PALS Tachycardia With a Pulse 3

Question 1

A 7-year-old with a known history of WPW presents with a wide-complex tachycardia and a pulse. Which drug should be AVOIDED?

Accepted Answer

Adenosine

Answer

Adenosine can enhance accessory pathway conduction in WPW during wide-complex tachycardia, potentially causing ventricular fibrillation.

Question 2

What is the maximum single dose of adenosine for treating SVT in a pediatric patient?

Accepted Answer

12 mg

Answer

The maximum single dose of adenosine in pediatric PALS is 12 mg, regardless of weight.

Question 3

An infant presents with a heart rate of 280 bpm, pallor, and cool extremities. Which finding would MOST indicate SVT over sinus tachycardia?

Accepted Answer

Absent P-waves with retrograde conduction on ECG

Answer

Absent or retrograde P-waves are characteristic of SVT, whereas sinus tachycardia always shows normal P-waves preceding each QRS.

Question 4

Which of the following is TRUE regarding vagal maneuvers in pediatric SVT?

Accepted Answer

Ice water facial immersion is preferred over carotid sinus massage in infants

Answer

Ice water facial immersion activates the diving reflex and is the preferred vagal maneuver in infants; carotid massage is reserved for older children.

Question 5

A 10-year-old with SVT successfully converts with adenosine. Thirty seconds later, the heart rate rises to 230 bpm again. What is the next step?

Accepted Answer

Administer a second dose of adenosine at 0.2 mg/kg

Answer

Recurrent SVT after adenosine conversion warrants a second adenosine dose at the higher dose of 0.2 mg/kg before escalating therapy.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Tachycardia With a Pulse 3