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PALS 50 post test Review Questions
With Answers
"I think the correct dose is 0.01 mg/kg. should I give that dose instead?" - โ โ During a resuscitation attempt, the team
leader asks you to administer an initial dose of Epinephrine at 0. mg/kg to be given IO. How should you respond?
Distributive Septic Shock - โ โ You are caring for a 12 year old girl with acute lymphoblastic leukemia. She is responsive but she does not feel well and appears to be flushed. Her Temp is 39 degrees C (102.2 F), HR is 118/min, respiratory rate is 36/min, BP is 100/40 mmHg, and oxygen sat is 96% on room air. Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% Oxygen by NRB mask.--- Laberatory studies document a lactic acidosis. On the basis of the patients clinical assessment and history. Which type of shock does this patient most likely have?
blood pressure - โ โ You are caring for a 12 year old girl with
acute lymphoblastic leukemia. She is responsive but she does not feel well and appears to be flushed. Her Temp is 39 degrees C (102.2 F), HR is 118/min, respiratory rate is 36/min, BP is 100/ mmHg, and oxygen sat is 96% on room air. Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% Oxygen by NRB mask.--- Which assessment finding is the most important in your determination of the severity of the patients condition?
20 ml/kg - โ โ You are caring for a 12 year old girl with acute
lymphoblastic leukemia. She is responsive but she does not feel well and appears to be flushed. Her Temp is 39 degrees C (102. F), HR is 118/min, respiratory rate is 36/min, BP is 100/40 mmHg, and oxygen sat is 96% on room air. Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% Oxygen by NRB mask.--- Which NS bolus is most appropriate for this patient?
Antibiotic Administration - โ โ You are caring for a 12 year old
girl with acute lymphoblastic leukemia. She is responsive but she does not feel well and appears to be flushed. Her Temp is 39 degrees C (102.2 F), HR is 118/min, respiratory rate is 36/min, BP is 100/40 mmHg, and oxygen sat is 96% on room air. Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving 100% Oxygen by NRB mask.--- In edition to oxygen administration and appropriate fluid resuscitation, which additional early intervention should you provide to the patient?
respiratory failure - โ โ A 3 year old boy is brought to the ED
by his mother. His is lethargic, with retractions and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk cap refill. To which immediate life treating condition could this Childs condition most likely progress if left untreated?
hypovolemic shock - โ โ You are caring for a 3 month old boy with a 2 day history of fever, vomiting and diarrhea. His parents state that he has been sleeping much more. His HR is 190/min, temp is 38.3 degrees C (101 F) blood pressure is 59/29 mmHg, Resp rate is 70/min and shallow, and oxygen sat is 94% on 100%
unresponsive, in not breathing, and doe not have a pulse. You shout for nearby help, but no one arrives. What action should you take next?
Supraventricular tachycardia - โ โ An unresponsive 9 year old boy is pale and cool to the touch his blood pressure is 70/ mmHg, heart rate is 190/min and respiratory rate is 12/min. The SpO2 is not detectable Cap refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. What rhythm is seen on the patient cardiac monitor?
Syncronized cardioversion. - โ โ An unresponsive 9 year old
boy is pale and cool to the touch his blood pressure is 70/ mmHg, heart rate is 190/min and respiratory rate is 12/min. The SpO2 is not detectable Cap refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. If initial treatment is unavailable or delayed, which intervention is indicated?
inspiratory stridor - โ โ You are performing the airway
component of the primary assessment. Which finding would lead you to conclude that the child has an upper airway obstruction?
Increased inspiratory effort with retractions - โ โ A 3 year old
child is having difficulty breathing. Which finding would most likely lead you to suspect an upper airway obstruction in this child?
A child who is grunting - โ โ You are caring for patients in the
emergency department. Which 2 year old child requires immediate intervention?
blood pressure - โ โ You are evaluating a 10 year old child
who is febrile and tachycardia. The Childs cap refill times 5 seconds. which parameter will determine if the child is in compensated shock?
Respiratory rate of 24/min - โ โ A 3 year old child is brought
to the emergency department by his mother. Which is a normal finding for a 3 year old child?
Sinus Bradycardia - โ โ An unresponsive 9 year old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His BP is 80/40 mmHg, HR is 45/min, respiratory rate is 6/min, and SpO2 is 60% no room air. He is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here. Which rhythm is most consistent with this patients presentation and ECG findings?
Provide bag-mask ventilation with 100% oxygen - โ โ An
unresponsive 9 year old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His BP is 80/40 mmHg, HR is 45/min, respiratory rate is 6/min, and SpO2 is 60% no room air. He is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here. What is your next action?
Heart rate of 88/min - โ โ A 10 year old child is being
evaluated for a head ache. Which is a normal finding for this 10 year old child?
Alert - โ โ A 5 year old child is brought to the emergency
department by ambulance after being involved in a MVC. You are using the primary assessment to evaluate the child. When assessing the Childs neurological status, you note that he has
Which finding would suggest that immediate intervention is needed?
upper airway obstruction - โ โ You are Caring for a 9 month
old girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infants SpO2 is 94% On auscultation, the lungs are clear bilaterally. Which is the most likely cause of this infants respiratory distress?
Epinephrine, nebulized - โ โ You are Caring for a 9 month old
girl who has increased work of breathing, a fever, and a cough. On assessment, you find an alert infant with stridor and retractions. The infants SpO2 is 94% On auscultation, the lungs are clear bilaterally. Which medication should you administer first?
Lower airway obstruction - โ โ Which condition is characterized by a prolonged excretory phase and wheezing?
Audible inspiratory stridor - โ โ A 6 year old boy is being evaluated for difficulty breathing. Which finding would suggest this child has respiratory distress?
upper airway obstruction - โ โ An 8 year old child is brought
to the ED by his mother for difficulty breathing. He has a history of asthma and nut allergies. He's mother tells you that he recently ate a cookie at a family picnic. Which condition is most likely to be present in this child?
88% on 4L of Nasal oxygen - โ โ A 10 year old child is
brought to the ED for fever and cough. You obtain an O2 sat on
the child. Which oxygen saturation would indicate that immediate intervention is needed?
The child has signs of probable respiratory failure - โ โ You
are evaluating a 1 yer old child for respiratory distress. His HR is 168/min, and his respiratory rate has decreased from 65/min to 30/min. He now appears more lethargic and continues to have severe subcostal retractions. On the basis of your assessment, which is the most likely reason for this change in the Childs condition.
Administer 20 ml/kg of isotonic crystalloid over 5 to 10 mins - โ
โ The parents of a 7 year old child who is undergoing
chemotherapy report that the child has been febrile and has not been feeling well, with recent onset of lethargy. Assessment reveals that the child is difficult to arouse and her skin color is pale. The Childs HR is 160/min, respiratory rate is 38/min, blood pressure is 76/45 mmHg, cap refill time is 5 to 6 seconds, and temp is 39.4 degrees C (103 F). IV access has been established, and blood cultures have been obtained. which action should you perform next?
Pulseless Electrical Activity - โ โ A 7 year old child in cardiac
arrest is brought to the ED by ambulance. No palpable pulses are detected. The Childs ECG is shown here. How would you characterize this Childs rhythm?
10 seconds - โ โ A 6 month old infant is unresponsive. You begin checking for breathing at the same time you check for the infants pulse. Which is the maximum time you should spend when trying to simultaneously check for breathing and palpate the infants pulse before starting CPR?
immediatly begin CPR. Which compression to ventilation ratio do you use?
94%-99% - โ โ In post resuscitation management after
cardiac arrest, extra care should be taken to avoid repercussion injury. what should the ideal oxygen saturation range most likely be?
"resume compressions" - โ โ 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 the rhythm shown here. Defibrillation is attempted with a shock dose of 2 J/kg. after administration of the shock, what should you say to you team members?
2-4 J/kg - โ โ A 4 year old child in cardiac arrest is brought to
the emergency department by ambulance. High quality CPR is being performed. The cardiac monitor displays the rhythm strip shown here. The estimated weight of the child is 20 kg. What dose range should you use for the initial defibrillation?
40 Joules - โ โ A 4 year old child in cardiac arrest is brought to the emergency department by ambulance. High quality CPR is being performed. The cardiac monitor displays the rhythm strip shown here. The estimated weight of the child is 20 kg. As the team leader, how many joules do you tell your team member to use to perform initial Defib?
Allowing complete chest wall recoil after each compression - โ
โ You are the team leader during a pediatric resuscitation
attempt. which action is an element of high quality CPR?
blood pressure - โ โ You are caring for a 3 month old boy
with a 2 day history of fever, vomiting and diarrhea. His parents state that he has been sleeping much more. His HR is 190/min, temp is 38.3 degrees C (101 F) blood pressure is 59/29 mmHg, Resp rate is 70/min and shallow, and oxygen sat is 94% on 100% oxygen. His capillary refills time is 4-5 seconds, and he has mottled, cool extremities. The infant weighs 6 Kg. Which assessment finding indicates that the infant is in hypotensive shock?
