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PALS Certification Course Exam With Complete Solutions Latest Update
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PALS Certification Course Exam With CompleteSolutions Latest Update
Which course topics are covered in the PALS course? -ANSWER PALS covers the
following:
(1) Overview of assessment
(2) Recognition and management of respiratory distress and failure
(3) Recognition and management of shock
(4) Recognition and management of cardiac arrhythmias
(5) Recognition and management of cardiac arrest
(6) Postresuscitation management of patients with pulmonary and cardiac arrest
(7) Review of pharmacology
The primary focus of the clinician in prevention of cardiopulmonary failure is: ANSWER
The clinician should focus on the prevention of cardiopulmonary failure by early
recognition and management of respiratory distress, respiratory failure, and shock that
can cause cardiac arrest because of hypoxia, acidosis, and ischemia.
What is the major cause of cardiac arrests in children? ANSWER Most cardiac arrests in
infants and children are caused by progressive respiratory failure and/or shock. Hence,
one of the objectives of PALS rapid assessment model is to prevent progression to
cardiac arrest.
What is the pediatric assessment triangle? ANSWER A brief visual and auditory
observation of child's overall: 1) appearance 2) work of breathing 3) circulation
What are the components of the initial assessment? What is the practitioner looking for?
- ANSWER In rapid sequence, the practitioner should assess:
(1) Airway (patent, patent with maneuvers/ adjuncts partially or completely obstructed)
,(2) Breathing (respiratory rate, effort, tidal volume, lung sounds, pulse oximetry)
(3) Circulation (skin color and temperature, heart rate and rhythm, blood pressure,
peripheral and central pulses, capillary refill time)
(4) Disability: (a) AVPU pediatric response scale: Alert, Voice, Pain, Unresponsive; (b)
Pupillary response to light
(с) Presence of hypoglycemia (rapid bedside glucose or response to empiric
administration of dextrose) (d) Glasgow Coma Scale
What are the components of the secondary survey? What does the clinician look for in
the secondary survey? - ANSWER This portion of the exam includes a thorough head to
toe physical exam, and a detailed medical history which includes the "SAMPLE" history:
(S) Signs and Symptoms
(A) Allergies
(M) Medications
(P) Past medical history
(L) Last meal
(E) Events leading to current illness
What does the tertiary survey consist of? -ANSWER Trauma and infection are common
causes of critical illness in the pediatric population. As such, ancillary studies during
this phase often are directed toward defining the extent of injury or an infectious source.
There are many causes for acute respiratory compromise in children. The clinician
should try to categorize respiratory distress or failure into one or more of the following: -
ANSWER (1) Upper airway obstruction (eg, croup, epiglottitis)
(2) Lower airway obstruction (eg, bronchiolitis, status asthmaticus)
(3) Lung tissue (parenchymal) disease (eg, bronchopneumonia)
(4) Disordered control of breathing (eg, seizure, coma, muscle weakness)
What is the focus of initial management - ANSWER The major focus of initial
, management is to support airway, breathing and circulation
How does the clinician support the airway? - ANSWER (1) Provide 100 percent inspired
oxygen
(2) Allow child to assume position of comfort or manually open airway
(3) Clear airway (suction)
(4) Insert an airway adjunct if consciousness is impaired (eg, nasopharyngeal airway or,
if gag reflex absent, oropharyngeal airway)
How does the clinician support ventilation? - ANSWER To support ventilation, the
clinician should:
(1) Deliver manual ventilation assistance in those who do not respond to the initial
airway maneuvers or are breathing poorly or ineffectively
(2) Monitor oxygenation by pulse oximetry
(3) Monitoring of ventilation via end-tidal carbon dioxide (EtCO2) if available
(4) Medications may be administered as indicated like albuterol or epinephrine
T of F: in preparation for intubation, the patient should receive 100 percent oxygen?
-ANSWER True! In preparation for intubation, the patient should receive 100 percent
oxygen via a high-concentration mask, or if indicated, positive pressure ventilation with
a bag-valve-mask to preoxygenate and improve ventilation.
What if the patient cannot maintain his or her airway, oxygenation, or ventilatory needs?
ANSWER An artificial airway is placed when this situation arises, most commonly
through endotracheal intubation but sometimes with a laryngeal mask airway or
alternative device.
T or F Some patients with upper airway obstruction and/or respiratory failure may
respond to noninvasive ventilation if airway reflexes are preserved. - ANSWER True!
Certain populations of patients with upper airway obstruction and/or respiratory failure
may respond to noninvasive ventilation (CPAP or BiPAP) if airway reflexes are
preserved.
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