PALS: Qquestion and Answer by (NHCPS)

PALS: Qquestion and Answer by (NHCPS)

True or False: Shock may occur with a normal, increased, or decreased systemic arterial pressure.
Your Answer: True

True or False: Respiratory failure or shock is the most common cause of cardiac arrest in children and infants.
Your Answer: True

True or False: Early signs of obstructive shock always resemble distributive shock.
Your Answer: False

True or False: Albuterol is a common recommendation for treatment of wheezing in a child with infectious pneumonia.
Your Answer: True

True or False: Cardiopulmonary arrest is a common result of respiratory failure and shock.
Your Answer: True

True or False: Symptomatic bradycardia is defined as bradycardia with signs of shock or respiratory failure or distress.
Your Answer: True

True or False: Hypotonic fluids are suggested for volume resuscitation.
Your Answer: False

True or False: Milrinone has known hypotensive effects that may be exacerbated by hypovolemia.
Your Answer: True

What item is NOT a sign of increased respiratory effort?
 *Delayed capillary refill time
 Nasal flaring
 Head bobbing or seesaw respirations
 Chest retractions

Abnormal breath sounds associated with upper airway obstruction include:
 Absent breath sounds
 Decreased breath sounds

Croup medications used for treatment are the following:
 Nebulized epinephrine
 Heliox (Oxygen)
 *All of the above

Common causes of lower airway obstruction include:
 Foreign body aspiration and croup
 *Bronchiolitis and asthma
 Pneumonia and pulmonary edema
 Pleural effusion and bronchospasm

Medications that may be used to treat moderate to severe asthma include all of the following EXCEPT:
 Ipratropium bromide
 Magnesium sulfate

Acute community-acquired pneumonia causes include:
 Streptococcus pneumonia
 Mycoplasma pneumonia
 Chlamydia pneumonia
 *All of the above

Which two components make up cardiac output?
 *Stroke volume and heart rate
 Heart rate and SVR
 SVR and stroke volume
 None of the above

The type of shock associated with inadequate tissue perfusion resulting from myocardial dysfunction is:
 Distributive shock
 Hypovolemic shock
 Obstructive shock
 *Cardiogenic shock

Effectiveness of fluid resuscitation and medication therapy should be frequently monitored by which of the following?
 Heart rate
 Blood pressure
 Mental status
 *All of the above

The consensus definition of hypoglycemia in children and infants is:
 Less than or equal to 50 mg/dL
 *Less than or equal to 60 mg/dL
 Less than or equal to 40 mg/dL
 Less than or equal to 80 mg/dL

What is the primary therapy for hypovolemic shock?
 *Fluid resuscitation
 Correction of metabolic derangements

What is caused by an accumulation of blood in the pericardial space that results in impaired systemic venous return, impaired ventricular filling, and reduced cardiac output?
 *Cardiac tamponade
 Ductal-dependent congenital heart lesions
 Tension pneumothorax
 Massive pulmonary embolism

The first energy dose recommended for synchronized cardioversion for unstable SVT or VT with a pulse that causes cardiovascular instability is:
 *0.5 to 1 Joules per kg
 3 to 5 Joules per kg
 1 to 2 Joules per kg
 0.1 to 0.5 Joules per kg

What is the preferred priority for drug delivery routes?
 ET route, IV route, IO route
 IV route, ET route, IO route
 IO route, ET route, IV route
 *IV route, IO route, ET route

The purpose of defibrillation is to:
 Provide electrically stimulated contraction of the heart
 Recharge the heart
 Treat symptomatic bradycardia
 *Reset the electrical systems of the heart allowing a normal rhythm a chance to return

The first management step in cardiac arrest is to:
 *Begin high-quality CPR
 Suppress or treat arrhythmias
 Increase coronary and cerebral perfusion pressures and blood flow
 Stimulate more forceful myocardial contractility

In an individual with ventricular fibrillation (VF), what should occur immediately following a shock?
 Administer epinephrine.
 *Resume CPR.
 Analyze rhythm.
 Check pulse.

When should a child be transferred to tertiary care?
 *If the child remains comatose post resuscitation
 After the first phase of resuscitation management
 As soon as possible

Poor ventilation causes which of the following:
 *Respiratory acidosis
 None of the above

Which statement best describes cardiogenic shock?
 Aggressive fluid therapy is always indicated for cardiogenic shock.
 Increased blood pressure with wide pulse pressures always indicates cardiogenic shock.
 Individuals in cardiogenic shock have normal peripheral pulses and blood pressure.
 *Increased myocardial dysfunction indicates cardiogenic shock and deteriorating condition.

Suitable oxygen delivery to body tissue is dependent on all of the following EXCEPT:
 Adequate hemoglobin
 Adequate perfusion
 Adequate blood oxygenation
 *Adequate IV access

Which statement regarding compensated versus hypotensive shock is correct?
 A child with shock is always hypotensive.
 *Individuals with compensated shock may maintain normal blood pressure.
 Confusion and deteriorating mental status are indications of hypotensive shock.
 Normal blood pressure always implies that the child is stable.

Which statement concerning cardiac arrest is NOT correct?
 Cell death within the brain often causes irreversible neurological damage.
 An individual may display signs of agonal breathing in stages of cardiac arrest.
 Pediatric individuals in cardiac arrest often have poor outcomes and poor survival rates.
 *High-quality CPR always produces good outcomes for pediatric cardiac arrest individuals.

Which statement about sinus tachycardia is NOT correct?
 *Sinus tachycardia often indicates impending arrest.
 Sinus tachycardia may occur in response to stress.
 Sinus tachycardia is a normal, non-dangerous rhythm.
 Sinus tachycardia may occur in response to fever.

Which statement concerning cardioversion for unstable pediatric indviduals is NOT correct?
 Cardioversion is indicated for unstable ventricular tachycardia with a pulse.
 Sedate them before cardioversion when possible, but do not delay cardioversion for sedation.
 Cardioversion is indicated for wide complex tachycardia with poor perfusion.
 *Cardioversion should not be done on pediatric indviduals under any circumstances.

Indicators of adequate tissue perfusion include:
 Capillary refill time more than four seconds
 Increased lactate
 Pulse oximetry below 90%
 *Urine ouput above one mL/kg per hour

Which of the following is a wide complex tachycardia?
 *Ventricular tachycardia
 Atrial flutter
 Supraventricular tachycardia
 Sinus tachycardia

Common signs of compensated shock include:
 *Increased heart rate
 Increased urine output
 Wide pulse pressure

Which statement about tachycardia is NOT correct?
 *Sinus tachycardia is commonly a dangerous rhythm that can quickly deteriorate to cardiac arrest.
 A normal heart rate for an infant may be twice as fast as a normal heart rate for an older child.
 A heart rate of 175 bpm is within normal range for a child up to two
 Tachycardia may be a normal, non-dangerous heart rate in response to stress or anxiety.

Which statement is correct with concerns to PEA?
 An individual in PEA has a detectable pulse.
 PEA always converts to asystole.
 *Reversible conditions, including hypovolemia and cardiac tamponade, can cause PEA.
 An individual in PEA has no electrical activity.

When should vasopressors be administered during the management of septic shock?
 *If the individual is severely hypotensive despite proper fluid management
 Vasopressors are never used for septic shock.
 If the individual develops pulmonary edema
 Always indicated as soon as IV access is obtained

Which statement regarding distributive shock is NOT true?
 Distributive shock can be characterized as either warm shock or cold s
 Distributive shock commonly results in inadequate tissue perfusion and oxygenation.
 Common forms of distributive shock include septic shock, anaphylactic shock, and neurogenic shock.
 *Warm shock is characterized by cool, pale extremities.

Which statement about cardiovascular support during post-resuscitation management is NOT correct?
 Shock and respiratory failure may produce decreased tissue perfusion and oxygenation, which may cause continued cardiovascular problems.
 *Invasive techniques should never be used to monitor blood pressure in individuals with poor perfusion or frequent arrhythmia.
 Cardiac dysfunction can last for hours after resuscitation.
 You should monitor urine output.

Which statement about sinus bradycardia is correct?
 Sinus bradycardia is never a normal rhythm.
 *Sinus bradycardia may be an abnormal heart rate resulting from a pathological condition.
 Sinus bradycardia always originates at the AV node.
 Sinus bradycardia often is the result of increased metabolic demand.

What is the best vasoactive agent for severe warm septic shock?

You should immediately begin chest compressions on a bradycardic individual if they:
 A. Have heart rate below 60 bpm
 B. Show signs of respiratory distress
 C. Show signs of poor perfusion
 *D. Both A and C

Untreated shock can lead to:
 Cardiopulmonary problems
 Cardiac arrest
 *All of the above

The purpose of post-resuscitation care of a PALS individual is to:
 Optimize ventilation
 Optimize circulation
 Preserve organ and tissue function
 *All of the above

All of the following are signs of cardiorespiratory distress EXCEPT:
 Irregular heart rhythm

When can post-resuscitation management be necessary?
 After cardiac arrest
 After severe shock
 After respiratory failure
 *All of the above

All of the following are examples of upper airway obstruction EXCEPT:

Exposure in PALS evaluations refers to an assessment for:
 *Any of the signs of a problem above