice exam
- 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 heard on auscultation. The cardiac monitor shows sinus tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation 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 saturation of 95% by pulse oximetry?
A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary oxygen should be administered
C. Unreliable; no supplementary oxygen is indicated
D. Unreliable; supplementary oxygen should be administered - ANSWERUnreliable; supplementary oxygen should be administered
- A 3-year-old child was recently diagnosed with leukemia and has been treated with chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min, respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is less than 2 seconds. What is the child's most likely condition?
A. Septic shock
B. Hypovolemic shock
C. Significant bradycardia
D. Cardiogenic shock - ANSWERSeptic shock
- A 2-week-old infant presents with irritability and a history of poor feeding. Blood pressure is 55/ mm Hg. What term describes this infant's blood pressure?
A. Hypotensive
B. Normal
C. Hypertensive
D. Compensated - ANSWERHypotensive
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- During a resuscitation attempt, the team leader orders an initial dose of epinephrine at 0.1 mg/kg to be given 10. What should the team member do?
A. Administer the drug as ordered
B. Administer 0.01 mg/kg of epinephrine
C. Respectfully ask the team leader to clarify the dose
D. Refuse to administer the drug - ANSWERRespectfully ask the team leader to clarify the dose
- Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds - ANSWERInadequate oxygenation and/or ventilation
- Which of the following is most likely to produce a prolonged expiratory phase and wheezing?
A. Disordered control of breathing
B. Hypovolemic shock
C. Lower airway obstruction
D. Upper airway obstruction - ANSWERLower airway obstruction
- A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few minutes ago. Which of the following most likely to be abnormal?
A. Vascular resistance
B. Pulse rate
C. Lung compliance
D. Control of breathing - ANSWERControl of breathing
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is 102°F (38.9°C). What is the best method of establishing immediate vascular access? A. Two providers may attempt peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line - ANSWERPlace an intraosseous line
- What is the appropriate fluid bolus to administer for a child with hypovolemic shock with adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer's - ANSWER20 mL/kg normal saline
- An alert toddler presents with a barking cough, moderate stridor, and moderate retractions. The child's color is pink. What is the most appropriate initial intervention?
A. Obtain a chest radiograph
B. Administer nebulized epinephrine
C. Prepare for a surgical airway
D. Use an epinephrine autoinjector - ANSWERAdminister nebulized epinephrine
- An 8-year-old child presents with a history of vomiting and diarrhea. The child has the following vital signs: heart rate 168/min, respiratory rate 15/min, blood pressure 9060 mm Hg, and temperature 98.6°F (37°C). The child's capillary refill time is 4 seconds. After 2 IV boluses of normal saline (20 mL/kg each), the child's vital signs are now as follows: heart rate 130/min, respiratory rate 16/min, blood pressure 94/62 mm Hg, capillary refill 2 seconds, and temperature 98.6°F (37°C). The child's urine output is 1 to 2 mL/kg in the past hour. The child is still lethargic. What diagnostic tests or information should be obtained first?
A. Arterial blood gas
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B. Serum potassium concentration
C. Glucose
D. A 12-lead ECG - ANSWERGlucose
- A 15-year-old boy presents with acute onset of severe respiratory distress, with retractions and an oxygen saturation of 85%. His trachea is deviated to the right, and there are no breath sounds on the left. His heart rate is 140/min, his blood pressure is 84/60 mm Hg, and his capillary refill time is 3 seconds. What is the most appropriate intervention?
A. Obtain a chest x-ray
B. Perform needle decompression on the left chest C. Insert a chest tube on the left side
D. Insert an IV and administer 20 mL/kg of normal saline - ANSWERPerform needle decompression on the left chest
- A 4-year-old is being treated for hypovolemic shock and has received a single fluid bolus of 20 mL/kg of normal saline. On reevaluation the child remains anxious, with a heart rate of 140/min, a blood pressure of 84/54 mm Hg, and a capillary refill time of 4 seconds. What describes this patient's condition?
A. Hypotensive shock
B. Compensated shock
C. No longer in shock
D. Cardiogenic shock - ANSWERCompensated shock
- An 8-year-old child had a sudden onset of palpitations and light-headedness. At the time of evaluation the child is alert. His respiratory rate is 26/ min, and his blood pressure is 104/70 mm Hg. A cardiac monitor is applied, and the rhythm below is noted. What is the most appropriate initial intervention?
A. Provide synchronized cardioversion at 0.5 to 1 J/kg
B. Attempt vagal maneuvers
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D. Aggressively suction the endotracheal tube - ANSWERVerify the endotracheal tube position
- For a 6-month-old infant with supraventricular tachycardia and adequate perfusion, which of the following is the preferred vagal maneuver?
A. Ocular pressure
B. Carotid pressure
C. Valsalva maneuver
D. Ice to the face - ANSWERIce to the face
- 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?
A. Nebulized albuterol
B. Epinephrine IM
C. Isotonic crystalloid IV
D. Methylprednisolone - ANSWEREpinephrine IM
- A 2-year-old child was found submerged in a swimming pool. She is unresponsive, not breathing, and pulseless. In addition to performing high-quality CPR and establishing vascular access, which of the following is the most appropriate intervention?
A. Give atropine 0.02 mg/kg lIO/IV
B. Apply cricoid pressure
C. Give epinephrine 0.01 mg/kg IO/IV
D. Provide transthoracic pacing - ANSWERGive epinephrine 0.01 mg/kg IO/IV
- A 3-year-old child is unresponsive, not breathing, and pulseless. High-quality CPR is in progress. A cardiac monitor is applied, and the rhythm below is noted. What is the next appropriate intervention?
A. Attempt defibrillation with a 2 J/kg shock
2024 - 2025 A+ Graded
B. Administer epinephrine 0.01 mg/kg
C. Consider placement of an advanced airway
D. Administer amiodarone 5 mg/kg - ANSWERAttempt defibrillation with a 2 J/kg shock
- A pulseless 6-week-old infant arrives in the emergency department, and high-quality CPR is in progress. The initial rhythm strip is shown below. CPR continues, and vascular access has been established. What is the next appropriate intervention?
A. Administer atropine 0.02 mg/kg IO/IV
B. Attempt defibrillation with a 2 J/kg shock
C. Administer epinephrine 0.01 mg/kg IO/IV
D. Consider insertion of an advanced airway - ANSWERAdminister epinephrine 0.01 mg/kg IO/IV
- A 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?
A. 10 seconds
B. 15 seconds
C. 30 seconds
D. 60 seconds - ANSWER10 seconds
- What is the recommended location to check for a pulse in a 3- month-old infant?
A. Carotid
B. Radial
C. Brachial
D. Cardiac apex - ANSWERC. Brachial
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- 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?
A. Unsynchronized shock with 0.5 to 1 J/kg
B. Synchronized shock with 0.5 to 1 J/kg
C. Unsynchronized shock with 2 J/kg
D. Synchronized shock with 2 J/kg - ANSWERSynchronized shock with 0.5 to 1 J/kg
- A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer. What is the next most appropriate intervention?
A. Administer 0.1 mg/kg of adenosine
B. Obtain a blood sample to evaluate arterial or venous blood gases
C. Reassess breath sounds and clinical status
D. Repeat the albuterol treatment - ANSWERReassess breath sounds and clinical status
- The respiratory rate of a 1-year-old child with respiratory distress has decreased from 65/min to 30/min. The child is more lethargic and continues to have subcostal retractions. What does this change likely indicate?
A. Respiratory distress is unchanged
B. Progression toward respiratory failure
C. Improved respiratory status
D. Neurologic impairment - ANSWERProgression toward respiratory failure
- What is the most likely cause of head bobbing in infants?
A. Increased respiratory effort
B. Improving respiratory status
C. Decompensated shock
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D. Brain injury - ANSWERIncreased respiratory effort
- Several healthcare providers are participating in an attempted resuscitation. Which of the following is most consistent with the responsibilities of the team leader of the resuscitation?
A. Records medications and interventions
B. Assigns roles to team members
C. Administers defibrillation shocks
D. Provides compressions - ANSWERAssigns roles to team members
- Which of the following conditions is appropriate for use of an oropharyngeal airway?
A. Conscious with no gag reflex
B. Unconscious with a gag reflex
C. Unconscious with no gag reflex
D. Conscious with a gag reflex - ANSWERUnconscious with no gag reflex
- 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?
A. Nebulized albuterol
B. Epinephrine IM
C. Isotonic crystalloid IV
D. Methylprednisolone IV - ANSWEREpinephrine IM
- A mother brings her 7-year-old child to the emergency department. The mother states that the child has had a fever for the past 4 days and has had little to eat or drink during the past 24 hours. Your initial impression reveals a lethargic child with increased respiratory rate and pale color. Heart rate is 160/min, respiratory rate is 38/min, and blood pressure is 86/48 mm Hg. Capillary refill is 4 seconds. Which of the following is the most appropriate intervention for this child?
2024 - 2025 A+ Graded
D. 97% on 50% oxygen - ANSWER93% on 4 L of oxygen
- A 3-year-old child presents with a 2-day history of nausea and vomiting. She is alert, with no increase in respiratory effort, and is pale in color. The child's heart rate is 160/min, respiratory rate is 40/min, and blood pressure is 100/70 mm Hg. Her extremities are cool, with sluggish capillary refill. Which term best describes this child's physiologic state?
A. Compensated shock
B. Cardiogenic shock
C. Hypotensive shock
D. Obstructive shock - ANSWERCompensated shock
- A 3-year-old child presents with dehydration after a 2-day history of vomiting and diarrhea. The child after has received 2 fluid boluses of 20 mL/ kg of normal saline. After the second bolus, the child is alert and interacting. Her heart rate is 110/ min, respiratory rate is 30/min, and blood pressure is 92/64 mm Hg. Her capillary refill time is 2 seconds, and oxygen saturation is 98%. What is the most appropriate next intervention for this child?
A. Administer another 20 mL/kg normal saline fluid bolus
B. Administer 10 mL/kg of packed red cells
C. Continue to monitor and reevaluate the child
D. Initiate a dopamine drip of 20 mcg/kg per minute - ANSWERContinue to monitor and reevaluate the child
- A 3-year-old child presents with a high fever and a petechial rash. The child is lethargic, has no signs of increased work of breathing, and is pale in color. His heart rate is 180/min, respiratory rate is 30/min, blood pressure is 80/68 mm Hg. Capillary refill time is 4 seconds, and oxygen saturation is 88%. Airway and lungs are clear. Peripheral pulses are diminished. Which of the following is the most appropriate initial intervention?
A. Provide 100% oxygen via a nonrebreathing mask B. Obtain IV access
C. Administer dopamine
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D. Administer an antibiotic - ANSWERProvide 100% oxygen via a nonrebreathing mask
- An alert toddler presents with a barking cough, moderate stridor, and moderate retractions. The child's color is pink. What is the most appropriate initial intervention?
A. Obtain a chest radiograph
B. Administer nebulized epinephrine
C. Prepare for a surgical airway
D. Use an epinephrine autoinjector - ANSWERAdminister nebulized epinephrine
- The initial impression of a 4-year-old child reveals a lethargic child who is diaphoretic, with no increased work of breathing and pink color. Her heart rate is 220/min, respiratory rate is 24/min, blood pressure is 84/46 mm Hg, and capillary refill time is 5 seconds. IV access has been established. The rhythm below is seen on the cardiac monitor. What is the most appropriate initial intervention?
A. Give adenosine 0.1 mg/kg rapid IV push
B. Perform carotid sinus massage
C. Perform synchronized cardioversion at 0.5 J/kg D. Attempt defibrillation at 2 J/kg - ANSWERGive adenosine 0.1 mg/kg rapid IV push
- An 8-month-old infant is being evaluated. The child's mother says the infant has not been feeding well. The infant is alert with rapid but unlabored breathing, and the infant's color is pale. A cardiac monitor is applied, and the rhythm below is noted. Distal pulses are readily palpable. You give oxygen and establish IV access. What is the most appropriate vagal maneuver?
A. Valsalva maneuver
B. Carotid massage
C. Ocular pressure
D. Ice to the face - ANSWERIce to the face
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A. 2 J/kg
B. 2 to 4 J/kg
C. 4 J/kg or greater
D. Greater than 10 J/kg - ANSWER4 J/kg or greater
- A 12-year-old child suddenly collapses while playing sports. He is unresponsive and not breathing. Emergency response is activated. The child has no pulse, and CPR is initiated. An AED arrives. What is the most appropriate next intervention?
A. Contact the child's family
B. Provide CPR for 2 minutes
C. Drive the child to the hospital
D. Use the AED - ANSWERUse the AED
- A 3-year-old child is in cardiac arrest, and high- quality CPR is in progress. The first rhythm check reveals the rhythm below. Defibrillation is attempted with a shock dose of 2 J/kg. After administration of the shock, what is the most appropriate next intervention?
A. Resume CPR, beginning with chest compressions
B. Check for a pulse
C. Analyze the rhythm
D. Administer epinephrine - ANSWERResume CPR, beginning with chest compressions
- Which of the following is a characteristic of respiratory failure?
A. Inadequate oxygenation and/or ventilation
B. Hypotension
C. An increase in serum pH (alkalosis)
D. Abnormal respiratory sounds - ANSWERInadequate oxygenation and/or ventilation
2024 - 2025 A+ Graded
- A 3-year-old child is in cardiac arrest, and a resuscitation attempt is in progress. The child is in ventricular fibrillation and was given a shock at 2 J/kg, followed by immediate CPR. At the next rhythm check, ventricular fibrillation is again noted on the cardiac monitor. What is the most appropriate next intervention?
A. Attempt defibrillation with a 4 J/kg shock
B. Attempt defibrillation with a 2 J/kg shock
C. Resume CPR
D. Check for a pulse for at least 10 seconds - ANSWERA. Attempt defibrillation with a 4 J/kg shock
- CPR is in progress on a 10-month-old infant who was unresponsive and not breathing, with no palpable pulse. A cardiac monitor is applied, and sinus bradycardia at a rate of 42/min is noted. CPR is resumed, and vascular access is obtained. Which of the following is the most appropriate intervention?
A. Epinephrine 0.01 mg/kg IO/IV
B. Atropine 0.5 mg/kg IO/IV
C. Amiodarone 5 mg/kg IO/IV
D. Lidocaine 1 mg/kg IO/IV - ANSWEREpinephrine 0.01 mg/kg IO/IV
- During a pediatric resuscitation attempt, what is most likely to contribute to high-quality CPR?
A. A depth of compressions of about one fourth the anterior-posterior depth of the chest
B. A compression rate of 80/min
C. Pulse checks performed once per minute
D. Allowing the chest wall to recoil completely between compressions - ANSWERAllowing the chest wall to recoil completely between compressions
- While you are performing CPR on an infant in cardiac arrest at a doctor's office, a second rescuer arrives with an AED. Which of the following best describes the use of an AED on this infant?
2024 - 2025 A+ Graded
C. Lower airway obstruction
D. Upper airway obstruction - ANSWERLower airway obstruction
- A 5-year-old child has had severe respiratory distress for 2 days. During assessment the child's heart rate decreases from 140/min to 90/min, and the child's respiratory rate decreases from 66/min to 8/min. Which of the following is the next appropriate intervention?
A. Rescue breaths at a rate of 12 to 20/min
B. Rescue breaths at a rate of 6 to 10/min
C. Chest compressions at a rate of at least 100/min D. Chest compressions at a rate of 60/min - ANSWERRescue breaths at a rate of 12 to 20/min
