AHA PALS Flashcards Preview

A-Para 2 Special Pop Mid > AHA PALS > Flashcards

Flashcards in AHA PALS Deck (66)
Loading flashcards...
1

1. 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

D. Unreliable; supplementary oxygen should be administered

2

2. 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

A. Septic shock

3

3. 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

A. Hypotensive

4

4. During a resuscitation attempt, the team leader orders an initial dose of epinephrine at 0.1
mg/kg to be given IO. 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

C. Respectfully ask the team leader to clarify the dose

5

5. 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

A. Inadequate oxygenation and/or ventilation

6

6. 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

C. Lower airway obstruction

7

7. 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

D. Control of breathing

8

8. 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

A. Decreased oxygen saturation

9

9. 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
C. Respiratory failure
D. Disordered control of breathing

A. Respiratory distress

10

10. 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 the
following: The child is difficult to arouse, with pale color. The child’s heart rate is 160/min,
respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary refill time is 5 to 6 seconds,
and temperature is 103°F (39.4°C). What is the most appropriate intervention?
A. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30 minutes
B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes
C. Obtain immediate blood cultures and chest x-ray
D. Obtain expert consultation with an oncologist to determine the chemotherapeutic regimen

B. Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes

11

11. A 2-year-old child presents with a 4-day history of vomiting. The initial impression reveals an
unresponsive child with intermittent apnea and mottled color. Heart rate is 166/min, respiratory
rate is now being supported with bag-mask ventilation, capillary refill time is 5 to 6 seconds, and
temperature is 102°F (38.9°C). What is the best method of establishing immediate vascular
access?
A. Two providers may attempt peripheral vascular access twice each
B. Three providers may attempt peripheral vascular access once each
C. Place a central venous line
D. Place an intraosseous line

D. Place an intraosseous line

12

12. What is the appropriate fluid bolus to administer for a child with hypovolemic shock with
adequate myocardial function?
A. 10 mL/kg normal saline
B. 20 mL/kg of 5% dextrose and 0.2% sodium chloride
C. 20 mL/kg normal saline
D. 10 mL/kg lactated Ringer’s

C. 20 mL/kg normal saline

13

13. 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

B. Administer nebulized epinephrine

14

14. An 8-year-old child presents with a history of vomiting and diarrhea. The child has the
following vital signs: heart rate 168/min, respiratory rate 15/min, blood pressure 90/60 mm Hg, and
temperature 98.6°F (37°C). The child’s capillary refill time is 4 seconds. After 2 IV boluses of
normal saline (20 mL/kg each), the child’s vital signs are now as follows: heart rate 130/min,
respiratory rate 16/min, blood pressure 94/62 mm Hg, capillary refill 2 seconds, and temperature
98.6°F (37°C). The child’s urine output is 1 to 2 mL/kg in the past hour. The child is still lethargic.
What diagnostic tests or information should be obtained first?
A. Arterial blood gas
B. Serum potassium concentration
C. Glucose
D. A 12-lead ECG

C. Glucose

15

15. A 15-year-old boy presents with acute onset of severe respiratory distress, with retractions
and an oxygen saturation of 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

B. Perform needle decompression on the left chest

16

16. 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

B. Compensated shock

17

17. 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

B. Attempt vagal maneuvers

18

18. 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%

C. 94% to 99%

19

19. 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

A. Administer oxygen and ensure adequate ventilation; be prepared to intervene further if heart rate
does not increase

20

20. 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

C. Verify the endotracheal tube position

21

21. 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

D. Ice to the face

22

22. 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

B. Epinephrine IM

23

23. 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 IO/IV
B. Apply cricoid pressure
C. Give epinephrine 0.01 mg/kg IO/IV
D. Provide transthoracic pacing

C. Give epinephrine 0.01 mg/kg IO/IV

24

24. 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

A. Attempt defibrillation with a 2 J/kg shock

25

25. A pulseless 6-week-old infant arrives in the emergency department, and high-quality CPR is in
progress. The initial rhythm strip is shown below.
CPR continues, and vascular access has been established. What is the next appropriate
intervention?
A. Administer atropine 0.02 mg/kg IO/IV
B. Attempt defibrillation with a 2 J/kg shock
C. Administer epinephrine 0.01 mg/kg IO/IV
D. Consider insertion of an advanced airway

C. Administer epinephrine 0.01 mg/kg IO/IV

26

26. A 6-month-old infant is unresponsive and not breathing. What is the maximum time that
should be spent trying to palpate the pulse before starting CPR?
A. 10 seconds
B. 15 seconds
C. 30 seconds
D. 60 seconds

A. 10 seconds

27

27. What is the recommended location to check for a pulse in a 3-month-old infant?
A. Carotid
B. Radial
C. Brachial
D. Cardiac apex

C. Brachial

28

28. A 7-year-old child presents in pulseless arrest. The child’s ECG shows the rhythm below.
Which of the following describes the patient’s condition?
A. Ventricular escape rhythm
B. Ventricular tachycardia
C. Pulseless electrical activity
D. Sinus bradycardia

C. Pulseless electrical activity

29

29. While you are performing CPR on an infant in cardiac arrest at a doctor’s office, a second
rescuer arrives with an AED. Which of the following best describes the use of an AED on this
infant?
A. The use of AEDs is not recommended on an infant.
B. There are not enough data to recommend for or against the use of AEDs on infants.
C. Only pediatric pads may be used on infants.
D. If pediatric pads are unavailable, it is acceptable to use adult pads.

D. If pediatric pads are unavailable, it is acceptable to use adult pads.

30

30. 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

D. Use the AED