PALS Shock Management 5

Question 1

A 2-year-old is brought in with vomiting and diarrhea for 3 days. HR is 175, CRT is 5 sec, skin turgor is poor, and mucous membranes are dry. What is the primary shock type?

Accepted Answer

Hypovolemic shock

Answer

Prolonged vomiting and diarrhea cause volume depletion leading to hypovolemic shock, the most common type of shock in children.

Question 2

Which PALS endpoint of resuscitation indicates that shock has been adequately treated?

Accepted Answer

Heart rate, CRT, mental status, and urine output normalized

Answer

PALS targets normalization of clinical perfusion markers — heart rate, CRT < 2 sec, mental status, and urine output ≥ 1 mL/kg/hr.

Question 3

During a trauma resuscitation, massive hemothorax is identified. After chest tube placement drains 500 mL of blood, the child remains in shock. What is the next intervention?

Accepted Answer

Administer blood products and prepare for operative intervention

Answer

Persistent hemorrhagic shock after initial chest tube output requires blood product resuscitation and surgical hemorrhage control.

Question 4

A 5-year-old post-cardiac surgery develops Beck's triad (hypotension, muffled heart sounds, JVD). Which diagnosis and treatment are correct?

Accepted Answer

Cardiac tamponade — pericardiocentesis

Answer

Beck's triad is pathognomonic for cardiac tamponade, which causes obstructive shock relieved by pericardiocentesis.

Question 5

In a pediatric patient with distributive shock from anaphylaxis, what is the FIRST drug to administer?

Accepted Answer

IM epinephrine 0.01 mg/kg (max 0.5 mg)

Answer

IM epinephrine is the first-line treatment for anaphylaxis, reversing bronchospasm and vasodilation before antihistamines or steroids.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Shock Management 5