PALS EXAM 1 ( UPDATED 2023 )
100 + VERIFIED Questions and Answers
- Age classification for a neonate?
ANSWER: – Birth + first 28 days of life - Age classification of an infant?
ANSWER: – 28 days up to 1 year. - Age classification for a toddler?
ANSWER: – 1 to 2 years - Age classification for a preschooler?
ANSWER: – 3 – 4 years - Age classification for a school age child?
ANSWER: – 5 – 12 years - Signs for adolescent development for HCPs?
ANSWER: – Signs of puberty. - Skin area of pediatrics are proportionately larger to their mass up
years.
ANSWER: – 10 years
sterior closes
- In pediatrics, the head accounts for approx. % of the total BSA.
ANSWER: -20% - Increased BSA and thin subcutaneous fat in younger children complicates
regulation.
ANSWER: – Temperature regulation. - When does the anterior and posterior fontanelles close?: – Poafter
4 months.
- Anterior diminishes by 6 months, but closes by 9 – 18 months.
- Depressed fontanelles can indicate .
ANSWER: – Dehydration - Protruding fontanelles can indicate , which could
be caused by trauma and meningitis.
ANSWER: – Increased ICP - What is an infants brain size by 30 months?
ANSWER: 75% of it’s adult size. - During a trauma assessment of an infants c-spine and back, what should you be concerned of?
ANSWER: – A pediatric can have a spinal injury without an obviousspinal
fracture due to the flexibility of the bones. - In pediatrics, what are 6 anatomical airway structures that we need to
consider for interventions and tx?
ANSWER: 1. Narrow, funnel-shaped larynx due to underdeveloped cricoid
cartilage.
- Larynx sits higher up and is more anterior.
- Proportionally large, and floppy tongue.
- Trachea is softer, more flexible, and more anterior
- More smooth muscle makes the airway more reactive to spasms and vagal tone
(factory setting model). - Large and floppy epiglottis.
- At what age does the larynx become for rigid and tubular?
ANSWER: – 10 years old. - What is the primary muscle of inspiration?
ANSWER: – Diaphragm - What is a common traumatic injury to the lungs in pediatrics? Why?
ANSWER: -Pulmonary contusion more common due to underdeveloped lung
tissue. - Pediatric lower airway differences (4)?
ANSWER: – Can become exhausted easily dueto underdeveloped accessory
muscles.
-use diaphragm to breathe
-consume more oxygen due to higher metabolic rate
- Small alveoli and lack of collateral ventilation.
- What are the two abdominal organs we need to worry about in in pediatric
trauma?
ANSWER: – Liver and the Spleen
PALS Exam ( UPDATED 2023 )
Completed 300 + Questions and Answers Included1) What is the duration of anticoagulation for Provoked or unprovoked
VTE>=?
ANSWER: 3 months minimum
2) occurs when the force of your blood, pushing against the walls of yourblood
vessels/arteries, is consistently too high.
ANSWER: Hypertension
3)Blood pressure is measured in units of
ANSWER: millimeters of mercury (mmHg)
4)In the heart, ventricles contract to force blood out of the heart
( ) and relax to refill the heart with blood ( )-
ANSWER: systolic pressure; diastolic pressure
5) What are the modifiable risk factors for hypertension?
ANSWER: Unhealthy dietLack of physical activity
Overweight/obesity
Heavy alcohol usage
Comorbidities
Illicit drug use
Smoking
6) What are the unmodifiable risk factors for hypertension?: Family history
Race
Age
Sex
7) Hypertension is known as the silent killer because there are no obvioussigns
or symptoms. It can lead to
ANSWER: Heart Attack
Heart Failure
Kidney Failure
Vision Loss
Stroke
8) What is normal blood pressure?
ANSWER: Systolic: <120AND
Diastolic: <80
9) What is elevated blood pressure?
ANSWER: Systolic: 120-120AND
Diastolic: <80
10) What is Stage I Hypertension?
ANSWER: Systolic: 130-139OR
Diastolic: 80-89
11) What is Stage II Hypertension?
ANSWER: Systolic: 140 or higherOR
Diastolic: 90 or higher
12) What is the goal blood pressure?
ANSWER: <130/ 80 mmHg
13) What are the anatomy of the stethoscope?
ANSWER: Eartips Binaural
Binaural Spring
Tube
Diaphragm
Bell
14) What are the initial pertinent questions to ask patient when taking blood
pressure?
ANSWER: 1. Have you ever been told that you have high blood pressure? Do you
take any medications for your high blood pressure?
- What is your usual blood pressure reading?
- What is your smoking status?
- Do you take any other medications(prescription medications, over-the counter
medications, herbal/supplements)? - What are the pertinent questions to ask before measuring blood pres-sure?
ANSWER: 1. Have you exercised within the last 30 minutes? - Have you had any caffeine within the last 30 minutes?
- Have you smoked any cigarettes or used other forms of tobacco within the last
30 minutes? - Would you like to use the restroom before I check your blood pressure?
- Did you take your blood pressure medication(s) this morning
- What should be the patient’s position and posture when taking theirblood
pressure?
ANSWER: Seated for at least 5 minutes
Back supported
Legs uncrossed
Feet flat on the floor
Support the arm at heart level - Where do you place the diaphragm to take the patient’s blood pressure?-
ANSWER: Medial side of the arm
Above the antecubital fossa (elbow pit)
Locate the brachial and artery - What are the treatment goals for VTE?
ANSWER: 1.Preventing thrombus expansionand embolization
2.Reducing risk of recurrence
3.Preventing long-term complications( Chronic venous insufficiency, Post-thrombotic syndrome) - What non-pharmacologic therapy for VTE increases velocity of venousblood
flow?
ANSWER: Compression stockings
Intermittent pneumatic compression devices - What non-pharmacologic therapy for VTE blocks embolization of throm-bus?
ANSWER: Inferior vena cava filter - What are the non-pharmacologic therapy for VTE?
ANSWER: Increasing velocity ofvenous blood flow
Blocking embolization of thrombus
Venous thrombectomy - What are the pharmacologic therapy forVTE?
ANSWER: Unfractionated heparin (UF)Low molecular weight hepartin (LMWH)
Direct Thrombin Inhibitors (DTI)
Vitamin K Antagnonist (VKA)
Factor Xa Inhibitors
Thrombolytics - potentiates action of ATIII and inactivates thrombin and prevents conver- sion
of fibrinogen to fibrin. It will not dissolve formed clots, but will preventgrowth
ANSWER: Unfractionated Heparin and LMWH - What are the uses of Unfractionated Heparin?
ANSWER: VTEACS/UA
A. Fib.
catheter patency
PCI
TIA - What are the disadvantages of Unfractionated Heparin?
ANSWER: requires monitor-ing
UF>HIT<LMWH
fast onset/offset - What is the reversal agent for unfractionated heparin and LMWH?
ANSWER: prota-mine
PALS EXAM 2 ( UPDATED 2023 )
100 + VERIFIED Questions and Answers
- BP above 5th percentile for age formula
ANSWER: 70 mmHg + (age in years x 2) - signs of poor perfusion
ANSWER: cool extremities, AMS, weak pulses, skin pale-ness/cyanosis - universal rate for CPR
ANSWER: 100-120/min - compression-breath ratio
ANSWER: 30:2 if alone, 15:2 with another rescuer - two thumb encircling hands technique is recommended when
ANSWER: CPR isprovided by 2 rescuers on an infant - victims 8 years and older use AED
ANSWER: adult - repeat evaluate-identify-intervene until the child is stable:
ANSWER: after each inter-vention OR when the child’s condition changes or
deteriorates - ABCDE + vital signs
ANSWER: airway, breathing, circulation, disability, exposure - normal respiratory rates
ANSWER: infant: 30-53toddler: 22-37
preschooler: 20-28
school aged child: 18-25
adolescent: 12-20 - irregular respiratory patterns may indicate:
ANSWER: neurologic problem - tachypnea in infants is generally the first sign of
ANSWER: respiratory distress - quiet tachypnea (no signs of increased respiratory effort) causes =
ANSWER: highfever, pain, anemia, cyanotic congenital heart disease, sepsis,
dehydration - bradypnea causes =
ANSWER: respiratory muscle fatigue, CNS injury, severe hypoxia,severe shock,
hypothermia, drugs that depress respiratory drive, muscle diseases - bradypnea or irregular respiratory rate often signals
ANSWER: impeding arrest - mild-moderate retraction locations:
ANSWER: subcostal, substernal, intercostal - severe retraction locations:
ANSWER: supraclavicular, suprasternal, sternal - head bobbing is a sign of
ANSWER: deterioration/respiratory failure - seesaw breathing
ANSWER: upper airway obstruction usually, sometimes severe lowerairway
obstruction, lung disease, !neuromuscular weakness!. very ineffecient wayof
breathing - minute ventilation =
ANSWER: RR x tidal volume - grunting is a sign of
ANSWER: lung tissue disease resulting from small airway collapse,alveolar
collapse or both. may indicate severe respiratory distress or failure! - normal pediatric heart rates: neonate
ANSWER: awake – 100-205, sleeping – 90-160infant: awake – 100-180,
sleeping – 90-160
toddler: awake – 98-140, sleeping – 80-120
preschooler: awake – 80-120, sleeping, 65100
school age child: awake – 75-118, sleeping 58-90
adolescent: awake – 60-100, sleeping 50-90 - exaggeration of the difference in quality between central and peripheral
pulses occurs with
ANSWER: peripheral vasoconstriction is associated with shock
PALS Final Exam 1 ( Latest 2023 – 2024 )
GRADED A+ Questions & Answers
- What is nystagmus?
ANS: involuntary eye movement - What does PERRLA stand for when assessing for visual reflexes?
ANS: PupilsEqual,Round and Reactive to Light and Accommodation - What type of light will we be observing in patients to assess PERRLA?
ANS: –
Direct, Consensual, accommodation - What is Mydriasis?
ANS: Excessive pupil dilation - Reducing sodium intake can provide reduction in blood pressure?
ANS: True - Diastolic blood pressure represents the maximum pressure that is felt on the
arteries during left ventricular contraction (or systole), and it is regulated by the
stroke volume (the volume of blood ejected with each heartbeat)
ANS: False - What is the correct name for blood pressure cuff?
ANS: Sphygmomanometer - What is the normal systolic BP for an adult?
ANS: <120 - What is the normal heart rate for an adult?
ANS: 60-100 bpm - Normal diastolic BP for an adult
ANS: <80 - Which of the following pulses is used for blood pressure for the arm?
ANS: –
Brachial - Which of the following is the most commonly used pulse to measureheart
rate?
ANS: Radial - What is the normal respiratory rate for an adult?
ANS: 12-20 rpm - How can you evaluate a patients respiratory rate
ANS: Looking at rise and fall ofchest - You should prime the nasal spray before using it for the first time
ANS: True
PALS Final Exam 2 ( Latest 2023 – 2024 )
GRADED A+ Questions & Answers
- A provider is assessing a child with suspected shock. Which statement
correctly describes hypotension and shock?
ANS: Hypotension is not a consistentfeature of shock presentation in children. - A 10-year-old child has collapsed in the gym of the elementary school. The
school nurse arrives and determines that the child is unresponsive.Theschool
nurse then simultaneously checks for breathing and a central pulse,limiting this
assessment to which time frame?
ANS: No more than 10 seconds - A 4-year-old child is brought to the emergency department by the parents.
Assessment reveals that the child has only gasping respirations and the pulse
rate is 65 beats per minute. Which action would the provider initiate first?
ANS: Deliver 1 BVM ventilation every 2 to 3 seconds. - A 7-year-old child collapses on the playground at school.The school nurseis
called to the scene and determines that the child is unresponsive and
is not breathing and has no pulse. The nurse initiates CPR. At what rate and
depth would the nurse deliver compressions to this child?
ANS: 100 to 120compressions per minute at a depth of about 2 inches - What is considered inadequate perfusion when assessing/caring for a
pediatric patient with an arrhythmia?
ANS: Diminished peripheral pulses Acutely altered mental status
Hypotension
- A 9-year-old child is brought to the emergency department because the child
suddenly collapsed at school. The child’s ECG reveals the following waveform,
and primary assessment findings indicate that the child has inad-equate
perfusion. Which primary assessment findings indicate this?
ANS: Signsof shock
Acutely altered mental status
Hypotension - A 9-year-old patient is presenting with diminished breath sounds, bradycardia, slowed respiratory rate and a low O2 saturation level. The provider
interprets these findings as indicating which condition?
ANS: Respiratory failure - A 6-year-old child is brought to the emergency department. The child hasbeen
experiencing extremely watery stools over the past several days. Aftercompleting
the assessment, the healthcare provider suspects that the childmay be
experiencing shock. Which type of shock would the provider most likely suspect?
ANS: Hypovolemia - A 2-year-old child of unknown weight arrives at the emergency depart- ment
in cardiac arrest. When preparing to administer medications, which action
would be appropriate for the team to take?
ANS: Estimate weight using alength-based resuscitation tape. - An 11-year-old child develops ventricular tachycardia with a pulse with
inadequate perfusion. The PALS team would prepare the child for which
intervention?
ANS: Synchronized electrical cardioversion
PALS Final Exam 3 ( Latest 2023 – 2024 )
GRADED A+ Questions & Answers
- A 12-year-old child being evaluated in the pediatric intensive care unit
displays the following ECG waveform. The team interprets this as which
arrhythmia?
ANS: second degree - Laboratory tests are ordered for a child who has been vomiting for 3 days and
is diaphoretic, tachypneic, lethargic and pale.Which test would theprovider use to
determine the adequacy of oxygen delivery?
ANS: Lactate - A 9-year-old patient is presenting with decreased breath sounds, bradycardia, slowed respiratory rate and a low O2 saturation level. The provider
interprets these findings as indicating which condition?
ANS: Respiratory failure - A 4-year-old child is brought to the emergency department by the parents.
Assessment reveals that the child has only gasping respirations and the pulse
rate is 65 beats per minute. Which action would the provider initiate first?
ANS: Deliver 1 BVM ventilation every 3 to 5 seconds. - A 15-year-old patient is being evaluated during a follow-up visit after being
diagnosed with Lyme disease 2 months ago. A rhythm strip is obtained
as shown below.The provider interprets this rhythm as indicating which
arrhythmia?
ANS: First-degree atrioventricular (AV) block
- A child in cardiac arrest experiences return of spontaneous circulationbut is
exhibiting signs of post-cardiac arrest syndrome (PCAS).The PALS
resuscitation team determines that the child is experiencing a systemic
response to ischemia/reperfusion. The team bases this determination on
which finding(s)?
ANS: Hypotension
Fever
Hyperglycemia - A 2-year-old child arrives at the emergency department with the parents. The
child is unresponsive, is not breathing and has no pulse. Two emer- gency
department providers begin high-quality CPR. Which action(s) by theproviders
demonstrates high-quality CPR?
ANS: Allowing the chest to recoil fully after each compression
Providing ventilations that last about 1 second each
Compressing the chest about 2 inches
Giving 2 ventilations to every 15 compressions - A PALS resuscitation team is preparing to defibrillate a child experiencing
cardiac arrest. For which rhythm(s) would this action be appropriate?
ANS: VF and pVT are shockable cardiac arrest rhythms. - A provider is assessing a child with suspected shock. Which statement
correctly describes hypotension and shock?
ANS: Hypotension is not a consistentfeature of shock;
PALS post test ( UPDATED 2023 )
Questions and Answers (Solved)
- A 6 month old infant is unresponsive.You begin checking for breathing atthe
same time you check for the infants pulse. Which is the maximum time you
should spend when trying to simultaneously check for breathing and palpate the
infants pulse before starting CPR?
ANSWER: 10 seconds - A 4 year old child is brought to the emergency department for seizures. The
seizures stopped a few minutes ago, but the child continues to have slow and
irregular respirations.Which condition is most consistent with yourassessment?
ANSWER: Disordered Control of Breathing - An 8 year old child is brought to the emergency department with a 2 day
history of lethargy and polyuria.The child has new onset rapid, deep,
and labored breathing.Which diagnostic test should you order first?
ANSWER: bloodglucose - After rectal administration of diazepam, an 8 year old boy with a history of
seizures is no unresponsive to painful stimuli. His respirations are shallow,at a
rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On
examination, the child is snoring with poor chest rise and poor air entry
bilaterally. What action should you take next?
ANSWER: Reposition the patient, and insert an oral airway
- After rectal administration of diazepam, an 8 year old boy with a history of
seizures is no unresponsive to painful stimuli. His respirations are shallow,at a
rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On
examination, the child is snoring with poor chest rise and poor air entry
bilaterally. After repositioning the patient and you insert an Oral airway, thepatient continues to deteriorate. What next step is the most appropriate?
ANSWER: – Provide bag mask ventilation - A 6 year old child is found unresponsive, not breathing, and without a pulse.
one health care worker leaves to activate the emergency response system and
get the resuscitation equipment. You and another healthcare provider
immediatly begin CPR.Which compression to ventilation ratio doyou use?
ANSWER: 15:2 - In post resuscitation management after cardiac arrest, extra care shouldbe
taken to avoid repercussion injury. what should the ideal oxygen satura-tion
range most likely be?
ANSWER: 94%-99% - A 3 year old child is in cardiac arrest, and high quality CPR is in progress.You
are the team leader. The first rhythm check reveals the rhythm shown here.
Defibrillation is attempted with a shock dose of 2 J/kg. after admini
PALS Precourse Test ( UPDATED 2023 )
Questions and Answers (Solved)
- Parents of a 1-year-old female phoned EMS when they picked up their
daughter from the babysitter. Paramedics perform an initial impression revealing an obtunded infant with irregular breathing, bruises over the ab- domen,
abdominal distension, and cyanosis. Assisted bag-mask ventilationwith 100%
oxygen is initiated. On primary assessment heart rate is 36/min, peripheral
pulses cannot be palpated, and central pulses are barely palpable.Cardiac monitor shows sinus bradycardia. Chest compressions are startedat 15:2. In the ED the
infant is intubated and ventilated, and IV access is established. The heart rate is
now up to 150/min, but there are weak centralpulses and no distal pulses.
Systolic BP is 74. Of the following, which wouldbe most useful in management of
this infant?
A. Synchronized cardioversion
B. Epinephrine 0.01 mg/kg (0.1 mL/kg of 1:10,000 dilution) IV
C. Rapid bolus of 20 mL/kg of isotonic crystalloid
D. Atropine 0.02 mg/kg IV - You enter a room to perform an initial impression of a previously stable 10-
year-old male and find him unresponsive and apneic. A code is called andbagmask ventilation is performed with 100% oxygen. The cardiac monitor shows a
wide-complex tachycardia. The boy has no detectable pulses so compressions
and ventilations are provided. As soon as the defibrillator arrives you deliver an
unsynchronized shock with 2 J/kg. The rhythm checkafter 2 minutes of CPR
reveals VF. You then deliver a shock of 4 J/kg and resume immediate CPR
beginning with compressions. A team member hasestablished IO access, so you give a dose of epi, 0.01 mg/kg (0.1 mL/kg of 1:10,000 dilution) IO after second
shock. At the next rhythm check, persistentVF is present.You administer another
4 J/kg shock and resume CPR. Basedon the PALS Pulseless Arrest Algorithm,
what is the next drug and dose to administer when CPR is restarted?
A. Magnesium sulfate 25-50 mg/kg IO
B. Atropine 0.02 mg/kg IO
C. Epinephrine 0.1 mg/kg of 1:10,000 dilution IO
D. Amiodarone 5 mg/kg IO
- Which of the following statements about calcium is true?
A. Calcium chloride 10% has the same bioavailability of elemental calciumas
calcium gluconate in critically ill children
B.The recommended dose is 1-2 mg/kg of calcium chloride.
C. Indications for administration of calcium include hypercalcemia, hypokalemia, and hypomagnesemia.
D. Routine administration of calcium is not indicated during cardiac arrest.- - Initial impression of a 9-year-old male with increased work of breathing
reveals the boy to be agitated and leaning forward on the bed with obvious
respiratory distress.You administer 100% oxygen by nonrebreathing mask.The
patient is speaking in short phrases and tells you that he has asthma but does
not carry an inhaler. He has nasal flaring, severe suprasternal and intercostal
retractions, and decreased air movement with prolonged expiratory time and
wheezing. His SpO2 is 96% (on nonrebreathing mask). What is the next medical
therapy to provide to this patient?
A. Adenosine 0.1 mg/kg
B. Amiodarone 5 mg/kg IV/IO
C. Albuterol by nebulization
D. Procainamide 15 mg/kg IV/IO - You are called to help resuscitate an infant with severe symptomatic
PALS Pretest ( UPDATED 2023 )
Questions and Answers (Solved)
- what should the first rescuer arriving on the scene of an unresponsive infant
or child do?
ANS: verify scene safety, check responsiveness, shout for help,activate
emergency response system - How long should assessing for breathing and checking for a pulse take?-
ANS: No longer than 10 seconds - If the AED indicates no shock advised, what should be the next action?
ANS: –
Start chest compressions - What is the compression-to-breath ratio for 1- and 2-rescuer CPR for
children and infants?
ANS: 1-rescuer, 30:2; 2-rescuer, 15:2 - Systematic Approach video 1: Blonde, 18-month-old child with pacifier.Does
this patient need immediate intervention?
ANS: Yes - Systematic Approach video 1: Blonde, 18-month-old child with pacifier.What
is the patient’s appearance?
ANS: Awake - Systematic Approach video 1: Blonde, 18-month-old child with pacifier.What
is the patient’s work of breathing?
ANS: Increased work of breathing - Systematic Approach video 1: Blonde, 18-month-old child with pacifier.What
is this patient’s color?
ANS: Pale - Systematic Approach video 2: 3-year-old child in yellow shirt. Does this
patient need immediate intervention?
ANS: No - Systematic Approach video 2: 3-year-old child in yellow shirt.What is the
patient’s appearance?
ANS: Increased interaction - Systematic Approach video 2: 3-year-old child in yellow shirt.What is the
patient’s work of breathing?
ANS: Normal - Systematic Approach video 2: 3-year-old child in yellow shirt.What is this
patient’s color?
ANS: Pink mucous membranes - Primary Assessment video 1: Patient with dragon nebulizer. Does this
patient need immediate intervention?
ANS: Yes
PALS Study Guide (Latest 2023 / 2024)
A+ Rated Guide
- You are caring for a child who was resuscitated after a drowning event.Thechild
is intubated and ventilated with 100% oxygen with equal breath soundsand
exhaled CO2 detected. The heart rate is slow and the monitor shows sinus
bradycardia. The skin is cool, mottled, and moist; distal pulses are not palpable
and the central pulses are weak. Intravenous access has beenestablished.The
core temperature is 37.3oC. Based on the PALS bradycardiaalgorithm, which of
the following should be provided first?
Epinephrine IV
Transcutaneous pacing
Atropine IV
Dobutamine IV infusion
ANS: Epinephrine IV - You are caring for a 5-year-old patient with supraventricular tachycardia (heart
rate = 220/min). The child is lethargic. The skin is pale and cool with delayed
capillary refill. Distal pulses are not palpable.Which of the followingwould be the
best treatment to provide without delay?
Place cold packs on the distal upper and lower extremitiesAsk
the child to blow through a small straw
Exert light pressure on the eyes bilaterally
Provide synchronized cardioversion at 0.5 to 1 J/kg
ANS: Provide synchronizedcardioversion at 0.5 to 1 J/kg - You are initiating treatment for a child with septic shock and hypotension.While
administering high-flow oxygen you determine that the child’s respi- rations are
adequate and SpO2 is 100%. You have just established vascularaccess and
obtained blood samples.Which of the following is the next mostappropriate
therapy to support systemic perfusion?
Administer repeated fluid boluses of isotonic colloid
Administer repeated fluid boluses of isotonic crystalloid
Begin immediate dopamine infusion
Begin immediate dobutamine infusion
ANS: Administer repeated fluid boluses ofisotonic crystalloid
- You are treating an 8-year-old with ventricular tachycardia with pulses and
adequate perfusion.You attempted synchronized cardioversion withoutsuccess.
While seeking expert consultation, it would be most appropriate to:
Administer a loading dose of milrinone
Consider possible metabolic and toxicologic causes
Initiate overdrive pacing transcutaneously
Deliver an unsynchronized shock
ANS: Consider possible metabolic and toxicologiccauses - You are caring for a 2-year-old unconscious patient who is intubated and
receiving mechanical ventilation. The child’s heart rate suddenly drops to 40/min
and his color becomes mottled.You should respond to these changesby:
Increasing the ventilator rate
Increasing tidal volume
Increasing positive end-expiratory pressure (PEEP)
Using a resuscitation bag provide manual ventilation with 100% oxygen
ANS: Us-ing a resuscitation bag provide manual ventilation with 100% oxygen - You are caring for a 9-month-old patient with pronounced respiratory distress.
You initiated high-flow oxygen using a nonrebreathing mask about10 minutes
ago and established intravenous access. Initially the infant’s heart rate was in the
150/min range with strong pulses. Suddenly the infant’srespiratory rate falls to
6/min with significant intercostals retractions, and little air movement is heard.
The infant becomes cyanotic and the heart ratedecreases to 95/min.Which of the
following treatments would be best for youto provide now?
Administer epinephrine IV Provide
bag-mask ventilation Administer
magnesium sulfate IV
Intubate and ventilate
ANS: Provide bag-mask ventilation - Which of the following is likely to be the most helpful technique to iden- tify
potentially reversible metabolic and toxic causes during the attempted
resuscitation of a young child in cardiac arrest?
Obtaining a urine sample for toxicology screen
Obtaining chest and abdominal radiographs
Soliciting a history from the caregiver or family
Obtaining a venous blood gas
ANS: Soliciting a history from the caregiver or family - You are caring for a patient who developed a tension pneumothorax after
several hours of positive-pressure ventilation. Which of the following would be the most appropriate site for needle decompression?
Over the third rib at the midclavicular line
Under the eighth rib at the midaxillary line
Over the fifth rib at the sternal border
Under the sixth rib at the midclavicular line
ANS: Over the third rib at the midclavic-ular line - You attempted synchronized cardioversion for an infant with supraventric- ular tachycardia (SVT) and poor perfusion. The SVT persists after the initial 1 J/kg
shock.Which of the following should you attempt now?
Synchronized cardioversion at a dose of 2 J/kg
Synchronized cardioversion at a dose of 4 J/kg
Unsynchronized cardioversion at a dose of 2 J/kg
Unsynchronized cardioversion at a dose of 4 J/kg
ANS: Synchronized cardioversionat a dose of 2 J/kg - You are treating a 5-month-old with a 2-day history of vomiting and diarrhea.
The patient is listless.The respiratory rate is 52/min and unlabored.The heart rate
is 170/min and pulses are present but weak. Capillary refill isdelayed.You are
administering high-flow oxygen, and intravenous access isin place. At this point
the most important therapy is to:
Administer an epinephrine bolus
Begin bag-mask ventilation
Provide a rapid 20 ml/kg isotonic crystalloid fluid bolus