PALS - Pediatric Advanced Life Support Pediatric Systematic Assessment Questions and Answers — Questions and Answers
Question 1: You are called to assess a 4-year-old child. From the doorway, you use the Pediatric Assessment Triangle (PAT). Which of the following combinations of findings would represent respiratory failure?
- Abnormal Appearance and Abnormal Work of Breathing (Correct answer)
- Abnormal Work of Breathing and Abnormal Circulation
- Normal Appearance and Abnormal Work of Breathing
- Abnormal Circulation and Abnormal Appearance
Correct answer: Abnormal Appearance and Abnormal Work of Breathing
In the Pediatric Assessment Triangle (PAT), the combination of an abnormal appearance (indicating neurological compromise, such as listlessness or unresponsiveness) and abnormal work of breathing (such as severe retractions or grunting) is indicative of respiratory failure. This combination suggests the child is no longer able to compensate, and their central nervous system function is impacted by hypoxia and/or hypercarbia.
Question 2: A 6-year-old is brought to the emergency department. After your initial impression, you begin the primary assessment. Which component of the 'ABCDE' approach involves checking capillary refill, skin color, and central vs. peripheral pulses?
- Airway
- Breathing
- Circulation (Correct answer)
- Disability
Correct answer: Circulation
The 'C' in the ABCDE approach stands for Circulation. This part of the primary assessment evaluates the child's cardiovascular status. Key elements include assessing heart rate and rhythm, the quality of central and peripheral pulses, capillary refill time, skin color, and temperature.
Question 3: During a pediatric systematic assessment, what is the correct sequence of the core process that is repeated until the child is stable?
- Intervene-Identify-Evaluate
- Primary Survey-Secondary Survey-Intervene
- Evaluate-Identify-Intervene (Correct answer)
- Assess-Categorize-Treat
Correct answer: Evaluate-Identify-Intervene
The PALS systematic approach is centered on the continuous 'Evaluate-Identify-Intervene' sequence. The provider first evaluates the patient (using tools like the Primary Assessment), then identifies the type and severity of the problem (e.g., respiratory distress, shock), and finally intervenes with appropriate treatment. This cycle is repeated to reassess the patient's response to interventions.
Question 4: You are conducting the secondary assessment on a 5-year-old who is ill. Which mnemonic is used to guide the focused history portion of this assessment?
- AVPU
- ABCDE
- DOTS
- SAMPLE (Correct answer)
Correct answer: SAMPLE
The SAMPLE mnemonic is used to obtain a focused history during the secondary assessment. It stands for Signs and symptoms, Allergies, Medications, Past medical history, Last meal, and Events leading to the illness or injury.
Question 5: Which of the following is considered a diagnostic test that might be performed as part of the PALS systematic approach, rather than a component of the primary or secondary hands-on assessment?
- Checking pupil response to light
- Obtaining a blood pressure reading
- Assessing for skin rashes or trauma
- Measuring arterial lactate levels (Correct answer)
Correct answer: Measuring arterial lactate levels
Measuring arterial lactate is a diagnostic test used to assess tissue hypoxia and the severity of shock. While pupil response, blood pressure, and skin assessment are part of the hands-on primary (Disability, Circulation) and secondary (Exposure, Physical Exam) assessments, lab tests like lactate levels are categorized under diagnostic tests to further evaluate the child's condition.
Question 6: A 2-year-old presents with labored breathing, nasal flaring, and audible wheezing. According to the Pediatric Assessment Triangle (PAT), which of the three sides is most clearly abnormal based on these findings?
- Appearance
- Work of Breathing (Correct answer)
- Circulation to the Skin
- Neurological Status
Correct answer: Work of Breathing
The Pediatric Assessment Triangle (PAT) evaluates three components: Appearance, Work of Breathing, and Circulation to the Skin. Findings such as labored breathing, nasal flaring, and audible wheezing are all direct indicators of increased respiratory effort and fall under the 'Work of Breathing' side of the triangle.
PALS - Pediatric Advanced Life Support Pediatric Systematic Assessment Questions and Answers
You are called to assess a 4-year-old child.
From the doorway, you use the Pediatric Assessment Triangle (PAT).
Which of the following combinations of findings would represent respiratory failure?