Deck 51: Nursing Care During a Pediatric Emergency

Question 1

The nurse is caring for a 6-year-old girl who was injured in a bicycle accident. Which question would be most important for the nurse to ask during the health history?

A) "Has she been diagnosed with any chronic disorders?"
B) "Is your daughter currently taking any medications?"
C) "Is she allergic to any medications or drugs?"
D) "Tell me how the bicycle accident happened."

Answer 1

"Tell me how the bicycle accident happened."

Question 2

The nurse is caring for a 7-year-old boy experiencing respiratory distress who is scheduled to have a chest radiograph. Which of the following would be most important for the nurse to include in the child's plan of care?

A) Administering a sedative to help calm the child
B) Assisting the child to lie still during the chest radiograph
C) Accompanying the child to continue observation
D) Informing the child that he might hear a loud banging noise

Answer 2

Assisting the child to lie still during the chest radiograph

Question 3

A 5-year-old girl is cyanotic, dusky, and anxious when she arrives in the emergency department. Which of the following would be most appropriate?

A) Ventilating the child with a bag-valve-mask
B) Estimating the child's weight using a Broselow tape
C) Providing therapy using automated external defibrillation
D) Using rescue breathing and chest compressions

Answer 3

Ventilating the child with a bag-valve-mask

Question 4

When caring for an 8-year-old boy injured in an automobile accident, the nurse demonstrates understanding of the principles of Pediatric Advanced Life Support (PALS) by which action?

A) Assisting ventilation with a bag-valve-mask (BVM) device
B) Treating ventricular fibrillation using a defibrillator
C) Managing compensated shock to prevent decompensated shock
D) Treating supraventricular tachycardia using cardioversion

Question 5

A 9-year-old girl who has fallen from a second-story window is brought to the emergency department. Which assessment would be a priority?

A) Evaluating pupils for equality and reactivity
B) Monitoring oxygen saturation levels
C) Asking the child if she knows where she is
D) Using the appropriate pain assessment scale

Question 6

The parents bring their 3-year-old son to the emergency department after having found that he has ingested some of his mother's medicine. Which assessment would be of critical importance for this child?

A) Assessing mental status and skin moisture and color
B) Evaluating the effectiveness of the child's breathing
C) Noting the child's pulse rate and quality
D) Auscultating all lung fields for signs of edema

Question 7

Which of the following would the nurse do first for a 5-year-old girl with profound bradycardia?

A) Provide oxygen at 100%
B) Administer epinephrine as ordered
C) Use warming blankets
D) Perform gastric lavage

Question 8

Which measure would be most appropriate for the nurse to do to ensure that a child's endotracheal (ET) tube is correctly positioned?

A) Auscultate for abdominal breath sounds
B) Mark the tracheal tube at the child's lip
C) Watch for a yellow display on a CO₂ monitor
D) Inspect for water vapor in the tracheal tube

Question 9

Which intervention would be most helpful in preventing barotrauma when ventilating a 3-year-old girl with a bag-valve-mask?

A) Choosing the correct size bag and face mask
B) Setting the flow rate at exactly 10 L/minute
C) Maintaining the airway in the open position
D) Delivering one breath every 3 to 5 seconds

Question 10

The nurse is providing care to a 4-year-old boy with a broken arm and an infected laceration from a fall. The nurse notes a significant elevation in the child's heart rate. Which intervention would be least appropriate?

A) Administering antipyretics as ordered for fever
B) Using a defibrillator to reduce the heart rate
C) Administering analgesics to reduce pain
D) Allowing the parents to comfort the child

Question 11

A child weighing 51 lbs requires defibrillation. How many joules would the nurse expect to give initially?

A) 46
B) 92
C) 102
D) 204

Question 12

A 1-month-old infant admitted to the emergency department in respiratory distress exhibits a regular pattern of breathing followed by brief periods of apnea, then tachypnea for a short time, eventually returning to a normal respiratory rate. The nurse documents this finding as which of the following?

A) Hypoventilation
B) Hyperventilation
C) Periodic breathing
D) Stridor

Question 13

The nurse is gathering the necessary equipment for tracheal intubation for a child who is 2 years old. Which tracheal tube size would the nurse obtain?

A) 4.5
B) 5
C) 5.5
D) 6

Question 14

Which of the following would lead the nurse to suspect that a 5-year-old child is experiencing supraventricular tachycardia?

A) Heart rate 160 beats per minute
B) Flattened P waves
C) Normal QRS complex
D) History of fever

Question 15

Which of the following would be most appropriate to use to help maintain a patent airway in an infant experiencing a respiratory emergency?

A) Neck hyperextension
B) Head tilt-chin lift technique
C) Jaw-thrust maneuver
D) Small towel under shoulders

Question 16

A child who weighs 53 lbs is receiving fluid volume replacement as part of the treatment for shock. The nurse is evaluating the child's hourly urinary output to determine if the child's condition is improving. Which output would the nurse interpret as most indicative of improvement?

A) 12 mL
B) 15 mL
C) 22 mL
D) 30 mL

Question 17

A child has a tracheal tube in place and will be receiving medications via this tube. Which of the following medications would the nurse expect to be administered in this manner? Select all answers that apply.

A) Lidocaine
B) Adenosine
C) Atropine
D) Dopamine
E) Epinephrine
F) Naloxone

Question 18

A group of students are reviewing information about respiratory arrest in children. The students demonstrate understanding of this information when they identify which of the following as a common cause involving the upper airway? Select all answers that apply.

A) Croup
B) Asthma
C) Pertussis
D) Epiglottitis
E) Pneumothorax

Question 19

The nurse is preparing the plan of care for a child experiencing respiratory distress. Which of the following would be the priority?

A) Providing supplemental oxygen
B) Monitoring for changes in status
C) Assisting ventilation
D) Maintaining a patent airway

Question 20

The nurse is providing care to a child who is intubated and the child's condition is deteriorating. Which of the following would the nurse do first?

A) Check if the tracheal tube is obstructed
B) Assess for displacement of the tracheal tube
C) Look for signs of a possible pneumothorax
D) Check the equipment for malfunction

Question 21

The nurse is providing care to a child experiencing shock. Which of the following intravenous solutions would the nurse expect to administer?

A) Ringer lactate
B) Dextrose 5% and water
C) Dextrose 5% and normal saline
D) Dextrose 10% and water

Question 22

A child is brought to the emergency department with a suspected poisoning. Which of the following would the nurse least likely expect to be used?

A) Gastric lavage
B) Syrup of ipecac
C) Activated charcoal
D) Whole bowel irrigation

Question 23

A group of students are working on a presentation for a local health fair about safety for children. When developing this presentation, the students would address which of the following as the most common cause of pediatric injury?

A) Sports
B) Firearm use
C) Falls
D) Automobile accidents

Question 24

As part of their orientation to their pediatric clinical rotation, an instructor is teaching a group of students how to perform cardiopulmonary resuscitation (CPR) on a child. Two students return demonstrate the skill using an infant manikin. Which of the following indicates the proper technique?

A) Compressing 30 times for every 2 breaths
B) Placing the heel of the hand on the midsternum
C) Giving 2 breaths followed by 15 compressions
D) Using two hands to perform chest compressions

Question 25

A child is undergoing rapid sequence intubation and is receiving atropine. The nurse understands that this agent is used to accomplish which of the following?

A) Lessen the vagal effects of intubation
B) Reduce intracranial pressure
C) Induce amnesia
D) Provide short-term paralysis