PALS PRETEST. PALS Pretest

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1 PALS PRETEST

2 1. A child with a fever, immune system compromise, poor perfusion and hypotension is most likely to be experiencing which type of shock A. cardiogenic B. Neurogenic C. Septic D. Hypovolemic 2. A 7 year old child presents with agitation, respiratory distress and dehydration. His heart rate is 120, his respiration rate is 34 and his cap refill is delayed. His skin color is mottled. His blood pressure is within normal limits for his age. His condition is best described as A. Decompensated shock B. Compensated shock C. Compensated shock with poor perfusion D. Decompensated shock with poor perfusion 3. A 4 week old girl is admitter to your ER complaining of stomach pain, vomiting and diarrhea. Her blood pressure is 55/42..Her condition would be described as A. Normal B. Compensated C. Hypertensive D. Hypotensive

3 4. A 5year old child has just had a seizure and appears with increased work of breathing. The respiration rate is 32 and the heart rate is 105. What best describes the patients condition A. Respiratory distress B. Upper airway obstruction C. Lower airway obstruction D, Disordered control of breathing 5. A 4 year old is admitted with croup moderate stridor and retractions. What is the best initial treatment. A. Stat chest x-ray B. An epinepherine autoinjector C. Nebulized epinepherine D. Intubate 6. The optimum oxygen saturation for an arrest victim with return of normal circulation is A % B % C % D %

4 7. The preferred vagal maneuver for a 6 month infant with stable SVT and adequate perfusion is A. Valsalva B. Ice to the face C. Carotid massage D. Pressure above the eye 8. A child presents with a severe symptomatic bradycardiawith no evidence of vagal etiology. The bradycardiapersists despite adequate oxygenation and ventilation. Which drug would you administer? A. Atropine B. Epinepherine C. Adenosine D. Dopamine 9. A child is admitted to the ER in pulsed ventricular tachycardia. What would you consider when evaluating the patient? A. A new onset of hypertension B. An immediate of epinepherine C. This rhythm is normal for this child D. A toxin or metabolic disorder

5 10. Which of the following characterizes respiratory failure A. Increases in serum ph B. Increased work of breathing C. Changes in heart rate and blood pressure D. inadequate oxygenation and ventilation 11. Children with lung tissue disease will usually have A. Stridor B. Decreased respiratory effort C. Hypertension D. decreased oxygen saturation 12. A 6year old child presents with difficulty breathing and pronounced stridor. He most likely has A. A lower airway obstruction B. An upper airway obstruction C, Disordered control of breathing D. Lung tissue disease 13. The difference between compensated and decompensated shock is A. Hypotension B. Skin color C. capillary refill

6 14. A 5 year old child is admitted for dehydration resulting from vomiting and diarrhea. He is hypotensive and you have administered a fluid bolus but he still remains hypotensive. You should next A. Start a dopamine drip B. Start whole blood after cross and match C. administer a 20ml/kg bolus of a crystalloid D. Administer 20ml/kg bolus of a colloid 15. A 15 year old is admitted for severe respiratory distress. He was playing football and had the wind knocked out. Breath sounds are heard only on the right side and the trachea deviates to the left. You should next A. Obtain a stat chest x-ray B. Intubate the patient C. Administer 100% oxygen D. Perform a needle chest decompression 16. The correct initial shock dose for pulseless Vtach and Vfibis A. 4 J/kg B. 2J/kg C. 9J.kg D. Do not shock but use drug therapy

7 17. The most appropriate drug for anaphylaxis with respiratory distress after ingestion is A. Nebularized albuterol B. Epinepherine IM C. Crystalloid bolus D. Methylprednisolone 18. For an infant in cardiac arrest what best describes the use of the AED A. Do not use the AED on an infant B. Use only pediatric pads C. If pediatric pads are not available use adult pads D. Cut down the adult pads until they fit 19 The correct dose of epinepherine for cardiac arrest is A. 0.01mg/kg 1/10000 solution IV/IO B. 0.01mg/kg 1/1000 solution IV/IO C. 0.1 mg/kg 1/10000 solution IV/IO D mg/kg 1/10000 solution ET

8 20. A 4 year old child experiences a confirmed choking episode. He is alert but cyanodic. and unable to talk. The best initial therapy is A. 5 Back blows and 5 chest thrests B. Perform a blind finger sweep C. Give abdominal thrusts D. When the victim is unconscious do abdominal thrusts 21. A 6 month boy presents with a heart rate of 280 bpm. The monitor shows narrow complex SVT. He is responsive but cyanodic, is unable to talk and not moving air. The most appropriate intervention is A. Make an appointment with a pediatric cardiologist B. Consider vagal maneuvers C. Perform immediate synchronized cardioversion D. Administer a 20mg/kg bolus of a crystalloid 22. The pulse for a 2 month old infant should be taken at the A. Carotid B. Brachial C. Femoral D. Radial

9 23. The pulse check for a pediatric patient should not take longer than A. 10 Seconds B. 20 Seconds C. 30 Seconds D. 15 seconds 24. The correct dose for amiodaronein arrest is A. 1 mg/kg B. 5 mg/kg C. 15 mg D. 30 mg/kg 25. You have just shocked a cardiac arrest victim at 2 J/kg. He remains in arrest. The next shock should be given at A. 2J/kg B. 4J/kg C. 6J/kg D. Only 1 shock should be given

10 26. 4 year old child has a blood pressure of 84/54 with delayed cap refill. By the AHA standards this child is A. Hypotensive B. In compensated shock C. No longer in shock D. In septic shock 27. An infant with respiratory distress experiences a drop in heart rate from 145 bpmto 70 bpmand remains alert with good perfusion. The next appropriate intervention is A. IV/IO access and give epinepherine 0.01 mg/kg B. IV/IO and give atropine 0.02 mg/kg C. Begin pacing D. Give oxygen, insure adequate ventilation and be prepared to intervene if the heart rate does not increase 28. A child in respiratory failure has a heart rate of 90 bpm and experiences a drop in respirations from 50 to 10 bpm. What should you do next A. Initiate chest compressions B. Rescue breaths at breaths /min

11 29. A 7 year old is admitted for palpitations and light headedness. His heart rate is 240 bpm. He is alert and oriented,blood pressure id 100/70 and the respiration rate is 28. What do you do next A. Synchronized cardioversion at j/kg B. Attempt vagal maneuvers C. Give adenosine 0.1 mg/kg oer5 minutes D. Give amiodarone 5/mg/kg 30. A pulseless infant is in PEA and CPR is in progress. Vascular access has been established. The next step is A. Give epinepherine 0.01 mg/kg iv/io B. Insert an advanced airway C. Defibrillate at 2 J/kg D. Give atropine 0.02 mg/kg

12 ANSWERS 1 C 2 C 3 D 4 D 5 C 6 C 7 B 8 B 9 D 10. D 11. D 12. B 13. A 14. C 15. D 16. B 17. B 18. C 19. A 20. C 21. C 22. B 23. A 24. B 25. B 26. A 27. D 28. B 29. B 30. A

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