1.
In which of the following situations may IO access be used?
1 out of 50
2.
A 2-week-old infant is being evaluated for irritability and poor feeding. His blood pressure is 55/40 mm Hg, and capillary refill time is 5 seconds. Which statement best describes your assessment of this infant’s blood pressure?
2 out of 50
3.
You are caring for patients in the emergency department. Which 2-year-old child requires immediate intervention?
3 out of 50
4.
A 3-year-old child is having difficulty breathing. What finding would most likely lead you to suspect an upper airway obstruction in this child?
4 out of 50
5.
A team member is unable to perform an assigned task because it is beyond the team member’s scope of practice. What action should the team member take?
5 out of 50
6.
You are the Team Leader during a pediatric resuscitation attempt. What action is an element of high-quality CPR?
6 out of 50
7.
An 8-year-old child is brought to the emergency department by his mother for difficulty breathing. He has a history of asthma and nut allergies. His mother tells you that he recently ate a cookie at a family picnic. What condition is most likely to be present in this child?
7 out of 50
8.
An 8-year-old child is brought to the emergency department by ambulance after being involved in a motor vehicle collision. What finding would suggest that immediate intervention is needed?
8 out of 50
9.
A 6-year-old child is found unresponsive, not breathing, and without a pulse. One healthcare worker leaves to activate the emergency response system and get the resuscitation equipment. You and another healthcare provider immediately begin performing CPR. What compression-to-ventilation ratio do you use?
9 out of 50
10.
A 3-year-old child is in cardiac arrest, and high-quality CPR is in progress. You are the Team Leader. The first rhythm check reveals the rhythm shown here. Defibrillation is attempted with a shock dose of 2 J/kg. After shock administration, what should you say to your team members?
10 out of 50
11.
What assessment finding is consistent with respiratory failure in this child?
Use this scenario to answer the next 2 questions:
You are caring for a 5-year-old boy with a 4-day history of high fever and cough. He is having increasing
lethargy, grunting, and sleepiness. Now he is difficult to arouse and is unresponsive to voice commands. His
oxygen saturation is 72% on room air and 89% when on a nonrebreathing oxygen mask. He has shallow
respirations with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles.
11 out of 50
12.
What medication would be most appropriate?
Use this scenario to answer the next 2 questions:
You are caring for a 5-year-old boy with a 4-day history of high fever and cough. He is having increasing
lethargy, grunting, and sleepiness. Now he is difficult to arouse and is unresponsive to voice commands. His
oxygen saturation is 72% on room air and 89% when on a nonrebreathing oxygen mask. He has shallow
respirations with a respiratory rate of 38/min. Auscultation of the lungs reveals bilateral crackles.
12 out of 50
13.
During a resuscitation attempt, the Team Leader asks you to administer an initial dose of epinephrine at 0.1 mg/kg to be given IO. How should you respond?
13 out of 50
14.
A 6-month-old infant is unresponsive. You begin checking for breathing at the same time you check for the infant’s pulse. What is the maximum time you should spend trying to simultaneously check for breathing and palpate the infant’s pulse before starting CPR?
14 out of 50
15.
A 10-year-old child is being evaluated for a headache. What is a normal finding for this 10-year-old child?
15 out of 50
16.
A 6-year-old boy is being evaluated for difficulty breathing. What finding would suggest this child has respiratory distress?
16 out of 50
17.
17. What dosage range should you use for initial defibrillation?
Use this scenario to answer the next 2 questions:
A 4-year-old child in cardiac arrest is brought to the emergency department by ambulance. High-quality CPR is being performed. The cardiac monitor displays the rhythm strip shown here. The estimated weight of the child is
20 kg.
17 out of 50
18.
As the Team Leader, how many joules do you tell your team member to use to perform initial defibrillation?
Use this scenario to answer the next 2 questions:
A 4-year-old child in cardiac arrest is brought to the emergency department by ambulance. High-quality CPR is being performed. The cardiac monitor displays the rhythm strip shown here. The estimated weight of the child is 20kg.
18 out of 50
19.
You respond to an infant who is unresponsive, is not breathing, and does not have a pulse. You do not have a mobile device, and you shout for nearby help but no one arrives. What action should you take next?
19 out of 50
20.
What ratio for compressions to breaths should be used for 1-rescuer infant CPR?
20 out of 50
21.
A 3-year-old boy is brought to the emergency department by his mother. He is lethargic, with retractions and nasal flaring. He has a respiratory rate of 70/min, with warm extremities and brisk capillary refill. Which immediate life-threatening condition could this child’s condition most likely progress to if left untreated?
21 out of 50
22.
You are evaluating a 10-year-old child who is febrile and tachycardic. The child’s capillary refill time is 5 seconds. What parameter will determine if the child is in compensated shock?
22 out of 50
23.
An 18-month old has had vomiting and diarrhea for the past 2 days; the mother brings him to the emergency department because he is becoming more lethargic. What diagnostic test should you order first?
23 out of 50
24.
What assessment finding indicates that the infant has hypotensive shock?
You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and diarrhea. His parents state that he has been sleeping much more. His heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refill time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg.
24 out of 50
25.
On the basis of this infant’s presentation, what type of shock does this infant have?
You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and diarrhea. His parents state that he has been sleeping much more. His heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refill time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg.
25 out of 50
26.
You have decided that this infant needs fluid resuscitation. How much fluid should you administer?
You are caring for a 3-month-old boy with a 2-day history of fever, vomiting, and diarrhea. His parents state that he has been sleeping much more. His heart rate is 190/min, temperature is 38.3°C (101°F), blood pressure is 59/29 mm Hg, respiratory rate is 70/min and shallow, and oxygen saturation is 94% on 100% oxygen. His capillary refill time is 4 to 5 seconds, and he has mottled, cool extremities. The infant weighs 6 kg.
26 out of 50
27.
What abnormality helps identify children with acute respiratory distress caused by lung tissue disease?
27 out of 50
28.
What is the most likely cause of this infant’s respiratory distress?
Use this scenario to answer the next 2 questions:
You are caring for a 9-month-old girl who has increased work of breathing, a fever, and a cough. On
assessment, you find an alert infant with stridor and retractions. The infant’s SpO2 is 94%. On auscultation, the lungs are clear bilaterally.
28 out of 50
29.
What medication should you administer first?
Use this scenario to answer the next 2 questions:
You are caring for a 9-month-old girl who has increased work of breathing, a fever, and a cough. On
assessment, you find an alert infant with stridor and retractions. The infant’s SpO2 is 94%. On auscultation, the lungs are clear bilaterally.
29 out of 50
30.
What condition is characterized by a prolonged expiratory phase and wheezing?
30 out of 50
31.
A 5-year-old child is brought to the emergency department by ambulance after being involved in a motor vehicle collision. You are using the primary assessment to evaluate the child. When assessing the child’s neurologic status, you note that he has spontaneous eye opening, is fully oriented, and is able to follow commands. How would you document this child’s AVPU (Alert, Voice, Painful, Unresponsive) Pediatric Response Scale finding?
31 out of 50
32.
A 4-year-old child is brought to the emergency department for seizures. The seizures stopped a few minutes ago, but the child continues to have slow and irregular respirations. What condition is most consistent with your assessment?
32 out of 50
33.
You are evaluating a 1-year-old child for respiratory distress. His heart rate is 168/min, and his respiratory rate has decreased from 65/min to 30/min. He now appears more lethargic and continues to have severe subcostal retractions. On the basis of your assessment, what is the most likely reason for this change in the child’s condition?
33 out of 50
34.
A 7-year-old child in cardiac arrest is brought to the emergency department by ambulance. No palpable pulses are detected. The child’s ECG is shown here. How would you characterize this child’s rhythm?
34 out of 50
35.
What action should you take next?
Scenario
After rectal administration of diazepam, an 8-year old boy with a history of seizures is now unresponsive to pain stimulation. His respirations are shallow, at a rate of 10/min. His oxygen saturation is 94% on 2 L/min of nasal cannula oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally.
35 out of 50
36.
If the patient continues to snore and exhibit poor chest rise and poor air entry bilaterally after your initial intervention, what next step is most appropriate?
Use this scenario to answer the next 2 questions:
After rectal administration of diazepam, an 8-year-old boy with a history of seizures is now unresponsive to painful stimulation. His respirations are shallow, at a rate of 10/min. His oxygen saturation is 94% on 2 L/min of nasal cannula oxygen. On examination, the child is snoring with poor chest rise and poor air entry bilaterally.
36 out of 50
37.
You are performing the airway component of the primary assessment. What finding would lead you to conclude that the child has an upper airway obstruction?
37 out of 50
38.
In management of post–cardiac arrest patients, extra care should be taken to avoid reperfusion injury. What should the ideal oxygen saturation range most likely be?
38 out of 50
39.
Laboratory studies document lactic acidosis. On the basis of the patient’s clinical assessment and history, what type of shock does this patient most likely have?
39 out of 50
40.
What assessment finding is most important in your determination of the severity of the patient’s condition?
Scenario:
You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is responsive, but she does
not feel well and appears to be flushed. Her temperature is 39°C (102.2°F), heart rate is 118/min,
respiratory rate is 36/min, blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air.
Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving
100% oxygen by nonrebreathing mask.
40 out of 50
41.
What is the most appropriate amount to administer for the first normal saline fluid bolus?
Scenario:
You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is responsive, but she does
not feel well and appears to be flushed. Her temperature is 39°C (102.2°F), heart rate is 118/min,
respiratory rate is 36/min, blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air.
Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving
100% oxygen by nonrebreathing mask.
41 out of 50
42.
In addition to oxygen administration and appropriate fluid resuscitation, what additional early intervention should you provide to this patient?
Scenario:
You are caring for a 12-year-old girl with acute lymphoblastic leukemia. She is responsive, but she does
not feel well and appears to be flushed. Her temperature is 39°C (102.2°F), heart rate is 118/min,
respiratory rate is 36/min, blood pressure is 100/40 mm Hg, and oxygen saturation is 96% on room air.
Your assessment reveals mild increase in work of breathing and bounding pulses. The child is receiving
100% oxygen by nonrebreathing mask.
42 out of 50
43.
A 10-year-old child is brought to the emergency department for fever and cough. You obtain an oxygen saturation on the child. What oxygen saturation would indicate that immediate intervention is needed?
43 out of 50
44.
What rhythm is seen on the patient’s cardiac monitor?
Use this scenario to answer the next 2 questions:
An unresponsive 14-year-old girl is pale and cool to the touch. Her blood pressure is 70/45 mm Hg, heart
rate is 190/min, and respiratory rate is 12/min. The SpO2 is not detectable. Capillary refill time is 5
seconds. An IV is in place. The cardiac monitor displays the rhythm shown here.
44 out of 50
45.
If pharmacological interventions are unavailable or delayed, what intervention is indicated?
Use this scenario
An unresponsive 14-year-old girl is pale and cool to the touch. Her blood pressure is 70/45 mm Hg, heart
rate is 190/min, and respiratory rate is 12/min. The SpO2 is not detectable. Capillary refill time is 5
seconds. An IV is in place. The cardiac monitor displays the rhythm shown here.
45 out of 50
46.
What is the most appropriate intervention?
46 out of 50
47.
What rhythm is most consistent with this patient’s presentation and ECG findings?
An unresponsive 9-year-old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His
blood pressure is 80/40 mm Hg, heart rate is 45/min, respiratory rate is 6/min, and SpO2 is 60% on room air. He
is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here.
47 out of 50
48.
What action do you take next?
Use this scenario to answer the next 2 questions:
An unresponsive 9-year-old boy was given a dose of rectal valium by his caretaker for a prolonged seizure. His
blood pressure is 80/40 mm Hg, heart rate is 45/min, respiratory rate is 6/min, and SpO2 is 60% on room air. He
is unresponsive and cyanotic. The cardiac monitor displays the rhythm shown here.
48 out of 50
49.
A 3-year-old child is brought to the emergency department by his mother. What is a normal finding for a 3- year-old child?
49 out of 50
50.
A 6-month-old infant is being evaluated for bradycardia. What is the most likely cause of bradycardia?
50 out of 50
