AHA PALS Latest Test_ answered_
Updated Fall 2023/2024
1.
Parents of a 1-year-old female phoned EMS when they picked up their daughter from
... [Show More] the
babysitter. Paramedics perform an initial impression revealing an obtunded infant with
irregular breathing, bruises over the abdomen, abdominal distension, and cyanosis. Assisted
bag-mask ventilation with 100% oxygen is initiated. On primary assessment heart rate is
36/min, peripheral pulses cannot be palpated, and central pulses are barely palpable. Cardiac
monitor shows sinus bradycardia. Chest compressions are started at 15:2. In the ED the
infant is intubated and ventilated, and IV access is established. The heart rate is now up to
150/min, but there are weak central pulses and no distal pulses. Systolic BP is 74. Of the
following, which would be most useful in management of this infant?
A. Synchronized cardioversion
B. Epinephrine 0.01 mg/kg (0.1 mL/kg of 1:10,000 dilution)
IV C. Rapid bolus of 20 mL/kg of isotonic crystalloid
D. Atropine 0.02 mg/kg IV
2. You enter a room to perform an initial impression of a previously stable 10-year-old male
and find him unresponsive and apneic. A code is called and bag-mask ventilation is
performed with 100% oxygen. The cardiac monitor shows a wide-complex tachycardia.
The boy has no detectable pulses so compressions and ventilations are provided. As soon
as the defibrillator arrives you deliver an unsynchronized shock with 2 J/kg. The rhythm
check after 2 minutes of CPR reveals VF. You then deliver a shock of 4 J/kg and resume
immediate CPR beginning with compressions. A team member has established IO access,
so you give a dose of epi, 0.01 mg/kg (0.1 mL/kg of 1:10,000 dilution) IO after second
shock. At the next rhythm check, persistent VF is present. You administer another 4 J/kg
shock and resume CPR. Based on the PALS Pulseless Arrest Algorithm, what is the next
drug and dose to administer when CPR is restarted?
A. Magnesium sulfate 25-50 mg/kg IO
B. Atropine 0.02 mg/kg IO
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C. Epinephrine 0.1 mg/kg of 1:10,000 dilution IO
D. Amiodarone 5 mg/kg IO
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3. Which of the following statements about calcium is true?
A. Calcium chloride 10% has the same bioavailability of elemental calcium
as calcium gluconate in critically ill children
B. The recommended dose is 1-2 mg/kg of calcium chloride.
C. Indications for administration of calcium include hypercalcemia, hypokalemia,
and hypomagnesemia.
D. Routine administration of calcium is not indicated during cardiac arrest.
4. Initial impression of a 9-year-old male with increased work of breathing reveals the boy
to be agitated and leaning forward on the bed with obvious respiratory distress. You
administer 100% oxygen by nonrebreathing mask. The patient is speaking in short
phrases and tells you that he has asthma but does not carry an inhaler. He has nasal
flaring, severe suprasternal and intercostal retractions, and decreased air movement
with prolonged expiratory time and wheezing. His SpO2 is 96% (on nonrebreathing
mask). What is the next medical therapy to provide to [Show Less]