PALS PRETEST QUESTIONS WITH CORRECT ANSWERS GRADED TO PASS

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? - 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? - 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? - Amiodarone 5 mg/kg IO Which statement is correct about the effects of epinephrine during attempted resuscitation? - 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. - 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? - It is the least desirable route of administration Which statement is correct about the use of calcium chloride in pediatric patients? - Routine administration is not indicated during cardiac arrest A 9yo boy is agitated and leaning forward on the bed in obvious respiratory distress. - Albuterol Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired oxygen to a 7yo child? - Nonrebreathing face mask 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 - Rapid bolus of 20ml/kg of isotonic crystalloid A 7yo boy is found unresponsive, apneic, and pulseless. CPR is ongoing - 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? - 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? - 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? - 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? - 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 - Administer a bolus of 20 ml/kg isotonic crystalloid You are evaluating an irritable 6yo girl with mottled skin color. - 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 - 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? - 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. - Epinephrine 0.01 mg/kg IV/IO A 1yo boy is brought to the emergency department for evaluation of poor feeding, irritability, and sweating - Administer adenosine 0.1 mg/kg IV rapid push 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 An 8yo child was struck by a car. He arrives in the ED alert, anxious, and in respiratory distress. His cervical spine is immobilized, and he is receiving a 10L/min flow of 100% oxygen by nonrebreathing face mask. - Perform needle decompression of the right chest You are caring for a 3yo with vomiting and diarrhea. You have established IV access. The child's pulses are palpable but faint, and the child is now lethargic - Atropine 0.02 mg/kg IV You need to provide rescue breaths to a child victim with a pulse. What is the appropriate rate for delivering breaths? - 1 breath every 3-5 seconds A child becomes unresponsive in the emergency department and is not breathing. You are uncertain if a faint pulse is present - Start high-quality CPR You find a 10yo boy to be unresponsive. You shout for help, and after finding that he is not breathing and has no pulse, you and a colleague begin CPR. Another colleague activates the emergency response s the emergency equipment, and places the child on a cardiac monitor/defibrillator, which reveals the rhythm shown here. You attempt defibrillation at 2 J/kg and give 2 minutes of CPR. The rhythm persists at the second rhythm check, at which point you attempt defibrillation with 4 J/kg. A fourth colleague arrives, starts an IV, and administers 1 dose of epinephrine 0.01 mg/kg. If ventricular fibrillation or pulseless ventricular tachycardia persists after 2 minutes of CPR, you will administer another shock. Which drug and dose should be administered next? - Lidocaine 1 mg/kg IV