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a) "Never let him out of your sight when outdoors."
Because they are curious and mobile, toddlers require direct observation and cannot be trusted to be
left alone, especially when outdoors. The priority guidance is to never let the child be out of sight.
Gating stairways, locking up chemicals, and not smoking around the child are excellent, but specific,
safety interventions. - ✔✔The nurse is teaching a first-time mother with a 14-month-old boy about
child safety. Which is the most effective overall safety information to provide guidance for the mother?
a) "Never let him out of your sight when outdoors."
b) "Don't smoke in the house or car."
c) "Put chemicals in a locked cabinet."
d) "Place a gate at the top of each stairway."
a) Call the local poison control center.
Not all poisons should be vomited. Strong acids, for example, could cause as much destruction of
tissue being vomited as being swallowed. The poison control center will provide the most accurate
information on the next steps for the client. - ✔✔When a poison has been ingested by a child, what
should the parents do first?
a) Call the local poison control center.
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b) Induce vomiting.
c) Get the child to an emergency facility.
d) Administer an emetic.
ANS: A
Airway management is the most critical element in pediatric emergency care. The other elements are
important, but airway is always the priority. - ✔✔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
ANS: A
Hypotension is a late sign of shock in children. The lower limit for systolic blood pressure for a child
more than 1 year old is 70 mm Hg plus two times the child's age in years. A systolic blood pressure of
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58 mm Hg calls for immediate action. The nurse should be direct in relaying the child's condition to
the physician. Comforting the child and assessing respiratory rate are not priorities. Assessing the
child's responsiveness is included in a neurologic assessment. It does not address the systolic blood
pressure of 58 mm Hg. Although this child most likely requires intravenous fluids, the physician must
be apprised of the systolic blood pressure so that appropriate intervention can be initiated. -
✔✔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.
ANS: A
The first intervention for a child in cardiopulmonary arrest, as for an adult, is to establish a patent
airway. Assessment of pulse follows establishment of a patent airway. Clothing may be removed from
the upper body for chest compressions after a patent airway is established. Reassuring the parents is
%
important, but the primary survey and associated interventions come first. - ✔✔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
ANS: A
The primary assessment consists of assessing the child's airway, breathing, circulation, level of
consciousness, and exposure (ABCDEs). Airway always comes first. History, vital signs, and pain
assessment are all part of the secondary survey - ✔✔A nurse is working triage in the emergency
department. A school-age child is brought in for treatment, carried by her mother. What assessment
takes priority?
a.
Assess airway patency.
b.
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