PALS Shock Management 2

Question 1

A 3-year-old presents with HR 170, BP 60/40, cool mottled extremities, and altered mental status after a bee sting. Which type of shock is most likely?

Accepted Answer

Distributive (anaphylactic) shock

Answer

Anaphylactic shock is a form of distributive shock triggered by allergen exposure, causing massive vasodilation and hypotension.

Question 2

In a pediatric patient with septic shock, what is the recommended initial fluid bolus dose per PALS guidelines?

Accepted Answer

20 mL/kg isotonic crystalloid

Answer

PALS recommends 20 mL/kg of isotonic crystalloid as the initial fluid bolus for septic shock, repeated as needed up to 60 mL/kg.

Question 3

A child in distributive shock remains hypotensive after 60 mL/kg of IV fluids. Which vasoactive agent is the FIRST-LINE choice for warm (vasodilatory) septic shock?

Accepted Answer

Norepinephrine

Answer

Norepinephrine is preferred for warm distributive shock because its alpha-adrenergic vasoconstriction counteracts pathologic vasodilation.

Question 4

Which finding is the MOST reliable early indicator of shock in a pediatric patient?

Accepted Answer

Tachycardia

Answer

Tachycardia is typically the earliest compensatory response to shock in children; hypotension is a late and ominous sign.

Question 5

A 6-month-old has HR 210, CRT 4 sec, cool extremities, and normal BP. This presentation is best classified as:

Accepted Answer

Compensated shock

Answer

Compensated shock maintains normal blood pressure through physiologic compensation; decompensated shock is defined by hypotension.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Shock Management 2