PALS Written Exam A
October 10, 2022 | Author: Anonymous | Category: N/A
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American Heart Association
PALS Provider
Written Exam
Version A
October 12 2 11
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ssocia tion
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American eart Association ® PALS Provider
C
Exam Version A (33 questions)
Please do not mark on this exam. Record the best answer on the separate answer sheet
1. 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 resp iratory rate is 30/min with crackles heard on auscultation. auscultat ion. The cardiac cardiac monitor shows sinus tachycardia tachycardia at a rate' 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 t he best interpret interpretation ation of the oxygen saturation of 95 by pulse oximetry?
Reliable ; no supplementary oxygen is indicated Reliable; B. Reliable; supplementary oxygen should be administered C. Unreliable Unreliable;; no supplementary oxygen is indicated D. Unreliable Unreliable;; supplementary oxygen should be administered
A.
A 3-year-old 3-year-old child was recently diagnosed wit h leukemia leu kemia and has been been treated with chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min, respiratory rate rat e is 36/min, blood pressure is i s 85 40 mm Hg, Hg, and capillar capi llary y refill time i s less than than 2 seconds. What is the child's most likely condition? 2.
Septic shock B . Hypovolemic shock C . Significant bradycardia D. Cardiogenic shock A.
3.
A 2-we 2-weekek-old old infant presents with with irr itability and a histor y o f poor feeding. Blood pressure is mm Hg. What term describes this infant's blood pressure?
55 40
Hypotensive B. Normal
A.
C. Hypertensive D. Compensated
During a resuscitation attempt, the team leader orders an initial dose of epinephrine at mglkg to be given 10. What shoul should d the team team member memb er do? 4.
0.1
Administer the drug as ordered B. Administer 0. 0 .01 mg/kg of epinephrine C. Respectfully ask the team leader to clarify the dose D. Refuse to administer the drug
A.
2 PALS Provider Written Exam Version A October 12 2011 © 20 II American Heart Association
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5 Which A B. C. D.
the following
is
a characteristic
o
respiratory failure?
Inadequate oxygenation and/or ventilation Hypotension An increase in serum pH (alkalosis) Abnormal respiratory sounds
6 Which A B. C. D.
o
o
the following is
most
likely to produce a prolonged expiratory phase and wheezing?
Disordered control of breathing Hypovolemic shock Lower airway obstruction Upper airway obstruction
7 A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few minutes ago. Which o the following most likely to be abnormal? A B. C D.
Vascular resistance Pulse rate Lung compliance Control of breathing
8 What abnormality is most likely to be present in children with acute respiratory distress caused by lung tissue disease? A B. C. D.
Decreased oxygen saturation Stridor Normal respiratory rate Decreased respiratory effort
9 An alert 2-year-old child with an increased work o breathing and pink color is being evaluated. Heart rat rate e is 110/min, and and respi respirator ratory y rate is 30/min. What would best describe this th is patient pa tient s condition? A B. C. D.
Respiratory distress Respiratory arrest Respiratory failure Disordered control o breathing
3 PALS Provider Wrinen Exam Version A October 12 2011 © 2011 American Heart Association
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10. 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 letharg lethargy. y. Assessment Assessm ent reveals the following: The child is difficult to arouse, with pale color. The child's heart rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm Hg capillary refill time is 5 to 6 seconds, and tempera tem perature ture is 103°F (39.4° (39.4°C). What is the th e most appropriate intervention? A. B. C. D.
Obtain vascular access and administer 20 mUkg of isotonic crystalloid over 30 minutes Obtain vascular access and administer administ er 20 m kg of isotonic crystalloid crystalloid over 5 to 10 minutes Obtain immediate blood cultures and chest x-ray Obtain expert consultation with an oncologist to determine the chemotherapeutic regimen
_
2-year-old -old child presents with a 4-day 4-day hist ory o f vomiting. The initial impression reveals an 11. A 2-year unresponsive child with intermittent apnea and mottled color. Heart rate is 166/min, respiratory rate rat e is now being supported supp orted with bag-maS bag-maSk k ventilation, ventil ation, capillary refill time is 5 to 6 seconds, and temperature temperatur e is i s 102 102° °F (38.9° (38.9°C). What is i s the bes bestt metho me thod d 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
What at is the appropriate appropriate fluid bolus to administe r for a child with hypovolem hypovolemic ic shock with 12. Wh adequate myocardial function? A. B. C. D.
10 20 20 10
mUkg mUkg mUkg mUkg
normal saline of 5 dextr dextrose ose and 0 .2 normal saline lactated Ringer' Ringer's
sodium chloride
13. 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 interv intervention? ention? A. B. C. D.
Obtain a chest radiograph Administer nebulized epinephrine Prepare for a surgical airway Use an epinephrine autoinjector
4 Provider Written Exam Version A October Associatio on © 2 II American Heart Associati PALS
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14. An 8-year-old child presents with a history o f vomiting and diarrhea. The child has the following vital signs: heart rate 168/min, respiratory rate 15/min, blood pressure 90 60 mm Hg, and tempe te mperat rat ure 98.6°F (37°C). The Th e child s capillary refill time is 4 seconds. After 2 IV boluses o f normal saline (2 (20 0 mUkg each), the child s vital signs are now as follows: heart rate 130/min, 130/min, respiratory rate 16/min, 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 o r information should be obtained first? Arterial blood gas B. Serum potassium concentration C Glucose D. A 12-lead ECG
A
15. A 15-year-old boy presents with acute onset o f severe respiratory distress, with retractions and an an oxygen saturatio n o f 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? Obtain a chest x-ray Perform needle decompression on the left chest , C. Insert a chest tube on the left side D Insert an IV an and d administer 20 mUkg of normal saline
A
B
16. A 4-year-old is being treated for hypovoiemic shock and has received a single fluid bolus o f 20 mUkg of normal saline. On reevaluation the child remains anxious, with a heart rate o f 140/min, a blood pressure o f 84 54 mm Hg, and a capillary refill time o f 4 seconds. What describes this patient's condition? Hypotensive shock B. Compensated shock C. No longer in shock D Cardiogenic shock
A
5 PALS
Provider Written Exam Version A A October American Heart Association
2011
12 20 II
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17. An 8-year-old child had a sudden onset o f palpitations and light-headedness. At the time o f evaluation the child is alert. His respiratory rate is 26/min, and his blood pressure is 1 417 mm Hg. A cardiac monitor is applied, and the rhythm below Is noted. ... ' :
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What is the most appropriate initial intervention? A.
Provide synchronized cardioversion at 0.5 to 1 J kg
B. Attempt vagal maneuvers C . Adm inister adenosine 0 . 1 mg kg over 5 minutes
D. Administer amiodarone 5 mg kg over 20 minutes 18. A 10-year-old child- had a sudden witnessed cardiac arrest and received immediate bystander CPR and defibrillation within 3 minutes. He had a return o f spontaneous circulation. The child remains unresponsive and has an advanced airway in place. There is no history o f trauma or signs of shock. What is the target range for oxygen saturation for this child? 92% B. 92% C. 94% D. 94%
A.
to to to to
100% 99% 99% 100%
6 PA LS Prov ovider ider Written Exam Versi on A, Octobe r 12, 2 011 © 20 II A meri can Heart Ass oc iation
American
Heart
Association 19. A 3-month-old 3-month-old infant with bronchiolitis is suctioned to remove upper airway secretions. The infant's heart rate decreases from 155/min to 65/min as sho wn below.
The infant remains alert, with easily palpable pulses. Capillary refi refill ll time is 1 second. What is the most appropriate initial initial interv ention?
A Administer oxygen and ensure adequate ventilation ; be prepared
to
intervene further if heart rate
does not increase Establish IVIIO access and administer epinephrine 0 01 mg kg IV C Establish IVIIO access and administer atropine 0 0 02 mg kg IV D Call for help and prepare to provide transthoracic pacing/transvenous pacing B
20. A 3-month-old 3-month-old infant with bronchiolitis is intubated for management of respiratory failure. During transport, transport, the infant deve lops bradycardia with a h eart rate of 60/min, 60/min, and the infant's oxygen saturation saturation decrease s to 75 . There are breath sound s on the the right side, but no air entry is heard o the left side. hat is the most appropriate initial intervention?
Administer epinephrine 0 0 01 mg kg IV B Place a chest tube on the left C Verify the endotracheal tube position D Aggressively suction the endotracheal tube A
21. For a 6-month-old infant with supraventricular tachycardia and adequate perfusion, which the following following is the preferred vagal maneuver?
of
Ocular pressure B Carotid pressure C Valsalva maneuver D Ice to the face A
7 PALS
Provider Written Exam Version A A October
© 2 II American Heart Association
12 2 11
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Heart
ssociation ®
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? 22
Nebulized albuterol B. Epinephrine M
A
C. Isotonic crystalloid crystalloid IV D. Methylprednisolone IV
A 2-year-o 2-year-old ld child was found submerged in a swimming swimm ing 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 appropriate intervention? 23
Give atropine 0 .02 mg/kg IO/lV B. Apply cricoid pressure C . Give epinephrine 0 .01 mg/kg IO/lV D. Provide transthoracic pacin pacing g
A
24
A 3-year3-year-old old child is unresponsive, not breathing, and pulseless. High-quality CPR CPR is in
progress. A cardiac monitor is applied, and the rhythm below is noted. . : .. : :.
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What is the next appropriate intervention? Attempt defibrillation with a 2 J kg shock B. Administer epinephrine 0 .01 mg/kg C . Consider placement of an advanced airway D. Administer amiodarone 5 mg kg
A
8 PALS Provider Written Exam Version A October 12 12 2 2 011 © 20 II American Heart Association
American
Heart
Association ® 25. A pulseless 6-week-old infant inf ant arrives in the emergency department and high high--quality CP R is progress. The initial rhythm strip is shown below.
in
CPR continues continues and vascular access has been been establishe d. What is the next appropriate intervention? A
B C D
Administer atropine 0 0with 02 mg/kg IO/IV Attempt defibrillation a 2 J/kg shock Administer epinephrine 0 0 01 mg/kg IOIlV Consider insertion of an advanced airway
26. A 6-month-old infant is unresponsive and not breathing. What is the maximum time that should e spent trying to palpate the pulse before starting CPR?
A
10
B
15
C D
30 60
seconds seconds seconds seconds
27. What is the recommended location to check for a pulse
in
a 3-month3-month -old infant?
Carotid B Radial C Brachial D Cardiac apex A
Written Ex am Versi o n A A October 12 12 2011 American Heart Assoc iation
PALS Provider
©
2 11
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28
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American eart Association ®
A 7-year-old child presents in pulseless arrest. The The child's ECG shows the rhythm below ..
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Which o f the following describes the patient s condition? Ventricular escape rhythm B. Ventricular tachycardia C. Pulseless electrical activity D. Sinus bradycardia
A
29. While you are performing CPR on
an
infant in cardiac arrest at a doctor's office, a second
with an AED. rescuer AED. Wh ich o f the following best describes the use o f an AED on this infant? arrives
The use of AEDs is not recommended on an infant. B. There are not enough data to recommend for or against again st the use of AEDs on infants. C. Only pediatric pads may be used on infants infants.. D. If pediatric pads are unavailable, it is acceptable to use adult pads. pads .
A
30. 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 B
Contact the child child s family Provide CPR for 2 minutes
C Drivethe theAED child to the hospital D.. Use
A 6-year-old child is found unresponsive, not breathing, and pulseless. What is the correct compression-to-ventilation ratio when 2 or more healthcare providers ar are e present to perform CPR? A 3: 1 B. 10 :1 C. 15 :2 D. 30 :2 31
10 PALS Provider Written Exam Version A, A, October October 12 2011 © 20 II American Heart Assoc iation
merican
Heart
ssociation ®
32. A 5-year-old child has had severe respiratory distress or 2 days. days. During assessment the chi ld s heart child h eart rate decreases from 140/min to gO/m gO/min in,, and the chi ld s respiratory ra rate te decreases from 66/min to S/min. What intervention is most appropriate? o
12toto10/min A. 20/min B, Provide Provide rescue rescue breaths breaths at at a a rate rate o 6 C Initiate chest che st compressions compress ions at a rate of at least 100/min D Initiate chest compressions at a rat rate e o f 60/min
33. A 7-year-old child presents with a narrow-complex supraventricular tachycardia, lethargy, and poo r perfusion. Pulses are weak weak and thready. thready. Vascular Vascul ar access cannot be established. What is the most
appropriate appropriat e intervent ion?
Unsynchronized shock with 0, 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 A.
11 PALS Provider Written Exam Version A A 2011 1 Amer ican Heart Association © 201
October
12
2
II
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