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The PALS systemic approach algorithm begins with the initial impression. This is an assessment of which 3 characteristics? - 1. Consciousness 2. Breathing 3. Color The right branch of the systemic approach algorithm focuses on what sequence to prevent cardiopulmonary arrest? - Evaluate, Identify, Intervene The evaluate portion of the sequence consists of three assessment tools: - 1. Primary 2. Secondary 3. Diagnostic What is included in the primary assessment of a patient? - A B c D E Vitals What is included in the secondary assessment of a patient? - Focused history and a focused physical exam The initial impression of the PALS systematic approach algorithm includes which of the following characteristics? (Choose all correct answers.) 1. Appearance 2. Breathing 3. Restlessness 4. Color 5. Pain - 1, 2,4 The second box of the PALS systematic approach algorithm contains a question. (Fill in the blank to complete the question.) Is the child or is immediate intervention needed? - unresponsive In the PALS systematic approach algorithm, if the child is determined to be unresponsive or immediate intervention is needed what will be your next step? 1. Start CPR 2. Apply breathing with a bag valve mask 3. Activate emergency response 4. Check for a pulse - 3. After the emergency response is activated, the next intervention is to 1. Lightly shake the child's shoulders. 2. Look, listen, and feel. 3. Open the airway. 4. Check for breathing and a pulse - 4. After it is determined that the child has no pulse, what should be done? 1. Call for help 2. Begin CPR 4. Primary assessment - 1, 3, 4 (True or False) The sequence of evaluate-identify-intervene should be used before and after each intervention and should continue until the child is stable. 1. True 2. False - 1. Aconsistent respiratory rate less than 10 or more than breaths per minute in a child of any age is abnormal and suggests the presence of a potentially serious problem. 1.40 2.50 3.60 4.70 - 3. The primary objective of the Airway assessment in the ABCDE model is to assess airway 1. effort of breathing 2. rate of breathing 3. disease 4. patency - 4. Within the EVALUATE portion of the evaluate-identify-intervene sequence, The primary assessment uses the ABCDE model for a hands-on evaluation of the critically ill child. What does ABCDE stand for? (Fill in the blanks) A E - Airway Breathing Circulation Disability Exposure Simple measures for maintaining airway patency include all of the following EXCEPT which intervention? 1. Continuous positive airway pressure 2. Head tilt chin lift 3. Jaw thrust 4. Nasopharyngeal airway - 1. Assessment of Breathing includes evaluation of: 1. Respiratory rate and effort 2. Chest expansion in air movement 3. Lung and airway sounds 4, 02 saturation 5. All of the above - 5. Tachypnea can have both respiratory and non-respiratory causes. Select all of the non-respiratory cause of tachypnea. E. Crackles An oxygen saturation of 2 % while a child is breathing room air usually indicates that oxygenation is adequate. 1. 90% 2.92% 3. 94% 4, 98% - 3. Heart rate and rhythm, pulses, capillary refill time, skin color and temperature, and blood pressure are all direct indicators of circulatory status. Which of the following are indirect indicators of circulatory status? (Choose all correct answers) 1. Urine output 2. Oxygen saturation 3. Level of consciousness 4. Respiratory rate - 1, 3. What is the most common cause of bradycardia in children? 1. Sepsis 2. Drug overdose 3. Hypoxia 4. Complete heart block - 3. (True or False) Tachycardia is a normal physiologic response in the critically ill child? 1. True 2. False - 1. An observed decrease in systolic blood pressure of mm Hg from baseline should prompt serial evaluations for additional signs of shock. 1.5 mm Hg 2. 10 mm Hg 3. 15 mm Hg 4. 20 mm Hg - 2. In healthy children, the heart rate may fluctuate with the respiratory cycle. The heart rate with inspiration and with expiration. (fill in each blank with a single word) - increases, decreases (True or False) When assessing circulation, it is only necessary to assess the central pulses. 1. True 2. False - 2. What is a common cause of vasoconstriction and can result in a discrepancy between the peripheral and central pulses in children? (Choose all correct answers) 1. hot environment 2. cold environment 3. environmental stress 4. tachyarrhythmias - 2. Normal capillary refill time in children is 1. 5 seconds 2. $ 3 seconds 3. < 2 seconds 4. $ 2 seconds - 4. 1. Decreased level of consciousness 2. Loss of muscular tone 3. Generalized seizures 4. Pupil dilation - 1, 2, 3, 4 When cerebral hypoxia develops more gradually, the neurologic signs are the same as when severe cerebral hypoxia develops suddenly. 1. True 2. False - 2. The AVPU scale is a scale used to evaluate cerebral cortex function and is used to rate a child's level of consciousness. What does the acronym AVPU stand for? 1. Alert, Voice, Painful, Unresponsive 2. Active, Verbal, Painful, Unresponsive 3. Alert, Voice, Pupils, Unresponsive 4. Alive, Voice, Pulses, Understands - 1. The Glasgow coma scale is used to evaluate a child's level of consciousness and neurologic status. The child's best eye-opening, verbal, and motor responses are scored. If a child is intubated, unconscious, or preverbal, the most important part of this scale is response. 1. Eye-opening 2. Verbal 3. Motor - 3. Pupil response to light is a indicator of function. 1. Cortex 2. Hypothalamus 3. Limbic 4, Brainstem - 4. The D(disability) of the primary assessment is a quick evaluation of neurologic function. Which standard evaluations are included in this assessment? (choose all correct answers) 1. AVPU scale 2. Glasgow coma scale 3. Pupil response to light 4. NIH stroke scale 5. Blood glucose test - 1, 2, 3,5 The E of the ABCDE primary assessment acronym stands for 1. Evidence 2. Emergency 3. Evaluate 4. Exposure - 4. After completion of the primary assessment, if the child does not have a life-threatening condition, the secondary assessment should be completed. The secondary assessment consists of which of the following components? (Choose all correct answers) 1. General physical exam 2. Family medical history 3. Focused history 4. Focused physical exam - 3, 4 In the seriously ill or injured child, the arterial lactate level can as a result of tissue hypoxia and anaerobic metabolism. 1. Fall 2. Rise - 2. (True or False) Pediatric cardiac arrest typically has a primary cause that is related to respiratory failure or shock. 1. True 2. False - 1. Pediatric cardiac arrest is typically the result of resulting from respiratory failure and/or shock. 1. coronary occlusion 2. tissue hypoxia 3. pulmonary embolism 4. hypovolemia - 2. (True or False) Outcomes for cardiac arrest in children is generally good. 1. True 2. False - 2. Which is the most common presenting initial rhythm for children in cardiac arrest? 1. PEA/asystole 2. ventricular tachycardia 3. ventricular fibrillation 4. complete heart block - 1. Sudden cardiac arrest is rare in children, and when it occurs, it is typically associated with underlying heart disease. Common causes include: (choose all that apply) 1. long QT syndrome 2. hypertrophic cardiomyopathy 3. myocarditis 4. drug intoxication - 1, 2, 3, 4 A majority of sudden cardiac arrest in children occurs during athletic activity. 1. True 2. False - 1. The correct location to palpate for a pulse in an unresponsive CHILD is . (choose all correct answers) 1. carotid 2. radial 3. femoral 4. brachial - 1, 3 (True or False) To ensure proper treatment of cardiac arrest, the rhythm must be identified before initiating CPR. 1. True 2. False - 2. In children, a pulse check should be limited to 1. no more than 5 seconds 2. no more than 10 seconds PALS - Pediatric Advanced Life Support Questions and Answers Complete UpdatePALS - Pediatric Advanced Life Support 
