PALS Systematic Assessment 3 — Questions and Answers
Question 1: During the secondary assessment of a pediatric patient, SAMPLE history is obtained. What does the 'A' in SAMPLE stand for?
- Allergies (Correct answer)
- Activity level
- Airway history
- Age and weight
Correct answer: Allergies
A in SAMPLE stands for Allergies, including drug, food, and environmental allergies that may affect treatment choices.
Question 2: A 3-year-old presents with fever, petechiae, and altered mental status. The PAT shows abnormal appearance and mottled skin. What is the most appropriate next action?
- Complete the secondary assessment before any intervention
- Immediately activate emergency response and begin primary assessment interventions (Correct answer)
- Obtain blood cultures before starting antibiotics
- Perform a full head-to-toe examination
Correct answer: Immediately activate emergency response and begin primary assessment interventions
Abnormal PAT findings indicating cardiopulmonary compromise require immediate emergency activation and primary assessment interventions without delay.
Question 3: In pediatric assessment, which capillary refill time is considered abnormal?
- Less than 1 second
- 1 to 2 seconds
- Greater than 2 seconds (Correct answer)
- Greater than 5 seconds
Correct answer: Greater than 2 seconds
Capillary refill greater than 2 seconds is abnormal and suggests reduced perfusion to the extremities.
Question 4: A 7-year-old has stridor at rest, drooling, and refuses to lie down. Which PAT component is most abnormal?
- Appearance only
- Work of Breathing only
- Circulation to Skin only
- Both Appearance and Work of Breathing (Correct answer)
Correct answer: Both Appearance and Work of Breathing
Stridor indicates increased work of breathing, while drooling and refusal to lie flat suggest altered appearance (anxious, posturing), making both components abnormal.
Question 5: During the tertiary assessment, which diagnostic tool is specifically used to detect occult dysrhythmias or conduction abnormalities?
- Chest X-ray
- 12-lead ECG (Correct answer)
- Point-of-care glucose
- End-tidal CO2 monitoring
Correct answer: 12-lead ECG
A 12-lead ECG is used in the tertiary assessment to identify dysrhythmias, conduction defects, and QT abnormalities not apparent on a monitor strip.
Question 6: Which assessment finding in a 2-year-old most strongly suggests compensated versus decompensated shock?
- Heart rate above 150 bpm
- Blood pressure within normal range for age (Correct answer)
- Weak central pulses
- Altered mental status with no urine output
Correct answer: Blood pressure within normal range for age
In compensated shock, blood pressure is maintained within normal limits for age through compensatory mechanisms before decompensation occurs.
Question 7: A child's SpO2 reads 94% on room air during the primary assessment. According to PALS, what oxygen saturation threshold should trigger supplemental oxygen administration?
- Below 99%
- Below 97%
- Below 94% (Correct answer)
- Below 90%
Correct answer: Below 94%
PALS recommends supplemental oxygen for pediatric patients with SpO2 below 94% to prevent progression to respiratory failure.
PALS Systematic Assessment 3
During the secondary assessment of a pediatric patient, SAMPLE history is obtained.
What does the 'A' in SAMPLE stand for?