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PALS Quiz

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Multiple Choice Quiz for PALS
Hayden Worwood
Quiz by Hayden Worwood, updated more than 1 year ago
Hayden Worwood
Created by Hayden Worwood over 5 years ago
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Resource summary

Question 1

Question
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
Answer
  • Unsynchronized cardioversion
  • Vagal maneuvers
  • Synchronized cardioversion
  • Amiodarone

Question 2

Question
A child has an advanced airway in place during cardiac arrest. How frequently should ventilations be given?
Answer
  • Every 3 Seconds
  • Every 6 Seconds
  • Every 10 Seconds
  • Every 12 Seconds

Question 3

Question
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?
Answer
  • 30 Chest compressions to 2 ventilations
  • 15 Chest compressions to 2 ventilations
  • 30 Ventilations to 2 chest compressions
  • 15 ventilations to 2 chest compressions

Question 4

Question
You are alone performing infant CPR. What is the correct ratio of chest compressions to ventilations?
Answer
  • 30 chest compressions to 2 ventilations
  • 15 chest compressions to 2 ventilations
  • 30 ventilations to 2 chest compressions
  • 15 ventilations to 2 chest compressions

Question 5

Question
A 7 month old appears to be unconscious and not breathing. You check for a pulse at the ________ artery.
Answer
  • Brachial
  • Femoral
  • Carotid
  • Coronary

Question 6

Question
A clear sign of upper airway obstruction is:
Answer
  • Decreased inspiratory effort
  • Breath sounds in all lung fields
  • Crying
  • A “whistling” sound during breathing

Question 7

Question
In children, which of the following is the most common form of arrest?
Answer
  • Respiratory arrest
  • Ventricular fibrillation – cardiac arrest
  • Ventricular tachycardia – cardiac arrest
  • PEA – cardiac arrest

Question 8

Question
In small children, a rescue breath should be given:
Answer
  • As quickly as possible
  • As slowly as possible
  • Over one second
  • Over three seconds

Question 9

Question
What is the normal range of heart rates for an 8-year-old child?
Answer
  • 80-205 per minute
  • 75-190 per minute
  • 60-140 per minute
  • 50-100 per minute

Question 10

Question
The child you are caring for is very pale. You know that this pallor can be caused by all of the following EXCEPT:
Answer
  • Anemia
  • Heat
  • Shock
  • Albinism

Question 11

Question
Clinical signs of respiratory distress may include all of the following EXCEPT:
Answer
  • Rapid respiratory rate
  • Grunting respirations
  • Warm, pink skin
  • Diminished level of consciousness

Question 12

Question
Late and ominous signs of respiratory failure include all of the following EXCEPT:
Answer
  • Rapid respiratory rate
  • Cyanosis
  • Bradycardia
  • Diminished level of consciousness

Question 13

Question
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:
Answer
  • Sinus tachycardia
  • Supraventricular tachycardia
  • Sinus rhythm
  • Ventricular tachycardia

Question 14

Question
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?
Answer
  • Atropine
  • Epinepherine
  • Sodium Bicarbonate
  • Dopamine

Question 15

Question
High-quality CPR for young children includes:
Answer
  • 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

Question 16

Question
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:
Answer
  • Asystole
  • PEA
  • Ventricular fibrillation
  • Ventricular tachycardia

Question 17

Question
The goal of the PALS team in the treatment of shock is to:
Answer
  • Improve oxygen delivery
  • Prevent organ injury
  • Stop the progression to cardiopulmonary failure
  • All of the above

Question 18

Question
When evaluating a child's bradycardia, it is important to consider the child's:
Answer
  • Baseline rate
  • Level of activity
  • Clinical condition
  • All of the above

Question 19

Question
For asystole, the team should do CPR until IV or IO access is achieved. The drug of choice for asystole is:
Answer
  • Amiodarone
  • Epinephrine
  • Lidocaine
  • Atropine

Question 20

Question
In school age children and infants, the two most common initial rhythms seen in pediatric cardiac arrest are:
Answer
  • Asystole and PEA
  • Asystole and VF
  • PEA and VF
  • Pulseless VT and VF

Question 21

Question
What is not a typical sign of respiratory distress?
Answer
  • tachypnea
  • fever
  • nasal flaring
  • tachycardia

Question 22

Question
What is the most common form of infectious pneumonia which often causes empyema?
Answer
  • streptococcus pneumoniae
  • mycoplasma pneumoniae
  • chlamydia pneumoniae
  • staphylococcus pneumoniae

Question 23

Question
Children with increased ICP typically will present with all the following except which? Mark one answer:
Answer
  • irregular breathing
  • bradycardia
  • tachycardia
  • hypertension

Question 24

Question
Shock occurs with which level of blood pressure?
Answer
  • decreased
  • increased
  • normal
  • all the above

Question 25

Question
The recommended priority of treatment of ischemic hypoxia is what?
Answer
  • oxygen administration
  • increase cardiac output
  • restore hemoglobin concentration
  • none of the above

Question 26

Question
Myocordial dysfunction impairs cardiac output and strock volume which can typically lead to which shock?
Answer
  • cardiogenic shock
  • septic shock
  • anaphylactic shock
  • neurogenic shock

Question 27

Question
What should be the first priority when assisting a critically ill or injured child in shock?
Answer
  • oxygen administration
  • monitoring
  • positioning
  • fluid resuscitation

Question 28

Question
Which is not a common assessment when determining the effectiveness of fluid resuscitation?
Answer
  • central venous catheter
  • aterial catheter
  • pulmonary artery catheter
  • none of the above

Question 29

Question
Which is not a common assessment when determining the effectiveness of fluid resuscitation? Mark one answer:
Answer
  • temperature
  • heart rate
  • skin coloration
  • urine output

Question 30

Question
To treat cold shock, _____________ is preferred.
Answer
  • dopamine
  • norepinephrine
  • epinephrine
  • dobutamine

Question 31

Question
For cardiogenic shock, you should deliver a fluid challenge (5 to 10 mL/kg bolus) over what length of time?
Answer
  • 1-5 minutes
  • 5-10 minutes
  • 10-20 minutes
  • under 3 minutes

Question 32

Question
______________ is described as an accumulation of pressurized air in the pleural space.
Answer
  • tension pneumothorax
  • cardiac tamponade
  • massive pulmonary embolism
  • none of the above

Question 33

Question
In a case of sinus tachycardia, the heart rate is ___________.
Answer
  • increased
  • decreased
  • unsteady
  • faint

Question 34

Question
Ventricular tachycardia is common in children.
Answer
  • true
  • false

Question 35

Question
What is the first sign of the body's defensive response when a child or infant is in shock?
Answer
  • body temperature drop
  • body temperature rise
  • heart rate increase
  • heart rate decrease

Question 36

Question
Each attempt for catheter insertion and suctioning of an infant should not surpass:
Answer
  • 3 seconds
  • 5 seconds
  • 7 seconds
  • 10 seconds

Question 37

Question
The first warning sign of respiratory dysfunction is:
Answer
  • decrease of heart rate
  • increase in blood pressure
  • increase in respiratory rate
  • decrease in body temperature

Question 38

Question
During resuscitation of a newborn infant, the blow-by oxygen rate of flow should always be more than:
Answer
  • 2 L/min.
  • 5 L/min.
  • 6 L/min.
  • 8 L/min.

Question 39

Question
What age period is croup most common to occur?
Answer
  • 3 - 5 years
  • 6 months - 3 years
  • 4 - 7 years
  • 1 month - 12 months

Question 40

Question
What is the recommended first energy level used for defibrillation?
Answer
  • 0.3 joules/kg.
  • 1.5 joules/kg.
  • 2.0 joules/kg.
  • 2.5 joules/kg.

Question 41

Question
A patient has a "do not resuscitate" order. Which action is least appropriate?
Answer
  • Endotracheal intubation
  • Nasogastric tube feedings
  • Intravenous line insertion
  • Oxygen by face mask

Question 42

Question
What agent is added to increase the half-life of imipenem?
Answer
  • Cilastatin
  • Probenecid
  • Allopurinol
  • Sodium bicarbonate

Question 43

Question
Which would be considered a normal serum potassium?
Answer
  • 2 mEq per L
  • 4 mEq per L
  • 6 mEq per L
  • 8 mEq per L

Question 44

Question
The proximal aorta is derived from which structure?
Answer
  • First aortic arch
  • Truncus arteriosus
  • Second brachial pouch
  • Sinus venosus

Question 45

Question
Select the medication that is contraindicated in cocaine associated myocardial infarction.
Answer
  • Benzodiazepines
  • Verapamil
  • Beta blockers
  • Nifedipine

Question 46

Question
Which physical finding is most indicative of a pleural effusion?
Answer
  • Decreased apical breath sounds
  • Decreased vesicular sounds
  • Increased adventitious sounds
  • Barrel chest

Question 47

Question
Which is false about the treatment of septic shock?
Answer
  • 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

Question 48

Question
What is the best position for a hospitalized patient experiencing difficulty breathing?
Answer
  • Lithotomy
  • Trendelenburg
  • Reverse Trendelenburg
  • High Fowler's

Question 49

Question
What is required for the diagnosis of repiratory failure?
Answer
  • PAO2<80mmHg
  • Patient is unable to breathe without Ventimask of 80% O2
  • Patient has cyanotic extremities
  • PACO2>50mmHg or PAO2<60mmHg

Question 50

Question
What does a carotid pulse indicate?
Answer
  • A functioning pump for blood flow
  • The circulating blood volume is reaching end organs
  • Diastolic blood pressure
  • None of the above

Question 51

Question
In addition to intravenous fluid, what is considered the mainstay of treatment for anaphylaxis?
Answer
  • Diphenhydramine
  • Prednisone
  • Propanolol
  • Epinephrine

Question 52

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

Question 53

Question
The right neck vein is preferred for central line over the left because of what structure? Mark one answer:
Answer
  • Subclavian
  • Lung apex
  • Thoracic duct
  • Heart

Question 54

Question
What is a normal finding after successful endotracheal intubation?
Answer
  • Bilateral chest wall expansion
  • Right side only breath sounds
  • Abdominal movement with ventilation
  • None of the above

Question 55

Question
What ECG wave represents the depolarization of atrium?
Answer
  • P wave
  • QRS complex
  • T wave
  • Q wave

Question 56

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

Question 57

Question
Which is not a typical sign of cardiogenic shock?
Answer
  • Hypotension
  • Polyuria
  • Tachycardia
  • Confusion

Question 58

Question
A chest tube will drain an effusion when the lumen is properly placed in which space?
Answer
  • Intra-alveolar
  • Pericardial
  • Pleural
  • Intercostal

Question 59

Question
Why does the ACLS protocol recommend epinephrine?
Answer
  • Increases muscular blood flow
  • Dilates the bronchioles
  • Enhances myocardial contractility
  • Raises the systolic blood pressure

Question 60

Question
Cardioversion delivery is syschronized with:
Answer
  • P wave
  • R wave
  • S wave
  • T wave

Question 61

Question
The most common rhythm identified in "cardiac arrest" is which of the following?
Answer
  • Torsade de point
  • Ventricula tachycardia
  • Asytole
  • Ventricular fibrillation

Question 62

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

Question 63

Question
What is the best first step in patient with angina and ST ECG changes?
Answer
  • Cardiac enzyme
  • Aspirin
  • IV fluid
  • Morphine

Question 64

Question
A patient presents to the emergency department and has hives, hypotension and wheezing on initial exam. What is the first step?
Answer
  • Administration of nebulized albuterol
  • Administration of cimetidine
  • Immediate Administration of intramuscular (IM) epinephrine
  • Administration of aspirin

Question 65

Question
Which of the following is the superior marker for myocardial injury?
Answer
  • LDH
  • CPK
  • AST
  • Troponin

Question 66

Question
Which of the following is not used to ensure correct placement of an endotracheal tube?
Answer
  • Ultrasound
  • Bilateral breath sounds
  • Sustained end-tidal CO2
  • Sustained end-tidal O2

Question 67

Question
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?
Answer
  • 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

Question 68

Question
In the femoral triangle, the order of the neurovascular bundles, from LATERAL TO MEDIAL, runs in what sequence?
Answer
  • Nerve, artery, vein
  • Nerve, vein, artery
  • Vein, artery, nerve
  • Vein, nerve, artery

Question 69

Question
Paroxysmal supraventricular tachycardia is best treated by which of the following?
Answer
  • Adenosine
  • Beta blockers
  • Calcium channel blockers
  • Digoxin

Question 70

Question
What is the estimated time a person's brain can be anoxic from cardiopulmonary failure and not develop permanent brain damage?
Answer
  • 10 minutes
  • 5 minutes
  • 2 minutes
  • 20 minutes

Question 71

Question
The phrenic nerve innervates which of the following?
Answer
  • Diaphragm
  • Heart
  • Stomach
  • Small intestine

Question 72

Question
-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?
Answer
  • Venous cut down
  • Central line
  • Intraosseous
  • Intrathecal

Question 73

Question
Which of the following conditions is a common side effect of adenosine?
Answer
  • Tremors
  • Sympathetic over activity
  • Facial flushing
  • GI intolerance

Question 74

Question
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?
Answer
  • Another attempt at defibrillation
  • Administer lidocaine
  • Administer amiodarone
  • Administer procainamide

Question 75

Question
How is the bradycardia caused by acetylcholine treated?
Answer
  • Epinephrine
  • Pacemaker
  • Atropine
  • Isoprenaline

Question 76

Question
What is the drug of choice for supraventricular tachycardia?
Answer
  • Metoprolol
  • Digoxin
  • Lidocaine
  • Adenosine

Question 77

Question
Performing CPR with chest compressions over the xiphoid process may result in laceration of which of the following organs?
Answer
  • Small bowel
  • Stomach
  • Lung
  • Liver

Question 78

Question
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?
Answer
  • Assess the vital signs and mental status
  • Call the physician immediately
  • Apply transcutaneous pacing pads and then call the physician
  • Call a code blue

Question 79

Question
What protective measure should be undertaken when performing tracheal suctioning on a patient requiring ventilation?
Answer
  • Face mask
  • Gloves
  • Eye protection
  • All of the above

Question 80

Question
What is the drug of choice for the treatment of ventricular dysrhythmias?
Answer
  • Metoprolol
  • Digoxin
  • Lidocaine
  • Adenosine

Question 81

Question
Which of the following is a first-line agent for rate control in the management of atrial fibrillation (AF)?
Answer
  • Beta-blockers
  • Amiodarone
  • Digoxin
  • Warfarin

Question 82

Question
Which is a not a sign of tension pneumothorax?
Answer
  • Decreased breath sounds
  • Tracheall deviation
  • Decreased compliance
  • Audible bronchial sounds

Question 83

Question
Which of the following statements regarding shock is correct?
Answer
  • 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

Question 84

Question
What is the proper way to deliver a breath?
Answer
  • Blow as hard and as fast as possible
  • Give over one second
  • Apply cricoid pressure first
  • Deliver during compressions

Question 85

Question
You are having difficulty using a bag-mask device. Which are potential causes for your difficulties?
Answer
  • The mask is too large
  • Pushing mask onto victim’s face
  • Improper seal
  • All the above

Question 86

Question
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?
Answer
  • Give two breaths
  • Check connections
  • Clear the victim
  • Check pulse

Question 87

Question
What is the most common cause of cardiac arrest in children?
Answer
  • Respiratory difficulties
  • Drug use
  • Congenital heart disease
  • Sepsis

Question 88

Question
Child CPR may be given using a one or two-handed technique?
Answer
  • True
  • False

Question 89

Question
A seven-year-old accidentally ingests grandma’s pain medication. What drug can you use to reverse the sedation?
Answer
  • Atropine
  • Naloxone
  • Epinephrine
  • Glucose

Question 90

Question
You are treating hypoglycemia in a three-week-old. What concentration of IV fluids is recommended?
Answer
  • D5
  • D10
  • D25
  • D50

Question 91

Question
Which of the following are potential causes of respiratory arrest?
Answer
  • Ingestion
  • Head trauma
  • Choking
  • All of the above

Question 92

Question
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?
Answer
  • CPR
  • Check pulse
  • Administer epinephrine
  • Pacing

Question 93

Question
What is the simplest way to open the airway in an unconcious patient?
Answer
  • Pull out the tongue
  • Tilt head and lift chin
  • Lift neck from behind
  • Jaw thrust

Question 94

Question
What is the most likely place for an over advanced endotracheal (ET) tube to enter?
Answer
  • Stomach
  • Right mainstem bronchus
  • Soft palate
  • Left mainstem bronchus

Question 95

Question
Which condition can have hyperresonance on percussion?
Answer
  • Pleuritis
  • Bronchitis
  • Pneumothorax
  • ARDS

Question 96

Question
What should be the initial temporizing measure in a patient with hypotension following the onset of 3rd degree heart block?
Answer
  • Transcutaneous pacing
  • Electric cardioversion
  • Amiodarone loading and then electric cardioversion
  • Stat placement of a permanent pacemaker

Question 97

Question
The first heart sound, 'lub', is produced by closure of which of the following valves?
Answer
  • Aortic and mitral
  • Pulmonary and tricuspid
  • Mitral and tricuspid
  • Tricuspid and mitral

Question 98

Question
Which of the following rhythms carries the worst long-term prognosis for survival?
Answer
  • Asystole
  • Atrial flutter
  • Ventricular fibrillation
  • Pulseless electrical activity

Question 99

Question
At what point should tracheal suctioning be performed?
Answer
  • Withdrawal of the catheter
  • Insertion of the catheter
  • Upon insertion and withdrawal of the catheter
  • None of the above

Question 100

Question
Which of the following is a lethal heart rhythm?
Answer
  • Pulseless ventricular tachycardia
  • Asymptomatic supraventricular tachycardia (SVT)
  • Atrial fibrillation (AF)
  • First degree heart block

Question 101

Question
Which of the following is the least preferred method of administering IV fluids?
Answer
  • Cubital veins
  • Cephalic veins
  • Subclavian veins
  • Saphenous vein

Question 102

Question
The trachea deviates with tension pneumothorax to the:
Answer
  • Affected side
  • Unaffected side
  • Anteriorly
  • Posteriorly

Question 103

Question
In a neonate, what is the proper method of performing chest compressions for two rescuers?
Answer
  • Two hands
  • One hand
  • Two thumb-encircling hands chest compression
  • Two fingers.

Question 104

Question
On ECG, no conduction through the atrioventricular (AV) node is considered:
Answer
  • First-degree AV block
  • Second-degree AV block
  • Third-degree AV block
  • None of the above

Question 105

Question
Which ECG change is associated with hyperkalemia?
Answer
  • U wave
  • Peaked T wave
  • Long PR interval
  • Absent P wave
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