NPS NPS Emergency and Critical Care 2

Question 1

What is the correct energy dose for the FIRST defibrillation attempt in a pediatric patient with ventricular fibrillation?

Accepted Answer

2 J/kg

Answer

PALS recommends an initial defibrillation dose of 2 J/kg for pediatric VF/pulseless VT, with subsequent shocks at 4 J/kg.

Question 2

A neonate in the NICU suddenly develops cyanosis, bradycardia, and absent breath sounds on the left. Chest transillumination is positive. What is the immediate intervention?

Accepted Answer

Needle decompression of the left chest at the 2nd intercostal space, midclavicular line

Answer

A tension pneumothorax in a neonate requires immediate needle decompression at the 2nd ICS, MCL on the affected side — waiting for X-ray confirmation is inappropriate.

Question 3

During neonatal transport, a 27-week premature neonate becomes increasingly tachycardic and pale. Blood glucose is 22 mg/dL. What is the first intervention?

Accepted Answer

IV dextrose 10% at 2 mL/kg bolus

Answer

Symptomatic hypoglycemia in a neonate is treated with a D10W minibolus of 2 mL/kg IV, providing approximately 200 mg/kg glucose to rapidly restore euglycemia.

Question 4

A pediatric patient with traumatic brain injury has a GCS of 7. What is the initial target PaCO2?

Accepted Answer

35–40 mmHg (normocapnia)

Answer

Normocapnia (PaCO2 35–40 mmHg) is targeted in pediatric TBI to avoid cerebral vasoconstriction from hypocapnia; prophylactic hyperventilation is no longer recommended.

Question 5

Which sign indicates that a pediatric patient in shock has transitioned from compensated to decompensated shock?

Accepted Answer

Hypotension

Answer

Hypotension marks the transition to decompensated shock in pediatric patients; children can maintain blood pressure for extended periods through vasoconstriction before decompensating.

NPS - Neonatal Pediatric Specialist Practice Test

NPS - Neonatal Pediatric Specialist Practice Test

NPS NPS Emergency and Critical Care 2