Hayden Worwood
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Multiple Choice Quiz for PALS

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Hayden Worwood
Created by Hayden Worwood over 5 years ago
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PALS Quiz

Question 1 of 105

1

A 5-year-old child in supraventricular tachycardia has adequate pulses with the rhythm. Supplemental oxygen is in place and vital signs are stable except for the elevated heart rate. The most appropriate next intervention for this child is

Select one of the following:

  • Unsynchronized cardioversion

  • Vagal maneuvers

  • Synchronized cardioversion

  • Amiodarone

Explanation

Question 2 of 105

1

A child has an advanced airway in place during cardiac arrest. How frequently should ventilations be given?

Select one of the following:

  • Every 3 Seconds

  • Every 6 Seconds

  • Every 10 Seconds

  • Every 12 Seconds

Explanation

Question 3 of 105

1

You are using a bag-valve mask to resuscitate an infant, while another rescuer is performing chest compressions. What is the correct ratio of chest compressions to ventilations?

Select one of the following:

  • 30 Chest compressions to 2 ventilations

  • 15 Chest compressions to 2 ventilations

  • 30 Ventilations to 2 chest compressions

  • 15 ventilations to 2 chest compressions

Explanation

Question 4 of 105

1

You are alone performing infant CPR. What is the correct ratio of chest compressions to ventilations?

Select one of the following:

  • 30 chest compressions to 2 ventilations

  • 15 chest compressions to 2 ventilations

  • 30 ventilations to 2 chest compressions

  • 15 ventilations to 2 chest compressions

Explanation

Question 5 of 105

1

A 7 month old appears to be unconscious and not breathing. You check for a pulse at the ________ artery.

Select one of the following:

  • Brachial

  • Femoral

  • Carotid

  • Coronary

Explanation

Question 6 of 105

1

A clear sign of upper airway obstruction is:

Select one of the following:

  • Decreased inspiratory effort

  • Breath sounds in all lung fields

  • Crying

  • A “whistling” sound during breathing

Explanation

Question 7 of 105

1

In children, which of the following is the most common form of arrest?

Select one of the following:

  • Respiratory arrest

  • Ventricular fibrillation – cardiac arrest

  • Ventricular tachycardia – cardiac arrest

  • PEA – cardiac arrest

Explanation

Question 8 of 105

1

In small children, a rescue breath should be given:

Select one of the following:

  • As quickly as possible

  • As slowly as possible

  • Over one second

  • Over three seconds

Explanation

Question 9 of 105

1

What is the normal range of heart rates for an 8-year-old child?

Select one of the following:

  • 80-205 per minute

  • 75-190 per minute

  • 60-140 per minute

  • 50-100 per minute

Explanation

Question 10 of 105

1

The child you are caring for is very pale. You know that this pallor can be caused by all of the following EXCEPT:

Select one of the following:

  • Anemia

  • Heat

  • Shock

  • Albinism

Explanation

Question 11 of 105

1

Clinical signs of respiratory distress may include all of the following EXCEPT:

Select one of the following:

  • Rapid respiratory rate

  • Grunting respirations

  • Warm, pink skin

  • Diminished level of consciousness

Explanation

Question 12 of 105

1

Late and ominous signs of respiratory failure include all of the following EXCEPT:

Select one of the following:

  • Rapid respiratory rate

  • Cyanosis

  • Bradycardia

  • Diminished level of consciousness

Explanation

Question 13 of 105

1

The 8-year-old child you are treating has a palpable pulse and a heart rate of 200. You look at the monitor and see a rapid rhythm with narrow QRS complexes. There are no discernible P waves on the monitor. The rhythm is probably:

Select one of the following:

  • Sinus tachycardia

  • Supraventricular tachycardia

  • Sinus rhythm

  • Ventricular tachycardia

Explanation

Question 14 of 105

1

You are doing CPR on a child with symptomatic bradycardia. An intravenous line is in place. What is the first drug of choice for the patient?

Select one of the following:

  • Atropine

  • Epinepherine

  • Sodium Bicarbonate

  • Dopamine

Explanation

Question 15 of 105

1

High-quality CPR for young children includes:

Select one of the following:

  • Compress to a depth of at least one third of the child's chest diameter

  • Compress at a rate between 100 and 120 compressions per minute

  • Minimize interruptions to chest compressions

  • All of the above

Explanation

Question 16 of 105

1

You are the team leader on a team resuscitating a child without a pulse or respirations. When you look at the monitor, you see a disorganized rhythm with chaotic electrical activity. This rhythm is most likely:

Select one of the following:

  • Asystole

  • PEA

  • Ventricular fibrillation

  • Ventricular tachycardia

Explanation

Question 17 of 105

1

The goal of the PALS team in the treatment of shock is to:

Select one of the following:

  • Improve oxygen delivery

  • Prevent organ injury

  • Stop the progression to cardiopulmonary failure

  • All of the above

Explanation

Question 18 of 105

1

When evaluating a child's bradycardia, it is important to consider the child's:

Select one of the following:

  • Baseline rate

  • Level of activity

  • Clinical condition

  • All of the above

Explanation

Question 19 of 105

1

For asystole, the team should do CPR until IV or IO access is achieved. The drug of choice for asystole is:

Select one of the following:

  • Amiodarone

  • Epinephrine

  • Lidocaine

  • Atropine

Explanation

Question 20 of 105

1

In school age children and infants, the two most common initial rhythms seen in pediatric cardiac arrest are:

Select one of the following:

  • Asystole and PEA

  • Asystole and VF

  • PEA and VF

  • Pulseless VT and VF

Explanation

Question 21 of 105

1

What is not a typical sign of respiratory distress?

Select one of the following:

  • tachypnea

  • fever

  • nasal flaring

  • tachycardia

Explanation

Question 22 of 105

1

What is the most common form of infectious pneumonia which often causes empyema?

Select one of the following:

  • streptococcus pneumoniae

  • mycoplasma pneumoniae

  • chlamydia pneumoniae

  • staphylococcus pneumoniae

Explanation

Question 23 of 105

1

Children with increased ICP typically will present with all the following except which?
Mark one answer:

Select one of the following:

  • irregular breathing

  • bradycardia

  • tachycardia

  • hypertension

Explanation

Question 24 of 105

1

Shock occurs with which level of blood pressure?

Select one of the following:

  • decreased

  • increased

  • normal

  • all the above

Explanation

Question 25 of 105

1

The recommended priority of treatment of ischemic hypoxia is what?

Select one of the following:

  • oxygen administration

  • increase cardiac output

  • restore hemoglobin concentration

  • none of the above

Explanation

Question 26 of 105

1

Myocordial dysfunction impairs cardiac output and strock volume which can typically lead to which shock?

Select one of the following:

  • cardiogenic shock

  • septic shock

  • anaphylactic shock

  • neurogenic shock

Explanation

Question 27 of 105

1

What should be the first priority when assisting a critically ill or injured child in shock?

Select one of the following:

  • oxygen administration

  • monitoring

  • positioning

  • fluid resuscitation

Explanation

Question 28 of 105

1

Which is not a common assessment when determining the effectiveness of fluid resuscitation?

Select one of the following:

  • central venous catheter

  • aterial catheter

  • pulmonary artery catheter

  • none of the above

Explanation

Question 29 of 105

1

Which is not a common assessment when determining the effectiveness of fluid resuscitation?
Mark one answer:

Select one of the following:

  • temperature

  • heart rate

  • skin coloration

  • urine output

Explanation

Question 30 of 105

1

To treat cold shock, _____________ is preferred.

Select one of the following:

  • dopamine

  • norepinephrine

  • epinephrine

  • dobutamine

Explanation

Question 31 of 105

1

For cardiogenic shock, you should deliver a fluid challenge (5 to 10 mL/kg bolus) over what length of time?

Select one of the following:

  • 1-5 minutes

  • 5-10 minutes

  • 10-20 minutes

  • under 3 minutes

Explanation

Question 32 of 105

1

______________ is described as an accumulation of pressurized air in the pleural space.

Select one of the following:

  • tension pneumothorax

  • cardiac tamponade

  • massive pulmonary embolism

  • none of the above

Explanation

Question 33 of 105

1

In a case of sinus tachycardia, the heart rate is ___________.

Select one of the following:

  • increased

  • decreased

  • unsteady

  • faint

Explanation

Question 34 of 105

1

Ventricular tachycardia is common in children.

Select one of the following:

  • true

  • false

Explanation

Question 35 of 105

1

What is the first sign of the body's defensive response when a child or infant is in shock?

Select one of the following:

  • body temperature drop

  • body temperature rise

  • heart rate increase

  • heart rate decrease

Explanation

Question 36 of 105

1

Each attempt for catheter insertion and suctioning of an infant should not surpass:

Select one of the following:

  • 3 seconds

  • 5 seconds

  • 7 seconds

  • 10 seconds

Explanation

Question 37 of 105

1

The first warning sign of respiratory dysfunction is:

Select one of the following:

  • decrease of heart rate

  • increase in blood pressure

  • increase in respiratory rate

  • decrease in body temperature

Explanation

Question 38 of 105

1

During resuscitation of a newborn infant, the blow-by oxygen rate of flow should always be more than:

Select one of the following:

  • 2 L/min.

  • 5 L/min.

  • 6 L/min.

  • 8 L/min.

Explanation

Question 39 of 105

1

What age period is croup most common to occur?

Select one of the following:

  • 3 - 5 years

  • 6 months - 3 years

  • 4 - 7 years

  • 1 month - 12 months

Explanation

Question 40 of 105

1

What is the recommended first energy level used for defibrillation?

Select one of the following:

  • 0.3 joules/kg.

  • 1.5 joules/kg.

  • 2.0 joules/kg.

  • 2.5 joules/kg.

Explanation

Question 41 of 105

1

A patient has a "do not resuscitate" order. Which action is least appropriate?

Select one of the following:

  • Endotracheal intubation

  • Nasogastric tube feedings

  • Intravenous line insertion

  • Oxygen by face mask

Explanation

Question 42 of 105

1

What agent is added to increase the half-life of imipenem?

Select one of the following:

  • Cilastatin

  • Probenecid

  • Allopurinol

  • Sodium bicarbonate

Explanation

Question 43 of 105

1

Which would be considered a normal serum potassium?

Select one of the following:

  • 2 mEq per L

  • 4 mEq per L

  • 6 mEq per L

  • 8 mEq per L

Explanation

Question 44 of 105

1

The proximal aorta is derived from which structure?

Select one of the following:

  • First aortic arch

  • Truncus arteriosus

  • Second brachial pouch

  • Sinus venosus

Explanation

Question 45 of 105

1

Select the medication that is contraindicated in cocaine associated myocardial infarction.

Select one of the following:

  • Benzodiazepines

  • Verapamil

  • Beta blockers

  • Nifedipine

Explanation

Question 46 of 105

1

Which physical finding is most indicative of a pleural effusion?

Select one of the following:

  • Decreased apical breath sounds

  • Decreased vesicular sounds

  • Increased adventitious sounds

  • Barrel chest

Explanation

Question 47 of 105

1

Which is false about the treatment of septic shock?

Select one of the following:

  • Adrenaline can be used to raise blood pressure

  • Noradrenaline can be used to raise blood pressure

  • Isoproterenol can be used to raise blood pressure

  • Dopamine can be used to raise blood pressure

Explanation

Question 48 of 105

1

What is the best position for a hospitalized patient experiencing difficulty breathing?

Select one of the following:

  • Lithotomy

  • Trendelenburg

  • Reverse Trendelenburg

  • High Fowler's

Explanation

Question 49 of 105

1

What is required for the diagnosis of repiratory failure?

Select one of the following:

  • PAO2<80mmHg

  • Patient is unable to breathe without Ventimask of 80% O2

  • Patient has cyanotic extremities

  • PACO2>50mmHg or PAO2<60mmHg

Explanation

Question 50 of 105

1

What does a carotid pulse indicate?

Select one of the following:

  • A functioning pump for blood flow

  • The circulating blood volume is reaching end organs

  • Diastolic blood pressure

  • None of the above

Explanation

Question 51 of 105

1

In addition to intravenous fluid, what is considered the mainstay of treatment for anaphylaxis?

Select one of the following:

  • Diphenhydramine

  • Prednisone

  • Propanolol

  • Epinephrine

Explanation

Question 52 of 105

1

During CPR, the highest amount of blood flow is observed which technique?

Select one of the following:

  • High impulse CPR at 80 compressions per min

  • High impulse CPR at 60 compressions per min

  • High impulse CPR at 100-120 compressions per min

  • High impulse CPR at 150 compressions per

Explanation

Question 53 of 105

1

The right neck vein is preferred for central line over the left because of what structure?
Mark one answer:

Select one of the following:

  • Subclavian

  • Lung apex

  • Thoracic duct

  • Heart

Explanation

Question 54 of 105

1

What is a normal finding after successful endotracheal intubation?

Select one of the following:

  • Bilateral chest wall expansion

  • Right side only breath sounds

  • Abdominal movement with ventilation

  • None of the above

Explanation

Question 55 of 105

1

What ECG wave represents the depolarization of atrium?

Select one of the following:

  • P wave

  • QRS complex

  • T wave

  • Q wave

Explanation

Question 56 of 105

1

To relive a right tension pneumothorax, where should the needle should be placed?

Select one of the following:

  • 4th intercostal space left of the mediastinum

  • 2nd intercostal space left of the mediastinum

  • 4th intercostal space right of the mediastinum

  • 2nd intercostal space right of the mediastinum

Explanation

Question 57 of 105

1

Which is not a typical sign of cardiogenic shock?

Select one of the following:

  • Hypotension

  • Polyuria

  • Tachycardia

  • Confusion

Explanation

Question 58 of 105

1

A chest tube will drain an effusion when the lumen is properly placed in which space?

Select one of the following:

  • Intra-alveolar

  • Pericardial

  • Pleural

  • Intercostal

Explanation

Question 59 of 105

1

Why does the ACLS protocol recommend epinephrine?

Select one of the following:

  • Increases muscular blood flow

  • Dilates the bronchioles

  • Enhances myocardial contractility

  • Raises the systolic blood pressure

Explanation

Question 60 of 105

1

Cardioversion delivery is syschronized with:

Select one of the following:

  • P wave

  • R wave

  • S wave

  • T wave

Explanation

Question 61 of 105

1

The most common rhythm identified in "cardiac arrest" is which of the following?

Select one of the following:

  • Torsade de point

  • Ventricula tachycardia

  • Asytole

  • Ventricular fibrillation

Explanation

Question 62 of 105

1

Which of the following statements is false about the airway in children?

Select one of the following:

  • Children are less reliant on the diaphragm for breathing

  • As the child grows, the subglottic narrowing widens with time

  • Cricothyrotomy should never be done in small children

  • The size of the endotracheal tube for a child is usually the same size as the child's 5th finger

Explanation

Question 63 of 105

1

What is the best first step in patient with angina and ST ECG changes?

Select one of the following:

  • Cardiac enzyme

  • Aspirin

  • IV fluid

  • Morphine

Explanation

Question 64 of 105

1

A patient presents to the emergency department and has hives, hypotension and wheezing on initial exam. What is the first step?

Select one of the following:

  • Administration of nebulized albuterol

  • Administration of cimetidine

  • Immediate Administration of intramuscular (IM) epinephrine

  • Administration of aspirin

Explanation

Question 65 of 105

1

Which of the following is the superior marker for myocardial injury?

Select one of the following:

  • LDH

  • CPK

  • AST

  • Troponin

Explanation

Question 66 of 105

1

Which of the following is not used to ensure correct placement of an endotracheal tube?

Select one of the following:

  • Ultrasound

  • Bilateral breath sounds

  • Sustained end-tidal CO2

  • Sustained end-tidal O2

Explanation

Question 67 of 105

1

During the resuscitation of your bradycardic patient, the code team requests an epinephrine infusion of 2 mcg/min. In the crash cart you find a 1 mL vial of a 1:1000 epinephrine solution and a 500 mL bag of normal saline. Which is correct?

Select one of the following:

  • Mix 1 vial in the 500 mL bag and infuse at 6 mL per hour

  • Mix 0.5 mL of the epinephrine in the bag and infuse at 6 mL per hour

  • Mix the 1 mL vial in the 500 mL normal saline and infuse at 60 mL per hour

  • Question the request because this is an excessive amount of medication

Explanation

Question 68 of 105

1

In the femoral triangle, the order of the neurovascular bundles, from LATERAL TO MEDIAL, runs in what sequence?

Select one of the following:

  • Nerve, artery, vein

  • Nerve, vein, artery

  • Vein, artery, nerve

  • Vein, nerve, artery

Explanation

Question 69 of 105

1

Paroxysmal supraventricular tachycardia is best treated by which of the following?

Select one of the following:

  • Adenosine

  • Beta blockers

  • Calcium channel blockers

  • Digoxin

Explanation

Question 70 of 105

1

What is the estimated time a person's brain can be anoxic from cardiopulmonary failure and not develop permanent brain damage?

Select one of the following:

  • 10 minutes

  • 5 minutes

  • 2 minutes

  • 20 minutes

Explanation

Question 71 of 105

1

The phrenic nerve innervates which of the following?

Select one of the following:

  • Diaphragm

  • Heart

  • Stomach

  • Small intestine

Explanation

Question 72 of 105

1

-A 2-year-old child presents with severe hypotension. Peripheral IV access could not be obtained. Which of the following is the best alternative for administering IV fluids in such situations?

Select one of the following:

  • Venous cut down

  • Central line

  • Intraosseous

  • Intrathecal

Explanation

Question 73 of 105

1

Which of the following conditions is a common side effect of adenosine?

Select one of the following:

  • Tremors

  • Sympathetic over activity

  • Facial flushing

  • GI intolerance

Explanation

Question 74 of 105

1

A patient collapses, a cardiac monitor is placed, and the rhythm is determined to be ventricular fibrillation. Despite three defibrillation shocks, intravenous epinephrine, and further attempt at defibrillation, there is no change. The patient is unconscious. What is most appropriate for the next step in this patient's management?

Select one of the following:

  • Another attempt at defibrillation

  • Administer lidocaine

  • Administer amiodarone

  • Administer procainamide

Explanation

Question 75 of 105

1

How is the bradycardia caused by acetylcholine treated?

Select one of the following:

  • Epinephrine

  • Pacemaker

  • Atropine

  • Isoprenaline

Explanation

Question 76 of 105

1

What is the drug of choice for supraventricular tachycardia?

Select one of the following:

  • Metoprolol

  • Digoxin

  • Lidocaine

  • Adenosine

Explanation

Question 77 of 105

1

Performing CPR with chest compressions over the xiphoid process may result in laceration of which of the following organs?

Select one of the following:

  • Small bowel

  • Stomach

  • Lung

  • Liver

Explanation

Question 78 of 105

1

An adult patient is observed to have premature ventricular contractions every other beat on a monitor. What is the next best step for this patient?

Select one of the following:

  • Assess the vital signs and mental status

  • Call the physician immediately

  • Apply transcutaneous pacing pads and then call the physician

  • Call a code blue

Explanation

Question 79 of 105

1

What protective measure should be undertaken when performing tracheal suctioning on a patient requiring ventilation?

Select one of the following:

  • Face mask

  • Gloves

  • Eye protection

  • All of the above

Explanation

Question 80 of 105

1

What is the drug of choice for the treatment of ventricular dysrhythmias?

Select one of the following:

  • Metoprolol

  • Digoxin

  • Lidocaine

  • Adenosine

Explanation

Question 81 of 105

1

Which of the following is a first-line agent for rate control in the management of atrial fibrillation (AF)?

Select one of the following:

  • Beta-blockers

  • Amiodarone

  • Digoxin

  • Warfarin

Explanation

Question 82 of 105

1

Which is a not a sign of tension pneumothorax?

Select one of the following:

  • Decreased breath sounds

  • Tracheall deviation

  • Decreased compliance

  • Audible bronchial sounds

Explanation

Question 83 of 105

1

Which of the following statements regarding shock is correct?

Select one of the following:

  • The body cannot metabolize glucose

  • The body is in a state of multi-system organ failure

  • The body cannot perfuse tissues properly

  • The body is resistant to antibiotics

Explanation

Question 84 of 105

1

What is the proper way to deliver a breath?

Select one of the following:

  • Blow as hard and as fast as possible

  • Give over one second

  • Apply cricoid pressure first

  • Deliver during compressions

Explanation

Question 85 of 105

1

You are having difficulty using a bag-mask device. Which are potential causes for your difficulties?

Select one of the following:

  • The mask is too large

  • Pushing mask onto victim’s face

  • Improper seal

  • All the above

Explanation

Question 86 of 105

1

You are using an AED and the device indicates that a SHOCK is advised. What is the very last step before pressing the SHOCK button?

Select one of the following:

  • Give two breaths

  • Check connections

  • Clear the victim

  • Check pulse

Explanation

Question 87 of 105

1

What is the most common cause of cardiac arrest in children?

Select one of the following:

  • Respiratory difficulties

  • Drug use

  • Congenital heart disease

  • Sepsis

Explanation

Question 88 of 105

1

Child CPR may be given using a one or two-handed technique?

Select one of the following:

  • True

  • False

Explanation

Question 89 of 105

1

A seven-year-old accidentally ingests grandma’s pain medication. What drug can you use to reverse the sedation?

Select one of the following:

  • Atropine

  • Naloxone

  • Epinephrine

  • Glucose

Explanation

Question 90 of 105

1

You are treating hypoglycemia in a three-week-old. What concentration of IV fluids is recommended?

Select one of the following:

  • D5

  • D10

  • D25

  • D50

Explanation

Question 91 of 105

1

Which of the following are potential causes of respiratory arrest?

Select one of the following:

  • Ingestion

  • Head trauma

  • Choking

  • All of the above

Explanation

Question 92 of 105

1

You are performing High-Quality CPR in a cardiac arrest case. The AED indicates a shock is advised. After delivering the shock, what is the next immediate step?

Select one of the following:

  • CPR

  • Check pulse

  • Administer epinephrine

  • Pacing

Explanation

Question 93 of 105

1

What is the simplest way to open the airway in an unconcious patient?

Select one of the following:

  • Pull out the tongue

  • Tilt head and lift chin

  • Lift neck from behind

  • Jaw thrust

Explanation

Question 94 of 105

1

What is the most likely place for an over advanced endotracheal (ET) tube to enter?

Select one of the following:

  • Stomach

  • Right mainstem bronchus

  • Soft palate

  • Left mainstem bronchus

Explanation

Question 95 of 105

1

Which condition can have hyperresonance on percussion?

Select one of the following:

  • Pleuritis

  • Bronchitis

  • Pneumothorax

  • ARDS

Explanation

Question 96 of 105

1

What should be the initial temporizing measure in a patient with hypotension following the onset of 3rd degree heart block?

Select one of the following:

  • Transcutaneous pacing

  • Electric cardioversion

  • Amiodarone loading and then electric cardioversion

  • Stat placement of a permanent pacemaker

Explanation

Question 97 of 105

1

The first heart sound, 'lub', is produced by closure of which of the following valves?

Select one of the following:

  • Aortic and mitral

  • Pulmonary and tricuspid

  • Mitral and tricuspid

  • Tricuspid and mitral

Explanation

Question 98 of 105

1

Which of the following rhythms carries the worst long-term prognosis for survival?

Select one of the following:

  • Asystole

  • Atrial flutter

  • Ventricular fibrillation

  • Pulseless electrical activity

Explanation

Question 99 of 105

1

At what point should tracheal suctioning be performed?

Select one of the following:

  • Withdrawal of the catheter

  • Insertion of the catheter

  • Upon insertion and withdrawal of the catheter

  • None of the above

Explanation

Question 100 of 105

1

Which of the following is a lethal heart rhythm?

Select one of the following:

  • Pulseless ventricular tachycardia

  • Asymptomatic supraventricular tachycardia (SVT)

  • Atrial fibrillation (AF)

  • First degree heart block

Explanation

Question 101 of 105

1

Which of the following is the least preferred method of administering IV fluids?

Select one of the following:

  • Cubital veins

  • Cephalic veins

  • Subclavian veins

  • Saphenous vein

Explanation

Question 102 of 105

1

The trachea deviates with tension pneumothorax to the:

Select one of the following:

  • Affected side

  • Unaffected side

  • Anteriorly

  • Posteriorly

Explanation

Question 103 of 105

1

In a neonate, what is the proper method of performing chest compressions for two rescuers?

Select one of the following:

  • Two hands

  • One hand

  • Two thumb-encircling hands chest compression

  • Two fingers.

Explanation

Question 104 of 105

1

On ECG, no conduction through the atrioventricular (AV) node is considered:

Select one of the following:

  • First-degree AV block

  • Second-degree AV block

  • Third-degree AV block

  • None of the above

Explanation

Question 105 of 105

1

Which ECG change is associated with hyperkalemia?

Select one of the following:

  • U wave

  • Peaked T wave

  • Long PR interval

  • Absent P wave

Explanation

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