1. A previously healthy infant with a history of vomiting and diarrhea is brought to
the emergency department by her parents. During your assessment, you
... [Show More] find that
the infant responds only to painful stimulation. The infant has good bilateral
breath sounds, cool extremities, and a capillary refill time of more than 5
seconds. The infant's blood pressure is 85/65 mmHg and glucose is 30 mg/dL.
You administer 100% oxygen via face mask and start an IV. Which treatment is
the most appropriate for this infant?
a) Administer D50W 0.45% NaCl 20 mL/kg bolus over 15 minutes
b) Administer LR solution 20 mL/kg over 60 minutes
c) Administer a bolus of isotonic crystalloid 20 mL/kg over 5 to 20 minutes
and also give D25W 2 to 4 mL/kg IV
d) Administer D10W 20 mL/kg over 5 minutes - c) Administer a bolus of
isotonic crystalloid 20 mL/kg over 5 to 20 minutes and also give D25W 2
to 4 mL/kg
2. Which statement is correct about endotracheal drug administration during
resuscitative efforts for pediatric patients?
a) The intravenous drug dose should be used
b) It is the preferred route of drug administration
c) The drug dose used is lower than the intravenous dose
d) It is the least desirable route of administration - d) It is the least desirable
route of administration
3. Which statement is correct about the effects of epinephrine during attempted
resuscitation?
a) Epi decreases peripheral vascular resistance and reduces myocardial
afterload
b) Epi stimulates spontaneous contractions when asystole is present
c) Epi decreases myocardial oxygen consumption
d) Epi is contraindicated in VFib - Epinephrine stimulates spontaneous
contractions when asystole is present4. Which oxygen delivery system most reliably delivers a high (90% or greater)
concentration of inspired oxygen to a 7yo child?
a) nasal cannula
b) simple oxygen mask
c) nonrebreather face mask
d) face tent - c) nonrebreathing face mask
5. A 9-year-old boy is agitated and leaning forward on the bed in obvious
respiratory distress. 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. You administer 100% oxygen by a
nonrebreathing mask. His POx is 92%. Which medication do you prepare to give
to this patient?
a) Albuterol
b) Adenosine
c) Amiodarone
d) Procainamide - a) Albuterol
6. You are part of team attempting to resuscitate a child with ventricular fibrillation
cardiac arrest. You deliver 2 unsynchronized shocks. A team member
established IO access, so you give a dose of epi, 0.01 mg/kg IO. At the next
rhythm check, persistent ventricular fibrillation is present. You administer a 4-J/kg
shock ad resume CPR. Which drug and dose should be administered next?
a) Magnesium sulfate 25 to 50 mg/kg IO
b) Epinephrine 0.1 mg/kg IO
c) Atropine 0.02 mg/kg IO
d) Amiodarone 5 mg/kg IO - d) Amiodarone 5 mg/kg IO
7. Paramedics are called to the home of a 1-year-old child. Their initial assessment
reveals a child who responds only to painful stimuli and has irregular breathing,
faint central pulse, bruises over the abdomen, abdominal distention, and
cyanosis. Bag-mask ventilation with 100% oxygen is initiated. The child's heart
rate is 36/min. Peripheral pulses cannot be palpated, and central pulses arebarely palpable. The cardiac monitor shows sinus bradycardia. Two-rescuer CPR
is started. Upon arrival to the emergency department, the child is intubated and
ventilated with 100% oxygen, and IV access is established. The heart rate is now
150/min with weak central pulses but no distal pulses. Systolic blood pressure is
74 mmHg. Which intervention should be provided?
a) Epinephrine 0.01 mg/kg IV
b) Rapid bolus of 20 mg/kg of isotonic crystalloid
c) Atropine 0.02 mg/kg IV
d) Amiodarone 5 mg/kg IV - b) Rapid bolus of 20 mg/kg of isotonic crystalloid
8. Initial impression of a 2yo girl shows her to be alert with mild breathing difficulty
during inspiration and pale skin color. On primary assessment, she makes highpitched inspiratory sounds (mild stridor) when agitated; otherwise, her breathing
is quiet. Her spO2 is 92% on room air, and she has mild inspiratory intercostal
retractions. Lung auscultation reveals transmitted upper airway sounds with
adequate distal breath sounds bilaterally. Which is the most appropriate initial
intervention for this child?
a) Endotracheal intubation
b) IV dexamethasone
c) Humidified oxygen as tolerated
d) Nebulized albuterol - c) Humidified oxygen as tolerated
9. Which statement is true about the use of calcium chloride in pediatric patients?
a) It has the same bioavailability of elemental calcium as calcium gluconate
b) It is indicated for hypercalcemia, hypokalemia, and hypomagnesemia
c) Routine administration is not indicate during cardiac arrest
d) The recommended dose is 1 to 2 mg/kg - c) Routine administration is not
indicated during cardiac arrest
10.You are called to help treat an infant with severe symptomatic bradycardia (HR
66/min) associated with respiratory distress. The bradycardia persists despite
establishment of an effective airway, oxygenation, and ventilation. There is no
heart block present. Which is the first drug you should administer?a) Adenosine
b) Atropine
c) Dopamine
d) Epinephrine - d) Epinephrine [Show Less]