PALS QUESTIONS WITH CORRECT ANSWERS RATED A+

compression to breath ratio children with 1 rescuer - 30:2 2 rescuer compression to breath ratio? - 15:2 Initial impression of a 2-year old girl shows her to be alert with mild breathing difficulty during inspiration and pale skin color. On primary assessment, she makes high pitched inspiratory sound (mild stridor) when agitated; otherwise, intercoastal retractions. Lung auscultation reveals transmitted upper airway sounds with adequate distal breath sounds bilaterally. Which is the most appropriate initial intervention for this child? - humidified oxygen as tolerated Which statement is correct about use of calcium chloride in pediatric? - Routine administration is not indicated during cardiac arrest Which statement is correct about endotracheal drug administration during resuscitative efforts for pediatric patients? - It is the least desirable route of administration You are a 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? - Amiodarone 5 mg/kg You are called to help treat an infant with severe symptomatic bradycardia (HR 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? - Epinephrine Which statement is correct about the effects of epinephrine during attempted resuscitation? - Epinephrine stimulates spontaneous contractions when asystole is present 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. Bag-mask ventilation with 100% oxygen is initiated. The child's heart rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the emergency department, the child is intubated and ventilated with 100% oxygen, and IV access is established. The heart rate is now 150/min with weak central pulses but no distal pulses. Systolic blood pressure is 74 mmHg. Which intervention should be provided next? - Rapid bolus of 20 ml/kg of isotonic crystalloid A 9-year old boy is agitated and leaning forward on the bed in obvious respiratory distress. 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 intercoastal retractions, and decreased air movement with prolonged expiratory time and wheezing. You administer 100% oxygen by a NRB mask. His SpO2 is 92%. Which medication do you prepare to give to this patient? - Albuterol A previously healthy infant with a history of vomiting and diarrhea is brought to the ER by her parents. During your assessment, you find that the infant responds only to painful stimulation. The infant's RR is 40/min, and central pulses are rapid and weak. The infant has good bilateral breath sounds, cool extremities, and a capillary refill time of ore than 5 seconds. The infant's blood pressure is 85/65 mmHg, and glucose is 30 mg/dL (1.56 mmol/L). You administer 100% oxygen via facemsk and start an IV. Which treatment is the most appropriate for this infant? - Administer a bolus of isotonic crystalloid 20 ml/kg over 5-20 minutes, and also give D25W to 4 ml/kg IV How can rescuers ensure that they are providing effective breaths when using a bag-mask device? - By observing the chest rise with each breath You need to provide rescue breaths to a child victim with a pulse. What is the appropriate rate for delivering breaths? - 1 breath every 3 to 5 seconds You just assisted with elective endotracheal intubation of a child with respiratory failure and perfusing rhythm. Which provide reliable , prompt assessment of correct endotracheal tube placement in this child? - Adequate bilateral breath sounds and chest expansion plus detection of ETCO2 with waveform capnography. An 18 month-old child has 1 week history of cough and runny nose. The child has diffuse cyanosis and responsive only to painful stimulation with slow respirations and rapid central pulses. The child's respiratory has decreased from 65/min to 10/min, severe inspiratory intercoastal retractions are present, HR is 160/min, SPO2 is 65% on RA, and capillary refill is less than2 seconds. Which are the most appropriate immediate interventions for this toddler? - Open the airway and provide positive-pressure ventilation using 100% O2 and a bag-mask device. 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? - Provide CPR about 2 minutes before leaving to activate the emergency response system You are caring for a 3 year old with vomitting and diarrhea. The child's pulses are palpable but faint, and the child is now lethargic. The HR is variable (range, 44/min to 62/min). You begin bag-mask ventilation with 100% oxygen. When the HR does not improve, you begin chest comnpressions. The rhythm shown here is seen on the cardiac monitor (bradycardia). Which would be the most appropriate therapy to consider next? - Atropine 0.02 mg/kg IV You are assisting in the elective intubation of an average-sized 4-year-old 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 ET tube for this child? - 5-mm tube A 7-year-old boy is found unresponsive, apneic, and pulseless. CPR is ongoing. The child is intubated, and vascular access is established. The ECG monitor shows an organized rhythm with a HR of 45/min, but a pulse check reveals no palpable pulses. High-quality CPR is resumed, and an initial IV dose of epinephrine is administered. Which intervention should you perform next? - Identify and treat reversible causes An 8-month old infant is brought to the ER department for evaluation of severe diarrhea and dehydration. On arrival to the ER department, the infant becomes unresponsive, apneic, and pulseless. You shout for help and start CPR. Another provider arrives, at which point you switch to 2-rescuer CPR. The rhythm shown is bradycardia on the cardiac monitor. The infant is intubated and ventilated with 100% oxygen. An IO line is established, and a dose of epinephrine is given. While continuing high-quality CPR, what do you do next? - Give normal saline 20 mL/kg IO rapidly An 8-year-old child was struck by a car. He arrives in the ER department alert, anxious, and in respiratory distress. His cervical spine is immobilized, and he is receiving a 10-L/min flow of 100% O2 by NRB face mask. His RR is 60/min, HR 150/min, systolic BP 70 mmHg, and SPO2 84%. Breath sounds are absent over the right chest but present over the left chest, and the trachea is deviated to the left. He has weak central pulses and absent distant pulses. Which intervention should be performed next? - Perform needle decompression of the right chest You are supervising a student who is inserting an IO needle into an infant's tibia. The student asks you what she should look for to know that she has successfully inserted the needle into the bone marrow cavity. What do you tell her? - Fluids can be administered freely without local soft tissue swelling You are giving chest compressions for a child in a cardiac arrest. What is the proper depth of compressions for a child - Compress at least 1/3 the depth of the chest , about 2 inches (5cm). During bag-mask ventilation, how should you hold the mask to make an effective seal between the child's face and the mask? - Position your fingers using the E-C clamp technique A 10-month-old infant boy is brought to the emergency department. Your initial assessment reveals a lethargic, pale infant with slow respirations and slow, weak central pulses. One team member begins ventilation with a BVM with 100% O2. A second team member attaches the monitor/defibrillator and obtains vital signs while a third team member attempts to establish IV/IO access. The patient's HR is 38/min with the rhythm (bradycardia) on the monitor. The infant's BP is 58/38 mmHg, and capillary refill is 4 seconds. His central pulses remain weak, and distal pulses cannot be palpated. Chest compressions are started and IO access is obtained. Which medication do you anticipate will be given next? - epinephrine 0.01 mg/kg IV/IO You are caring for a 6-year old patient who is receiving positive-pressure mechanical ventilation via ETT. The child begins to move his head and suddenly become cyanotic, and his HR decreases. His SPO2 is 65%. You remove the child from the mechanical ventilator and begin to provide manual ventilation with a bag via the ETT. During manual ventilation with 100% O2, the child's color and HR improved slightly and his BP remains adequate. Breath sounds and chest expansion are present and adequate on the right side and are present but consistently diminished on the left side. The trachea is not deviated, and the neck veins are not distended. A suction catheter passes easily beyond the tip of the ETT. Which of the following is the most likely cause of this child's acute deterioration? - Tracheal tube displacement into the right main bronchus.