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RQI PALS Entry 2025
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. What condition is most consistent with your assessment? Lung tissue disease Upper airway obstruction Lower airway obstruction Disordered control of breathing - ✔✔Disordered control of breathing A 2-week-old infant is being evaluated for irritability and poor feeding. His blood pressure is 55/40 mm HG, and capillary refill time is 5 seconds. Which statement best describes your assessment of this infants blood pressure? It is hypotensive It is hypertensive It is normal It represents compensated shock - ✔✔It is hypotensive You are performing the airway component of the primary assessment. What finding would lead you to conclude that the child has an upper airway obstruction? Dry, nonproductive cough
Inspiratory stridor Subcostal retractions Wheezing - ✔✔Inspiratory stridor A 5-year-old child is brought to the emergency department by ambulance after being involved in a motor vehicle collision. You are using the primary assessment to evaluate the child. When assessing the child's neurologic status, you note that he has spontaneous eye opening, is fully oriented, and is able to follow commands. How would you document this child's AVPU Scale finding? Alert Unresponsive Painful Voice - ✔✔Alert A 3-uear-old child is brought to the emergency department by his mother. What is a normal finding for a 3-year-old child? Blood pressure of 55/30 mm Hg Respiratory rate of 24/min Oxygenation saturation of 90% Heart rate of 220/min - ✔✔Respiratory rate of 24/min
You are caring for a 9-month-ol girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infant's SpO2 is 94%. On auscultation, the lings are clear bilaterally. What is the most likely cause of this infants distress? Upper airway obstruction Lower airway obstruction Disordered control of breathing Parenchymal lung disease - ✔✔Upper airway obstruction A 3-year-old boy is brought to the emergency department by his mother. He is lethargic, with retractions and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk capillary refill. Which immediate life-threatening condition could this child's condition most likely progress to if left untreated? Respiratory failure Respiratory distress Hypovolemic shock Cardiogenic shock - ✔✔Respiratory failure After rectal administration of diazepam, an 8 year old boy with a history of seizures is now unresponsive to painful stimulation.
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? Reposition the patient and insert an oral airway Administer naloxone Increase nasal cannula flow Perform endotracheal intubation - ✔✔Reposition the patient and insert an oral airway After rectal administration of diazepam, an 8 year old boy with a history of seizures is now unresponsive to painful stimulation. 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. If the patient continues to snore and exhibit poor chest and poor air entry bilaterally after your initial intervention, what next step is most appropriate? Perform nasal suctioning Increase nasal cannula flow Administer nebulized epinephrine Provide bag-mask ventilation - ✔✔Provide bag-mask ventilation 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.
Distributive Obstructive - ✔✔Hypovolemic 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. Difficult to arouse Pale HR 160/min RR 38/min BP 76/45 mm Hg Cap refill 5-6 seconds Temp 39.4 C (103 F) IV access established, Blood Culture obtained What is the most appropriate intervention? Administer 5-10 mL/kg of PRBCs Obtain chest x-ray Administer 20-30 mL/kg of isotonic crystalloid over 30 min Administer 1 0 - 20 mL/kg of isotonic crystalloid over 5-10min - ✔✔Administer 10-20 mL/kg of isotonic crystalloid over 5-10min An unresponsive 14-year-old girl is pale and cool to the touch. BP 70/45 mm Hg HR 190/min RR 12/min SpO2 undetected
Cap refill 5 seconds IV in place What rhythm is seen on the patient's cardiac monitor? - ✔✔SVT An unresponsive 14-year-old girl is pale and cool to the touch. BP 70/45 mm Hg HR 190/min RR 12/min SpO2 undetected Cap refill 5 seconds IV in place If pharmacological interventions are unavailable pr delayed, what intervention is indicated? - ✔✔Synchronized carioversion AN unresponsive 9-year-old boy was given a does of rectal valium by his caretaker for a prolonged seizure. BP 80/ HR 45/min RR 6/min SpO2 60% room air He is unresponsive and cyanotic What rhythm is most consistent with his patient's presentation and ECG findings? - ✔✔Sinus bradycardia
