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Pals Heartcode 2025 QUESTIONS WITH COMPLETE SOLUTIONS
GRADED A+ PASS.
Where can you check a pulse on an infant and child? - ANSWERS-infant - brachial child - femoral What are signs of increased respiratory effort that can lead to fatigue and respiratory failure? Select all that apply nasal flaring unlabored breathing apnea seesaw respirations retractions head bobbing - ANSWERS-nasal flaring seesaw respirations retractions head bobbing Determine the respiratory rate by counting the number of times the chest rises in _____ seconds and multiplying by _____. - ANSWERS- 2 Tachypnea is often the first sign of respiratory ______ in infants - ANSWERS- distress Hypotension fro children 1 to 10 years of age is a systolic blood pressure of less than
40mmHg + 2 x age in years 50mmHg + 2 x age in years 60mmHg + 2 x age in years 70mmHg + 2 x age in years - ANSWERS-70mmHg + 2 x age in years What sequence is used when care for a seriously ill or injured child to help determine the best treatment or intervention? The __________ ___________ ____________ sequence - ANSWERS-Evaluate Identify Intervene Automated blood pressure cuffs may provide _________ ________ readings when the child is in shock. - ANSWERS-inaccurately high The primary assessment included the ABCDE approach. What does it assess? - ANSWERS-Airway, breathing, circulation, disability, exposure What does a prolonged capillary refill time indicate? - ANSWERS-low cardiac output ________ is usually high-pitched breathing during inspiration, whereas ___________ is usually during expiration - ANSWERS-Stridor wheezing Normal capillary refill time is _____ seconds or less - ANSWERS- What pulses should be assessed to monitor systemic perfusion in a child? - ANSWERS-Peripheral and central What do weak central pulses indicate a need for immediate intervention to prevent? - ANSWERS-Cardiac arrest When oxygenation delivery to the extremities becomes inadequate, the _______ and ________ are the first to exhibit designs. - ANSWERS-Hands
PMH
last meal events leading to illness/injury What should be included in the history when asking about medications? - ANSWERS-OTC medications current prescribed medications Which component of SAMPLE assesses immunization status? - ANSWERS-PMH What are some examples of diagnostic assessments? - ANSWERS-ABG VBG Hemoglobin Concentration What dictates the timing of diagnostic assessments? - ANSWERS-clinical situation Which component of effective high-performance teams is represented by the use of real-time feedback devices? - ANSWERS-Quality Crackles happen during ________ and grunting happens during ________ - ANSWERS-inspiration expiration What is an advantage of effective teamwork? - ANSWERS-division of tasks What is the best example of the team leader role? - ANSWERS-models excellent team behavior What is the best example of a team member role? - ANSWERS-committed to success What is the primary purpose of the CPR coach on a resuscitation team? - ANSWERS-improve cpr quality How can the CPR coach improve CPR quality in a resuscitation event? - ANSWERS-
coach to midrange targets Which high performance team member has the responsibility for assigning roles (positions)? - ANSWERS-team leader What element of team dynamics describes when a team member needs to correct actions? - ANSWERS-constructive intervention Which of the following describe how to communicate? - ANSWERS-closed-loop communications clear messaging Which resuscitation strategy will result in an improved chest compression fraction? - ANSWERS-hovering over the chest during compression pauses What is one way to increase chest compression fraction during a code? - ANSWERS-Charging the defibrillator 15 seconds before a rhythm check A chest compression fraction of at least ____ is recommended, and a goal of ____ is often achievable with good teamwork - ANSWERS-60% 80% What is chest compression fraction? - ANSWERS-proportion of time that compressions are performed For an unwitnessed cardiac arrest, what should you do after determining unresponsiveness and there is no breathing or pulse? - ANSWERS-perform high- quality CPR for 2 mins What is the definition of oxygen saturation? - ANSWERS-the amount of oxygen bound to hemoglobin Children develop hypoxemia and tissue hypoxia more quickly than adults because of their? - ANSWERS-higher metabolic rate In infants and toddlers, the young and epiglottis, relative to those of an adult are ________ - ANSWERS-large
How are effective oxygenation and ventilation assessed? - ANSWERS-oxygen saturation visible chest rise exhaled carbon dioxide How can gastric inflation impair bag mask ventilation? - ANSWERS-It decreases lung compliance What is the most appropriate precautionary action to minimize gastric inflation during bag-mask ventilation? - ANSWERS-Deliver each breath over 1 second Hypoxemia is defined as oxygen saturation less than _____ - ANSWERS-94% Which is true about the difference between hypoxemia and tissue hypoxia? - ANSWERS-Tissue hypoxia can occur with normal arterial spo What does hyperventilation, which refers to increase alveolar ventilation result in
- ANSWERS-PaCO2 <35mmHg What happens to the arterial oxygen level in a child with severe anemia? - ANSWERS-may increase when dissolved oxygen is increased Which is true of increased CO2 tension in the arterial blood? - ANSWERS-it may be caused by disordered control of breathing What happens when ventilation is inadequate? - ANSWERS-CO2 levels rise and pH falls What is a critical sign of hypercarbia? - ANSWERS-Decreased level of consciousness What can indicate mild respiratory distress? - ANSWERS-What can indicate mild respiratory distress? Which of the following indicates severe respiratory distress? - ANSWERS-marked tachypnea and/or apnea
Which of the following statements about respiratory failure is true? - ANSWERS- may occur without signs of respiratory distress Which is most likely to be present in a child who has respiratory distress (not respiratory failure)? - ANSWERS-ability to maintain a patent airway What steps should be taken as a part of initial management of a child in respiratory distress? - ANSWERS-Monitor O2 by pulse ox Monitor hr, rhythm, and bpSupport open airway Which are ideal characteristic of face masks for ventilation? - ANSWERS-covers mouth & nose has soft rim transparent What is the rationale for using a transparent mask? - ANSWERS-allows you to see the color of the childs lips What is the function of the nonrebreathing outlet valve of a self-inflating bag - ANSWERS-prevents retreating of carbon dioxide Which of the following is required to appropriately ventilate a child with a flow- inflating bag? - ANSWERS-tidal volume needs to be delivered at the correct rate. What should be checked to ensure proper function of a bag mask system? - ANSWERS-Oxygen Tubing is connected to the device and oxygen source Pop off valve can be closed How is the sniffing position achieved in an infant or a child? - ANSWERS-Ensure the external ear canal is anterior to the shoulder Where may padding be needed under a child 2 years and older to maintain an patent airway? - ANSWERS-the occiput What actions are appropriate when providing 1 person bag mask ventilation? - ANSWERS-Perform a head tilt, insert and oral airway, and squeeze the bag until
The appropriate flow rate for a simple mask is ___ to ____ L/min - ANSWERS- 10 For a nonrebreathing mask to be effective, the oxygen flow rate must be at least ____ L/min - ANSWERS- High-flow oxygen systems reliably deliver an oxygen concentration of greater than _____% - ANSWERS-60% The gas flow rate for a nebulizer treatment is ___ to ___ L/min - ANSWERS- 6 What is an indication that the nebulizer treatment is complete? - ANSWERS-No mist is visible When using a metered-dose inhaler with a spacer device, what should you? - ANSWERS-shake the MDI and spacer vigorously What are the signs of upper airway obstruction? - ANSWERS-stridor use of accessory muscles A child presents with a barking cough, good air entry during auscultation, a pulse oximetry reading 93% on room air and retractions at rest. What are appropriate initial interventions? - ANSWERS-consider dexamethasone administer O2 & nebulized epinepherine Which diagnosis may present with upper airway obstruction? - ANSWERS-foreign body obstruction epiglottitis croup When may pulse oximetry be inaccurate? - ANSWERS-the displayed heart rate
does not correlate with the child's heart rate An 8 month old boy is brought to the hospital by his parents. He has a hoarse cry and barking cough. His mother says that during the night, her son had difficulty breathing, which has progressively worsened throughout the day. The infant most likely has what type of respiratory emergency? - ANSWERS-upper airway obstruction According to the systematic approach algorithm, what are the correct assessments to perform during the evaluation phase? - ANSWERS-initial, primary, secondary The infant is responsive and is breathing. What is an initial measure that you can perform to maintain his airway? - ANSWERS-Sit him up What are the components of breathing assessment? - ANSWERS-lung and airway sounds chest expansion and air movement oxygen saturation respiratory rate respiratory effort When calculating the tube size based on the child's age, to avoid injury to the subglottic area, you should use an endotracheal tube that is: - ANSWERS-half a size smaller than predicted for the child Which anatomical features may contribute to upper airway obstruction in infants?
- ANSWERS-large tongue large occiput When monitoring pulse oximetry in a child, what finding would prompt immediate evaluation of the child? - ANSWERS-there is a decrease in oxygen saturation What are the common causes of lower airway obstruction? - ANSWERS-
What pulses should be assessed to monitor systemic perfusion in a child? - ANSWERS-Peripheral and central Which of the following signs of disordered control of breathing? - ANSWERS- variable RR decreased air movement shallow breathing What condition is characterized by signs of adequate carbon dioxide elimination and hypoxemia - ANSWERS-lung tissue disease Which of the following are most commonly associated with disordered control of breathing? - ANSWERS-neuro disorders drug overdose What intervention can reduce metabolic demand in a child with pneumonia? - ANSWERS-treat the fever What are the characteristics of shock? - ANSWERS-decreased level of consciousness inadequate peripheral perfusion decreased end-organ perfusion Which type of respiratory problem is most likely in a child with an altered level of consciousness and variable respiratory rate? - ANSWERS-disordered control of breathing What is the most accurate definition of shock? - ANSWERS-inadequate tissue perfusion What should you do before suctioning a child who has upper airway obstruction?
- ANSWERS-determine the underlying cause of the obstruction If cardiac output is compromised, signed of poor perfusion will be _____ even if
blood pressure is normal - ANSWERS-present Low blood pressure in children is defined as systolic blood pressure less than ______ percentile for age - ANSWERS-fifth For general shock management, administer an isotonic crystalloid bolus of __ mL/kg over __ to __min - ANSWERS-20 ml 5-20min
