Learn & Master ACLS/PALS

Over 100,000 Satisfied Health Care Providers

  • Main Menu
    • Free BLS Course
    • ACLS Made Simple
      • ACLS Interactive Course Guide
      • ACLS Audio Quiz Series
      • ACLS Knowledge Base
      • Practice Test Library
      • ACLS Megacode Simulator
      • EKG Practice Test Library
      • ACLS Algorithm Video
      • ACLS Megacode Series
      • ACLS Download Library
    • PALS Made Simple
      • PALS Interactive Course Guide
      • PALS Audio Review Series
      • PALS Knowledge Base
      • PALS Practice Test Library
      • EKG Practice Test Library
      • PALS Megacode Simulator
      • PALS Download Library
    • Contact
  • Log In
  • Sign Up

PALS Megacode Scenario 2

In this PALS Megacode scenario, use the appropriate PALS algorithms to treat the patient. There are 11 questions for this PALS megacode scenario. Assume the use of biphasic defibrillator in all scenarios.

Time limit: 0

Quiz Summary

0 of 11 questions completed

Questions:

  1. 1
  2. 2
  3. 3
  4. 4
  5. 5
  6. 6
  7. 7
  8. 8
  9. 9
  10. 10
  11. 11

Information

You have already completed the quiz before. Hence you can not start it again.

Quiz is loading...

You must sign in or sign up to start the quiz.

You must first complete the following:

Results

Quiz complete. Results are being recorded.

Results

0 of 11 questions answered correctly

Time has elapsed

You have reached 0 of 0 point(s), (0)

Earned Point(s): 0 of 0, (0)
0 Essay(s) Pending (Possible Point(s): 0)

Categories

  1. Not categorized 0%
  1. 1
  2. 2
  3. 3
  4. 4
  5. 5
  6. 6
  7. 7
  8. 8
  9. 9
  10. 10
  11. 11
  1. Answered
  2. Review
  1. Question 1 of 11
    1. Question

    You are taking care of patients in the emergency room when the triage nurse from the admissions area calls out for some help with a patient. When you approach the triage room, you make your "initial impression of the child" to begin the systematic approach algorithm. You observe a school aged female child leaning forward in the tripod position and note the following for your initial impression:

    Initial impression of patient:
    Appearance: Alert but focused on breathing; unable to speak because of resp. difficulty
    Breathing: Tachypnea and significant work of breathing; accessory muscle use; loud audible wheezing
    Color: Skin is pale

    The mother states that the child has a history of mild asthma, but her albuterol inhaler has not been helping for the past 12 hours.
    Based upon your assessment, how would you classify the severity of the child's asthma exacerbation?

    Correct

    Incorrect

  2. Question 2 of 11
    2. Question

    Based upon your initial impression how would you classify this respiratory problem?

    Correct

    Incorrect

  3. Question 3 of 11
    3. Question

    After the initial at the door impression and identification of severe respiratory distress what would be your first priority?

    Correct

    Incorrect

  4. Question 4 of 11
    4. Question

    The nurse has applied 100% oxygen by non-rebreathing mask. The cardiac monitor and continuous pulse oximetry are on the patient.

    You perform the Primary Assessment and these are your findings:

    Female
    10-year-old

    Vital Signs: HR 130; RR 45; O2 Sat 85% prior to o2 admin.; BP 105/75

    Focused Primary Assessment:
    Airway: The airway is patent, moderate retractions and accessory muscle use.
    Breathing: Respiratory rate is 45, and breathing is shallow and labored. O2 sat is 85%. Audible wheezing and crackles and on auscultation.
    Circulation: Heart rate is 140; capillary refill remains less than 2 sec.
    Disability: Patient moves all extremities, Irritable and anxious
    Exposure: Skin pale

    What should be initiated at this time? (choose the best answer)

    Correct

    Incorrect

  5. Question 5 of 11
    5. Question

    As you attach the patient to a monitor and pulse oximeter, you request the nurse to initiate oxygen therapy.

    Which is the appropriate choice of oxygen supplementation for the patient at this time?

    Correct

    Incorrect

  6. Question 6 of 11
    6. Question

    Continuous albuterol + ipratropium nebulizer treatments are being given. At this time, a peripheral IV is inserted per your request.
    What IV medication would be appropriate for the treatment of the patient's current condition?

    Correct

    Incorrect

  7. Question 7 of 11
    7. Question

    Oxygen via non-rebreather mask has been on the patient for 5 minutes, and she is being given albuterol + ipratropium by continuous nebulizer.

    You reevaluate per the systematic approach algorithm.

    Vital Signs: HR 140; RR 40; O2 Sat 92%; BP 110/48

    Repeat Focused Primary Assessment:
    Airway: The airway remains patent, wheezing and crackles slightly improved with continued retractions.
    Breathing: Respiratory rate is 40, and breathing remains labored with accessory muscle use . O2 sat is 92% with 100% oxygen by non-rebreathing mask. Continued wheezes on auscultation.
    Circulation: Heart rate is 140; capillary refill remains less than 2 sec.; IV is intact and saline locked
    Disability: Patient moves all extremities, remains irritable, with anxiety
    Exposure: Pale skin

    Based upon the reassessment above what is your next intervention?

    Correct

    Incorrect

  8. Question 8 of 11
    8. Question

    You initiate BIPAP with an FIO2 of 60%. As you continue on with the Systematic Approach Algorithm, the "Evaluate" phase of the algorithm also calls for diagnostic assessments. For this scenario, what are the two most important diagnostic assessments to perform while you continue to treat the patient's severe asthma?

    Correct

    Incorrect

  9. Question 9 of 11
    9. Question

    BIPAP with age appropriate settings has been on the patient for 5 minutes, and she is started on her 3rd albuterol + ipratropium by continuous nebulizer treatment.

    You reevaluate per the systematic approach algorithm.

    Vital Signs: HR 130; RR 30; O2 Sat 96%; BP 102/45

    Repeat Focused Primary Assessment:
    Airway: The airway remains patent, wheezing and retractions improved, and there are fewer crackles on auscultation.
    Breathing: Respiratory rate is 30, and breathing is now less labored with minimal accessory muscle use. O2 sat is 96% with Bipap and Fio2 set at 60%.
    Circulation: Heart rate is 130; capillary refill remains less than 2 sec.; IV is intact and saline locked
    Disability: Patient moves all extremities, remains irritable, with anxiety
    Exposure: Pale skin

    Based upon the reassessment above what would you do at this time?

    Correct

    Incorrect

  10. Question 10 of 11
    10. Question

    The patient's condition is stabilizing and your are preparing for the patient to be transferred to the pediatric ICU for continued observation. While you are waiting for the transfer what other IV medication can be given to the patient?

    Correct

    Incorrect

  11. Question 11 of 11
    11. Question

    Great Job! The patient is continuing to stabilize and will soon be transferred to a higher level of care.
    Last question. Which of the following could be indications that intubation of the patient would be necessary? (Choose all correct answers)

    Correct

    Incorrect

(2015-2020 guidelines)

Go to PALS Megacode Scenario #3

Return to PALS Scenario Library

Comments

  1. Carol RAmos says

    July 8, 2020 at 9:59 am

    this website of PALS review is much clearer and easy to understand.I hope you will provide more scenarios that will help us to learn and manage the treatments for each cases. Thank you very much.

    Reply
    • ACLS says

      July 14, 2020 at 3:47 am

      Hi Carol,
      I’m so glad that the site has been helpful for you. Thank you for the encouraging words. Kind regards, Jeff

      Reply
  2. Fred Bozeman says

    September 8, 2019 at 3:58 pm

    Jeff,
    I probably would have recommended BiPAP earlier but I question mag. PEEP, bronchodilator, and steroids are working. Isn’t the choice of magnesium more for refractory bronchospasms. Also, living in the Rocky Mountains, I wouldn’t be alarms by a SpO2 less than 94% even for an adolescent.

    Reply
    • ACLS says

      September 12, 2019 at 4:25 am

      Thank you for the feedback. Kind regards, Jeff

      Reply
  3. Alan Mclean says

    July 10, 2019 at 10:50 am

    Hi Jeff, I think that the wording of this question leads to the correct answer being “provide oxygen” rather than “all of the above”
    [1]we have already established that the problem is a lower respiratory obstruction so really at this point there is NOTHING you can do for the airway and
    [2]this patient is fully self ventilating. “Supporting the ventilation” means either providing BMV or ventilating with a LMA or ETT etc: and at this point, in this patient, this is entirely the wrong management
    Airway and ventilation support may be needed later but at this point assess, give oxygen and try to relieve the bronchospasm if that is the problem

    Reply
    • ACLS says

      July 12, 2019 at 12:49 am

      I understand what you’re saying with regard to the scenario, however, these scenarios are designed to help the learner apply the systematic approach algorithm to each situation. Within the systematic approach algorithm, all of the interventions are necessary as you initiate support for the critically ill child. Kind regards, Jeff

      Reply
  4. Sonny Yates says

    January 18, 2019 at 10:51 am

    I certainly agree that intubation is out of the realm but bibap/cpap. Pretty simple to do and seems there would not be anything wrong with that in this scenario. That’s actually a question not a statement.

    Reply
    • Jeff with admin. says

      January 19, 2019 at 9:32 am

      This is covered later on in the scenario.

      The least invasive measures should be attempted prior to using more invasive measures such as BiPAP or CPAP.

      Oxygen via non-rebreathing mask is quite often effective with asthmatic patient while the airway is treated with bronchodilators and systemic corticosteroids initiated.

      Kind regards,
      Jeff

      Reply
  5. Benjamin Manzano says

    December 27, 2018 at 3:22 pm

    great scenario, learned more details about post BPAP management

    Reply

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

I accept the Privacy Policy

Prepare for AHA PALS Today!

Full PALS access starting at $19.95. Gain instant access to all of the practice tests, megacode scenarios, and knowledge base.

Sign Up

Step-by-Step Training

  • PALS Interactive Course Guide
  • Accreditation and Continuing Education Information

Pediatric Advanced Life Support

  • PALS Home Page
  • PALS Knowledge Base
  • PALS Download Library
  • Learn & Master PALS Checklist

PALS Practice Test Library

  • Practice Test Index
  • EKG Practice Test Library
  • PALS Audio Series

PALS Megacode Simulator

  • PALS Scenario Library

ACLS/PALS Updates

Click the Icon and then like the Facebook page to receive regular updates and Question of the Day.

Search This Site

Security Seals

Credit Card Online Payments

SSL Certificate Authority
SSL Certificate Authority

Official PayPal Seal

Need immediate help?

Between 8AM & 10PM call or TEXT technical support:

1-316-243-7096

  • Contact Email
  • Answers To Frequently Asked Questions & Problems
  • About ACLS-ALGORITHMS
  • Accreditation and Continuing Education Information
  • Add This Site to Your Phone
  • Track and View ACLS Quiz Results
  • PALS Checklist
  • ACLS Checklist

Profile Page


  • ACLS Download Library
  • PALS Download Library
  • Facility Subscriptions
  • Individual Subscriptions
  • Money Back Guarantee
  • Take the Course

© 2021 · acls-algorithms.com · Privacy Policy · Terms of Use