PALS Shock Management 4

Question 1

A newborn with ductal-dependent congenital heart disease develops cardiogenic shock at day 3 of life. Which medication is critical to administer?

Accepted Answer

Prostaglandin E1 (alprostadil)

Answer

Prostaglandin E1 keeps the ductus arteriosus open in ductal-dependent lesions, maintaining pulmonary or systemic blood flow.

Question 2

During resuscitation of a child in shock, which lab value most directly assesses tissue oxygen delivery and adequacy of perfusion?

Accepted Answer

Lactate level

Answer

Elevated serum lactate indicates anaerobic metabolism from inadequate oxygen delivery to tissues, reflecting shock severity.

Question 3

A 7-year-old with acute myocarditis develops cardiogenic shock with severe hypotension despite dobutamine. Which therapy should be added next?

Accepted Answer

Norepinephrine to support blood pressure

Answer

Norepinephrine provides vasopressor support to maintain perfusion pressure when cardiogenic shock is severe and inotropes alone are insufficient.

Question 4

Which parameter best indicates ADEQUATE fluid resuscitation response in a child with hypovolemic shock?

Accepted Answer

Decrease in heart rate toward normal range

Answer

Return of heart rate toward age-appropriate normal is a key clinical indicator that perfusion and volume status are improving.

Question 5

A child with hemorrhagic shock due to trauma requires packed red blood cells. What is the recommended initial PRBC dose in pediatric patients?

Accepted Answer

10 mL/kg over 30–60 minutes

Answer

10 mL/kg of PRBC over 30–60 minutes is the standard pediatric transfusion dose for hemorrhagic or anemia-related shock.

PALS - Pediatric Advanced Life Support Practice Test