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NUNP 6541 Pediatric Final Exam Questions With Solved Solutions.
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Recommended treatment for RSV in a 7 month old (outpatient) - Answer Use of saline drops and suctioning of the nares. Indications of when to use antipyretics. Signs of respiratory distress or dehydration. Guidelines for feeding an infant with signs of mild respiratory distress which includes sma...

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  • October 14, 2024
  • 15
  • 2024/2025
  • Exam (elaborations)
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NUNP 6541 Pediatric Final Exam
Questions With Solved Solutions.
Recommended treatment for RSV in a 7 month old (outpatient) - Answer Use of saline drops and
suctioning of the nares. Indications of when to use antipyretics. Signs of respiratory distress or
dehydration. Guidelines for feeding an infant with signs of mild respiratory distress which includes
smaller more frequent feedings; monitoring of the respiratory rate; and guarding against vomiting. The
parents should be educated that the child may have the symptoms over the course of 2-3 weeks



Epiglottitis s/s - Answer Acute and rapid onset of high fever, chills, and toxicity. Severe sore throat and
drooling saliva. Will not eat or drink, muffled (hot potato) voice, and anxiety. Sitting posture with
hyperextended neck with open-mouth breathing. Stridor, tachycardia, and tachypnea



Epiglottitis prevention - Answer Haemophilus influenzae type B (Hib) vaccine



Steeple sign - Answer a radiologic sign found on radiograph where the subglottic tracheal narrowing
produces a shape of a church steeple which supports a diagnosis of croup



Foreign body aspiration antibiotic? - Answer Depends on the nature of the material aspirated, plus the
location and degree of obstruction. Bronchial or laryngeal foreign body aspiration, a bronchoscopy must
be performed for removal of the foreign body



Antibiotics for bronchiolitis? - Answer Use of saline drops and suctioning of the nares. There is no
evidence to support the routine use of antibiotics



Antibiotics for croup? - Answer Nebulized epinephrine, corticosteroids (dexamethasone oral or IM),
blow by oxygen or heliox in severe croup. Racemic epinephrine with the use of corticosteroids to limit
rebound swelling



Antibiotics for epiglottitis? - Answer Establish an airway preferably by nasotracheal intubation.
Administer IV antibiotics such as rocephin to cover H.influenzae. Administer oxygen and respiratory
support. Antibiotics should be continued for 10 days. Rifampin prophylaxis 20 mg/kg in a single dose
(maximum of 600 mg) for 4 days for infants and children, 600 mg once a day for adults for 4 days. Should
be provided for household contacts who are at risk (Younger than 4 years old who is non-immunized or

, incompletely immunized, children less than 12 months who have not received primary series of Hib, and
immunocompromised children.



Asthma treatment - Answer The pharmacological management of asthma in children is based on the
severity of asthma and the child's age. After initial control, decrease treatment to the least amount of
medication needed to maintain control. Systemic corticosteroids may be needed at any time and
stepped up if there is a major flare-up of symptoms.



Step 1 Asthma management for children 0-4 years old - Answer Step 1: SABA (Short acting beta2-
agonist) PRN: With viral respiratory symptoms short acting beta 2-agonist should be used every 4-6
hours up to 24 hours (longer with a physician consult). Consider short course of oral systemic
corticosteroids if severe exacerbation. Frequent use of SABA may indicate the need to step up treatment



Step 2 Asthma management for children 0-4 years old - Answer Step 2: Consider consultation with
asthma specialist. Low dose of inhaled corticosteroids.



Step 3 asthma mgmt for children 0-4 yrs - Answer Step 3: Medium-dose of inhaled corticosteroids



Steps 4-6 asthma mgmt for children 0-4 yrs - Answer Step 4: Medium-dose ICS and Long acting beta2-
agonist or montelukast.



Step 5: High dose ICS and Long acting beta 2-agonist or montelukast.



Step 6: High dose of ICS and LABA or montelukast and oral corticosteroids



Steps 1-3 asthma mgmt for children 5-11 yrs - Answer Step 1: SABA (Short acting beta 2-agonist) PRN:
Increasing the use of short-acting beta 2-agonist or use greater than 2 days a week for symptom relief
generally indicates inadequate control and the need to step up treatment.



Step 2: Consider consultation with asthma specialist. Low dose of inhaled corticosteroids.



Step 3: Low dose of inhaled corticosteroid and LABA. Or medium dose of inhaled corticosteroids.

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