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Exam (elaborations)

PALS All Questions with solved solutions .

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PALS All Questions with solved solutions .

You ware wcaring wfor wa wchild wwho wwas wresuscitated wafter wa wdrowning wevent. wThe wchild wis wintubated
wand wventilated wwith w100% woxygen wwith wequal wbreath wsounds wand wexhaled wCO2 wdetected. wThe

wheart wrate wis wslow wand wthe wmonitor wshows wsinus wbradycardia. wThe wskin wis wcool, wmottled, wand

wmoist; wdistal wpulses ware wnot wpalpable wand wthe wcentral wpulses ware wweak. wIntravenous waccess whas

wbeen westablished. wThe wcore wtemperature wis w37.3oC. wBased won wthe wPALS wbradycardia walgorithm,

wwhich wof wthe wfollowing wshould wbe wprovided wfirst?




Epinephrine wIV

Transcutaneous wpacing

Atropine wIV

Dobutamine wIV winfusion w- w w w wcorrect wanswer.Epinephrine wIV



You ware wcaring wfor wa w5-year-old wpatient wwith wsupraventricular wtachycardia w(heart wrate w= w220/min).
wThe wchild wis wlethargic. wThe wskin wis wpale wand wcool wwith wdelayed wcapillary wrefill. wDistal wpulses ware

wnot wpalpable. wWhich wof wthe wfollowing wwould wbe wthe wbest wtreatment wto wprovide wwithout wdelay?




Place wcold wpacks won wthe wdistal wupper wand wlower wextremities

Ask wthe wchild wto wblow wthrough wa wsmall wstraw

Exert wlight wpressure won wthe weyes wbilaterally

Provide wsynchronized wcardioversion wat w0.5 wto w1 wJ/kg w- w w w wcorrect wanswer.Provide wsynchronized
wcardioversion wat w0.5 wto w1 wJ/kg




You ware winitiating wtreatment wfor wa wchild wwith wseptic wshock wand whypotension. wWhile wadministering
whigh-flow woxygen wyou wdetermine wthat wthe wchild's wrespirations ware wadequate wand wSpO2 wis w100%.

wYou whave wjust westablished wvascular waccess wand wobtained wblood wsamples. wWhich wof wthe wfollowing

wis wthe wnext wmost wappropriate wtherapy wto wsupport wsystemic wperfusion?




Administer wrepeated wfluid wboluses wof wisotonic wcolloid

Administer wrepeated wfluid wboluses wof wisotonic wcrystalloid

,Begin wimmediate wdopamine winfusion

Begin wimmediate wdobutamine winfusion w- w w w wcorrect wanswer.Administer wrepeated wfluid wboluses wof
wisotonic wcrystalloid




You ware wtreating wan w8-year-old wwith wventricular wtachycardia wwith wpulses wand wadequate wperfusion.
wYou wattempted wsynchronized wcardioversion wwithout wsuccess. wWhile wseeking wexpert wconsultation, wit

wwould wbe wmost wappropriate wto:




Administer wa wloading wdose wof wmilrinone

Consider wpossible wmetabolic wand wtoxicologic wcauses

Initiate woverdrive wpacing wtranscutaneously

Deliver wan wunsynchronized wshock w- w w w wcorrect wanswer.Consider wpossible wmetabolic wand wtoxicologic
wcauses




You ware wcaring wfor wa w2-year-old wunconscious wpatient wwho wis wintubated wand wreceiving wmechanical
wventilation. wThe wchild's wheart wrate wsuddenly wdrops wto w40/min wand whis wcolor wbecomes wmottled.

wYou wshould wrespond wto wthese wchanges wby:




Increasing wthe wventilator wrate

Increasing wtidal wvolume

Increasing wpositive wend-expiratory wpressure w(PEEP)

Using wa wresuscitation wbag wprovide wmanual wventilation wwith w100% woxygen w- w w w wcorrect
wanswer.Using wa wresuscitation wbag wprovide wmanual wventilation wwith w100% woxygen




You ware wcaring wfor wa w9-month-old wpatient wwith wpronounced wrespiratory wdistress. wYou winitiated
whigh-flow woxygen wusing wa wnonrebreathing wmask wabout w10 wminutes wago wand westablished

wintravenous waccess. wInitially wthe winfant's wheart wrate wwas win wthe w150/min wrange wwith wstrong

wpulses. wSuddenly wthe winfant's wrespiratory wrate wfalls wto w6/min wwith wsignificant wintercostals

wretractions, wand wlittle wair wmovement wis wheard. wThe winfant wbecomes wcyanotic wand wthe wheart wrate

wdecreases wto w95/min. wWhich wof wthe wfollowing wtreatments wwould wbe wbest wfor wyou wto wprovide

wnow?




Administer wepinephrine wIV

, Provide wbag-mask wventilation

Administer wmagnesium wsulfate wIV

Intubate wand wventilate w- w w w wcorrect wanswer.Provide wbag-mask wventilation



Which wof wthe wfollowing wis wlikely wto wbe wthe wmost whelpful wtechnique wto widentify wpotentially
wreversible wmetabolic wand wtoxic wcauses wduring wthe wattempted wresuscitation wof wa wyoung wchild win

wcardiac warrest?




Obtaining wa wurine wsample wfor wtoxicology wscreen

Obtaining wchest wand wabdominal wradiographs

Soliciting wa whistory wfrom wthe wcaregiver wor wfamily

Obtaining wa wvenous wblood wgas w- w w w wcorrect wanswer.Soliciting wa whistory wfrom wthe wcaregiver wor
wfamily




You ware wcaring wfor wa wpatient wwho wdeveloped wa wtension wpneumothorax wafter wseveral whours wof
wpositive-pressure wventilation. wWhich wof wthe wfollowing wwould wbe wthe wmost wappropriate wsite wfor

wneedle wdecompression?




Over wthe wthird wrib wat wthe wmidclavicular wline

Under wthe weighth wrib wat wthe wmidaxillary wline

Over wthe wfifth wrib wat wthe wsternal wborder

Under wthe wsixth wrib wat wthe wmidclavicular wline w- w w w wcorrect wanswer.Over wthe wthird wrib wat wthe
wmidclavicular wline




You wattempted wsynchronized wcardioversion wfor wan winfant wwith wsupraventricular wtachycardia w(SVT)
wand wpoor wperfusion. wThe wSVT wpersists wafter wthe winitial w1 wJ/kg wshock. wWhich wof wthe wfollowing

wshould wyou wattempt wnow?




Synchronized wcardioversion wat wa wdose wof w2 wJ/kg

Synchronized wcardioversion wat wa wdose wof w4 wJ/kg

Unsynchronized wcardioversion wat wa wdose wof w2 wJ/kg
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