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AHA PEDIATRIC ADVANCED LIFE SUPPORT EXAM PALS QUESTIONS AND ANSWERS, Exams of Pediatrics

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Typology: Exams

2024/2025

Uploaded on 05/28/2025

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AHA PEDIATRIC ADVANCED LIFE SUPPORT EXAM / PALS QUESTIONS
AND ANSWERS
1. A 6 month old infant is unresponsive. You begin checking for
breathing at the same time you check for the infants pulse. Which is the
maximum time you should spend when trying to simultaneously check
for breathing and palpate the infants pulse before starting CPR>ANS 10
seconds
2. A 4 year old child is brought to the emergency department for
seizures. The seizures stopped a few minutes ago, but the child
continues to have slow and irregular respirations. Which condition is
most consistent with your assessment>ANS Disordered Control of
Breathing
3. An 8 year old child is brought to the emergency department with a 2
day history of lethargy and polyuria. The child has new onset rapid,
deep, and labored breathing. Which diagnostic test should you order
first>ANS blood glucose
4. After rectal administration of diazepam, an 8 year old boy with a
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AND ANSWERS

  1. A 6 month old infant is unresponsive. You begin checking for breathing at the same time you check for the infants pulse. Which is the maximum time you should spend when trying to simultaneously check for breathing and palpate the infants pulse before starting CPR>ANS 10 seconds
  2. A 4 year old child is brought to the emergency department for seizures. The seizures stopped a few minutes ago, but the child continues to have slow and irregular respirations. Which condition is most consistent with your assessment>ANS Disordered Control of Breathing
  3. An 8 year old child is brought to the emergency department with a 2 day history of lethargy and polyuria. The child has new onset rapid, deep, and labored breathing. Which diagnostic test should you order first>ANS blood glucose
  4. After rectal administration of diazepam, an 8 year old boy with a

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AND ANSWERS

history of seizures is no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. What action should you take next>ANS Reposition the patient, and insert an oral airway

  1. After rectal administration of diazepam, an 8 year old boy with a history of seizures is no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilat- erally. After repositioning the patient and you insert an Oral airway, the patient continues to deteriorate. What next step is the most appropriate>ANS Provide bag mask ventilation
  2. A 6 year old child is found unresponsive, not breathing, and without a pulse. one health care worker leaves to activate the emergency response system and get the resuscitation equipment. You and another healthcare provider imme- diatly begin CPR. Which compression to

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AND ANSWERS

displays the rhythm strip shown here. The estimated weight of the child is 20 kg. What dose range should you use for the initial defibrillation>ANS 2-4 J/kg

  1. A 4 year old child in cardiac arrest is brought to the emergency department by ambulance. High quality CPR is being performed. The cardiac monitor displays the rhythm strip shown here. The estimated weight of the child is 20 kg. As the team leader, how many joules do you tell your team member to use to perform initial Defib>ANS 40 Joules
  2. You are the team leader during a pediatric resuscitation attempt. which action is an element of high quality CPR>ANS Allowing complete chest wall recoil after each compression

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AND ANSWERS

  1. You are caring for a 3 month old boy with a 2 day history of fever, vomiting and diarrhea. His parents state that he has been sleeping much more. His HR is 190/min, temp is 38.3 degrees C (101 F) blood pressure is 59/29 mmHg, Resp rate is 70/min and shallow, and oxygen sat is 94% on 100% oxygen. His capillary refills time is 4-5 seconds, and he has mottled, cool extremities. The infant weighs 6 Kg. Which assessment finding indicates that the infant is in hypotensive shock>ANS blood pressure
  2. You are caring for a 3 month old boy with a 2 day history of fever, vomiting and diarrhea. His parents state that he has been sleeping much more. His HR is 190/min, temp is 38.3 degrees C (101 F) blood pressure is 59/29 mmHg, Resp rate is 70/min and shallow, and oxygen sat is 94% on 100% oxygen. His capillary refills time is 4-5 seconds, and he has mottled, cool extremities. The infant weighs 6 Kg. On the basis of this infants presentation, which type of shock does this infant have>ANS hypovolemic shock

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AND ANSWERS

  1. A team member is unable to perform an assigned task because it is beyond the team members scope of practice. Which action should the team member take>ANS Ask for a new task or role
  2. Which abnormality helps identify children with acute respiratory distress caused by lung tissue disease>ANS crackles
  3. Which condition in a child would IO access most likely be attempted before vascular access>ANS cardiac arrest
  4. You respond to an infant who is unresponsive, in not breathing, and doe not have a pulse. You shout for nearby help, but no one arrives. What action should you take next>ANS Begin CPR for 2 mins before leaving to activate the emergency response system.
  5. An unresponsive 9 year old boy is pale and cool to the touch his blood pressure is 70/45 mmHg, heart rate is 190/min and respiratory rate is 12/min. The SpO2 is not detectable Cap refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. What

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AND ANSWERS

rhythm is seen on the patient cardiac monitor>ANS Supraventricular tachycardia

  1. An unresponsive 9 year old boy is pale and cool to the touch his blood pressure is 70/45 mmHg, heart rate is 190/min and respiratory rate is 12/min. The SpO2 is not detectable Cap refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. If initial treatment is unavail- able or delayed, which intervention is indicated>ANS Syncronized cardioversion.
  2. You are performing the airway component of the primary assessment. Which finding would lead you to conclude that the child has an upper airway obstruction>ANS inspiratory stridor
  3. A 3 year old child is having difficulty breathing. Which finding would most likely lead you to suspect an upper airway obstruction in this child>ANS Increased inspiratory effort with retractions
  4. You are caring for patients in the emergency department. Which 2

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AND ANSWERS

is most consistent with this patients presentation and ECG findings>ANS Sinus Bradycardia

  1. An unresponsive 9 year old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His BP is 80/40 mmHg, HR is 45/min, respiratory rate is 6/min, and SpO2 is 60% no room air. He is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here. What is your next action>ANS Provide bag-mask ventilation with 100% oxygen
  2. A 10 year old child is being evaluated for a head ache. Which is a normal finding for this 10 year old child>ANS Heart rate of 88/min
  3. A 5 year old child is brought to the emergency department by

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AND ANSWERS

ambulance after being involved in a MVC. You are using the primary assessment to evaluate the child. When assessing the Childs neurological status, you note that he has spontaneous eye opening, is fully oriented, and is able to follow command. How would you document this Childs AVPU pediatric response scale finding>ANS Alert

  1. A 6 month old infant is being evaluated for bradycardia. Which is the most likely cause of bradycardia>ANS Hypoxia
  2. 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 O2 sat is 72% on room air and 89% when on a NRB O2 mask. He has shallow respirations, with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles. Which assessment finding is consistent with respiratory failure in this child>ANS oxygen saturation
  3. 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.

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AND ANSWERS

  1. You are Caring for a 9 month old girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infants SpO2 is 94% On auscultation, the lungs are clear bilaterally. Which is the most likely cause of this infants respiratory distress?-

ANS upper airway obstruction

  1. You are Caring for a 9 month old girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infants SpO2 is 94% On auscultation, the lungs are clear bilaterally. Which medication should you administer first>ANS Epinephrine, nebulized
  2. Which condition is characterized by a prolonged excretory phase and wheezing>ANS Lower airway obstruction

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AND ANSWERS

  1. During a resuscitation attempt, the team leader asks you to administer an initial dose of Epinephrine at 0.1 mg/kg to be given IO. How should you respond>ANS "I think the correct dose is 0.01 mg/kg. should I give that dose instead?"
  2. You are caring for a 12 year old girl with acute lymphoblastic leukemia. She is responsive but she does not feel well and appears to be flushed. Her Temp is 39 degrees C (102.2 F), HR is 118/min, respiratory rate is 36/min, BP is 100/40 mmHg, and oxygen sat is 96% on room air. Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% Oxygen by NRB mask.--- Laberatory studies document a lactic acidosis. On the basis of the patients clinical assessment and history. Which type of shock does this patient most likely have>ANS Distributive Septic Shock
  3. You are caring for a 12 year old girl with acute lymphoblastic leukemia. She is responsive but she does not feel well and appears to be flushed. Her Temp is 39 degrees C (102.2 F), HR is 118/min, respiratory

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AND ANSWERS

Temp is 39 degrees C (102.2 F), HR is 118/min, respiratory rate is 36/min, BP is 100/40 mmHg, and oxygen sat is 96% on room air. Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% Oxygen by NRB mask.--- In edition to oxygen administration and appropriate fluid resuscitation, which additional early intervention should you provide to the patient>ANS Antibiotic Administration

  1. A 3 year old boy is brought to the ED by his mother. His is lethargic, with retractions and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk cap refill. To which immediate life treating condition could this Childs condition most likely progress if left untreated>ANS respiratory failure
  2. A 6 year old boy is being evaluated for difficulty breathing. Which finding would suggest this child has respiratory distress>ANS Audible inspiratory stridor

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AND ANSWERS

  1. An 8 year old child is brought to the ED by his mother for difficulty breathing. He has a history of asthma and nut allergies. He's mother tells you that he recently ate a cookie at a family picnic. Which condition is most likely to be present in this child>ANS upper airway obstruction
  2. A 10 year old child is brought to the ED for fever and cough. You obtain an O2 sat on the child. Which oxygen saturation would indicate that immediate intervention is needed>ANS 88% on 4L of Nasal oxygen
  3. You are evaluating a 1 yer old child for respiratory distress. His HR is 168/min, and his respiratory rate has decreased from 65/min to 30/min. He now appears more lethargic and continues to have severe subcostal retractions. On the basis of your assessment, which is the most likely reason for this change in the Childs condition.>ANS The child has signs of probable respiratory failure
  4. The parents of a 7 year old child who is undergoing chemotherapy report that the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals that the child is difficult to