PALS Managing Respiratory Emergencies 2

Question 1

A 3-year-old presents with sudden onset stridor, drooling, and refusal to lie down. Which condition is most likely?

Accepted Answer

Epiglottitis

Answer

Epiglottitis classically presents with the 'tripod position,' drooling, high fever, and toxic appearance — lying down worsens airway obstruction.

Question 2

When using a bag-mask device in a child, which ventilation rate is correct for a child with a pulse but absent respirations?

Accepted Answer

12-20 breaths/min

Answer

PALS guidelines recommend 12–20 breaths/min for rescue breathing in a child with a perfusing rhythm but no spontaneous respirations.

Question 3

A 6-month-old with RSV bronchiolitis has SpO2 of 88% on room air. What is the most appropriate initial oxygen delivery method?

Accepted Answer

High-flow nasal cannula

Answer

High-flow nasal cannula delivers warmed, humidified oxygen at flows exceeding anatomical dead space, improving oxygenation and reducing work of breathing in bronchiolitis.

Question 4

During assessment of a pediatric patient in respiratory distress, which finding indicates impending respiratory failure?

Accepted Answer

Decreased muscle tone and poor respiratory effort

Answer

Decreased muscle tone combined with poor respiratory effort signals fatigue and impending arrest, requiring immediate intervention.

Question 5

A child with known asthma arrives with severe wheeze, SpO2 92%, and accessory muscle use. After two doses of albuterol, symptoms persist. What is the next best intervention?

Accepted Answer

Administer IV magnesium sulfate

Answer

IV magnesium sulfate is indicated for severe, refractory asthma after initial bronchodilator therapy has failed, as it causes bronchial smooth muscle relaxation.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Managing Respiratory Emergencies 2