PALS POST TEST AND ANSWERS

"I think the correct dose is 0.01 mg/kg. should I give that dose instead?" - answer-During a resuscitation attempt, the team leader asks you to administer an initial dose of Epinephrine at 0.1 mg/kg to be given IO. How should you respond? "resume compressions" - answer-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? 10 seconds - answer-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? 15:2 - answer-A 6 year old child is found unresponsive, not breathing, and without a pulse. one health care worker leaves to activate the emergency response system and get the resuscitation equipment. You and another healthcare provider immediatly begin CPR. Which compression to ventilation ratio do you use? 2-4 J/kg - answer-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? 20 ml/kg - answer-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.--- Which NS bolus is most appropriate for this patient? 20 ml/kg normal saline - answer-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. You have decided that this infant Needs fluid resuscitation. How much fluid should you administer? 40 Joules - answer-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? 88% on 4L of Nasal oxygen - answer-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? 94%-99% - answer-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? A child who is grunting - answer-You are caring for patients in the emergency department. Which 2 year old child requires immediate intervention? Administer 20 ml/kg of isotonic crystalloid over 5 to 10 mins - answer-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? Alert - answer-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 spontaneous eye opening, is fully oriented, and is able to follow command. How would you document this Childs AVPU pediatric response scale finding? Allowing complete chest wall recoil after each compression - answer-You are the team leader during a pediatric resuscitation attempt. which action is an element of high quality CPR? an antibiotic - answer-You are caring for a 5 year old boy with a 4 day history of high fever and cough. He is having increasing lethargy, grunting, and sleepiness. Now he is difficult to arouse and is unresponsive to voice commands. His O2 sat is 72% on room air and 89% when on a NRB O2 mask. He has shallow respirations, with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles. Which medication would be most appropriate? Antibiotic Administration - answer-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? Ask for a new task or role - answer-A team member is unable to perform an assigned task because it is beyond the team members scope of practice. Which action should the team member take? Audible inspiratory stridor - answer-A 6 year old boy is being evaluated for difficulty breathing. Which finding would suggest this child has respiratory distress? Begin CPR for 2 mins before leaving to activate the emergency response system. - answer-You respond to an infant who is 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? blood glucose - answer-An 8 year old child is brought to the emergency department with a 2 day history of lethargy and polyuria. The child has new onset rapid, deep, and labored breathing. Which diagnostic test should you order first? blood pressure - answer-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.--- Which assessment finding is the most important in your determination of the severity of the patients condition? blood pressure - answer-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? blood pressure - answer-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? cardiac arrest - answer-Which condition in a child would IO access most likely be attempted before vascular access? crackles - answer-Which abnormality helps identify children with acute respiratory distress caused by lung tissue disease? Decreased level of consciousness - answer-An 8 year old child is brought to the ED by ambulance after being involved in a MVC. Which finding would suggest that immediate intervention is needed? Disordered Control of Breathing - answer-A 4 year old child is brought to the emergency department for seizures. The seizures stopped a few minutes ago, but the child continues to have slow and irregular respirations. Which condition is most consistent with your assessment? Distributive Septic Shock - answer-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? Epinephrine, nebulized - answer-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? Give 30 compressions to 2 breaths - answer-What ratio for compressions to breaths should be used for 1 rescuer infant CPR Heart rate of 88/min - answer-A 10 year old child is being evaluated for a head ache. Which is a normal finding for this 10 year old child? hypovolemic shock - answer-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. On the basis of this infants presentation, which type of shock does this infant have? Hypoxia - answer-A 6 month old infant is being evaluated for bradycardia. Which is the most likely cause of bradycardia? Increased inspiratory effort with retractions - answer-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? inspiratory stridor - answer-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? It is Hypotensive - answer-A 2 week old infant is being evaluated for irritability and poor feeding. His BP is 55/40 mmHg, and cap refill time is 5 seconds. Which statement best describes your assessment of this infants BP? Lower airway obstruction - answer-Which condition is characterized by a prolonged excretory phase and wheezing? oxygen saturation - answer-You are caring for a 5 year old boy with a 4 day history of high fever and cough. He is having increasing lethargy, grunting, and sleepiness. Now he is difficult to arouse and is unresponsive to voice commands. His O2 sat is 72% on room air and 89% when on a NRB O2 mask. He has shallow respirations, with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles. Which assessment finding is consistent with respiratory failure in this child? Provide bag mask ventilation - answer-After rectal administration of diazepam, an 8 year old boy with a history of seizures is no unresponsive to painful stimuli. His respirations are shallow, at a rate of 10/min. His Oxygen saturation is 94% on 2L of NC oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. After repositioning the patient and you insert an Oral airway, the patient continues to deteriorate. What next step is the most appropriate? Pro