PALS exam -with 100% verified solutions 2024-2025-tutor verified.docx, Exams of Nursing

Download PALS exam -with 100% verified solutions 2024-2025-tutor verified.docx and more Exams Nursing in PDF only on Docsity! PALS exam -with 100% verified solutions 2024-2025- tutor verified You are caring for a child who was resuscitated after a drowning event. The child is intubated and ventilated with 100% oxygen with equal breath sounds and exhaled CO2 detected. The heart rate is slow and the monitor shows sinus bradycardia. The skin is cool, mottled, and moist; distal pulses are not palpable and the central pulses are weak. Intravenous access has been established. The core temperature is 37.3oC. Based on the PALS bradycardia algorithm, which of the following should be provided first? Epinephrine IV You are caring for a 5-year-old patient with supraventricular tachycardia (heart rate = 220/min). The child is lethargic. The skin is pale and cool with delayed capillary refill. Distal pulses are not palpable. Which of the following would be the best treatment to provide without delay? Provide synchronized cardioversion at 0.5 to 1 J/kg You are initiating treatment for a child with septic shock and hypotension. While administering high-flow oxygen you determine that the child's respirations are adequate and SpO2 is 100%. You have just established vascular access and obtained blood samples. Which of the following is the next most appropriate therapy to support systemic perfusion? Administer repeated fluid boluses of isotonic crystalloid You are treating an 8-year-old with ventricular tachycardia with pulses and adequate perfusion. You attempted synchronized cardioversion without success. While seeking expert consultation, it would be most appropriate to: Consider possible metabolic and toxicologic causes You are caring for a 2-year-old unconscious patient who is intubated and receiving mechanical ventilation. The child's heart rate suddenly drops to 40/min and his color becomes mottled. You should respond to these changes by: Using a resuscitation bag provide manual ventilation with 100% oxygen You are caring for a 9-month-old patient with pronounced respiratory distress. You initiated high-flow oxygen using a nonrebreathing mask about 10 minutes ago and established intravenous access. Initially the infant's heart rate was in the 150/min range with strong pulses. Suddenly the infant's respiratory rate falls to 6/min with significant intercostals retractions, and little air movement is heard. The infant becomes cyanotic and the heart rate decreases to 95/min. Which of the following treatments would be best for you to provide now? Provide bag-mask ventilation Which of the following is likely to be the most helpful technique to identify potentially reversible metabolic and toxic causes during the attempted resuscitation of a young child in cardiac arrest? Soliciting a history from the caregiver or family You are caring for a patient who developed a tension pneumothorax after several hours of positive-pressure ventilation. Which of the following would be the most appropriate site for needle decompression? Over the third rib at the midclavicular line You attempted synchronized cardioversion for an infant with supraventricular tachycardia (SVT) and poor perfusion. The SVT persists after the initial 1 J/kg shock. Which of the following should you attempt now? Synchronized cardioversion at a dose of 2 J/kg You are treating a 5-month-old with a 2-day history of vomiting and diarrhea. The patient is listless. The respiratory rate is 52/min and unlabored. The heart rate is 170/min and pulses are present but weak. Capillary refill is delayed. You are administering high-flow oxygen, and Withdrawal from a painful stimulus Localization of a painful stimulus Localization of a painful stimulus You are caring for an 8-year-old child who was struck by a car. The child is alert, very anxious, and in respiratory distress. The child is receiving high- flow oxygen by face mask, has a respiratory rate of 60/min, the heart rate is 150/min, systolic blood pressure is 70 mm Hg, and a SpO2 of 86% and falling. Breath sounds and chest rise are absent over the right chest. Which of the following is the most likely cause of this child's distress? Tension Pneumothorax Cardiac temponade Severe hypovolemia Cardiac asthma Tension Pneumothorax You are treating a 10-year-old victim of multisystem trauma. The child is very anxious and confused. The respiratory rate is 44/min and unlabored. the pulse is rapid and weak. Capillary refill is delayed. High-flow oxygen and an intravenous line are in place. The most appropriate initial fluid for rapid volume expansion is: 10% dextrose in water 5% dextrose in Ringer's lactate 5% dextrose in normal saline Normal saline or Ringer's lactate Normal saline or Ringer's lactate When monitoring the quality of chest compressions during a resuscitation, you should ensure that providers are: Allowing complete recoil - let the chest return to its original position between compressions You are treating an 8-year-old with ventricular tachycardia (VT) with pulses and adequate perfusion. You attempted synchronized cardioversion without success. While seeking expert consultation, it would be most appropriate to: Consider possible metabolic and toxicologic causes You are caring for a patient who developed a tension pneumothorax after several hours of positive-pressure ventilation. Which of the following would be the most appropriate site for needle decompression? Over the third rib (ie, second intercostal space) at the mid-clavicular line You are initiating treatment for a child with septic shock and hypotension. While administering high-flow oxygen, you determine that the child's respirations are adequate and SpO2 is 100%. You have just established vascular access and obtained blood samples. Which of the following is the next most appropriate therapy to support systemic perfusion? Administer repeated fluid boluses of isotonic crystalloid You are caring for a 5-year-old patient with supraventricular tachycardia (SVT) (heart rate is 220/min). The child is lethargic. The skin is pale and cool with delayed capillary refill. Distal pulses are not palpable. Which of the following would be the best treatment to provide without delay? Provide synchronized cardioversion at 0.5 to 1 J/kg You attempted synchronized cardioversion for an infant with SVT and poor perfusion. The SVT persists after the initial shock of 1 J/kg. Which of the following should you attempt now? Synchronized cardioversion at a dose of 2 J/kg You are caring for a 2-year-old unconscious patient who is intubated and receiving mechanical ventilation. The child's heart rate suddenly drops to 40/min and his color becomes mottled. You should respond to these changes by: Using a resuscitation bag to provide manual ventilation with 100% oxygen You are caring for a 9-month-old patient with pronounced respiratory distress. You initiated high-flow oxygen using a nonrebreathing mask about 10 minutes ago and established intravenous access. Initially the infant's heart rate was in the 150/min range with strong pulses. Suddenly the infant's respiratory rate falls to 6/min with significant intercostal retractions, and little air movement is heard. The infant becomes cyanotic and the heart rate decreases to 95/min. Which of the following treatments would be best for you to provide now? Administer epinephrine IV Provide bag-mask ventilation Administer magnesium sulfate IV lntubate and ventilate Provide bag-mask ventilation You are caring for an 8-year-old child who was struck by a car. The child is alert, very anxious, and in respiratory distress. The child is receiving high- flow oxygen by face mask, has a respiratory rate of 60/min, heart rate of 150/min, systolic blood pressure of 70 mm Hg, and Spot of 86% and falling. Breath sounds and chest rise are absent over the right chest. Which of the following is the most likely cause of this child's distress? You arrive on the scene where a 12-year-old child has suddenly collapsed on the playground. The child is unresponsive, apneic, and pulseless, and CPR is in progress. A lay rescuer just arrived with the school AED, turned it on, and attached it. The AED recommends a shock. Which of the following should be done next? Attempt defibrillation You are caring for a child in persistent VF. Which of the following would best describe the child's cardiac condition? The heart is not pumping blood at all You are called to treat a 5-year-old with a 3-day history of worsening respiratory distress. The child responds only to pain. The heart rate is initially 45/min and regular with poor capillary refill. You provide bag-mask ventilation with high-flow oxygen, which produces good chest rise with full and clear bilateral breath sounds. The heart rate rises in response to ventilation, but after you suction the posterior pharynx, bradycardia recurs (40/min). Which of the following interventions would be most appropriate for you to do first? Resume bag-mask ventilation You are caring for a 7-year-old with respiratory distress that has worsened over the past few hours. The child is alert and in moderate respiratory distress with prolonged exhalation time. The respiratory rate is 28/min with bilateral expiratory wheezes. The heart rate is 112/min with good capillary refill. The wheezing in this patient indicates: Disordered control of breathing Lung tissue (parenchymal) lung disease Lower airway obstruction Upper airway obstruction Lower airway obstruction Which of the following assessments is most useful in evaluating the effectiveness of bagmask ventilation? Observation of visible chest rise You are assessing a 6-year-old child who appears to be unconscious after striking his head on a concrete step. You pinch the patient's chest and the patient grabs your hand. You would document this response as: Localization of a painful stimulus Withdrawal from a painful stimulus Decerebrate posturing Decorticate posturing Localization of a painful stimulus You are treating a 10-year-old victim of multisystem trauma. The child is very anxious and confused. The respiratory rate is 44/min and unlabored. The pulse is rapid and weak. Capillary refill is delayed. High-flow oxygen and an intravenous line are in place. The most appropriate initial fluid for rapid volume expansion is: Normal saline or Ringer's lactate When monitoring the quality of chest compressions during a resuscitation, you should ensure that providers are: Allowing complete recoil-let the chest return to its original position between compressions You are caring for a child who was resuscitated after a drowning event. The child is intubated and ventilated with 100% oxygen with equal breath sounds and exhaled CO2 detected. The heart rate is slow and the monitor shows a sinus bradycardia. The skin is cool, mottled, and moist; distal pulses are not palpable and central pulses are weak. Intravenous access has been established. The core temperature is 37.3°C. Based on the PALS bradycardia algorithm, which of the following should be Epinephrine IV You are caring for a 2-year-old with a 1-day history of respiratory distress and stridor. The patient is alert. The child's respiratory rate is 32/min with good chest rise. Spot is 98% in room air. The heart rate is 128/min and capillary refill is normal. Skin is warm, pink, and dry. At this point you should: Keep the patient calm and comfortable