AHA PALS EXAM ACTUAL EXAM TEST BANK 250 QUESTIONS& CORRECT DETAILED ANSWERS WITH RATIONALE, Exams of Nursing

Download AHA PALS EXAM ACTUAL EXAM TEST BANK 250 QUESTIONS& CORRECT DETAILED ANSWERS WITH RATIONALE and more Exams Nursing in PDF only on Docsity! AHA PALS EXAM ACTUAL EXAM TEST BANK 250 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+||NEWEST VERSION 2024 -2025 1. A 13-year-old patient with asthma just received oxygen and albuterol via a nebulizer. What is the next most appropriate intervention? A. Administer 0.1 mg/kg of adenosine B. Obtain a blood sample to evaluate arterial or venous blood gases C. Reassess breath sounds and clinical status D. Repeat the albuterol treatment Correct Answer Reassess breath sounds and clinical status 2. The respiratory rate of a 1-year-old child with respiratory distress has decreased from 65/min to 30/min. The child is more lethargic and continues to have subcostal retractions. What does this change likely indicate? A. Respiratory distress is unchanged B. Progression toward respiratory failure C. Improved respiratory status D. Neurologic impairment Correct Answer Progression toward respiratory failure 3. What is the most likely cause of head bobbing in infants? A. Increased respiratory effort B. Improving respiratory status C. Decompensated shock D. Brain injury Correct Answer Increased respiratory effort 4. Several healthcare providers are participating in an attempted resuscitation. Which of the following is most consistent with the responsibilities of the team leader of the resuscitation? A. Records medications and interventions B. Assigns roles to team members C. Administers defibrillation shocks D. Provides compressions Correct Answer Assigns roles to team members 5. Which of the following conditions is appropriate for use of an oropharyngeal airway? A. Conscious with no gag reflex B. Unconscious with a gag reflex C. Unconscious with no gag reflex D. Conscious with a gag reflex Correct Answer Unconscious with no gag reflex 7. A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10 minutes after eating peanuts. What is the most appropriate initial medication for this child? A. Nebulized albuterol B. Epinephrine IM C. Isotonic crystalloid IV D. Methylprednisolone IV Correct Answer Epinephrine IM 8. A mother brings her 7-year-old child to the emergency department. The mother states that the child has had a fever for the past 4 days and has had little to eat or drink during the past 24 hours. Your initial impression reveals a lethargic child with increased respiratory rate and pale color. Heart rate is 160/min, respiratory rate is 38/min, and blood pressure is 86/48 mm Hg. B. Obtain IV access C. Administer dopamine D. Administer an antibiotic Correct Answer Provide 100% oxygen via a nonrebreathing mask 16. An alert toddler presents with a barking cough, moderate stridor, and moderate retractions. The child's color is pink. What is the most appropriate initial intervention? A. Obtain a chest radiograph B. Administer nebulized epinephrine C. Prepare for a surgical airway D. Use an epinephrine autoinjector Correct Answer Administer nebulized epinephrine 17. The initial impression of a 4-year-old child reveals a lethargic child who is diaphoretic, with no increased work of breathing and pink color. Her heart rate is 220/min, respiratory rate is 24/min, blood pressure is 84/46 mm Hg, and capillary refill time is 5 seconds. IV access has been established. The rhythm below is seen on the cardiac monitor. What is the most appropriate initial intervention? A. Give adenosine 0.1 mg/kg rapid IV push B. Perform carotid sinus massage C. Perform synchronized cardioversion at 0.5 J/kg D. Attempt defibrillation at 2 J/kg Correct Answer Give adenosine 0.1 mg/kg rapid IV push 18. An 8-month-old infant is being evaluated. The child's mother says the infant has not been feeding well. The infant is alert with rapid but unlabored breathing, and the infant's color is pale. A cardiac monitor is applied, and the rhythm below is noted. Distal pulses are readily palpable. You give oxygen and establish IV access. What is the most appropriate vagal maneuver? A. Valsalva maneuver B. Carotid massage C. Ocular pressure D. Ice to the face Correct Answer Ice to the face 19. A 7-year-old child presents with a narrow-complex supraventricular tachycardia, lethargy, and poor perfusion. Pulses are weak and thready. Vascular access cannot be established. What is the most appropriate intervention? A. Unsynchronized shock with 0.5 to 1 J/kg B. Synchronized shock with 0.5 to 1 J/kg C. Unsynchronized shock with 2 J/kg D. Synchronized shock with 2 J/kg Correct Answer Synchronized shock with 0.5 to 1 J/kg 20. A 3-month-old infant presents with lethargy and a 3-day history of vomiting, diarrhea, and poor feeding. The initial impression reveals lethargy, increased respiratory effort with retractions, and pale, mottled skin color. Vital signs are as follows: heart rate 210/min, respiratory rate 60/min, and blood pressure 60/40 mm Hg. Peripheral pulses are thready, and capillary refill time is 4 seconds. The cardiac monitor displays the rhythm below. After administration of oxygen and establishment of vascular access, what is the most appropriate intervention? A. Adenosine O.1 mg/kg IV rapid push B. Vagal maneuvers C. Synchronized shock at 0.5 to 1 J/kg D. IV fluid bolus of 20 mL/kg normal saline Correct Answer IV fluid bolus of 20 mL/kg normal saline 21. A 3-year-old child is unresponsive, gasping, and has no detectable pulse. CPR is initiated. A monitor is attached, and the rhythm is shown below. What is the appropriate next therapy? A. Attempted defibrillation with 2 J/kg B. Synchronized cardioversion with 0.5 to 1 J/kg C. Epinephrine 0.01 mg/kg 10/IV D. Amiodarone 5 mg/kg 1O/IV Correct Answer Attempted defibrillation with 2 J/kg 22. A 2-year-old child is in pulseless arrest. The child has received high-quality CPR, 2 shocks, and a dose of IV epinephrine. The next rhythm check reveals the rhythm shown below. What would be an appropriate energy dose for the third defibrillation attempt? A. 2 J/kg B. 2 to 4 J/kg C. 4 J/kg or greater D. Greater than 10 J/kg Correct Answer 4 J/kg or greater 23. A 12-year-old child suddenly collapses while playing sports. He is unresponsive and not breathing. Emergency response is activated. The child has no pulse, and CPR is initiated. An AED arrives. What is the most appropriate next intervention? A. Contact the child's family B. Provide CPR for 2 minutes C. Drive the child to the hospital D. Use the AED Correct Answer Use the AED 24. A 3-year-old child is in cardiac arrest, and high- quality CPR is in progress. The first rhythm check reveals the rhythm below. Defibrillation is attempted with a shock dose of 2 J/kg. After administration of the shock, what is the most appropriate next intervention? A. Resume CPR, beginning with chest compressions B. Check for a pulse C. Analyze the rhythm D. Administer epinephrine Correct Answer Resume CPR, beginning with chest compressions 25. Which of the following is a characteristic of respiratory failure? A. Inadequate oxygenation and/or ventilation C. Escort the family to an assigned family room where they can be given regular updates D. Take the family to the chapel or an assigned quiet room so they can receive expert consultation. Correct Answer Allow the family to stay at the bedside with a staff member who is assigned to provide information and assistance 32. Which of the following is most likely to produce a prolonged expiratory phase and wheezing? A. Disordered control of breathing B. Hypovolemic shock C. Lower airway obstruction D. Upper airway obstruction Correct Answer Lower airway obstruction 33. A 5-year-old child has had severe respiratory distress for 2 days. During assessment the child's heart rate decreases from 140/min to 90/min, and the child's respiratory rate decreases from 66/min to 8/min. Which of the following is the next appropriate intervention? A. Rescue breaths at a rate of 12 to 20/min B. Rescue breaths at a rate of 6 to 10/min C. Chest compressions at a rate of at least 100/min D. Chest compressions at a rate of 60/min Correct Answer Rescue breaths at a rate of 12 to 20/min 34. A 5-year-old child presents with lethargy, increased work of breathing, and pale color. The primary assessment reveals that the airway is open and the respiratory rate is 30/min, with crackles heard on auscultation. The cardiac monitor shows sinus tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of 95% and a pulse rate of 93/min. On the basis of this information, which of the following provides the best interpretation of the oxygen saturation of 95% by pulse oximetry? A. Reliable; no supplementary oxygen is indicated B. Reliable; supplementary oxygen should be administered C. Unreliable; no supplementary oxygen is indicated D. Unreliable; supplementary oxygen should be administered Correct Answer Unreliable; supplementary oxygen should be administered 35. A 3-year-old child was recently diagnosed with leukemia and has been treated with chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min, respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is less than 2 seconds. What is the child's most likely condition? A. Septic shock B. Hypovolemic shock C. Significant bradycardia D. Cardiogenic shock Correct Answer Septic shock 36. A 2-week-old infant presents with irritability and a history of poor feeding. Blood pressure is 55/40 mm Hg. What term describes this infant's blood pressure? A. Hypotensive B. Normal C. Hypertensive D. Compensated Correct Answer Hypotensive 37. During a resuscitation attempt, the team leader orders an initial dose of epinephrine at 0.1 mg/kg to be given 10. What should the team member do? A. Administer the drug as ordered B. Administer 0.01 mg/kg of epinephrine C. Respectfully ask the team leader to clarify the dose D. Refuse to administer the drug Correct Answer Respectfully ask the team leader to clarify the dose 38. Which of the following is a characteristic of respiratory failure? A. Inadequate oxygenation and/or ventilation B. Hypotension C. An increase in serum pH (alkalosis) D. Abnormal respiratory sounds Correct Answer Inadequate oxygenation and/or ventilation 39. Which of the following is most likely to produce a prolonged expiratory phase and wheezing? A. Disordered control of breathing B. Hypovolemic shock C. Lower airway obstruction D. Upper airway obstruction Correct Answer Lower airway obstruction 40. A 4-year-old child presents with seizures and irregular respirations. The seizures stopped a few minutes ago. Which of the following most likely to be abnormal? A. Vascular resistance B. Pulse rate C. Lung compliance D. Control of breathing Correct Answer Control of breathing 41. What abnormality is most likely to be present in children with acute respiratory distress caused by lung tissue disease? A. Decreased oxygen saturation B. Stridor C. Normal respiratory rate D. Decreased respiratory effort Correct Answer Decreased oxygen saturation 42. An alert 2-year-old child with an increased work of breathing and pink color is being evaluated. Heart rate is 110/min, and respiratory rate is 30/min. What would best describe this patient's condition? A. Respiratory distress B. Respiratory arrest 85%. His trachea is deviated to the right, and there are no breath sounds on the left. His heart rate is 140/min, his blood pressure is 84/60 mm Hg, and his capillary refill time is 3 seconds. What is the most appropriate intervention? A. Obtain a chest x-ray B. Perform needle decompression on the left chest C. Insert a chest tube on the left side D. Insert an IV and administer 20 mL/kg of normal saline Correct Answer Perform needle decompression on the left chest 49. A 4-year-old is being treated for hypovolemic shock and has received a single fluid bolus of 20 mL/kg of normal saline. On reevaluation the child remains anxious, with a heart rate of 140/min, a blood pressure of 84/54 mm Hg, and a capillary refill time of 4 seconds. What describes this patient's condition? A. Hypotensive shock B. Compensated shock C. No longer in shock D. Cardiogenic shock Correct Answer Compensated shock 50. An 8-year-old child had a sudden onset of palpitations and light-headedness. At the time of evaluation the child is alert. His respiratory rate is 26/ min, and his blood pressure is 104/70 mm Hg. A cardiac monitor is applied, and the rhythm below is noted. What is the most appropriate initial intervention? A. Provide synchronized cardioversion at 0.5 to 1 J/kg B. Attempt vagal maneuvers C. Administer adenosine 0.1 mg/kg over 5 minutes D. Administer amiodarone 5 mg/kg over 20 minutes Correct Answer Attempt vagal maneuvers 51. A 10-year-old child had a sudden witnessed cardiac arrest and received immediate bystander CPR and defibrillation within 3 minutes. He had a return of spontaneous circulation. The child remains unresponsive and has an advanced airway in place. There is no history of trauma or signs of shock. What is the target range for oxygen saturation for this child? A. 92% to 100% B. 92% to 99% C. 94% to 99% D. 94% to 100% Correct Answer 94% to 99% 52. A 3-month-old infant with bronchiolitis is suctioned to remove upper airway secretions. The infant's heart rate decreases from 155/min to 65/min as shown below. The infant remains alert, with easily palpable pulses. Capillary refill time is 1 second. What is the most appropriate initial intervention? A. Administer oxygen and ensure adequate ventilation; be prepared to intervene further if heart rate does not increase B. Establish IV/IO access and administer epinephrine 0.01 mg/kg IV C. Establish IV/IO access and administer atropine 0.02 mg/kg IV D. Call for help and prepare to provide transthoracic pacing/transvenous pacing Correct Answer Administer oxygen and ensure adequate ventilation; be prepared to intervene further if heart rate 53. A 3-month-old infant with bronchiolitis is intubated for management of respiratory failure. During transport, the infant develops bradycardia with a heart rate of 60/min, and the infant's oxygen saturation decreases to 75%. There are breath sounds on the right side, but no air entry is heard on the left side. What is the most appropriate initial intervention? A. Administer epinephrine 0.01 mg/kg IV B. Place a chest tube on the left C. Verify the endotracheal tube position D. Aggressively suction the endotracheal tube Correct Answer Verify the endotracheal tube position 54. For a 6-month-old infant with supraventricular tachycardia and adequate perfusion, which of the following is the preferred vagal maneuver? A. Ocular pressure B. Carotid pressure C. Valsalva maneuver D. Ice to the face Correct Answer Ice to the face 55. A child presents with severe respiratory distress, urticaria, stridor, and tachycardia about 10 minutes after eating peanuts. What is the most appropriate initial medication for this child? A. Nebulized albuterol B. Epinephrine IM C. Isotonic crystalloid IV D. Methylprednisolone Correct Answer Epinephrine IM 56. A 2-year-old child was found submerged in a swimming pool. She is unresponsive, not breathing, and pulseless. In addition to performing high-quality CPR and establishing vascular access, which of the following is the most appropriate intervention? A. Give atropine 0.02 mg/kg lIO/IV B. Apply cricoid pressure C. Give epinephrine 0.01 mg/kg IO/IV D. Provide transthoracic pacing Correct Answer Give epinephrine 0.01 mg/kg IO/IV 57. A 3-year-old child is unresponsive, not breathing, and pulseless. High-quality CPR is in progress. A cardiac monitor is applied, and the rhythm below is noted. What is the next appropriate intervention? A. Attempt defibrillation with a 2 J/kg shock B. Administer epinephrine 0.01 mg/kg C. Consider placement of an advanced airway D. Administer amiodarone 5 mg/kg Correct Answer Attempt defibrillation with a 2 J/kg shock 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? There is no electrical activity in the heart The heart is pumping so fast that it cannot fill completely between beats Correct Answer The heart is not pumping blood at all You are called to treat a 5-year-old with a 3-day history of worsening respiratory distress. The child responds only to pain. The heart rate is initially 45/min and regular with poor capillary refill. You provide bag-mask ventilations (BMV) with high-flow oxygen that produces good chest rise with full and clear bilateral breath sounds. The heart rate rises in response to ventilation, but after you suction the posterior pharynx, bradycardia recurs (40/min). Which of the following interventions would be most appropriate for you to do first? Perform transcutaneous pacing Administer epinephrine IV Administer atropine IV Resume bag-mask ventilation Correct Answer Resume bag-mask ventilation You are caring for an 8-month-old with bradycardia and very poor perfusion that has persisted despite effective ventilations with high-flow oxygen. You should begin chest compressions if the heart rate is: More than 200/min More than 150/min Less than 100/min Less than 60/min Correct Answer Less than 60/min You are caring for a 2-year-old with a 1-day history of respiratory distress and stridor. The patient is alert. The child's respiratory rate is 32/min with good chest rise. SPO2 is 98% in room air. The heart rate is 128/min and capillary refill is normal. Skin is warm, pink, and dry. At this point you should: Assist ventilations with bag-mask device Use a nonrebreathing mask with tight mask seal Keep the patient calm and comfortable Give IV methylprednisolone (Solumedrol) Correct Answer Keep the patient calm and comfortable You are caring for a 7-year-old with respiratory distress that has worsened over the past few hours. The child is alert and in moderate respiratory distress with prolonged exhalation time. The respiratory rate is 28/min with bilateral expiratory wheezes. The heart rate is 112/min with good capillary refill. The wheezing in this patient indicates: Lung tissue (parenchymal) lung disease Disordered control of breathing Upper airway obstruction Lower airway obstruction Correct Answer Lower airway obstruction Which of the following assessments is most useful in evaluating the effectiveness of bag-mask ventilations? Hearing an air leak around the mask when the bag is fully compressed Seeing the abdomen rise during ventilation Observation of visible chest rise A normal systolic, diastolic, and mean arterial pressure Correct Answer Observation of visible chest rise You are assessing a 6-year-old child who appears unconscious after striking his head on a concrete step. You pinch the patient's chest and the patient grabs your hand. You would document this response as: Decerebrate posturing Decorticate posturing Withdrawal from a painful stimulus Localization of a painful stimulus Correct Answer Localization of a painful stimulus You are caring for an 8-year-old child who was struck by a car. The child is alert, very anxious, and in respiratory distress. The child is receiving high-flow oxygen by face mask, has a respiratory rate of 60/min, the heart rate is 150/min, systolic blood pressure is 70 mm Hg, and a SpO2 of 86% and falling. Breath sounds and chest rise are absent over the right chest. Which of the following is the most likely cause of this child's distress? Tension Pneumothorax Cardiac temponade Severe hypovolemia Cardiac asthma Correct Answer Tension Pneumothorax You are treating a 10-year-old victim of multisystem trauma. The child is very anxious and confused. The respiratory rate is 44/min and unlabored. the pulse is rapid and weak. Capillary refill is delayed. High-flow oxygen and an intravenous line are in place. The most appropriate initial fluid for rapid volume expansion is: 10% dextrose in water 5% dextrose in Ringer's lactate 5% dextrose in normal saline Normal saline or Ringer's lactate Correct Answer Normal saline or Ringer's lactate When monitoring the quality of chest compressions during a resuscitation, you should ensure that providers are: rate suddenly drops to 40/min and his color becomes mottled. You should respond to these changes by: Increasing the ventilator rate Using a resuscitation bag to provide manual ventilation with 100% oxygen Increasing tidal volume Increasing positive end-expiratory pressure (PEEP) Correct Answer Using a resuscitation bag to 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 intercostal 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 lntubate and ventilate Correct Answer Provide bag-mask ventilation You are caring for an 8-year-old child who was struck by a car. The child is alert, very anxious, and in respiratory distress. The child is receiving high-flow oxygen by face mask, has a respiratory rate of 60/min, heart rate of 150/min, systolic blood pressure of 70 mm Hg, and Spot of 86% and falling. Breath sounds and chest rise are absent over the right chest. Which of the following is the most likely cause of this child's distress? Cardiac tamponade Severe hypovolemia Tension pneumothorax Cardiac asthma Correct Answer Tension pneumothorax 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? Soliciting a history from the caregiver or family Obtaining a urine sample for toxicology screen Obtaining chest and abdominal radiographs Obtaining a venous blood gas Correct Answer Soliciting a history from the caregiver or family Which of the following rhythms is shown on this ECG rhythm strip? Sinus bradycardia Ventricular fibrillation (VF) Asystole Supraventricular tachycardia) Correct Answer Ventricular fibrillation (VF) You are caring for an 8-month-old with bradycardia and very poor perfusion that has persisted despite effective ventilations with high-flow oxygen. You should begin chest compressions if the heart rate is: More than 200/min More than 150/min Less than 100/min Less than 60/min Correct Answer Less than 60/min You are caring for a 3-year-old with myocarditis and heart failure. She has become poorly responsive to a sternal rub and is difficult to rouse. She has a sinus rhythm with a heart rate of 175/min, and a blood pressure of 88/65 mm Hg. Her skin is cool and mottled, capillary refill time is 5 seconds and she has barely palpable distal pulses. Oxygen saturation is 90% on high-flow, high- concentration oxygen by face mask. Her respirations are labored at 50/min with moderate retractions, and crackles are heard at the bases. Which of the following would be the most appropriate therapy for this child? Obtain a STAT echocardiogram and chest x-ray Perform synchronized cardioversion at 0.5 joules/kg Provide assisted ventilations with 100% oxygen and prepare for endotracheal intubation Administer epinephrine 0.1 mL/kg of 1:10,000 solution IV Correct Answer Provide assisted ventilations with 100% oxygen and prepare for endotracheal intubation You are treating a 5-month-old with a 2-day history of vomiting and diarrhea. The patient is listless. The respiratory rate is 52/min and unlabored. The heart rate is 170/min and pulses are present but weak. Capillary refill is delayed. You are administering high- flow oxygen and intravenous access is in place. At this point the most important therapy is to: Administer an epinephrine bolus Begin bag-mask ventilation Provide a rapid 20 mL/kg isotonic crystalloid fluid bolus Administer a bolus of 0.5 g/kg of dextrose Correct Answer Provide a rapid 20 mL/kg isotonic crystalloid fluid bolus Which of the following groups of clinical findings would be most consistent with categorizing a patient with compensated shock? heart rate is 112/min with good capillary refill. The wheezing in this patient indicates: Disordered control of breathing Lung tissue (parenchymal) lung disease Lower airway obstruction Upper airway obstruction Correct Answer Lower airway obstruction Which of the following assessments is most useful in evaluating the effectiveness of bagmask ventilation? Hearing an air leak around the mask when the bag is fully compressed Seeing the abdomen rise during ventilationcation Observation of visible chest rise A normal systolic, diastolic, and mean arterial pressure Correct Answer Observation of visible chest rise You are assessing a 6-year-old child who appears to be unconscious after striking his head on a concrete step. You pinch the patient's chest and the patient grabs your hand. You would document this response as: Localization of a painful stimulus Withdrawal from a painful stimulus Decerebrate posturing Decorticate posturing Correct Answer Localization of a painful stimulus You are treating a 10-year-old victim of multisystem trauma. The child is very anxious and confused. The respiratory rate is 44/min and unlabored. The pulse is rapid and weak. Capillary refill is delayed. High-flow oxygen and an intravenous line are in place. The most appropriate initial fluid for rapid volume expansion is: 10% dextrose in water 5% dextrose in Ringer's lactate 5% dextrose in normal saline Normal saline or Ringer's lactate Correct Answer Normal saline or Ringer's lactate When monitoring the quality of chest compressions during a resuscitation, you should ensure that providers are: Pushing hard-ensure that the chest is compressed 3/4 of the anterior-posterior diameter Pushing fast-compress at a rate of 150/min Allowing complete recoil-let the chest return to its original position between compressions Minimizing interruptions-do not permit interruptions for more than 1 minute Correct Answer Allowing complete recoil-let the chest return to its original position between compressions 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 a sinus bradycardia. The skin is cool, mottled, and moist; distal pulses are not palpable and central pulses are weak. Intravenous access has been established. The core temperature is 37.3°C. Based on the PALS bradycardia algorithm, which of the following should be provided first? Transcutaneous pacing Epinephrine IV Atropine IV Dobutamine IV infusion Correct Answer Epinephrine IV You are caring for a 2-year-old with a 1-day history of respiratory distress and stridor. The patient is alert. The child's respiratory rate is 32/min with good chest rise. Spot is 98% in room air. The heart rate is 128/min and capillary refill is normal. Skin is warm, pink, and dry. At this point you should: Keep the patient calm and comfortable Assist ventilations with a bag-mask devicecation Give IV methylprednisolone (Solumedrol) Use a nonrebreathing mask with a tight mask seal Correct Answer Keep the patient calm and comfortable 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? Correct Answer 10 seconds 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? Correct Answer Disordered Control of Breathing 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? Correct Answer blood glucose 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. What 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? Correct Answer 20 ml/kg normal saline 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? Correct Answer It is Hypotensive 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? Correct Answer Ask for a new task or role Which abnormality helps identify children with acute respiratory distress caused by lung tissue disease? Correct Answer crackles Which condition in a child would IO access most likely be attempted before vascular access? Correct Answer cardiac arrest 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? Correct Answer Begin CPR for 2 mins before leaving to activate the emergency response system. An unresponsive 9 year old boy is pale and cool to the touch his blood pressure is 70/45 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? Correct Answer Supraventricular tachycardia An unresponsive 9 year old boy is pale and cool to the touch his blood pressure is 70/45 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? Correct Answer Syncronized cardioversion. 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? Correct Answer inspiratory stridor 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? Correct Answer Increased inspiratory effort with retractions You are caring for patients in the emergency department. Which 2 year old child requires immediate intervention? Correct Answer A child who is grunting 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? Correct Answer blood pressure 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? Correct Answer Respiratory rate of 24/min 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? Correct Answer Sinus Bradycardia 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? Correct Answer Provide bag-mask ventilation with 100% oxygen A 10 year old child is being evaluated for a head ache. Which is a normal finding for this 10 year old child? Correct Answer Heart rate of 88/min 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? Correct Answer Alert A 6 month old infant is being evaluated for bradycardia. Which is the most likely cause of bradycardia? Correct Answer Hypoxia 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 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? Correct Answer 20 ml/kg 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? Correct Answer Antibiotic Administration 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? Correct Answer respiratory failure A 6 year old boy is being evaluated for difficulty breathing. Which finding would suggest this child has respiratory distress? Correct Answer Audible inspiratory stridor 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? Correct Answer upper airway obstruction 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? Correct Answer 88% on 4L of Nasal oxygen 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. Correct Answer The child has signs of probable respiratory failure 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? Correct Answer Administer 20 ml/kg of isotonic crystalloid over 5 to 10 mins 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? Correct Answer Pulseless Electrical Activity In which of the following situations may IO access be used? Correct Answer An extremity with slow capillary refill time. A 2 - week old infant is being evaluated irritability and poor feeding. His blood pressure is 55/40 mm Hg and capillary refill time is 5 seconds. Which statement best describes your assessment of this infants blood pressure? Correct Answer It is Hypotensive You are caring for patients in the emergency department. Which two year old requires immediate interventions? Correct Answer A child who is grunting A 3 year old child is having difficulty breathing. What finding would most likely lead you to expect an upper airway obstruction in this child? Correct Answer Increased inspiratory effort with retractions A team member is unable to perform an assigned task because it is beyond the team member's scope of practice. What action should the team member take? Correct Answer Ask for a new task or role. You are the team lead during a pediatric resuscitation attempt. Which action is high quality CPR? Correct Answer Allow complete chest wall recoil after each compression. A 8 year old child is brought to the emergency department by his mother for difficultly breathing. He has a history is asthma and nut allergies. His mother tells you that he has recently ate a cookie at a family picnic. Which condition is most likely present with this child? Correct Answer Upper airy way obstruction An 8-year-old child is brought to the emergency department by ambulance after being involved in a motor vehicle collision. What finding would suggest that immediate intervention is needed? Correct Answer Decreased level of consciousness A 6-year-old child is found unresponsive, not breathing, and without a pulse. One healthcare worker leaves to activate the emergency response system and get the resuscitation equipment. You and another healthcare provider immediately begin performing CPR. What compression-to-ventilation -ratio do you use? Correct Answer 15:2 A 3-year-old boy is brought to the emergency department by his mother. He is lethargic, with retractions and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk capillary refill. Which immediate life-threatening condition could this child's condition most likely progress to if left untreated? Correct Answer Respiratory Failure You are evaluating a 10-year-old child who is febrile and tachycardic. The child's capillary refill time is 5 seconds. What parameter will determine if the child is in compensated shock? Correct Answer Blood Pressure An 18-month old has had vomiting and diarrhea for the past 2 days; the mother brings him to the emergency department because he is becoming more lethargic. What diagnostic test should you order first? Correct Answer Blood Glucose 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 heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg. 24. What assessment finding indicates that the infant has hypotensive shock? Correct Answer Blood Pressure 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 heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg. On the basis of this infant's presentation, what type of shock does this infant have? Correct Answer Hypovolemic Shock 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 heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refili time is 4 to 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? Correct Answer 20 ml/kg normal saline What abnormality helps identify children with acute respiratory distress caused by lung tissue disease? Correct Answer Crackles 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 infant's SpOz is 94%. On auscultation, the lungs are clear bilaterally. What is the most likely cause of this infant's respiratory distress? Correct Answer Upper airway obstruction 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 infant's SpOz is 94%. On auscultation, the lungs are clear bilaterally. What medication should you administer first? Correct Answer Epinephrine, nebulized What condition is characterized by a prolonged expiratory phase and wheezing? Correct Answer Lower airway obstruction A 5-year-old child is brought to the emergency department by ambulance after being involved in a motor vehicle collision. You are using the primary assessment to evaluate the child. When assessing the child's neurologic status, you note that he has spontaneous eye opening, is fully oriented, and is able to follow commands. How would you document this child's AVPU (Alert, Voice, Painful, Unresponsive) Pediatric Response Scale finding? Correct Answer Alert 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. What condition is most consistent with your assessment? Correct Answer Disordered control of breathing You are evaluating a 1-year-old child for respiratory distress. His heart rate 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, what is the most likely reason for this change in the child's condition? Correct Answer The child has signs of respiratory failure. A 7-year-old child in cardiac arrest is brought to the emergency department by ambulance. No palpable pulses are detected. The child's ECG is shown here. How would you characterize this child's rhythm? Correct Answer Pulseless electrical activity After rectal administration of diazepam, an 8-year-old boy with a history of seizures is now unresponsive to paintul stimulation. His respirations are shallow, at a rate of 10/min. His oxygen saturation is 94% on 2 L/min of nasal cannula oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally. An unresponsive 14-year-old girl is pale and cool to the touch. Her blood pressure is 70/45 mm Hg, heart rate is 190/min, and respiratory rate is 12/min. The Spoz is not detectable. Capillary refill time is 5 seconds. An IV is in place. The cardiac monitor displays the rhythm shown here. Correct Answer Supraventricular tachycardia If pharmacological interventions are unavailable or delayed, what intervention is indicated? Correct Answer Synchronized cardioversion 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 child's heart rate is 160/min, respiratory rate is 38/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds, and temperature is 39.4°C (103°F). I access has been established, and blood cultures have been obtained. What is the most appropriate intervention? Correct Answer Administer 10 to 20 mL/kg of isotonic crystalloid over 5 to 10 minutes An unresponsive 9-year-old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His blood pressure is 80/40 mm Hg, heart rate is 45/min, respiratory rate is 6/min, and Spoz is 60% on room air. He is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here. Correct Answer Sinus Bradycardia An unresponsive 9-year-old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His blood pressure is 80/40 mm Hg, heart rate is 45/min, respiratory rate is 6/min, and Spoz is 60% on room air. He is unresponsive and cyanotic. What action do you take next? Correct Answer Provide bag-mask ventilation with 100% oxygen A 3-year-old child is brought to the emergency department by his mother. What is a normal finding for a 3-year-old child? Correct Answer Respiratory rate of 24/min A 6-month-old infant is being evaluated for bradycardia. What is the most likely cause of bradycardia? Correct Answer Hypoxia compression to breath ratio children with 1 rescuer Correct Answer 30:2 2 rescuer compression to breath ratio? Correct Answer 15:2 Initial impression of a 2-year old girl shows her to be alert with mild breathing difficulty during inspiration and pale skin color. On primary assessment, she makes high pitched inspiratory sound (mild stridor) when agitated; otherwise, intercoastal retractions. Lung auscultation reveals transmitted upper airway sounds with adequate distal breath sounds bilaterally. Which is the most appropriate initial intervention for this child? Correct Answer humidified oxygen as tolerated Which statement is correct about use of calcium chloride in pediatric? Correct Answer Routine administration is not indicated during cardiac arrest Which statement is correct about endotracheal drug administration during resuscitative efforts for pediatric patients? Correct Answer It is the least desirable route of administration You are a part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You administer a 4-J/kg shock and resume CPR. Which drug and dose should be administered next? Correct Answer Amiodarone 5 mg/kg You are called to help treat an infant with severe symptomatic bradycardia (HR 66/min) associated with respiratory distress. The bradycardia persists despite establishment of an effective airway, oxygenation, and ventilation. There is no heart block present. Which is the first drug you should administer? Correct Answer Epinephrine Which statement is correct about the effects of epinephrine during attempted resuscitation? Correct Answer Epinephrine stimulates spontaneous contractions when asystole is present Paramedics are called to the home of a 1yo child. Their initial assessment reveals a child who responds only to painful stimuli and has irregular breathing, faint central pulses, bruises over the abdomen, abdominal distention, and cyanosis. Bag-mask ventilation with 100% oxygen is initiated. The child's heart rate is 36/min. Peripheral pulses cannot be palpated, and central pulses are barely palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR is started. Upon arrival to the emergency department, the child is intubated and ventilated with 100% oxygen, and IV access is established. The heart rate is now 150/min with weak central pulses but no distal pulses. Systolic blood pressure is 74 mmHg. Which intervention should be provided next? Correct Answer Rapid bolus of 20 ml/kg of isotonic crystalloid A 9-year old boy is agitated and leaning forward on the bed in obvious respiratory distress. The patient is speaking in short phrases and tells you that he has asthma but does not carry an administered. Which intervention should you perform next? Correct Answer Identify and treat reversible causes An 8-month old infant is brought to the ER department for evaluation of severe diarrhea and dehydration. On arrival to the ER department, the infant becomes unresponsive, apneic, and pulseless. You shout for help and start CPR. Another provider arrives, at which point you switch to 2-rescuer CPR. The rhythm shown is bradycardia on the cardiac monitor. The infant is intubated and ventilated with 100% oxygen. An IO line is established, and a dose of epinephrine is given. While continuing high-quality CPR, what do you do next? Correct Answer Give normal saline 20 mL/kg IO rapidly An 8-year-old child was struck by a car. He arrives in the ER department alert, anxious, and in respiratory distress. His cervical spine is immobilized, and he is receiving a 10-L/min flow of 100% O2 by NRB face mask. His RR is 60/min, HR 150/min, systolic BP 70 mmHg, and SPO2 84%. Breath sounds are absent over the right chest but present over the left chest, and the trachea is deviated to the left. He has weak central pulses and absent distant pulses. Which intervention should be performed next? Correct Answer Perform needle decompression of the right chest You are supervising a student who is inserting an IO needle into an infant's tibia. The student asks you what she should look for to know that she has successfully inserted the needle into the bone marrow cavity. What do you tell her? Correct Answer Fluids can be administered freely without local soft tissue swelling You are giving chest compressions for a child in a cardiac arrest. What is the proper depth of compressions for a child Correct Answer Compress at least 1/3 the depth of the chest , about 2 inches (5cm). During bag-mask ventilation, how should you hold the mask to make an effective seal between the child's face and the mask? Correct Answer Position your fingers using the E-C clamp technique A 10-month-old infant boy is brought to the emergency department. Your initial assessment reveals a lethargic, pale infant with slow respirations and slow, weak central pulses. One team member begins ventilation with a BVM with 100% O2. A second team member attaches the monitor/defibrillator and obtains vital signs while a third team member attempts to establish IV/IO access. The patient's HR is 38/min with the rhythm (bradycardia) on the monitor. The infant's BP is 58/38 mmHg, and capillary refill is 4 seconds. His central pulses remain weak, and distal pulses cannot be palpated. Chest compressions are started and IO access is obtained. Which medication do you anticipate will be given next? Correct Answer epinephrine 0.01 mg/kg IV/IO You are caring for a 6-year old patient who is receiving positive- pressure mechanical ventilation via ETT. The child begins to move his head and suddenly become cyanotic, and his HR decreases. His SPO2 is 65%. You remove the child from the mechanical ventilator and begin to provide manual ventilation with a bag via the ETT. During manual ventilation with 100% O2, the child's color and HR improved slightly and his BP remains adequate. Breath sounds and chest expansion are present and adequate on the right side and are present but consistently diminished on the left side. The trachea is not deviated, and the neck veins are not distended. A suction catheter passes easily beyond the tip of the ETT. Which of the following is the most likely cause of this child's acute deterioration? Correct Answer Tracheal tube displacement into the right main bronchus. You are alone and witness a child suddenly collapse. There is no suspected head or neck injury. A colleague responded to your shout for help and is activating the emergency response system and is retrieving the resuscitation equipment, including a defibrillator. After delivering 30 compressions, what would be your next action? Correct Answer Open the airway with a head tilt-chin lift maneuver and give 2 breaths You find a 10 yo boy to be unresponsive. You shout for help, and after finding that he is not breathing and has no pulse, you and a colleague begin CPR. Another colleague activates the emergency response system, brings the emergency equipment, and places the child on a cardiac monitor/defibrillator, which reveals the rhythm shown here (Vtach). You attempt defibrillation at 2 J/kg and give 2 minutes of CPR. The rhythm persists at the second rhythm check, at which point you attempt defibrillation with 4 J/kg. A fourth colleague arrives, starts an IV, and administers 1 dose of epinephrine 0.01 mg/kg. If ventricular fibrillation or pulseless ventricular tachycardia persists after 2 minutes of CPR, you will administer another shock. Which drug and dose should be administered next? Correct Answer Lidocaine 1mg/kg IV A 1-year-old boy is brought to the emergency department for evaluation of poor feeding, irritability, and sweating. The child is lethargic but arousable. He has labored breathing, very rapid pulses, and dusky color. His RR is 68/min, HR 300/min, and BP 70/45 mmHg. He has weak brachial pulses and absent radial pulses, a capillary refill of 6 seconds, SPO2 85% on RA, and good bilateral BS. You administer high-flow O2 and place the child on a cardiac monitor and see the rhythm (SVT). The child has no history of congenital heart disease IV access has beeb established. Which therapy is most appropriate for this child? Correct Answer Adenosine 0.1 mg/kg IV rapid push You are preparing to use a manual defibrillator in the pediatric setting. Which best describes when it is appropriate to use the