1. A 6-month-old infant is unresponsive. You begin checking for breathing at the same time you
check for the infant's pulse. What is the maximum time you should spend when trying to
simultaneously check for breathing and palpate the infant's pulse before starting CPR?
a. 5 seconds
b. 10 seconds
c. 15 seconds
d. 20 seconds
10 seconds
PALS guidelines recommend limiting the pulse and breathing check to no more than 10 seconds;
if no definite pulse or breathing is detected within that time, CPR should be initiated
immediately.
2. 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 your assessment?
a. Lower airway obstruction
b. Disordered control of breathing
c. Lung tissue disease
d. Upper airway obstruction
Disordered control of breathing
,Slow and irregular respirations following seizures suggest a central nervous system issue
affecting the brainstem's respiratory drive, which is classified as disordered control of breathing.
3. 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?
a. Chest X-ray
b. Blood glucose
c. Complete blood count
d. Electrolytes
Blood glucose
Lethargy, polyuria, and rapid deep breathing (Kussmaul respirations) are classic signs of
diabetic ketoacidosis; checking blood glucose first allows rapid diagnosis and treatment.
4. After rectal administration of diazepam, an 8-year-old boy with a history of seizures is now
unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His oxygen
saturation is 94% on 2L of nasal cannula oxygen. On examination, the child is snoring with poor
chest rise and poor air entry bilaterally. What action should you take next?
a. Administer another dose of diazepam
b. Reposition the patient and insert an oral airway
c. Intubate immediately
d. Increase oxygen to 15L via non-rebreather mask
Reposition the patient and insert an oral airway
,Snoring with poor chest rise indicates upper airway obstruction from the tongue or soft tissues;
repositioning and placing an oral airway are first-line interventions to open the airway.
5. After rectal administration of diazepam, an 8-year-old boy with a history of seizures is now
unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His oxygen
saturation is 94% on 2L of nasal cannula oxygen. On examination, the child is snoring with poor
chest rise and poor air entry bilaterally. After repositioning the patient and inserting an oral
airway, the patient continues to deteriorate. What next step is the most appropriate?
a. Administer naloxone
b. Provide bag-mask ventilation
c. Perform a head CT scan
d. Administer a fluid bolus
Provide bag-mask ventilation
When positioning and an oral airway fail to improve ventilation, bag-mask ventilation is the next
step to provide positive pressure and support breathing in a patient with respiratory failure.
6. A 6-year-old child is found unresponsive, not breathing, and without a pulse. One healthcare
worker leaves to activate the emergency response system and get the resuscitation equipment.
You and another healthcare provider immediately begin CPR. Which compression to ventilation
ratio do you use?
a. 30:2
b. 15:2
c. 5:1
d. 30:1
, *15:2*
*For two-rescuer CPR in children and infants (excluding newborns), the recommended
compression-to-ventilation ratio is 15:2, while single rescuer uses 30:2.*
7. In post-resuscitation management after cardiac arrest, extra care should be taken to avoid
reperfusion injury. What should the ideal oxygen saturation range most likely be?
a. 85%-90%
b. 90%-94%
c. 94%-99%
d. 100%
*94%-99%*
*Post-cardiac arrest, hyperoxia can worsen reperfusion injury; guidelines recommend titrating
oxygen to achieve normoxemia with saturation between 94% and 99% to avoid both hypoxia and
hyperoxia.*
8. 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 a shockable rhythm. Defibrillation is attempted with a
shock dose of 2 J/kg. After administration of the shock, what should you say to your team
members?
a. "Check for a pulse now"
b. "Resume compressions"
c. "Wait 2 minutes before resuming CPR"
d. "Deliver another shock immediately"
Resume compressions
check for the infant's pulse. What is the maximum time you should spend when trying to
simultaneously check for breathing and palpate the infant's pulse before starting CPR?
a. 5 seconds
b. 10 seconds
c. 15 seconds
d. 20 seconds
10 seconds
PALS guidelines recommend limiting the pulse and breathing check to no more than 10 seconds;
if no definite pulse or breathing is detected within that time, CPR should be initiated
immediately.
2. 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 your assessment?
a. Lower airway obstruction
b. Disordered control of breathing
c. Lung tissue disease
d. Upper airway obstruction
Disordered control of breathing
,Slow and irregular respirations following seizures suggest a central nervous system issue
affecting the brainstem's respiratory drive, which is classified as disordered control of breathing.
3. 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?
a. Chest X-ray
b. Blood glucose
c. Complete blood count
d. Electrolytes
Blood glucose
Lethargy, polyuria, and rapid deep breathing (Kussmaul respirations) are classic signs of
diabetic ketoacidosis; checking blood glucose first allows rapid diagnosis and treatment.
4. After rectal administration of diazepam, an 8-year-old boy with a history of seizures is now
unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His oxygen
saturation is 94% on 2L of nasal cannula oxygen. On examination, the child is snoring with poor
chest rise and poor air entry bilaterally. What action should you take next?
a. Administer another dose of diazepam
b. Reposition the patient and insert an oral airway
c. Intubate immediately
d. Increase oxygen to 15L via non-rebreather mask
Reposition the patient and insert an oral airway
,Snoring with poor chest rise indicates upper airway obstruction from the tongue or soft tissues;
repositioning and placing an oral airway are first-line interventions to open the airway.
5. After rectal administration of diazepam, an 8-year-old boy with a history of seizures is now
unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His oxygen
saturation is 94% on 2L of nasal cannula oxygen. On examination, the child is snoring with poor
chest rise and poor air entry bilaterally. After repositioning the patient and inserting an oral
airway, the patient continues to deteriorate. What next step is the most appropriate?
a. Administer naloxone
b. Provide bag-mask ventilation
c. Perform a head CT scan
d. Administer a fluid bolus
Provide bag-mask ventilation
When positioning and an oral airway fail to improve ventilation, bag-mask ventilation is the next
step to provide positive pressure and support breathing in a patient with respiratory failure.
6. A 6-year-old child is found unresponsive, not breathing, and without a pulse. One healthcare
worker leaves to activate the emergency response system and get the resuscitation equipment.
You and another healthcare provider immediately begin CPR. Which compression to ventilation
ratio do you use?
a. 30:2
b. 15:2
c. 5:1
d. 30:1
, *15:2*
*For two-rescuer CPR in children and infants (excluding newborns), the recommended
compression-to-ventilation ratio is 15:2, while single rescuer uses 30:2.*
7. In post-resuscitation management after cardiac arrest, extra care should be taken to avoid
reperfusion injury. What should the ideal oxygen saturation range most likely be?
a. 85%-90%
b. 90%-94%
c. 94%-99%
d. 100%
*94%-99%*
*Post-cardiac arrest, hyperoxia can worsen reperfusion injury; guidelines recommend titrating
oxygen to achieve normoxemia with saturation between 94% and 99% to avoid both hypoxia and
hyperoxia.*
8. 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 a shockable rhythm. Defibrillation is attempted with a
shock dose of 2 J/kg. After administration of the shock, what should you say to your team
members?
a. "Check for a pulse now"
b. "Resume compressions"
c. "Wait 2 minutes before resuming CPR"
d. "Deliver another shock immediately"
Resume compressions
