Deck 39: The Pediatric Patient

Question 1

What is the initial treatment for hypoxia,acidosis,or hypothermia?

A) Vasopressin
B) Bronchodilators
C) Oxygenation and ventilation
D) Hydration

Answer 1

Oxygenation and ventilation

Question 2

What is the initial setting on a manual defibrillator for a patient older than 1 year?

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

Answer 2

2 joules/kg

Question 3

What is the key to effective pain management in children?

A) Behavioral assessment
B) Pain assessment
C) Physical assessment
D) Activity assessment

Answer 3

Pain assessment

Question 4

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

A) Match the endotracheal tube size 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) No method is needed, as only one size is available.

Question 5

Which medication is used for weaning a child with an opioid dependency?

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

Question 6

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 which condition?

A) Mild dehydration
B) Moderate dehydration
C) Desiccation
D) Severe dehydration

Question 7

What are the normal cerebral perfusion pressure values for a child?

A) 30 to 50 mm Hg
B) 40 to 60 mm Hg
C) Values are unknown
D) 60 to 100 mm Hg

Question 8

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

A) Initiate 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 with fever,chills,headache,vomiting,lethargy,photophobia,and nuchal rigidity.Based on these clinical manifestations,what diagnosis would the nurse anticipate?

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

Question 10

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 11

Central cyanosis is associated with which phenomena?

A) Decreased peripheral blood flow
B) Desaturation of arterial blood
C) Reduced hemoglobin of 15 g/dL
D) Permanent cerebral hypoxia

Question 12

A 5-year-old boy has been admitted with severe asthma.His initial PaCO₂ was 30 mm Hg.One hour later his PaCO₂ is 45 mm Hg,and 1 hour after that,his PaCO₂ is 56 mm Hg.Which intervention would the nurse anticipate being ordered by the practitioner?

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

Question 13

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 14

The nurse is caring for a 6-month-old infant who is having frequent episodes of apparent life-threatening events (ALTEs).The practitioner has ordered a number of treatments for the patient.Which treatment would the nurse question as being inappropriate in this situation?

A) Prone positioning
B) Moderate sedation
C) Nasal continuous positive airway pressure
D) Recurrent cutaneous stimulation

Question 15

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

Question 16

What is the difference between the upper airway of an infant and that of an adult?

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

Question 17

What is the pathophysiologic characteristic of a left-to-right shunt resulting from a congenital heart defect?

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

A 4-year-old child is admitted with fever,chills,headache,vomiting,lethargy,photophobia,and nuchal rigidity.Nursing management for this patient would include which intervention?

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 19

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.What is the preferred method for determining the insertion length of the nasogastric tube?

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

Question 20

Which process is a pathophysiologic consequence of respiratory syncytial virus (RSV)?

A) Replacement of the epithelium with nonciliated tissue resulting in submucosal edema and eventual necrosis
B) Necrosis of the alveoli resulting in collapse and destruction
C) Inflammation of the diaphragm resulting in alveolar hypoventilation
D) Bronchoconstriction resulting in airway inflammation and eventual airflow obstruction

Question 21

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

A) An outside support system
B) A resilient personality
C) Another child with the same illness
D) A supportive family
E) A fatalistic practitioner

Question 22

Which 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 reflex is a normal finding.

Question 23

A 3-year-old patient is admitted with head trauma as the result of a motor vehicle crash.The nurse knows that the complications of a head injury include which conditions?

A) Infection
B) Seizures
C) Hemorrhage
D) Cerebral bleeding
E) Brain herniation

Question 24

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

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

Question 25

What are the causes of status epilepticus in children?

A) High fever
B) Encephalitis
C) Metabolic disorders
D) Meningitis
E) Gradual weaning of anticonvulsant drugs