PALS Managing Respiratory Emergencies 4

Question 1

A 2-year-old with croup has moderate stridor at rest and moderate retractions. After racemic epinephrine, the child improves. What is the minimum observation period before discharge?

Accepted Answer

2–4 hours

Answer

Because racemic epinephrine's effect is temporary (rebound phenomenon can occur), children must be observed for 2–4 hours before discharge.

Question 2

During bag-mask ventilation, you notice the child's chest is not rising. After repositioning the head and ensuring a proper mask seal, there is still no rise. What is the next step?

Accepted Answer

Check for and relieve airway obstruction with a jaw thrust

Answer

If repositioning and mask seal fail to produce chest rise, a jaw thrust to open the airway is the next maneuver before escalating to a more invasive airway.

Question 3

A 9-year-old post-drowning victim is intubated and ventilated. ETCO2 reads 55 mmHg. Which action is correct?

Accepted Answer

Increase the respiratory rate to lower ETCO2

Answer

An ETCO2 of 55 mmHg indicates hypercapnia (hypoventilation); increasing the respiratory rate will blow off more CO2 and correct this.

Question 4

Which of the following is the most reliable indicator of correct ETT placement after intubation?

Accepted Answer

Continuous waveform capnography

Answer

Continuous waveform capnography (ETCO2) is the gold standard for confirming and continuously monitoring ETT placement in a perfusing patient.

Question 5

A 3-month-old with bronchiolitis has apnea lasting 20 seconds. What is the most appropriate immediate intervention?

Accepted Answer

Apply stimulation and prepare for bag-mask ventilation

Answer

Apnea in an infant with bronchiolitis requires immediate stimulation and readiness for bag-mask ventilation to support oxygenation and ventilation.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Managing Respiratory Emergencies 4