MCQ
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
CORRECT
True or False: Respiratory failure or shock is the most common cause of cardiac arrest in children and infants.
Your Answer: True
CORRECT
True or False: Early signs of obstructive shock always resemble distributive shock.
Your Answer: False
CORRECT
True or False: Albuterol is a common recommendation for treatment of wheezing in a child with infectious pneumonia.
Your Answer: True
CORRECT
True or False: Cardiopulmonary arrest is a common result of respiratory failure and shock.
Your Answer: True
CORRECT
True or False: Symptomatic bradycardia is defined as bradycardia with signs of shock or respiratory failure or distress.
Your Answer: True
CORRECT
True or False: Hypotonic fluids are suggested for volume resuscitation.
Your Answer: False
CORRECT
True or False: Milrinone has known hypotensive effects that may be exacerbated by hypovolemia.
Your Answer: True
CORRECT
What item is NOT a sign of increased respiratory effort?
*Delayed capillary refill time
Nasal flaring
Head bobbing or seesaw respirations
Chest retractions
CORRECT
Abnormal breath sounds associated with upper airway obstruction include:
Crackles
Absent breath sounds
Decreased breath sounds
*Stridor
CORRECT
Croup medications used for treatment are the following:
Dexamethasone
Nebulized epinephrine
Heliox (Oxygen)
*All of the above
CORRECT
Common causes of lower airway obstruction include:
Foreign body aspiration and croup
*Bronchiolitis and asthma
Pneumonia and pulmonary edema
Pleural effusion and bronchospasm
CORRECT
Medications that may be used to treat moderate to severe asthma include all of the following EXCEPT:
Ipratropium bromide
*Antibiotics
Magnesium sulfate
Albuterol
CORRECT
Acute community-acquired pneumonia causes include:
Streptococcus pneumonia
Mycoplasma pneumonia
Chlamydia pneumonia
*All of the above
CORRECT
Which two components make up cardiac output?
*Stroke volume and heart rate
Heart rate and SVR
SVR and stroke volume
None of the above
CORRECT
The type of shock associated with inadequate tissue perfusion resulting from myocardial dysfunction is:
Distributive shock
Hypovolemic shock
Obstructive shock
*Cardiogenic shock
CORRECT
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
CORRECT
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
CORRECT
What is the primary therapy for hypovolemic shock?
*Fluid resuscitation
Antibiotics
Vasopressors
Correction of metabolic derangements
CORRECT
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
CORRECT
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
CORRECT
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
CORRECT
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
CORRECT
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
CORRECT
In an individual with ventricular fibrillation (VF), what should occur immediately following a shock?
Administer epinephrine.
*Resume CPR.
Analyze rhythm.
Check pulse.
CORRECT
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
Immediately
CORRECT
Poor ventilation causes which of the following:
*Respiratory acidosis
Hypocarbia
Hyperglycemia
None of the above
CORRECT
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.
CORRECT
Suitable oxygen delivery to body tissue is dependent on all of the following EXCEPT:
Adequate hemoglobin
Adequate perfusion
Adequate blood oxygenation
*Adequate IV access
CORRECT
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.
CORRECT
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.
CORRECT
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.
CORRECT
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.
CORRECT
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
CORRECT
Which of the following is a wide complex tachycardia?
*Ventricular tachycardia
Atrial flutter
Supraventricular tachycardia
Sinus tachycardia
CORRECT
Common signs of compensated shock include:
*Increased heart rate
Increased urine output
Hypertension
Wide pulse pressure
CORRECT
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.
CORRECT
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.
CORRECT
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
CORRECT
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.
CORRECT
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.
CORRECT
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.
CORRECT
What is the best vasoactive agent for severe warm septic shock?
Dobutamine
Milrinone
Phenylephrine
*Norepinephrine
CORRECT
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
CORRECT
Untreated shock can lead to:
Cardiopulmonary problems
Hypotension
Cardiac arrest
*All of the above
CORRECT
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
CORRECT
All of the following are signs of cardiorespiratory distress EXCEPT:
Fatigue
Irregular heart rhythm
Tachypnea
*Jaundice
CORRECT
When can post-resuscitation management be necessary?
After cardiac arrest
After severe shock
After respiratory failure
*All of the above
CORRECT
All of the following are examples of upper airway obstruction EXCEPT:
Croup
Laryngitis
*Asthma
Anaphylaxis
CORRECT
Exposure in PALS evaluations refers to an assessment for:
Trauma
Burns
Fractures
*Any of the signs of a problem above
CORRECT
){kind=link}