CPEN Cardiac Emergencies 2

Question 1

A 4-year-old presents with sudden onset of HR 220 bpm, narrow QRS, and no P waves visible before each QRS on ECG. What is the most likely diagnosis?

Accepted Answer

Supraventricular tachycardia (SVT)

Answer

SVT in children typically presents with HR >200 bpm, narrow QRS, and absent or retrograde P waves.

Question 2

Which medication is the first-line pharmacologic treatment for SVT in a hemodynamically stable pediatric patient when vagal maneuvers fail?

Accepted Answer

Adenosine

Answer

Adenosine is the drug of choice for SVT in stable pediatric patients, given as a rapid IV push.

Question 3

A 3-week-old infant presents with pallor, poor feeding, and HR of 280 bpm. The most appropriate immediate intervention is:

Accepted Answer

Synchronized cardioversion

Answer

A hemodynamically unstable infant with SVT requires immediate synchronized cardioversion at 0.5–1 J/kg.

Question 4

What is the recommended initial energy dose for synchronized cardioversion in a pediatric patient with unstable SVT?

Accepted Answer

0.5–1 J/kg

Answer

PALS guidelines recommend 0.5–1 J/kg for the initial synchronized cardioversion, increasing to 2 J/kg if needed.

Question 5

A 7-year-old with known Wolff-Parkinson-White syndrome presents in SVT. Which medication should be AVOIDED?

Accepted Answer

Verapamil

Answer

Verapamil is contraindicated in WPW because it can accelerate conduction through the accessory pathway, precipitating VF.

CPEN - Certified Pediatric Emergency Nurse Practice Test