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Cpnp-ac study With 100% ACCURATE QUESTIONS AND ANSWERS GRADED A+
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JACKLINEPNCB Acute Care questions With 100% ALL DETAILED CORRECT ANSWERS
Terms in this set (150)
B. Respiratory distress
In a child with myasthenia gravis, which of the
(Characterized by weakness and fatigue of skeletal muscle tissue that results from autoimmune
following symptoms would be MOST indicative of
destruction of acetylcholine receptors (AchR). A crisis event, or myasthenic crisis, is an acute
a myasthenic crisis?
exacerbation of the disease process that results in severe weakness from dysfunction of the
A. Eye drooling
neuromuscular junctions. It is characterized by respiratory failure due to weakness of the airway
B. Respiratory distress
or respiratory muscles.
C. Excessive salivation
A cholinergic crisis, is a severe weakness caused by overtreatment with cholinergic medications
D. Muscle fasciculation
used to treat MG & crisis present with excessive salivation, excessive lacrimation, diarrhea,
sweating, pupillary constriction, and muscle fasciculation.
A child with a history of congenital heart disease D. Propranolol (Inderal)
fell while playing and presents with a closed
fracture of the humerus. Physical exam reveals (Decreases heart rate, myocardial contractility, blood pressure, and myocardial oxygen demand.
mild bradycardia and a moderate pain score. Adverse effects include bradycardia, hypotension, and atrioventricular conduction disturbances)
Which of the following medications would MOST
likely explain this child's bradycardia?
A. Enalapril (Vasotec)
B. Furosemide (Lasix)
C. Levothyroxine (Synthroid)
PNCB Acute Care questions
1/39
,9/4/24, 2:46 AM
Enteral nutrition is initiated in a child with severe A. Phosphate 3.0 ml/dL & potassium 2.8 mEq/L
malnutrition. Laboratory values indicative of
refeeding syndrome include a magnesium level of (Refeeding syndrome occurs when malnourished patients are refed too aggressively leading. It
1.5 mg/dL, and: can occur within 1-3 days after reinstitution of nutrition.
A. Phosphate 3.0 ml/dL & potassium 2.8 mEq/L The major manifestations include fluid overload, hypophosphatemia (phosphate less than 3.5
B. Phosphate 3.0 ml/dL & potassium 6 mEq/L mg/dL), hypokalemia (potassium less than 3.5 mEq/L), hypomagnesemia (magnesium less than 1.8
C. Phosphate 7.0 ml/dL & potassium 2.8 mEq/L mg/dL), and thiamine deficiency. Complications include heart failure, dysrhythmias, respiratory
D. Phosphate 7.0 ml/dL & potassium 6 mEq/L muscle weakness, seizures,
When informing a family that a report is being A. Focus on the child's well being
made to Child Protective Services for suspected
abuse, it is MOST important to
A. Focus on the child's well being
B. Identify the suspected perpetrator
C. Identify legal requirements for mandatory
reporting
D. Share details with family to avoid
misunderstanding
Manifestations of abdominal injuries secondary to C. Delayed 8-36 hours after exposure
a blast mechanism are typically:
A. Acute & immediately apparent (Blast attack, as seen in explosions, causes extensive compression and distortion of the
B. Observed less than 6 hours after exposure gastrointestinal (GI) tract & other air-filled organs. Manifestations generally delayed, presenting
C. Delayed 8-36 hours after exposure 8-36 hours after exposure.)
D. Chronic & slow to develop
PNCB Acute Care questions
2/39
,9/4/24, 2:46 AM
A previously healthy preschooler who is fully D. Administer a fluid bolus & consult oncology
immunized, presents with a history of fever, URI
symptoms, & joint pain over the past several days. (The combination of leukocytosis, thrombocytopenia, and anemia should raise red flags for an
Physical exam reveals petechiae and oncologic process, most likely leukemia. After initial laboratory values are obtained, the child
hepatosplenomegaly. Vital signs include HR 156, should receive aggressive hydration.)
RR 32, temp 101.6 (38.7), BP 86/44 & O2 98% on
RA. Lab results include Na+ 132, K+ 6, Glucose 100,
Ca+ 0.95, Phos 6.3, WBC 105,000, Hgb 6.1 & Plt
10,000. Which is the BEST course of action?
A. Obtain LFTS & type & cross for blood products
B. Administer calcium gluconate & consult
nephrology
C. Obtain blood cultures & administer IV
Ceftriaxone
D. Administer a fluid bolus & consult oncology
An adolescent presents with bilateral knee pain C. Patellofemoral pain syndrome
that has occurred for several months, exacerbated
with activities such as climbing stairs and running. (Type of idiopathic anterior knee pain, common in adolescents. This type of knee pain worsens
Pain is also worsened by sitting with the knees with activity, especially going up and down stairs, and when sitting in one position for a
flexed for an extended time and is described as a prolonged period of time. Treatment involves an exercise program focusing on hip girdle and
grinding sensation under the kneecaps. No joint vastus medialis strengthening with lower extremity flexibility)
swelling is noted on examination. The MOST likely
diagnosis is:
A. Osgood-Schlatter disease
B. Osteochondritis dissecans
C. Patellofemoral pain syndrome
D. Popliteal cyst (Baker's cyst)
A toddler presents with vomiting and altered D. Ensure adequate airway protection
mental status after an ingestion of a large amount
of aspirin about 45 minutes ago. Prior to the
administration of activated charcoal, the PRIORITY
is to:
A. Obtain a urine drug screen
B. Ensure IV access
C. Obtain and EKG
D. Ensure adequate airway protection
PNCB Acute Care questions
3/39
, 9/4/24, 2:46 AM
Which of the following children is MOST at risk for B. Infant intubated for respiratory failure receiving a morphine infusion for 6 days
opiate withdrawal?
A. Infant intubated for respiratory failure receiving (Opiate withdrawal should be suspected in any child who has received opioids for a minimum of
Dexmedetomidine (Precedex) infusion for 5 days 3 days. After 5 days, approximately 50% of children are expected to experience some withdrawal
B. Infant intubated for respiratory failure receiving symptoms. When opiates are administered for >10 days, withdrawal should be expected in 100% of
a morphine infusion for 6 days patients)
C. Adolescent post-posterior spinal fusion
receiving hydromorphone via PCA for 3 days
D. Adolescent post-cardiac surgery receiving PO
oxycodone PRN for 2 days
Following an episode of gastroenteritis, a child is C. PT & OT
diagnosed with reactive inflammatory arthritis that
is affecting joints in the lower extremities. To (Maintain joint range of motion and strength of associated muscle groups, to decrease pain, and
maximize return to the previous level of mobility, to prevent contractures and deformities, all of which maximize the potential to return to the
the treatment plan should include: previous level of activity).
A. Weight-bearing exercise plan
B. Administration of corticosteroids
C. PT & OT
D. Calcium & vitamin D supplementation
Which of the following is the MOST likely D. Frequent temper tantrums
presentation of behavioral and psychiatric
disorders in a preschooler?
A. Fear of the dark
B. Issues with identity formation
C. Learning disabilities
D. Frequent temper tantrums
Routine preventive healthcare for an infant with B. Penicillin prophylaxis until 5 years of age
sickle cell disease includes
A. The MMR vaccine at 6 months of age
B. Penicillin prophylaxis until 5 years of age
C. Pneumococcal polysaccharide vaccine at 6
months of age
D. Sulfamethoxazole-trimethoprim prophylaxis
until 5 years of age
PNCB Acute Care questions
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