PALS PreTest Questions and Answers 2023 You are called to help treat an infant with severe symptomatic bradycardia (heart rate 66/min) associated with respiratory distress. The bradycardia persists despite establishment of an effective airway, oxygenation, and ventilation. There is no heart block present. Which is the first drug you should administer? - answer Epinephrine Initial impression of a 2yo girl shows her to be alert with mild breathing difficulty during inspiration and pale skin color. On primary assessment, she makes high-pitched inspiratory sounds (mild stridor) when agitated; otherwise, her breathing is quiet. Her spO2 is 92% on room air, and she has mild inspiratory intercostal retractions. Lung auscultation reveals transmitted upper airway sounds with adequate distal breath sounds bilaterally. Which is the most appropriate initial intervention for this child? - answer Humidified oxygen as tolerated You are part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You administer a 4 J/kg shock and resume CPR. Which drug and dose should be administered next? - answer Amiodarone 5 mg/kg IO Which statement is correct about the effects of epinephrine during attempted resuscitation? - answer Epinephrine stimulates spontaneous contractions when asystole is present A previously healthy infant with a history of vomiting and diarrhea is brought to the emergency department by her parents. During your assessment, you find that the infant responds only to painful stimulation. - answer Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W 2-4 ml/kg IV Which statement is correct about endotracheal drug administration during resuscitative efforts for pediatric patients? - answer It is the least desirable route of administration Which statement is correct about the use of calcium chloride in pediatric patients? - answer Routine administration is not indicated during cardiac arrest A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. - answer Albuterol Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired oxygen to a 7yo child? - answer Nonrebreathing face mask 1 / 2
Paramedics are called to the home of a 1yo child. Their initial assessment reveals a child who responds only to painful stimuli and has irregular breathing, faint central pulses, bruises over the abdomen, abdominal distention, and cyanosis - answer Rapid bolus of 20ml/kg of isotonic crystalloid A 7yo boy is found unresponsive, apneic, and pulseless. CPR is ongoing - answer Identify and treat reversible causes You are preparing to use a manual defibrillator in the pediatric setting. Which best describes when it is appropriate to use the smaller, pediatric-sized paddles? - answer If the child weighs less than 10kg or is less than 1 year old What compression-to-ventilation ratio should be used for 2-rescuer infant CPR? - answer 15 compressions to 2 breaths You find an infant who is unresponsive, is not breathing, and does not have a pulse.You shout for nearby help, but no one arrives. What action should you take next? - answer Provide CPR for about 2 minutes before leaving to activate the emergency response system You are assisting in the elective intubation of an average-sized 4yo child with respiratory failure. A colleague is retrieving the color-coded length-based tape from the resuscitation cart. Which of the following is likely to be the estimated size of the uncuffed endotracheal tube for this child? - answer 5mm tube A pale and very sleepy but arousable 3yo child with a hx of diarrhea is brought to the hospital. Primary assessment reveals a respiratory rate of 45/min with good breath sounds bilaterally - answer Administer a bolus of 20 ml/kg isotonic crystalloid You are evaluating an irritable 6yo girl with mottled skin color. - answer Compensated shock associated with tachycardia and inadequate tissue perfusion You assisted with the elective endotracheal intubation of a child with respiratory failure and a perfusing rhythm - answer Adequate bilateral breath sounds and chest expansion plus detection of ETCO2 with waveform capnography You and another rescuer begin CPR. Your colleague begins compressions, and you notice that the compression rate is too slow. What should you say to offer constructive feedback? - answer You need to compress at a rate of 100-120 per minute." A 10mo infant boy is brought to the emergency department. Your initial assessment reveals a lethargic, pale infant with slow respirations and slow, weak central pulses. - answer Epinephrine 0.01 mg/kg IV/IO A 1yo boy is brought to the emergency department for evaluation of poor feeding, irritability, and sweating - answer Administer adenosine 0.1 mg/kg IV rapid push
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