Deck 34: Emergency Care of the Child

Question 1

What is the goal of the initial intervention for a child in cardiopulmonary arrest?

A) Establishing a patent airway
B) Determining a pulse rate
C) Removing clothing
D) Reassuring the parents

Answer 1

Establishing a patent airway

Question 2

Which is the most critical element of pediatric emergency care?

A) Airway management
B) Prevention of neurologic impairment
C) Maintaining adequate circulation
D) Supporting the child's family

Answer 2

Airway management

Question 3

A 3-year-old is brought to the emergency department by ambulance after her body was found submerged in the family pool.The child has altered mental status and shallow respirations.She did not require resuscitative interventions.Which condition should the nurse monitor first in this child?

A) Neurologic status
B) Hypothermia
C) Hypoglycemia
D) Hypoxia

Answer 3

Hypoxia

Question 4

Which action should the nurse working in the emergency department implement in order to decrease fear in a 2-year-old child?

A) Keep the child physically restrained during nursing care.
B) Allow the child to hold a favorite toy or blanket.
C) Direct the parents to remain outside the treatment room.
D) Let the child decide whether to sit up or lie down for procedures.

Question 5

Which nursing action facilitates care being provided to a child in an emergency situation?

A) Encourage the family to remain in the waiting room.
B) Include parents as partners in providing care for the child.
C) Always reassure the child and family.
D) Give explanations using professional terminology.

Question 6

You are the nurse working triage in the emergency department.A school-age child is brought in for treatment,carried by her mother.What is part of a primary assessment that should be performed first on this child?

A) Determine level of consciousness.
B) Obtain a health history.
C) Obtain a full set of vital signs.
D) Evaluate for pain.

Question 7

What should be the emergency department nurse's next action when a 6-year-old child has a systolic blood pressure of 58 mm Hg?

A) Alert the physician about the systolic blood pressure.
B) Comfort the child and assess respiratory rate.
C) Assess the child's responsiveness to the environment.
D) Alert the physician that the child may need intravenous fluids.

Question 8

Which nursing action is most appropriate to assist a preschool-age child in coping with the emergency department experience?

A) Explain procedures and give the child at least 1 hour to prepare.
B) Remind the child that she is a big girl.
C) Avoid the use of bandages.
D) Use positive terms and avoid terms such as "shot" and "cut."

Question 9

How should the nurse instruct the mother who calls the emergency department because her 9-year-old child has just fallen on his face and one of his front teeth fell out?

A) Put the tooth back in the child's mouth and call the dentist right away.
B) Place the tooth in milk or water and go directly to the emergency department.
C) Gently place the tooth in a plastic zippered bag until she makes a dental appointment.
D) Clean the tooth and call the dentist for an immediate appointment.

Question 10

Assessment of a child with a submersion injury focuses on which system?

A) Cardiovascular
B) Respiratory
C) Neurologic
D) Gastrointestinal

Question 11

In which situation is the administration of milk or water indicated after ingestion?

A) The child is suspected of ingesting lead paint chips.
B) The child ingested approximately 15 tablets of baby aspirin.
C) The child ingested an over-the-counter product containing acetaminophen.
D) The child ingested an acid or alkali.

Question 12

You are the nurse caring for a child who is diagnosed with septic shock.He begins to develop an dysrhythmia and hemodynamic instability.Endotracheal intubation is necessary.The physician feels that cardiac arrest may soon develop.What drug do you anticipate the physician will order?

A) Atropine sulfate
B) Epinephrine
C) Sodium bicarbonate
D) Inotropic agents

Question 13

Which observations made by an emergency department nurse raises the suspicion that a 3-year-old child has been maltreated?

A) The parents are extremely calm in the emergency department.
B) The injury is unusual for a child of that age.
C) The child does not remember how he got hurt.
D) The child was doing something unsafe when the injury occurred.

Question 14

Which action should the nurse incorporate into a care plan for a 14-year-old child in the emergency department?

A) Limit the number of choices to be made by the adolescent.
B) Insist that parents remain with the adolescent.
C) Provide clear explanations and encourage questions.
D) Give rewards for cooperation with procedures.

Question 15

What is the nurse's immediate action when a child comes to the emergency department with sweating,chills,and fang bite marks on the thigh?

A) Secure antivenin therapy.
B) Apply a tourniquet to the leg.
C) Ambulate the child.
D) Reassure the child and parent.

Question 16

A preschool child in the emergency department has a respiratory rate of 10 breaths per minute.How should the nurse interpret this finding?

A) The child is relaxed.
B) Respiratory failure is likely.
C) This child is in respiratory distress.
D) The child's condition is improving.

Question 17

The emergency department nurse notices that the mother of a young child is making a lot of phone calls and getting advice from her friends about what she should do.This behavior is an indication of

A) Stress
B) Healthy coping skills
C) Attention-getting behaviors
D) Low self-esteem

Question 18

What is an appropriate nursing intervention for a 6-month-old infant in the emergency department?

A) Distract the infant with noise or bright lights.
B) Avoid warming the infant.
C) Remove any pacifiers from the baby.
D) Encourage the parent to hold the infant.

Question 19

The nurse observes abdominal breathing in a 2-year-old child.What does this finding indicate?

A) Imminent respiratory failure
B) Hypoxia
C) Normal respiration
D) Airway obstruction

Question 20

The father of a child in the emergency department is yelling at the physician and nurses.Which action is contraindicated in this situation?

A) Provide a nondefensive response.
B) Encourage the father to talk about his feelings.
C) Speak in simple, short sentences.
D) Tell the father he must wait in the waiting room.

Question 21

What is the leading cause of unintentional death in children younger than 19 years of age in the United States?

A) Drowning
B) Airway obstruction
C) Pedestrian injury
D) Motor vehicle injuries

Question 22

What condition does the nurse recognize as an early sign of distributive shock?

A) Hypotension
B) Skin warm and flushed
C) Oliguria
D) Cold, clammy skin

Question 23

A child is brought to the emergency department.When he is called to triage,which vital sign should be measured first?

A) Temperature
B) Heart rate
C) Respiratory rate
D) Blood pressure

Question 24

A 2-year-old child is in the playroom.The nurse observes him picking up a small toy and putting it in his mouth.The child begins to choke.He is unable to speak.Which intervention is appropriate?

A) Heimlich maneuver
B) Abdominal thrusts
C) Five back blows
D) Five chest thrusts

Question 25

Automatic external defibrillators (AEDs)are becoming increasingly more available in community settings.They are very effective for correcting serious rhythm disturbances in adults; however,they are not recommended for use in children.

Question 26

What may cause hypovolemic shock in children? Select all that apply.

A) Hyperthermia
B) Burns
C) Vomiting or diarrhea
D) Hemorrhage
E) Skin abscess that cultures positive for methicillin-resistant Staphylococcus aureus (MRSA)

Question 27

A 10-year-old girl is brought to the emergency department manifesting the following physical symptoms: sweating,nausea,headache,abdominal cramps,cool moist skin,and an elevated temperature.The child's mother reports that since this was the first warm day of summer,they spent most of the day at the beach.This patient is experiencing ___________.

Question 28

Regardless of the cause of traumatic injury,most children do well unless the injuries are extremely severe.Even children with traumatic brain injuries (TBI)have far more favorable chances of recovery than most adults.Is this statement true or false?

Question 29

Which initial assessment made by the triage nurse suggests that a child requires immediate intervention?

A) The child has thick yellow rhinorrhea.
B) The child has a frequent nonproductive cough.
C) The child's oxygen saturation is 95% by pulse oximeter.
D) The child is grunting.

Question 30

An emergency department nurse is making a general appearance assessment on a preschool child just admitted to the emergency department.Which general assessment findings indicate the child "looks bad"? Select all that apply.

A) Color pale
B) Capillary refill less than 2 seconds
C) Unwilling to separate from parents
D) Cold extremities
E) Lethargic