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?

Accepted Answer

D

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?

Accepted Answer

B

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?

Accepted Answer

Ventilating the child with a bag-valve-mask is the most appropriate immediate action to address cyanosis and respiratory distress, ensuring adequate oxygenation.

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?

Accepted Answer

PALS emphasizes the importance of early recognition and management of compensated shock to prevent progression to decompensated shock, which is critical in pediatric care.

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?

Accepted Answer

Monitoring oxygen saturation levels is a priority to ensure the child is receiving adequate oxygen, which is critical in trauma situations to prevent hypoxia and further complications.

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?

Accepted Answer

The answer of The parents bring their 3-year-old son to...

Question 7

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

Accepted Answer

In a situation involving profound bradycardia, especially in a pediatric patient, the first step is to ensure adequate oxygenation. Providing oxygen at 100% is a critical initial intervention to support the child's cardiovascular status and improve oxygen delivery to tissues. Oxygenation takes precedence over other interventions like medication administration, warming, or gastric lavage in the acute management of bradycardia.

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?

Accepted Answer

A yellow display on a CO2 monitor indicates the presence of exhaled carbon dioxide, confirming that the ET tube is in the trachea and not the esophagus.

Question 9

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

Accepted Answer

The answer of Which intervention would be most helpful in...

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?

Accepted Answer

Using a defibrillator to reduce heart rate is least appropriate in this scenario because defibrillators are used for life-threatening cardiac arrhythmias, not for managing elevated heart rate due to pain or infection.

Question 11

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

Accepted Answer

The initial dose for defibrillation in children is 2 joules/kg. The child weighs 51 lbs, which is approximately 23 kg (since 1 kg ≈ 2.2 lbs). Therefore, 23 kg * 2 joules/kg = 46 joules.

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?

Accepted Answer

Periodic breathing is characterized by a pattern of breathing that includes regular breathing, followed by brief periods of apnea, and then tachypnea, which is what the infant is experiencing.

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?

Accepted Answer

For a 2-year-old child, the appropriate tracheal tube size is typically calculated using the formula (age/4) + 4, which results in a size of approximately 4.5.

Question 14

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

Accepted Answer

Flattened or absent P waves can indicate supraventricular tachycardia, as the rapid heart rate can cause the P waves to be obscured or merged with the T waves.

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?

Accepted Answer

Placing a small towel under the shoulders of an infant helps to maintain a neutral airway position without causing hyperextension, which is crucial for keeping the airway open in infants.

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?

Accepted Answer

An hourly urinary output of 30 mL is most indicative of improvement in a child, as a general guideline for adequate urinary output is about 1 mL/kg/hour for children. Given the child weighs 53 lbs (approximately 24 kg), an output of 30 mL/hour meets this criterion, suggesting better kidney function and fluid balance.

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.

Accepted Answer

Medications such as Lidocaine, Atropine, Epinephrine, and Naloxone can be administered via a tracheal tube as part of emergency protocols or when intravenous access is not available. These medications are chosen for their ability to be absorbed through the tracheal mucosa and exert their effects rapidly in critical situations.

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.

Accepted Answer

Croup and epiglottitis are conditions that involve the upper airway and can lead to respiratory arrest in children.

Question 19

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

Accepted Answer

Maintaining a patent airway is the priority in managing a child experiencing respiratory distress, as it is essential for effective breathing and oxygenation, following the airway, breathing, circulation (ABC) priority setting framework in emergency care.

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?

Accepted Answer

Assessing for displacement of the tracheal tube is the first step in the "DOPE" mnemonic (Displacement, Obstruction, Pneumothorax, Equipment failure) used to assess and manage a deteriorating patient with an artificial airway.

Quiz 51: Nursing Care During a Pediatric Emergency