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Exam (elaborations)

PALS All Questions 100% Solved

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You are caring for a child who was resuscitated after a drowning event. The child is intubated and ventilated with 100% oxygen with equal breath sounds and exhaled CO2 detected. The heart rate is slow and the monitor shows sinus bradycardia. The skin is cool, mottled, and moist; distal pulses are n...

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  • August 9, 2024
  • 16
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • PALS
  • PALS
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PALS All Questions 100% Solved

You are caring for a child who was resuscitated after a drowning event. The child is
intubated and ventilated with 100% oxygen with equal breath sounds and exhaled CO2
detected. The heart rate is slow and the monitor shows sinus bradycardia. The skin is
cool, mottled, and moist; distal pulses are not palpable and the central pulses are weak.
Intravenous access has been established. The core temperature is 37.3oC. Based on
the PALS bradycardia algorithm, which of the following should be provided first?



Epinephrine IV

Transcutaneous pacing

Atropine IV

Dobutamine IV infusion - CORRECT ANSWER-Epinephrine IV



You are caring for a 5-year-old patient with supraventricular tachycardia (heart rate =
220/min). The child is lethargic. The skin is pale and cool with delayed capillary refill.
Distal pulses are not palpable. Which of the following would be the best treatment to
provide without delay?



Place cold packs on the distal upper and lower extremities

Ask the child to blow through a small straw

Exert light pressure on the eyes bilaterally

Provide synchronized cardioversion at 0.5 to 1 J/kg - CORRECT ANSWER-Provide
synchronized cardioversion at 0.5 to 1 J/kg



You are initiating treatment for a child with septic shock and hypotension. While
administering high-flow oxygen you determine that the child's respirations are adequate
and SpO2 is 100%. You have just established vascular access and obtained blood
samples. Which of the following is the next most appropriate therapy to support
systemic perfusion?



Administer repeated fluid boluses of isotonic colloid

Administer repeated fluid boluses of isotonic crystalloid

,Begin immediate dopamine infusion

Begin immediate dobutamine infusion - CORRECT ANSWER-Administer repeated fluid
boluses of isotonic crystalloid



You are treating an 8-year-old with ventricular tachycardia with pulses and adequate
perfusion. You attempted synchronized cardioversion without success. While seeking
expert consultation, it would be most appropriate to:



Administer a loading dose of milrinone

Consider possible metabolic and toxicologic causes

Initiate overdrive pacing transcutaneously

Deliver an unsynchronized shock - CORRECT ANSWER-Consider possible metabolic
and toxicologic causes



You are caring for a 2-year-old unconscious patient who is intubated and receiving
mechanical ventilation. The child's heart rate suddenly drops to 40/min and his color
becomes mottled. You should respond to these changes by:



Increasing the ventilator rate

Increasing tidal volume

Increasing positive end-expiratory pressure (PEEP)

Using a resuscitation bag provide manual ventilation with 100% oxygen - CORRECT
ANSWER-Using a resuscitation bag provide manual ventilation with 100% oxygen



You are caring for a 9-month-old patient with pronounced respiratory distress. You
initiated high-flow oxygen using a nonrebreathing mask about 10 minutes ago and
established intravenous access. Initially the infant's heart rate was in the 150/min range
with strong pulses. Suddenly the infant's respiratory rate falls to 6/min with significant
intercostals retractions, and little air movement is heard. The infant becomes cyanotic
and the heart rate decreases to 95/min. Which of the following treatments would be best
for you to provide now?



Administer epinephrine IV

, Provide bag-mask ventilation

Administer magnesium sulfate IV

Intubate and ventilate - CORRECT ANSWER-Provide bag-mask ventilation



Which of the following is likely to be the most helpful technique to identify potentially
reversible metabolic and toxic causes during the attempted resuscitation of a young
child in cardiac arrest?



Obtaining a urine sample for toxicology screen

Obtaining chest and abdominal radiographs

Soliciting a history from the caregiver or family

Obtaining a venous blood gas - CORRECT ANSWER-Soliciting a history from the
caregiver or family



You are caring for a patient who developed a tension pneumothorax after several hours
of positive-pressure ventilation. Which of the following would be the most appropriate
site for needle decompression?



Over the third rib at the midclavicular line

Under the eighth rib at the midaxillary line

Over the fifth rib at the sternal border

Under the sixth rib at the midclavicular line - CORRECT ANSWER-Over the third rib at
the midclavicular line



You attempted synchronized cardioversion for an infant with supraventricular
tachycardia (SVT) and poor perfusion. The SVT persists after the initial 1 J/kg shock.
Which of the following should you attempt now?



Synchronized cardioversion at a dose of 2 J/kg

Synchronized cardioversion at a dose of 4 J/kg

Unsynchronized cardioversion at a dose of 2 J/kg

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