PALS Tachycardia With a Pulse 4

Question 1

A 5-year-old with SVT remains stable. Vagal maneuvers and two doses of adenosine have failed. What is the next recommended treatment?

Accepted Answer

Synchronized cardioversion at 1 J/kg with sedation

Answer

After two failed adenosine doses, synchronized cardioversion with sedation is the next step for SVT even if still stable.

Question 2

Which finding on ECG indicates that a synchronized cardioversion shock is delivered correctly?

Accepted Answer

Shock fires on the R-wave of the QRS complex

Answer

The 'sync' mode delivers the shock on the R-wave to avoid the vulnerable T-wave period and prevent ventricular fibrillation.

Question 3

Which of the following statements about adenosine administration is CORRECT?

Accepted Answer

It must be given as a rapid IV bolus followed immediately by a saline flush

Answer

Adenosine has an extremely short half-life (~10 seconds) and must be given as a rapid bolus followed by an immediate saline flush to reach the heart.

Question 4

A 4-year-old develops a wide-complex tachycardia at 190 bpm with signs of shock. The team is uncertain if this is VT or SVT with aberrancy. What is the correct approach?

Accepted Answer

Treat as VT; perform synchronized cardioversion immediately

Answer

In an unstable child with wide-complex tachycardia, treat as VT and perform synchronized cardioversion without delaying for diagnostic workup.

Question 5

Which accessory pathway conduction syndrome is most commonly associated with recurrent SVT in pediatric patients?

Accepted Answer

Wolff-Parkinson-White (WPW) syndrome

Answer

WPW syndrome, caused by an accessory bundle (Bundle of Kent) bypassing the AV node, is the most common structural cause of SVT in children.

PALS - Pediatric Advanced Life Support Practice Test

PALS - Pediatric Advanced Life Support Practice Test

PALS Tachycardia With a Pulse 4