Certified Pediatric Emergency Nurse (CPEN) Practice Exam

What is the appropriate action if a child's pulse is less than 60?

1. Monitor for signs of shock

2. Start compressions

3. Administer oxygen therapy

4. Call for emergency assistance

The correct answer is: Start compressions

When a child’s pulse is less than 60 beats per minute, especially if the child is showing signs of poor perfusion or is unresponsive, initiating chest compressions is the appropriate action. This is based on guidelines from advanced life support in pediatrics, which states that for a child with bradycardia accompanied by inadequate perfusion, high-quality chest compressions should be started immediately. In this case, bradycardia in a child can indicate a serious condition, and the immediate need for oxygenated blood flow to vital organs becomes critical. Initiating compressions helps to restore blood circulation and can potentially revive the child's heart rate. While monitoring for signs of shock, administering oxygen therapy, and calling for emergency assistance are important steps to take in a critical situation involving a pediatric patient, they are secondary to the actionable response required when the pulse is dangerously low and the child is in a state of bradycardia leading to cardiopulmonary arrest. Therefore, starting compressions aligns with the emergency management of pediatric patients in this scenario and is an immediate life-saving measure.