PALS ALL QUESTIONS AND ANSWERS
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SCORE. i
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You iare icaring ifor ia ichild iwho iwas iresuscitated iafter ia idrowning ievent. iThe ichild iis
iintubated iand iventilated iwith i100% ioxygen iwith iequal ibreath isounds iand iexhaled
iCO2 idetected. iThe iheart irate iis islow iand ithe imonitor ishows isinus ibradycardia. iThe
iskin iis icool, imottled, iand imoist; idistal ipulses iare inot ipalpable iand ithe icentral ipulses
iare iweak. iIntravenous iaccess ihas ibeen iestablished. iThe icore itemperature iis i37.3oC.
iBased ion ithe iPALS ibradycardia ialgorithm, iwhich iof ithe ifollowing ishould ibe iprovided
ifirst? i
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Epinephrine iIV
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Transcutaneous ipacing
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Atropine iIV
Dobutamine iIV iinfusion i- i icorrect ianswer. i i iEpinephrine iIV
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You iare icaring ifor ia i5-year-old ipatient iwith isupraventricular itachycardia i(heart irate
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220/min). iThe ichild iis ilethargic. iThe iskin iis ipale iand icool iwith idelayed icapillary irefill.
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Distal ipulses iare inot ipalpable. iWhich iof ithe ifollowing iwould ibe ithe ibest itreatment
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provide iwithout idelay?
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Place icold ipacks ion ithe idistal iupper iand ilower iextremities i
Ask ithe ichild ito iblow ithrough ia ismall istraw i
Exert ilight ipressure ion ithe ieyes ibilaterally i
Provide isynchronized icardioversion iat i0.5 ito i1 iJ/kg i- i icorrect ianswer. i i iProvide
isynchronized icardioversion iat i0.5 ito i1 iJ/kg i
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You iare iinitiating itreatment ifor ia ichild iwith iseptic ishock iand ihypotension. iWhile
iadministering ihigh-flow ioxygen iyou idetermine ithat ithe ichild's irespirations iare
iadequate iand iSpO2 iis i100%. iYou ihave ijust iestablished ivascular iaccess iand iobtained
iblood isamples. iWhich iof ithe ifollowing iis ithe inext imost iappropriate itherapy ito isupport
isystemic iperfusion? i
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Administer irepeated ifluid iboluses iof iisotonic icolloid i
Administer irepeated ifluid iboluses iof iisotonic icrystalloid i
Begin iimmediate idopamine iinfusion i
Begin iimmediate idobutamine iinfusion i- i icorrect ianswer. i i iAdminister irepeated ifluid
iboluses iof iisotonic icrystalloid i
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, You iare itreating ian i8-year-old iwith iventricular itachycardia iwith ipulses iand iadequate
iperfusion. iYou iattempted isynchronized icardioversion iwithout isuccess. iWhile iseeking
iexpert iconsultation, iit iwould ibe imost iappropriate ito: i
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Administer ia iloading idose iof imilrinone i
Consider ipossible imetabolic iand itoxicologic icauses i
Initiate ioverdrive ipacing itranscutaneously i
Deliver ian iunsynchronized ishock i- i icorrect ianswer. i i iConsider ipossible imetabolic iand
itoxicologic icauses i
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You iare icaring ifor ia i2-year-old iunconscious ipatient iwho iis iintubated iand ireceiving
imechanical iventilation. iThe ichild's iheart irate isuddenly idrops ito i40/min iand ihis icolor
ibecomes imottled. iYou ishould irespond ito ithese ichanges iby: i
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Increasing ithe iventilator irate
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Increasing itidal ivolume
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Increasing ipositive iend-expiratory ipressure i(PEEP)
Using ia iresuscitation ibag iprovide imanual iventilation iwith i100% ioxygen i- i icorrect
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answer. i i iUsing ia iresuscitation ibag iprovide imanual iventilation iwith i100% ioxygen
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You iare icaring ifor ia i9-month-old ipatient iwith ipronounced irespiratory idistress. iYou
iinitiated ihigh-flow ioxygen iusing ia inonrebreathing imask iabout i10 iminutes iago iand
iestablished iintravenous iaccess. iInitially ithe iinfant's iheart irate iwas iin ithe i150/min
irange iwith istrong ipulses. iSuddenly ithe iinfant's irespiratory irate ifalls ito i6/min iwith
isignificant iintercostals iretractions, iand ilittle iair imovement iis iheard. iThe iinfant
ibecomes icyanotic iand ithe iheart irate idecreases ito i95/min. iWhich iof ithe ifollowing
itreatments iwould ibe ibest ifor iyou ito iprovide inow? i
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Administer iepinephrine iIV
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Provide ibag-mask iventilation
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Administer imagnesium isulfate iIV
Intubate iand iventilate i- i icorrect ianswer. i i iProvide ibag-mask iventilation
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Which iof ithe ifollowing iis ilikely ito ibe ithe imost ihelpful itechnique ito iidentify ipotentially
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reversible imetabolic iand itoxic icauses iduring ithe iattempted iresuscitation iof ia iyoung
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child iin icardiac iarrest?
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Obtaining ia iurine isample ifor itoxicology iscreen i
Obtaining ichest iand iabdominal iradiographs i
Soliciting ia ihistory ifrom ithe icaregiver ior ifamily i
Obtaining ia ivenous iblood igas i- i icorrect ianswer. i i iSoliciting ia ihistory ifrom ithe
icaregiver ior ifamily i
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You iare icaring ifor ia ipatient iwho ideveloped ia itension ipneumothorax iafter iseveral ihours
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of ipositive-pressure iventilation. iWhich iof ithe ifollowing iwould ibe ithe imost iappropriate