Multiple Choice Questions

Which ratio of compressions to breaths should be used for 1-rescuer child CPR
  • The heart will refill with blood between compressions
  • 15 compressions to 2 breaths
  • Routine administration is not indicated during cardiac arrest
  • 30 compressions to 2 breaths
You are preparing to use a manual defibrillator in the pediatric setting. Which best describes when it is appropriate to use the smaller, pediatric-sized paddles?
  • If the child weighs less than 10kg or is less than 1 year old
  • Routine administration is not indicated during cardiac arrest
  • Tracheal tube displacement into the right main bronchus
  • Compress the chest at least one third the depth of the chest, about 2 inches (5 cm)
A 9yo 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 spO2 is 92%. Which med do you prepare to give to this patient?
  • Amiodarone 5 mg/kg IO
  • Administer adenosine 0.1 mg/kg IV rapid push
  • Albuterol (duh)
  • Magnesium sulfate 25-50 mg/kg IV
You are assisting in the elective intubation of an average-sized 4yo child with respiratory failure. A colleague is retrieving the color-coded length-based tape from the resuscitation cart. Which of the following is likely to be the estimated size of the uncuffed endotracheal tube for this child?
  • Adequate bilateral breath sounds and chest expansion plus detection of ETCO2 with waveform capnography
  • Epinephrine
  • 5mm tube
  • Open the airway with a head tilt-chin lift maneuver and give 2 breaths
Which statement is correct about the use of calcium chloride in pediatric patients?
  • It is the least desirable route of administration
  • 30 compressions to 2 breaths
  • Epinephrine stimulates spontaneous contractions when asystole is present
  • Routine administration is not indicated during cardiac arrest
You find a 10yo boy to be unresponsive. You shout for help, and after finding that he is not breathing and has no pulse, you and a colleague begin CPR. Another colleague activates the emergency response system, brings the emergency equipment, and places the child on a cardiac monitor/defibrillator, which reveals the rhythm shown here. You attempt defibrillation at 2 J/kg and give 2 minutes of CPR. The rhythm persists at the second rhythm check, at which point you attempt defibrillation with 4 J/kg. A fourth colleague arrives, starts an IV, and administers 1 dose of epinephrine 0.01 mg/kg. If ventricular fibrillation or pulseless ventricular tachycardia persists after 2 minutes of CPR, you will administer another shock. Which drug and dose should be administered next?
  • Amiodarone 5 mg/kg IO
  • Atropine 0.02 mg/kg IV
  • Epinephrine 0.01 mg/kg IV/IO
  • Lidocaine 1 mg/kg IV
You are giving chest compressions for a child in cardiac arrest? What is the proper depth of compressions for a child?
  • Compensated shock associated with tachycardia and inadequate tissue perfusion
  • It is the least desirable route of administration
  • Compress the chest at least one third the depth of the chest, about 2 inches (5 cm)
  • "You need to compress at a rate of 100-120 per minute."
You are evaluating an irritable 6yo girl with mottled skin color. The patient is febrile (temperature 40C [104F]), and her extremities are cold with capillary refill of 5 seconds. Distal pulses are absent and central pulses are weak. Heart rate is 180/min, respiratory rate is 45/min, and blood pressure is 98/56 mmHg. How would you categorize this child's condition?
  • Compress the chest at least one third the depth of the chest, about 2 inches (5 cm)
  • Compensated shock associated with tachycardia and inadequate tissue perfusion
  • Administer a bolus of 20 ml/kg isotonic crystalloid
  • If the child weighs less than 10kg or is less than 1 year old
You are caring for a 3yo with vomiting and diarrhea. You have established IV access. The child's pulses are palpable but faint, and the child is now lethargic. The heart rate is variable (range, 44/min to 62/min). You begin bag-mask ventilation with 100% oxygen. When the heart rate does not improve, you begin chest compressions. The rhythm shown here is seen on the cardiac monitor. Which would be the most appropriate therapy to consider next?
  • Tracheal tube displacement into the right main bronchus
  • Atropine 0.02 mg/kg IV
  • Amiodarone 5 mg/kg IO
  • Open the airway with a head tilt-chin lift maneuver and give 2 breaths
Paramedics are called to the home of a 1yo child. Their initial assessment reveals a child who responds only to painful stimuli and has irregular breathing, faint central pulses, 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 are barely 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 next?
  • Administer adenosine 0.1 mg/kg IV rapid push
  • Epinephrine 0.01 mg/kg IV/IO
  • Rapid bolus of 20ml/kg of isotonic crystalloid
  • Tracheal tube displacement into the right main bronchus
You are part of a team attempting to resuscitate a child with ventricular fibrillation cardiac arrest. You delivered 2 unsynchronized shocks. A team member established IO access, so you give a dose of epinephrine, 0.01 mg/kg IO. At the next rhythm check, persistent ventricular fibrillation is present. You administer a 4 J/kg shock and resume CPR. Which drug and dose should be administered next?
  • Epinephrine
  • Lidocaine 1 mg/kg IV
  • Amiodarone 5 mg/kg IO
  • Atropine 0.02 mg/kg IV
Which oxygen delivery system most reliably delivers a high (90% or greater) concentration of inspired oxygen to a 7yo child?
  • Routine administration is not indicated during cardiac arrest
  • 1 breath every 3-5 seconds
  • 30 compressions to 2 breaths
  • Nonrebreathing face mask
An 8yo child was struck by a car. He arrives in the ED alert, anxious, and in respiratory distress. His cervical spine is immobilized, and he is receiving a 10L/min flow of 100% oxygen by nonrebreathing face mask. His respiratory rate is 60/min, HR 150/min, systolic BP 70 mmHg, and spO2 84%. Breath sounds are absent over the right chest but present over the left chest, and the trachea is deviated to the left. He has weak central pulses and absent distal pulses. Which intervention should be performed next?
  • Administer adenosine 0.1 mg/kg IV rapid push
  • Give normal saline 20 ml/kg IO rapidly
  • Open the airway and provide positive-pressure ventilation using 100% oxygen and a bag-mask device
  • Perform needle decompression of the right chest
During bag-mask ventilation, how should you hold the mask to make an effective seal between the child's face and the mask?
  • Position your fingers using the E-C clamp technique
  • "You need to compress at a rate of 100-120 per minute."
  • Compress the chest at least one third the depth of the chest, about 2 inches (5 cm)
  • If the child weighs less than 10kg or is less than 1 year old
Which statement is correct about the effects of epinephrine during attempted resuscitation?
  • Epinephrine stimulates spontaneous contractions when asystole is present
  • Routine administration is not indicated during cardiac arrest
  • It is the least desirable route of administration
  • If the child weighs less than 10kg or is less than 1 year old
You are caring for a 6yo patient who is receiving positive-pressure mechanical ventilation via an endotracheal tube. The child begins to move his head and suddenly becomes cyanotic, and his heart rate decreases. His spO2 is 65%. You remove the child from the mechanical ventilator and begin to provide manual ventilation with a bag via the endotracheal tube. During manual ventilation with 100% oxygen, the child's color and heart rate improve slightly and his BP remains adequate. Breath sounds and chest expansion are present and adequate on the right side and are present but consistently diminished on the left side. The trachea is not deviated, and the neck veins are not distended. a suction catheter passes easily beyond the tip of the endotracheal tube. Which of hte following is the most likely cause of this child's acute deterioration?
  • Tracheal tube displacement into the right main bronchus
  • Open the airway with a head tilt-chin lift maneuver and give 2 breaths
  • Rapid bolus of 20ml/kg of isotonic crystalloid
  • Compress the chest at least one third the depth of the chest, about 2 inches (5 cm)
A 4yo boy is in pulseless arrest in the PICU. High-quality CPR is in progress. You quickly review his chart and find that his baseline-corrected QT interval on a 12-lead ECG is prolonged. The monitor shows recurrent episodes of the rhythm shown here. The patient has received 1 dose of epinephrine 0.01 mg/kg, but the rhythm shown here continues. If this rhythm persists at the next rhythm check, which medication would be most appropriate to administer at that time?
  • Albuterol (duh)
  • Magnesium sulfate 25-50 mg/kg IV
  • Give normal saline 20 ml/kg IO rapidly
  • Identify and treat reversible causes
A child becomes unresponsive in the emergency department and is not breathing. You are uncertain if a faint pulse is present. You shout for help and provide ventilation with 100% oxygen. The rhythm shown here is seen on the cardiac monitor. What is your next action?
  • Humidified oxygen as tolerated
  • Atropine 0.02 mg/kg IV
  • Amiodarone 5 mg/kg IO
  • Start high-quality CPR
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Multiple Choice Questions
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