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PALS Certification Course 2025 Questions and Answers, Exams of Nursing

Academy For Nursing And Health OccupationsNursing

PALS Certification Course 2025 QUESTIONS WITH COMPLETE SOLUTIONS.

Typology: Exams

2022/2023

Available from 05/30/2023

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PALS Certification Course 2025 QUESTIONS
WITH COMPLETE SOLUTIONS.
1. Which topics are included in the PALS course ? - ✅✅✅PALS
includes the following:
(1) Overview of assessment
(2) Recognition and management of respiratory
distress and failure
(3) Recognition and management of shock
(4) Recognition and management of cardiac
arrhythmias
(5) Recognition and management of cardiac arrest
(6) Postresuscitation management of patients with
pulmonary and cardiac arrest
(7) Review of pharmacology
2. What should be the primary focus of the clinician on
prevention of cardiopulmonary failure - ✅✅✅The clinician
should primarily focus on prevention of cardiopulmonary
failure through early recognition and management of
respiratory distress, respiratory failure, and shock that can
lead to cardiac arrest from hypoxia, acidosis, and ischemia.
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Download PALS Certification Course 2025 Questions and Answers and more Exams Nursing in PDF only on Docsity!

PALS Certification Course 2025 QUESTIONS

WITH COMPLETE SOLUTIONS.

  1. Which topics are included in the PALS course? - ✅✅✅PALS includes the following: (1) Overview of assessment (2) Recognition and management of respiratory distress and failure (3) Recognition and management of shock (4) Recognition and management of cardiac arrhythmias (5) Recognition and management of cardiac arrest (6) Postresuscitation management of patients with pulmonary and cardiac arrest (7) Review of pharmacology
  2. What should be the primary focus of the clinician on prevention of cardiopulmonary failure - ✅✅✅The clinician should primarily focus on prevention of cardiopulmonary failure through early recognition and management of respiratory distress, respiratory failure, and shock that can lead to cardiac arrest from hypoxia, acidosis, and ischemia.
  1. What is the main cause of cardiac arrests in children? - ✅✅✅In infants and children, most cardiac arrests result from progressive respiratory failure and/or shock, thus one of the aims of PALS rapid assessment model is to prevent progression to cardiac arrest.
  2. What is the pediatric assessment triangle? - ✅✅✅Brief visual and auditory observation of child's overall (1) appearance, (2) work of breathing, (3) circulation
  3. What are the components of the primary assessment? What signs should the clinician look for? - ✅✅✅The clinician should in rapid sequence assess: (1) Airway (patent, patent with maneuvers/adjuncts, partially or completely obstructed) (2) Breathing (respiratory rate, effort, tidal volume, lung sounds, pulse oximetry) (3) Circulation (skin color and temperature, heart rate and rhythm, blood pressure, peripheral and central pulses, capillary refill time) (4) Disability: (a)AVPU pediatric response scale: Alert, Voice, Pain, Unresponsive; (b) Pupillary response to light
  1. There are many causes of acute respiratory compromise in children. The clinician should strive to categorize respiratory distress or failure into one or more of the following: - ✅✅✅(1) Upper airway obstruction (eg, croup, epiglottitis)
  2. (2) Lower airway obstruction (eg, bronchiolitis, status asthmaticus)
  3. (3) Lung tissue (parenchymal) disease (eg, bronchopneumonia)
  4. (4) Disordered control of breathing (eg, seizure, coma, muscle weakness)
  5. What is the focus of initial management - ✅✅✅The main focus of initial management is to support airway, breathing, and circulation
  6. How can the clinician support the airway? - ✅✅✅(1) Provide 100 percent inspired oxygen
  7. (2) Allow child to assume position of comfort or manually open airway
  8. (3) Clear airway (suction)
  1. (4) Insert an airway adjunct if consciousness is impaired (eg, nasopharyngeal airway or, if gag reflex absent, oropharyngeal airway)
  2. How can the clinician support breathing? - ✅✅✅For supporting breathing, the clinician should: (1) Assist ventilation manually in patients not responding to basic airway maneuvers or with inadequate or ineffective respiratory effort (2) Monitor oxygenation by pulse oximetry (3) Monitor ventilation by end-tidal carbon dioxide (EtCO2) if available (4) Administer medications as needed (eg, albuterol, epinephrine)
  3. T of F: in preparation for intubation, the patient should receive 100 percent oxygen? - ✅✅✅True! In preparation for intubation, the patient should receive 100 percent oxygen via a high-concentration mask, or if indicated, positive pressure ventilation with a bag-valve- mask to preoxygenate and improve ventilation.
  1. In children, does shock present with low or high cardiac output? - ✅✅✅Shock in children usually presents with low cardiac output, but some patients may have high cardiac output, such as with sepsis or severe anemia.
  2. How can shock be classified? - ✅✅✅Shock severity is usually classified based on its effect on systolic blood pressure at presentation (i.e. compensated vs. decompensated) or based on its pathophysiology (i.e hypovolemic; distributive; cardiogenic; obstructive shock)
  3. What is the meaning of "compensated" shock, when does it occur? - ✅✅✅Compensated shock occurs when compensatory mechanisms (including tachycardia, increased systemic vascular resistance, increased inotropy, and increased venous tone) maintain a systolic blood pressure within a normal range
  4. What is the meaning of hypovolemic "decompensated" shock? When does it occur? - ✅✅✅Hypotensive shock occurs when compensatory mechanisms fail to maintain systolic blood pressure.
  1. Define hypotension in term infants? - ✅✅✅In term infants 0 to 1 month of age, systolic pressure <60 mmHg
  2. Define hypotension in infants 1 to 12 months of age? - ✅✅✅For infants 1 to 12 months of age, hypotension is defined by systolic pressure <70 mmHg
  3. Define hypotension in infants 1 to 10 years of age? - ✅✅✅In children 1 to 10 years of age, hypotension is defined as:
  4. Systolic pressure (5th percentile) < (70 mmHg + [child's age in years x 2])
  5. Define hypotension in children over 10 years of age? - ✅✅✅In children over 10 years of age, systolic blood pressure <90 mmHg
  6. What is key to know about hypotensive "decompensated" shock in contrast to compensated shock? - ✅✅✅Hypotensive shock may rapidly progress to cardiopulmonary failure.

cardiomyopathy, arrhythmias, sepsis, poisoning or drug toxicity, and myocardial injury (trauma).

  1. What is obstructive shock? - ✅✅✅A form of shock that arises from obstructed blood flow to the heart or great vessels. Common causes include cardiac tamponade, tension pneumothorax, ductal-dependent congenital heart lesions, and massive pulmonary embolism.
  2. Can patients suffer from more than one type of shock? - ✅✅✅Yes, any given patient may suffer from more than one type of shock. For example, a child in septic shock may develop hypovolemia during the prodrome phase, distributive shock during the early phase of sepsis, and cardiogenic shock later in the course.
  3. What is the definition of cardiopulmonary failure? - ✅✅✅Respiratory failure + hypotensive shock
  4. Which are the "airway" physical findings preceding cardiopulmonary failure that a clinician should look for? - ✅✅✅Stridor, stertor, drooling, and/or severe retractions
  1. Which are the "breathing" physical findings preceding cardiopulmonary failure that a clinician should look for? - ✅✅✅Bradypnea, irregular, ineffective respiration, gasping, and/or cyanosis
  2. •
  3. What are the "circulation" physical findings preceding cardiopulmonary failure that a clinician should look for? - ✅✅✅Bradycardia, capillary refill >5 seconds, weak central pulses, no peripheral pulses, hypotension, cool extremities, and/or mottled/cyanotic skin
  4. What are the "disability" physical findings preceding cardiopulmonary failure that a calinician should look for? - ✅✅✅Signs suggesting the presence of diminished level of consciousness
  5. What interventions should be performed in all patients with cardiopulmonary failure? - ✅✅✅Positive pressure ventilations with 100 percent inspired oxygen, chest compressions for heart rate <60 beats per minute in patients with poor perfusion, and administration of
  1. What is primary bradycardia? - ✅✅✅Primary bradycardia is the result of congenital and acquired heart conditions that directly slow the spontaneous depolarization rate of the heart's pacemaker or slow conduction through the heart's conduction system.
  2. What is secondary bradycardia? - ✅✅✅Secondary bradycardia is the result of conditions that alter the normal function of the heart, including hypoxia, acidosis, hypotension, hypothermia, and drug effects.
  3. What are the ECG findings of bradycardia - ✅✅✅(1) Slow heart rate relative to normal rates (table 4)
  4. (2) P waves that may or may not be visible
  5. (3) QRS complex that is narrow (electrical conduction arising from the atrium or high nodal area) or wide (electrical conduction from low nodal or ventricular region)
  6. (4) P wave and QRS complex may be unrelated (ie, atrioventricular dissociation) or have an abnormally long period between them (atrioventricular block)
  7. What are the subtypes of bradycardia? - ✅✅✅(1) Sinus bradycardia
  1. (2) AV block (first, second, third degree)
  2. In general terms what is the definition of tachycardia in children? - ✅✅✅A heart rate that is too fast for the child's age, level of activity, and clinical condition
  3. What are the usual causes of sinus tachycardia? - ✅✅✅Hypovolemia, fever, physiologic response to stress or fear, or drug effect (such as with beta agonists).
  4. What are tachyarrhythmias? - ✅✅✅Fast abnormal rhythms originating in the atria or the ventricles.
  5. How can tachyarrhythmias present in children? - ✅✅✅In children tachyarrythmia symptoms may include palpitations, lightheadedness, dizziness, fatigue and syncope
  6. How can prolonged tachycardia present in infants? - ✅✅✅In infants, prolonged tachycardia may cause poor feeding, tachypnea, and irritability with signs of heart failure.
  1. (4) Variable R-R intervals.
  2. (5) Narrow QRS complexes.
  3. What is pulseless arrest? - ✅✅✅Pulseless arrest refers to the cessation of blood circulation caused by absent or ineffective cardiac mechanical activity
  4. What is the most common cause of pediatric cardiac arrest? - ✅✅✅Most pediatric cardiac arrests are hypoxic/asphyxial arrests that result from a progression of respiratory distress, respiratory failure, or shock rather than from primary cardiac arrhythmias ("sudden cardiac arrest").
  5. What is the most frequent presentation of children with pulseless arrest? - ✅✅✅Children with pulseless arrest usually appear apneic or display a few agonal gasps. They have no palpable pulses and are unresponsive.
  6. How can we classify pulseless arrest rhythms? - ✅✅✅(1) Shockable rhythms and (2) Asystole and Pulseless electrical activity
  1. Which are the "shockable" rhythms? - ✅✅✅(1) Shockable rhythms: (a) V. Fib (b)Pulseless V. Tach; and (c) TDP
  2. What is asystole? What is the most common cause in children? - ✅✅✅Patients with asystole have cardiac standstill with no discernible electrical activity. The most common cause in children is respiratory failure progressing to critical hypoxemia, bradycardia, and then cardiac standstill. Underlying conditions include airway obstruction, pneumonia, submersion, hypothermia, sepsis, and poisoning (eg, carbon monoxide poisoning, sedative- hypnotics) leading to hypoxia and acidosis.
  3. What is Pulseless electrical activity (PEA)? - ✅✅✅PEA consists of any organized electrical activity observed on ECG in a patient with no central palpable pulse.
  4. PEA 6 H's - ✅✅✅Hypovolemia; hypoxia, hydrogen ions, hypo/hyperkalemia, hypoglycemia and, hypothermia

disturbance, or drug overdose) may prevent effective electrical capture.

  1. TACHYCARDIA ALGORITHM: What is the focus of tachycardia management in children? - ✅✅✅The management of sinus tachycardia focuses on treatment of the underlying physiologic derangement and is largely supportive.
  2. What is the focus of the management of tachycardia that is not sinus in origin? - ✅✅✅The management of tachyarrhythmias that are not sinus in origin is guided by the appearance of the QRS complex, and by the patient's status, whether unstable or stable
  3. What is the management protocol for unstable patients? - ✅✅✅Patients with a pulse and either narrow or wide complex tachycardia who have significantly impaired consciousness and hypotensive shock should be treated with synchronized cardioversion (initial dose: 0.5 to 1 J/kg)
  1. What is the management protocol for stable patients?
    • ✅✅✅For patients who are mentating and not hypotensive, treatment is determined by the QRS complex:
  2. In stable patients with narrow QRS (≤0.09 seconds)? - ✅✅✅For narrow complex tachycardia suggestive of supraventricular tachycardia (SVT), vagal maneuvers may be attempted while preparing for medication administration. Appropriate vagal maneuvers include application of ice to the face or, in a cooperative child, a Valsalva maneuver by bearing down or blowing into an occluded straw.
  3. What is the first recommended medication for SVT? - ✅✅✅Adenosine, 0.1 mg/kg (maximum dose 6 mg) administered rapidly IV/IO and followed by a rapid saline flush
  4. What should be done is if the wide-complex rhythm is monomorphic and regular? - ✅✅✅If the wide-complex rhythm is monomorphic and regular, it is acceptable to administer a dose of adenosine to determine if the rhythm