Deck 40: The Pediatric Patient

Question 1

The upper airway of an infant is different from that of an adult in that the infant's

A) epiglottis is located lower than an adult's.
B) tongue is larger, and it fills the oral cavity.
C) larynx is tubular shaped with its narrowest portion at the epiglottis.
D) airway is more rigid than an adult's.

Answer 1

tongue is larger, and it fills the oral cavity.

Question 2

Initial treatment for hypoxia,acidosis,or hypothermia is

A) vasopressin.
B) bronchodilators.
C) oxygenation and ventilation.
D) hydration.

Answer 2

oxygenation and ventilation.

Question 3

What is the daily fluid requirement for a 60-kg child?

A) 2600 mL/m² per day
B) 1500 mL/m² per day
C) 2400 mL/m² per day
D) 3000 mL/m² per day

Answer 3

1500 mL/m² per day

Question 4

Central cyanosis is associated with

A) visible cyanosis but normal arterial oxygen saturation.
B) desaturation of arterial blood.
C) reduced hemoglobin of 15 g/dL.
D) permanent cerebral hypoxia.

Question 5

The nurse is caring for a 6-month-old infant who has had an apparent life-threatening event (ALTE).The nurse is aware that treatment of the infant after ALTE will include all of the following EXCEPT

A) prone positioning.
B) supine positioning.
C) nasal continuous positive airway pressure.
D) continuous gavage feedings.

Question 6

The patient is a 1-month-old infant with stable supraventricular tachycardia (SVT)at a rate of 250 beats/min.She weighs 6 kg.How much adenosine should be given?

A) 0.05 mg rapid IV push
B) 0.1 mg rapid IV push
C) 0.6 mg rapid IV push
D) 0.5 mg rapid IV push

Question 7

A 4-year-old child is admitted to the critical care unit with fever,chills,headache,vomiting,lethargy,photophobia,and nuchal rigidity.Based on these clinical manifestations,what is the anticipated diagnosis?

A) Status epilepticus
B) Bacterial meningitis
C) Head trauma
D) Septic shock

Question 8

To establish a patent airway in an infant or child younger than 2 years of age,the nurse would

A) perform the head tilt/chin lift maneuver.
B) hyperextend the neck and pull the jaw forward.
C) place a towel under the upper shoulders with the jaw slightly extended into "sniffing" position.
D) place a folded towel under the head to extend the neck.

Question 9

A 4-year-old child is admitted to the critical care unit with fever,chills,headache,vomiting,lethargy,photophobia,and nuchal rigidity.The patient has been unable to eat,and tube feedings are to be initiated.The preferred method for determining the insertion length of the nasogastric tube is to measure from the

A) naris to ear to xiphoid process.
B) ear to the umbilicus.
C) naris to the xiphoid to ear.
D) naris to ear to a point between the xiphoid process and the umbilicus.

Question 10

A 4-year-old child is admitted to the critical care unit with fever,chills,headache,vomiting,lethargy,photophobia,and nuchal rigidity.Nursing management for this patient would include

A) measuring and documenting head circumference.
B) allowing the patient's siblings to visit.
C) isolating the patient during initial antibiotic treatment and for 24 hours thereafter.
D) administering anticonvulsant medications every 6 hours.

Question 11

A 3-month old infant presents with vomiting and diarrhea.The infant appears to be drowsy; his pulse rate is 180 beats/min; and he has had a dry diaper for the past 3 hours.The nurse suspects the patient has developed

A) mild dehydration.
B) moderate dehydration.
C) a gastrointestinal virus.
D) severe dehydration.

Question 12

The pathophysiologic consequences of respiratory syncytial virus include

A) replacement of the epithelium with nonciliated tissue, leading to submucosal edema and eventual necrosis.
B) necrosis of the alveoli, resulting in collapse.
C) inflammation of the diaphragm, resulting in alveolar hypoventilation.
D) bronchoconstriction, resulting in severe airflow obstruction.

Question 13

Which of the following drugs is used for weaning from iatrogenic narcotic dependency?

A) Morphine
B) Fentanyl
C) Meperidine
D) Methadone

Question 14

A 5-year-old boy has been admitted with severe asthma.His initial PaCO? was 30 mm Hg.One hour later his PaCO? is 45 mm Hg,and 1 hour after that,his PaCO? is 56 mm Hg.Which of the following interventions would be anticipated?

A) High-dose steroids
B) Chest percussion and vibration
C) Fluid resuscitation with normal saline
D) Mechanical ventilation

Question 15

The normal cerebral perfusion pressure in an infant is

A) 50 mm Hg.
B) 40 to 60 mm Hg.
C) unknown.
D) 60 mm Hg.

Question 16

The key to effective pain management is to perform a(n)

A) behavioral assessment.
B) pain assessment.
C) physical assessment.
D) activity assessment.

Question 17

The pathophysiologic characteristic of a left-to-right shunt resulting from a congenital heart defect is

A) decreased pulmonary blood flow.
B) mixed lesions with variable clinical symptoms.
C) increased pulmonary blood flow.
D) obstruction of blood flow to the ventricles.

Question 18

Which of the following methods can be used to establish an endotracheal tube size for a child younger than 2 years of age?

A) The endotracheal tube size is matched to the infant's age.
B) Take the child's age, add 16, and divide by 4.
C) Measure the length of the child's little finger and divide by 2.
D) Only one size is available; thus, no method is needed.

Question 19

What is the circulating blood volume of a neonate?

A) 40 to 60 mL/kg
B) 75 to 80 mL/kg
C) 80 to 85 mL/kg
D) 65 to 70 mL/kg

Question 20

The initial setting on a manual defibrillator for a patient older than 1 year is

A) 100 joules.
B) 360 joules.
C) 2 joules/kg.
D) 4 joules/kg.

Question 21

Which of the following anatomic and physiologic findings are normal in infants younger than 1 year old?

A) The epiglottis is large and floppy.
B) The basal metabolic rate is lower than that of an adult.
C) The size of the head is smaller compared with the rest of the body.
D) The hormonal and metabolic response to pain is the same as that of an adult.
E) A positive Babinski response is a normal finding.

Question 22

A 3-year-old patient is being admitted to the critical care unit with the diagnosis of head trauma as the result of a motor vehicle accident.The nurse knows that the primary complications of head injuries include

A) infection.
B) seizures.
C) hemorrhage.
D) cerebral bleeding.
E) brain herniation.

Question 23

Causes associated with the diagnosis status epilepticus include

A) high fever.
B) encephalitis.
C) metabolic disorder.
D) meningitis.
E) gradual weaning of anticonvulsant drugs.

Question 24

Optimal treatment of a pediatric patient with status asthmaticus includes which of the following?

A) Placing the patient in the knee-chest position
B) Extending the neck to promote opening of the airway
C) Giving humidified oxygen
D) Giving ?-adrenergic therapy
E) Giving corticosteroids

Question 25

What elements help a child cope successfully with a critical care crisis?

A) An outside support system
B) Resilient personality
C) The health care team applying family-centered concepts to help the family cope with the illness
D) A supportive family
E) Treating the patient as an adult