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WorksheetsQuiz Tea Reward March & April 2021
Total questions: 20
Worksheet time: 44mins
Which of the following is true regarding provision of assisted ventilation in the early moments of an emergency?
Any technique that helps clear the upper airway and safely produces air movement in both lung fields is acceptable
No one should attempt to deliver positive-pressure ventilation until tracheal intubation can be accomplished
Mouth-to-mouth ventilation is preferred strongly over bag-mask ventilation
In proper assisted ventilation, there should be no movement of the abdominal wall during inspiration
A 2-yr-old patient, previously admitted to the hospital for respiratory distress, is found apneic and pulseless in the early morning hours. She is intubated and ventilated adequately, and an intra-osseous needle is placed, but she remains pulseless. The first medications you should employ are:
Lidocaine and epinephrine
Epinephrine and norepinephrine
Norepinephrine and atropine
Lidocaine and atropine
Epinephrine and atropine
The drug of choice for shock refractory ventricular fibrillation is:
Magnesium
Bretylium
Aminophylline
Amiodarone
Digoxin
A 9-yr-old with vomiting and diarrhea has a systolic blood pressure of 75 mm Hg. You should
Check the fundi for papilledema
Administer 20 mL/kg of normal saline
Administer 20 mL/kg of lactated Ringer solution in 5% dextrose in water
Obtain upper and lower limb blood pressure readings
Begin administration of epinephrine or atropine
The condition of a patient in the PICU appears to be worsening, and the supervising physician asks for the one best test to determine if shock is present. You suggest:
A mixed venous O2 saturation measurement
An arterial blood gas analysis
A venous blood gas
A hematocrit
The factor most clearly predicting mortality in shock is:
Cardiac failure
Renal failure
Hepatic failure
Metabolic acidosis
Multiple organ system failure
The drug pair that meets the dual goals of stimulating the heart and relaxing peripheral vasculature is:
Isoproterenol and epinephrine
Dopamine and dobutamine
Dobutamine and amrinone
Epinephrine and norepinephrine
Amrinone and norepinephrine
A 5-yr-old boy presents with petechiae, fresh bruises, low-grade fever, dizziness, and lethargy. You admit him to the hospital and start an IV infusion. The most appropriate next step in management would be:
Administration of high-dose Solu-Medrol or Decadron
A CT scan of the head to rule out meningococcal meningitis
Collection of blood for a culture, CBC, and platelet count
Administration of 20 mL/kg of normal saline
The normal alveolar-arterial (A-a) oxygen gradient is:
>300 mm Hg
<10 mm Hg
50 mm Hg
>100 mm Hg
A patient in respiratory distress presents to your office. The most appropriate immediate response is to:
Attempt a blood gas determination
Immediately intubate the airway and begin positive-pressure
Call 911
Place the child in a comfortable position, reassess the airway, and provide oxygen and other supportive measures as necessary
The initial ventilator settings are determined by:
The patient's underlying disease
The patient's preferences
Standard order sets
Attempts to normalize the blood gases
The most important maneuver in preserving renal function in septic shock is:
Intravenous infusion of furosemide
Infusion of dopamine at a rate of 1-3 g/kg/min
Rapid restoration of the circulating volume
Proper antibiosis against the offending organism
Appropriate nutritional support for the child receiving mechanical ventilation for bacterial pneumonia should include:
Amino acids, 2 g/kg/day, given intravenously
Full maintenance solution containing 35% dextrose
An age-appropriate enteral formula via nasogastric tube
An age-appropriate enteral formula via nasogastric tube
In the severely ill child, a catabolic state ensues. Which of the following statements is true?
Administration of growth hormone diminishes insulin resistance
Hyperglycemia is a beneficial state in the catabolic child
Branch-chain amino acids are beneficial to the previously normal child
Intensive insulin therapy has reduced mortality in adult ICU patients
The differential diagnosis for the afebrile child with nausea and vomiting should include:
Intracranial tumor
Viral gastroenteritis
Salmonella infection
Type A influenza
A 15-yr-old boy is struck by a car while walking. On arrival in the ED, he is alert and has no signs of upper airway obstruction. Pulse is 140/min, respiratory rate 40 breaths/min, and blood pressure 70/50 mm Hg. Heart sounds are distinct, but breath sounds are decreased in the left hemithorax. What is the most appropriate next step in patient management?
Needle thoracentesis of the left hemithorax
Upright radiograph of the chest
Pericardiocentesis
Rapid intravenous bolus of Ringer's lactate
Arterial blood gas analysis
A 4-yr-old girl sustains a head injury after pulling a television set onto her. The paramedics intubate her at the scene because of inadequate respiratory effort. On arrival in the ED, she is being ventilated at a rate of 20 breaths/min, and her chest wall rises adequately. Pulse is 100/min, blood pressure is 100/70 mm Hg, and peripheral perfusion is good. What is the most appropriate next step in patient management?
Immediate head CT
Hyperventilation to attain a PCO2 of 25 mm Hg
Gentle hyperventilation and an intravenous bolus of mannitol
Evaluation of level of alertness and pupil size and reactivity
Evaluation of level of alertness and pupil size and reactivity
A 3-yr-old boy is brought to the ED after falling two stories from an open window. He arrives appropriately immobilized and is alert. Pulse is 190/min; respiratory rate, 28 breaths/min; and blood pressure, 70/30 mm Hg. It is clear that he has a femur fracture. His abdomen is diffusely tender. After a 20 mL/kg bolus of Ringer's lactate, his pulse is 180/min and blood pressure is 72/35 mm Hg. The most appropriate next step in patient management would be:
Insertion of a central venous catheter
Emergent abdominal laparotomy
20 mL/kg bolus of Ringer's lactate
10 mL/kg infusion of cross-matched, packed red blood cells
58. A 10-yr-old boy is brought to the ED after being kicked in the abdomen by a horse. Pulse is 80/min; respiratory rate, 18 breaths/min; and blood pressure, 110/70 mm Hg. His abdomen is diffusely tender. The most appropriate diagnostic study for this patient would be:
Abdominal ultrasound study
MRI of the abdomen
Diagnostic peritoneal lavage
Abdominal CT study with intravenous contrast
For the child with ARDS receiving mechanical ventilation the prone position is alternated with the supine position. This measure is used to:
Heart or lung
Heart or liver
Cornea or heart
Kidney or liver
