Question

1.All of the following are examples of upper airway obstruction EXCEPT: Asthma Croup Laryngitis Anaphylaxis

1. Exposure in PALS evaluations refers to an assessment for:
   • Trauma
   • Burns
   • Fractures
   • Any of the signs of a problem above
2. Which statement about fluid therapy for shock is NOT correct? Fluid therapy is never indicated for cardiogenic shock. Fluid therapy with small boluses is commonly indicated for cardiogenic shock.Increased urine output often indicates improved condition, None of the above

True or False: When treating obstructive shock, you should focus on diagnosing and correcting the cause.

• True
• False

True or False: Symptomatic bradycardia is defined as bradycardia with signs of shock or respiratory failure or distress.

• True
• False

All of the following are signs of cardiogenic shock EXCEPT:

• Declined respiratory function in response to fluid therapy
• Signs of increased respiration, often times including extended neck veins
• Signs of pulmonary or systemic venous congestion
• Improved tissue perfusion in response to fluid therapy

Poor ventilation causes which of the following:

• Respiratory acidosis
• Hypocarbia
• Hyperglycemia
• None of the above

All of the following are causes of obstructive shock EXCEPT:

• Congenital heart malformations
• Cardiac tamponade
• Acute blood loss
• Tension pneumothorax

Pulse oximetry is monitored during post-resuscitation care to:

• Monitor hypovolemia
• Monitor hypoglycemia
• Optimize ventilation and circulation
• Stabilize blood pressure

Which statement about shock is NOT correct?

• Decreased urine output is not a symptom of shock.
• Secondary conditions such as fever, infection, respiratory distress, and pain also contribute to shock.
• Children in shock may become disorientated.
• Children in shock can progress to cardiac failure.

Which medication is used for the treatment of metabolic acidosis?

• Sodium chloride
• Sodium bicarbonate
• Milrinone
• Magnesium sulfate

What is the best vasoactive agent for severe warm septic shock?

• Dobutamine
• Phenylephrine
• Norepinephrine
• Milrinone

1. Children under the age of ten have _________ normal heart rates when awake compared to adults.
   • Lower
   • Higher
   • Roughly equal
   • Completely unpredictable

Answer 1

• All of the following are examples of upper airway obstruction EXCEPT Asthma Croup Laryngitis Anaphylaxis

Answer: Asthma. All other given options cause obstruction to the airway. In the case of croup, the virus causes swelling of the trachea. Anaphylaxis causes swelling in the throat, and in laryngitis, the larynx swells up. All these are part of the upper airway. But Asthma is characterized by an attack of spasm in the bronchi in the lungs lower airway obstruction). So the correction option is Asthma.

• Exposure in PALS evaluations refer to an assessment for:
  • Trauma
  • Burns
  • Fractures
  • Any of the signs of a problem above

Answer: During PALS evaluation the rescuer checks in the child or infant whether he has got any trauma, burn or fracture by exposing the child’s body. So the correct option for a given question is option (4)

• Which statement about fluid therapy for shock is NOT correct?

Answer: Option (b). Fluid therapy with small boluses is not indicated. When patients arrive, initially they are treated with urgent IV infusions to restore their fluid volume and then they are reassessed for the fluid and electrolyte balance. Based on the reports, fluids are administered. Fluid therapy is never indicated for cardiogenic shock. An increase in the urine output often indicates improved condition.

• True or False: When treating obstructive shock, you should focus on diagnosing and correcting the cause.

Answer: True. An Obstructive Shock usually occurs when the amount of blood reaching the heart decreases due to some obstruction like Aortic dissection, tension pneumothorax, etc. In such cases, the primary focus during the treatment is to diagnose and correct the cause.

• True or False: Symptomatic bradycardia is defined as bradycardia with signs of shock or respiratory failure or distress.

Answer: False. In the case of Symptomatic bradycardia, the main criteria observed are reduced heart rate and patient exhibiting symptoms. Shock and respiratory failure or distress is attributed to Relative bradycardia

• All of the following are signs of cardiogenic shock EXCEPT:

Answer: Improved tissue perfusion in response to fluid therapy. All the other given conditions are signs of cardiogenic shock. But the last option is a response observed after giving treatment. The tissue perfusion gets improved only after the fluid resuscitation

• Poor ventilation causes which of the following:

Answer: Respiratory acidosis. Poor ventilation can cause Respiratory acidosis. Hypocarbia is caused due to artificial ventilation while Hyperglycemia is increased sugar levels which has no relation to Poor ventilation

• All of the following are causes of obstructive shock EXCEPT:

Answer: Acute blood loss. Obstructive shock does not happen because of Acute blood loss. All the other given options create an obstruction in the heart leading to a decrease in blood flow to heart resulting in Obstructive shock.

• Pulse oximetry is monitored during post-resuscitation care to:

Answer: Optimize ventilation and circulation. Pulse oximetry is used to measure oxygen saturation in the blood. This information tells us whether the process of ventilation and circulation is proper in the human body. Hypovolemia or fluid deficit cannot be monitored using Pulse oximetry. Hypoglycemia is reduced blood sugar level and this too cannot be measured by using Pulse oximetry. Also, Pulse oximetry is an assessment tool, this cannot be used to stabilize blood pressure.

• Which statement about shock is NOT correct?

Answer: Decreased urine output is not a symptom of shock also referred medically as Oliguria is observed during shock. It occurs due to reduced blood supply to the kidneys. All other given options are observed during shock.

• Which medication is used for the treatment of metabolic acidosis?

Answer: Sodium bicarbonate. Sodium Bicarbonate adds the base to counter high acidic levels in the body. This is required to counter metabolic acidosis.

• What is the best vasoactive agent for severe warm septic shock?

Answer: Norepinephrine. When patients are suffering from severe warm septic shock, guidelines recommend starting a vasoactive agent that has inotropic properties. In the case of infants, a vasopressor agent is recommended to be administered.

• Children under the age of ten have _________ normal heart rates when awake compared to adults.

Answer: Higher. Children under the age of 10 have a heart rate of 60 to 100 beats per minute while and the average heart rate of an adult is around 70 to 80.