PALS HEARTCODE 2025 QUESTIONS WITH COMPLETE SOLUTIONS
The infant is placed on the ambulance stretcher
and responds with a groan when stimulated and
has a temperature of 36.3 C (97.3 F) - --
Monitor and support ABCs What is the most appropriate method of
-Establish IV/IO access delivering rapid fluid boluses to this patient? -
-Monitor heart rate, blood pressure, and pulse -A syringe and 3-way stopcock
oximetry
-Call for assistance if needed
After the first fluid bolus is administered, the child
is reassessed and her vital signs are HR 167, BP
When you evaluate the patient, you find the 58/44 mm Hg, RR 56/min and SpO2 92%. Her
lungs are clear, skin is cool and mottled, glucose skin is still cool and pale and she is still lethargic
is 97 mg/dL and capillary refill time is 5 seconds. and weak.
What are the warning signs that the patient is
progressing from compensated shock to What should be the next intervention? - -
hypotensive shock? - --Hypotension (late Deliver a second fluid bolus of 20 mL/kg and
sign) reassess
-Increasing tachycardia
When should vasoactive therapy be considered
The patient still has a blood pressure of 58/38 be considered in managing distributive shock? -
mm Hg. Her condition would be classified as -If the child remains hypotensive and
___________ shock. - -Hypotensive poorly perfused despite rapid bolus fluid
administration
What should be included in the initial treatment
for this patient? - --Rapid fluid bolus How does the clinical presentation of distributive
administration shock compare with hypovolemic shock? -
-Establishing IV/IO access -Distributive shock has more variable
presentation than that of hypovolemic shock
The mother does not recall the infant's most
recent weight. What is the most appropriate way For general shock management, administer an
to rapidly determine her weight and calculate isotonic crytalloid bolus of __ mL/kg over __ to __
correct medication? - -Measure her by minutes - -For general shock management,
using color-coded length-based tape administer an isotonic crytalloid bolus of 20
mL/kg over 5 to 20 minutes
You measure the infant to be 7 kg and prepare to
administer a fluid bolus of what type? - - What signs distinguish anaphylactic shock from
Normal saline 20 mL/kg other types of shock? - --Angioedema
, PALS HEARTCODE 2025 QUESTIONS WITH COMPLETE SOLUTIONS
(swelling of the face, lips and tongue) What is the recommendation for fluid bolus of
-Urticaria (hives) isotonic crystalloids in cardiogenic shock? -
-Respiratory distress with stridor, wheezing or -5 to 10 mL/kg over 10 to 20 minutes
both
What is the focus of the initial management of
in a child with anaphylactic shock, what is the distributive shock? - --Correcting
most appropriate initial treatment? - -IM hypovolemia
epinephrine -Filling expanded dilated vascular space
-Expanding intravascular volume
How soon after exposure do symptoms typically
occur in anaphylactic shock? - -Seconds to What are causes of obstructive shock? - --
minutes Pulmonary embolus
-Tension pneumothorax
-Congenital heart defects
-Cardiac tamponade
What should you evaluate to recognize septic
shock? - --Temp
-Heart rate
-Systemic perfusion What signs are present as obstructive shock
-Blood pressure progresses? - --Increased respiratory effort
-Clinical signs of end-organ perfusion -Cyanosis
-Signs of vascular congestion
When should antibiotics be administered in
septic shock? - -Within the first hour Most patients in cardiogenic shock will need
inotropic support with medications.
Which of the following could be used? - --
What are the initial assessment findings for Milrinone
septic shock? - --Fever -Epinephrine
-Hypothermia
-Normal, elevated or decreased WBC
What is the main objective of managing
obstructive shock? - --Correct the cause of
For septic shock, how soon should fluid cardiac output obstruction
resuscitation begin? - -Within 10 to 15 -Restore tissue perfusion
minutes after recognizing shock
Why is it important to immediately identify
The infant is placed on the ambulance stretcher
and responds with a groan when stimulated and
has a temperature of 36.3 C (97.3 F) - --
Monitor and support ABCs What is the most appropriate method of
-Establish IV/IO access delivering rapid fluid boluses to this patient? -
-Monitor heart rate, blood pressure, and pulse -A syringe and 3-way stopcock
oximetry
-Call for assistance if needed
After the first fluid bolus is administered, the child
is reassessed and her vital signs are HR 167, BP
When you evaluate the patient, you find the 58/44 mm Hg, RR 56/min and SpO2 92%. Her
lungs are clear, skin is cool and mottled, glucose skin is still cool and pale and she is still lethargic
is 97 mg/dL and capillary refill time is 5 seconds. and weak.
What are the warning signs that the patient is
progressing from compensated shock to What should be the next intervention? - -
hypotensive shock? - --Hypotension (late Deliver a second fluid bolus of 20 mL/kg and
sign) reassess
-Increasing tachycardia
When should vasoactive therapy be considered
The patient still has a blood pressure of 58/38 be considered in managing distributive shock? -
mm Hg. Her condition would be classified as -If the child remains hypotensive and
___________ shock. - -Hypotensive poorly perfused despite rapid bolus fluid
administration
What should be included in the initial treatment
for this patient? - --Rapid fluid bolus How does the clinical presentation of distributive
administration shock compare with hypovolemic shock? -
-Establishing IV/IO access -Distributive shock has more variable
presentation than that of hypovolemic shock
The mother does not recall the infant's most
recent weight. What is the most appropriate way For general shock management, administer an
to rapidly determine her weight and calculate isotonic crytalloid bolus of __ mL/kg over __ to __
correct medication? - -Measure her by minutes - -For general shock management,
using color-coded length-based tape administer an isotonic crytalloid bolus of 20
mL/kg over 5 to 20 minutes
You measure the infant to be 7 kg and prepare to
administer a fluid bolus of what type? - - What signs distinguish anaphylactic shock from
Normal saline 20 mL/kg other types of shock? - --Angioedema
, PALS HEARTCODE 2025 QUESTIONS WITH COMPLETE SOLUTIONS
(swelling of the face, lips and tongue) What is the recommendation for fluid bolus of
-Urticaria (hives) isotonic crystalloids in cardiogenic shock? -
-Respiratory distress with stridor, wheezing or -5 to 10 mL/kg over 10 to 20 minutes
both
What is the focus of the initial management of
in a child with anaphylactic shock, what is the distributive shock? - --Correcting
most appropriate initial treatment? - -IM hypovolemia
epinephrine -Filling expanded dilated vascular space
-Expanding intravascular volume
How soon after exposure do symptoms typically
occur in anaphylactic shock? - -Seconds to What are causes of obstructive shock? - --
minutes Pulmonary embolus
-Tension pneumothorax
-Congenital heart defects
-Cardiac tamponade
What should you evaluate to recognize septic
shock? - --Temp
-Heart rate
-Systemic perfusion What signs are present as obstructive shock
-Blood pressure progresses? - --Increased respiratory effort
-Clinical signs of end-organ perfusion -Cyanosis
-Signs of vascular congestion
When should antibiotics be administered in
septic shock? - -Within the first hour Most patients in cardiogenic shock will need
inotropic support with medications.
Which of the following could be used? - --
What are the initial assessment findings for Milrinone
septic shock? - --Fever -Epinephrine
-Hypothermia
-Normal, elevated or decreased WBC
What is the main objective of managing
obstructive shock? - --Correct the cause of
For septic shock, how soon should fluid cardiac output obstruction
resuscitation begin? - -Within 10 to 15 -Restore tissue perfusion
minutes after recognizing shock
Why is it important to immediately identify
