Deck 8: Perioperative Pediatrics

Question 1

Into what stage would Erikson place a 24-month-old child to determine his or her psychological development?

A) Trust vs.mistrust
B) Autonomy vs.shame/doubt
C) Initiative vs.guilt
D) Intimacy vs.isolation

Answer 1

B
The characteristics of this stage are developing a two-way relationship with the primary caregiver,suffering separation anxiety when isolated from established relationships,personality becoming introverted or extroverted,establishing a sense of will,using sentences for communication,having fear of immediate threats,and not projecting thoughts beyond the present.

Question 2

During a pediatric bowel case,a surgeon may opt to use a ____ instead of a Richardson retractor to retract blood vessels or small structures.

A) vessel loop
B) Balfour retractor
C) Bookwalter retractor
D) Gelpi retractor

Answer 2

A
Umbilical tape or vessel loops are used frequently to retract blood vessels and small structures,giving the surgeon greater visibility in a small surgical site and eliminating the weight of retractors.

Question 3

Talipes ____ means the forefoot is inverted and talipes ____ means the forefoot is everted.

A) venous;valgus
B) varus;valgus
C) equines;various
D) venous;verigated

Answer 3

B
In talipes varus,the forefoot is inverted and rotated,whereas in talipes valgus the forefoot is everted.

Question 4

For a child approaching puberty who weighs 40 kg,what would the estimated blood volume be?

A) 1540 mL
B) 3000 mL
C) 3200 mL
D) 2880 mL

Question 5

During a tonsillectomy and adenoidectomy,it is always important to control bleeding and prevent any aspiration of blood.

Question 6

A newborn's heart rate ranges from:

A) 120 to 140 beats per minute (bpm).
B) 80 to 120 bpm.
C) 110 to 130 bpm.
D) 100 to 170 bpm.

Question 7

The pediatric patient may be left alone while recovering from surgery in the PACU.

Question 8

Anorectal malformation occurs during what weeks of fetal development?

A) 13th to 16th weeks
B) 4th to 12th weeks
C) 3rd to 6th weeks
D) 17th to 20th weeks

Question 9

Neonates born before completion of 37 weeks' gestation are referred to as:

A) preterm.
B) postterm.
C) infant.
D) fetus.

Question 10

What procedure may have to be performed as a result of a child ingesting caustic agents that may burn the mouth,lips,pharynx,and esophagus?

A) Adenoidectomy
B) Tonsillectomy
C) Esophageal dilation
D) Herniorrhaphy

Question 11

If a pediatric patient receives too much oxygen (oxygen toxicity),the result can be retrolental fibroplasias.

Question 12

If a 6-year-old child has a congenital dislocated hip,the preferred treatment is a closed reduction.

Question 13

Which is a congenital anomaly characterized by a fusion of two or more fingers or toes?

A) Dyndactyly
B) Syndactyly
C) Polydactyly
D) Manydactyly

Question 14

When greater than ____ of estimated blood volume is lost,hypotension is apparent in the pediatric patient.

A) 40%
B) 50%
C) 60%
D) 75%

Question 15

In the school-aged child the most common cause for an abdominal surgical procedure is:

A) obstructive stomach lesion.
B) bezoars.
C) appendicitis.
D) intussusception.

Question 16

Which type of injury is the leading cause of death in children?

A) Head
B) Intestinal
C) Lethal
D) Accidental

Question 17

Which type of tube is placed during a gastrostomy procedure?

A) EGD
B) PEG
C) RBC
D) PPD

Question 18

Pediatric patients have a higher occurrence and frequency of malignant tumors than adults.

Question 19

Excess drapes with extra weight should be used on the pediatric patient in the OR.

Question 20

The resting metabolic rate of an infant is about the same as an adult.

Question 21

Which is one of the four defects that make up the tetralogy of Fallot?

A) Left ventricular hypertrophy
B) Displacement of aorta to the left
C) Pulmonary valve dilation
D) Ventricular septal defect

Question 22

What are the two ways in which an atrial septal defect can be closed?

A) Suture,patch graft
B) Wires,antibiotics
C) Valve,ligating clips
D) Electrosurgery,antibiotics

Question 23

Which is one of the most common causes of cardiac death within the first week of life?

A) Pulmonary fibrosis
B) Hypoplastic left heart syndrome
C) Aortic valve insufficiency
D) Ventricular septal defect

Question 24

Which is one of the seven physical anomalies referred to in the VACTERL association or syndrome?

A) Lateral gastric fistula
B) Aortic deficiency
C) Cardiac anomaly
D) Retinal detachment

Question 25

Which is one of the "rule of tens" in regard to cleft lip repair?

A) Over 10 years in age
B) 10 % of body fat
C) Less than 10 cm of lip tissue
D) 10 pounds in body weight

Question 26

What condition occurs when a portion of the bowel slides into another segment and causes obstruction?

A) Intussusception
B) Intubation
C) Internation
D) Infraterning

Question 27

In a Jantene procedure,which two vessels are anatomically switched?

A) Aorta and pulmonary artery
B) Superior vena cava and left pulmonary vein
C) Aortic arch and pulmonary artery
D) Right pulmonary vein and inferior vena cava

Question 28

What is one specific feature of patients with "pectus excavatum"?

A) Barrel-shaped chest
B) Extreme convex-shaped chest tissue
C) Concave depression over lower end of sternum
D) Under developed pectus muscle

Question 29

Which is a common pediatric procedure performed that results from the diagnosis of otitis media?

A) Goniotomy
B) Tenotomy
C) Luque fixation
D) Myringotomy

Question 30

What valve allows normal blood flow between the right atrium and ventricle?

A) Tricuspid
B) Mitral
C) Pulmonary
D) Bicuspid

Question 31

What criteria is fetal viability based on?

A) Gestational age greater than 18 weeks
B) Birthweight greater than 250 g
C) Ability to sustain life outside the uterus
D) Able to exchange oxygen using a ventilator

Question 32

What body part is affected with the condition of cryptorchidism?

A) Lack of breast tissue
B) Testicles that are undescended
C) Nasal tissue
D) Toenail fungal infection

Question 33

Choose the palliative procedure performed on an infant with transposition of the great vessels.

A) Mustard procedure
B) Jantene procedure
C) Rashkind procedure
D) Senning procedure

Question 34

When is pulmonary ventilation established?

A) 1 to 3 weeks after birth
B) At birth
C) 2 to 3 months after birth
D) At conception

Question 35

What is the average blood volume of the average newborn?

A) 10 to 12 mL
B) 40 mL
C) 100 mL
D) 250 mL

Question 36

Which principle of surgical instrumentation in pediatric procedures is correct?

A) The size and weight of the instruments used are the same as the ones used for adult procedures.
B) Surgical instruments used during pediatric procedures must be made of plastic materials to decrease their weight.
C) Instruments not in use should never be placed on the patient during a procedure.
D) Mosquito hemostats are rarely used to clamp vessels.

Question 37

What type of shunt is placed when attempting to drain fluid from the ventricles to the right atrium of the heart?

A) Ventriculoperitoneal shunt
B) Ventriculoamniotic shunt
C) Ventriculoatrial shunt
D) Ventriculocoronary shunt