PALS Systematic Assessment 5

Question 1

A 6-year-old has decreased breath sounds on the left, tracheal deviation to the right, and hypotension. Which diagnosis does this assessment suggest?

Accepted Answer

Tension pneumothorax

Answer

Absent unilateral breath sounds, tracheal deviation away from the affected side, and hemodynamic compromise indicate tension pneumothorax requiring immediate needle decompression.

Question 2

In the PALS systematic approach, what is the primary purpose of the tertiary assessment?

Accepted Answer

To obtain advanced diagnostics and identify underlying etiology

Answer

The tertiary assessment uses advanced diagnostics (labs, imaging, ECG) to identify the underlying cause of the child's illness or injury.

Question 3

Which respiratory rate range is considered normal for a 1-year-old child?

Accepted Answer

30–53 breaths/min

Answer

Normal respiratory rate for a 1-year-old is approximately 24–40 breaths/min; the range 30–53 breaths/min is within expected variation for infants and toddlers.

Question 4

A toddler is brought in after ingesting an unknown substance. She has miosis, bradycardia, excessive secretions, and bronchospasm. Which toxidrome does this systematic assessment suggest?

Accepted Answer

Cholinergic (organophosphate)

Answer

SLUDGE/DUMBELS signs (salivation, lacrimation, urination, defecation, GI distress, emesis, bradycardia, bronchospasm, miosis) indicate cholinergic toxidrome from organophosphate or similar agents.

Question 5

During reassessment after an intervention, which change in the PAT most clearly indicates clinical improvement in a child who had compensated shock?

Accepted Answer

Skin color normalizes and mental status improves

Answer

Normalization of circulation to skin (color, capillary refill) and improved appearance (mental status) on the PAT indicates effective treatment of shock.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Systematic Assessment 5