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AHA PALS Flashcards

1
Q
  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
A

D. Unreliable; supplementary oxygen should be administered

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2
Q
  1. 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

A. Septic shock

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3
Q
  1. 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

A. Hypotensive

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4
Q
  1. 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
A

C. Respectfully ask the team leader to clarify the dose

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5
Q
  1. 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

A. Inadequate oxygenation and/or ventilation

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6
Q 
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
A

C. Lower airway obstruction

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7
Q
  1. 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
A

D. Control of breathing

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8
Q 
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

A. Decreased oxygen saturation

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9
Q
  1. 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

A. Respiratory distress

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10
Q
  1. 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
A

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

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11
Q
  1. 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
A

D. Place an intraosseous line

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12
Q
  1. 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
A

C. 20 mL/kg normal saline

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13
Q
  1. 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
A

B. Administer nebulized epinephrine

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14
Q
  1. 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
A

C. Glucose

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15
Q
  1. 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
A

B. Perform needle decompression on the left chest

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16
Q
  1. 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
A

B. Compensated shock

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17
Q
  1. 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
A

B. Attempt vagal maneuvers

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18
Q
  1. 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%
A

C. 94% to 99%

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19
Q
  1. 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

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

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20
Q
  1. 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
A

C. Verify the endotracheal tube position

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21
Q
  1. 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
A

D. Ice to the face

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22
Q
  1. 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
A

B. Epinephrine IM

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23
Q
  1. 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
A

C. Give epinephrine 0.01 mg/kg IO/IV

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24
Q
  1. 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

A. Attempt defibrillation with a 2 J/kg shock

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25
Q
  1. 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
A

C. Administer epinephrine 0.01 mg/kg IO/IV

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26
Q
  1. 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

A. 10 seconds

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27
Q 
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
A

C. Brachial

28
Q
  1. 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
A

C. Pulseless electrical activity

29
Q
  1. 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.
A

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

30
Q
  1. 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
A

D. Use the AED

31
Q
  1. A 6-year-old child is found unresponsive, not breathing, and pulseless. What is the correct
    compression-to-ventilation ratio when 2 or more healthcare providers are present to perform
    CPR?
    A. 3:1
    B. 10:1
    C. 15:2
    D. 30:2
A

C. 15:2

32
Q
  1. 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. What intervention is most appropriate?
    A. Provide rescue breaths at a rate of 12 to 20/min
    B. Provide rescue breaths at a rate of 6 to 10/min
    C. Initiate chest compressions at a rate of at least 100/min
    D. Initiate chest compressions at a rate of 60/min
A

A. Provide rescue breaths at a rate of 12 to 20/min

33
Q
  1. 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
A

B. Synchronized shock with 0.5 to 1 J/kg

34
Q
  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
A

C. Reassess breath sounds and clinical status

35
Q
  1. 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
A

B. Progression toward respiratory failure

36
Q 
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
A

A. Increased respiratory effort

37
Q
  1. 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
A

B. Assigns roles to team members

38
Q 
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
A

C. Unconscious with no gag reflex

39
Q
  1. 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%
A

C. 94% to 99%

40
Q
  1. 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
A

B. Epinephrine IM

41
Q
  1. 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. Capillary refill
    is 4 seconds. Which of the following is the most appropriate intervention for this child?
    A. Fluid bolus of 10 mL/kg of isotonic crystalloid
    B. Fluid bolus of 20 mL/kg of isotonic crystalloid
    C. Maintenance fluid infusion of isotonic crystalloid at 10 mL/h
    D. Maintenance fluid infusion of 5% dextrose and water at 20 mL/h
A

B. Fluid bolus of 20 mL/kg of isotonic crystalloid

42
Q
  1. An intubated 5-year-old child who was in a motor vehicle collision becomes increasingly more
    difficult to ventilate. The child has diminished breath sounds and chest expansion on the right
    side of the chest, with audible breath sounds and visible chest expansion on the left. The
    endotracheal tube insertion depth has not changed. What is the most appropriate intervention?
    A. Deflate the cuff and pull the tube back
    B. Perform needle decompression on the right chest
    C. Perform needle decompression on the left chest
    D. Insert a gastric tube
A

B. Perform needle decompression on the right chest

43
Q
  1. A 2-year-old child with a 2-day history of a barking cough presents with audible stridor on
    inspiration, intercostal retractions, and agitation. What is the most appropriate intervention for
    this child?
    A. Lay the child flat on a stretcher
    B. Suction the mouth and nose
    C. Administer nebulized epinephrine
    D. Administer inhaled albuterol
A

C. Administer nebulized epinephrine

44
Q 
11. Which of the following oxygen saturations indicates the need for additional intervention?
A. 96% on room air
B. 95% on room air
C. 93% on 4 L of oxygen
D. 97% on 50% oxygen
A

C. 93% on 4 L of oxygen

45
Q
  1. A 3-year-old child presents with a 2-day history of nausea and vomiting. She is alert, with no
    increase in respiratory effort, and is pale in color. The child’s heart rate is 160/min, respiratory rate
    is 40/min, and blood pressure is 100/70 mm Hg. Her extremities are cool, with sluggish capillary
    refill. Which term best describes this child’s physiologic state?
    A. Compensated shock
    B. Cardiogenic shock
    C. Hypotensive shock
    D. Obstructive shock
A

A. Compensated shock

46
Q
  1. A 3-year-old child presents with dehydration after a 2-day history of vomiting and diarrhea.
    The child after has received 2 fluid boluses of 20 mL/kg of normal saline. After the second bolus,
    the child is alert and interacting. Her heart rate is 110/min, respiratory rate is 30/min, and blood
    pressure is 92/64 mm Hg. Her capillary refill time is 2 seconds, and oxygen saturation is 98%.
    What is the most appropriate next intervention for this child?
    A. Administer another 20 mL/kg normal saline fluid bolus
    B. Administer 10 mL/kg of packed red cells
    C. Continue to monitor and reevaluate the child
    D. Initiate a dopamine drip of 20 mcg/kg per minute
A

C. Continue to monitor and reevaluate the child

47
Q
  1. A 3-year-old child presents with a high fever and a petechial rash. The child is lethargic, has
    no signs of increased work of breathing, and is pale in color. His heart rate is 180/min, respiratory
    rate is 30/min, blood pressure is 80/68 mm Hg. Capillary refill time is 4 seconds, and oxygen
    saturation is 88%. Airway and lungs are clear. Peripheral pulses are diminished. Which of the
    following is the most appropriate initial intervention?
    A. Provide 100% oxygen via a nonrebreathing mask
    B. Obtain IV access
    C. Administer dopamine
    D. Administer an antibiotic
A

A. Provide 100% oxygen via a nonrebreathing mask

48
Q
  1. You are examining a 2-year-old child who has a history of gastroenteritis. The initial
    impression reveals that the child is lethargic, with increased work of breathing and pale color. The
    child has a heart rate of 180/min, a respiratory rate of 40/min, a blood pressure of 80/60 mm Hg, a
    capillary refill time of 4 seconds, and an oxygen saturation of 96%. Central pulses are strong and
    peripheral pulses are weak, and the extremities are cool below the knee. What best describes the
    patient’s condition?
    A. Compensated shock
    B. Hypotensive shock
    C. Obstructive shock
    D. Anaphylactic shock
A

A. Compensated shock

49
Q
  1. 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
A

B. Administer nebulized epinephrine

50
Q
  1. 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
A

A. Give adenosine 0.1 mg/kg rapid IV push

51
Q
  1. 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
A

D. Ice to the face

52
Q
  1. 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
A

B. Synchronized shock with 0.5 to 1 J/kg

53
Q
  1. 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 0.1 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
A

D. IV fluid bolus of 20 mL/kg normal saline

54
Q
  1. 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 IO/IV
    D. Amiodarone 5 mg/kg IO/IV
A

A. Attempted defibrillation with 2 J/kg

55
Q
  1. 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
A

C. 4 J/kg or greater

56
Q
  1. 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
A

D. Use the AED

57
Q
  1. 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
A

A. Resume CPR, beginning with chest compressions

58
Q
  1. 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

A. Inadequate oxygenation and/or ventilation

59
Q
  1. A 3-year-old child is in cardiac arrest, and a resuscitation attempt is in progress. The child is in
    ventricular fibrillation and was given a shock at 2 J/kg, followed by immediate CPR. At the next
    rhythm check, ventricular fibrillation is again noted on the cardiac monitor. What is the most
    appropriate next intervention?
    A. Attempt defibrillation with a 4 J/kg shock
    B. Attempt defibrillation with a 2 J/kg shock
    C. Resume CPR
    D. Check for a pulse for at least 10 seconds
A

A. Attempt defibrillation with a 4 J/kg shock

60
Q
  1. CPR is in progress on a 10-month-old infant who was unresponsive and not breathing, with no
    palpable pulse. A cardiac monitor is applied, and sinus bradycardia at a rate of 42/min is noted.
    CPR is resumed, and vascular access is obtained. Which of the following is the most appropriate
    intervention?
    A. Epinephrine 0.01 mg/kg IO/IV
    B. Atropine 0.5 mg/kg IO/IV
    C. Amiodarone 5 mg/kg IO/IV
    D. Lidocaine 1 mg/kg IO/IV
A

A. Epinephrine 0.01 mg/kg IO/IV

61
Q
  1. During a pediatric resuscitation attempt, what is most likely to contribute to high-quality CPR?
    A. A depth of compressions of about one fourth the anterior-posterior depth of the chest
    B. A compression rate of 80/min
    C. Pulse checks performed once per minute
    D. Allowing the chest wall to recoil completely between compressions
A

D. Allowing the chest wall to recoil completely between compressions

62
Q
  1. 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.
A

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

63
Q
  1. A 5-year-old child is hit in the chest with a baseball and suddenly collapses. High-quality CPR
    is being performed. When the AED arrives, only adult AED pads are available. What should the
    rescuer do?
    A. Use the AED with adult pads
    B. Wait for pediatric AED pads and use them as soon as they are available
    C. Continue the steps of CPR for 2 minutes before using the AED
    D. Await arrival of a manual defibrillator
A

A. Use the AED with adult pads

64
Q
  1. A team is attempting to resuscitate a child who was brought to the emergency department by
    EMS after a traumatic injury. The family members arrive at the child’s bedside and request to
    remain in the room during the resuscitation attempt. What does the American Heart Association
    recommend?
    A. Allow the family to stay at the bedside alone, but they should not talk to anyone
    B. Allow the family to stay at the bedside with a staff member who is assigned to provide information
    and assistance
    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.
A

B. Allow the family to stay at the bedside with a staff member who is assigned to provide information
and assistance

65
Q 
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
A

C. Lower airway obstruction

66
Q
  1. 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
A

A. Rescue breaths at a rate of 12 to 20/min

AHA PALS (1 decks)

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