1. Ask about any new bed-wetting or sleep disturbances
Pediatric patients with anxiety and PTSD may present with physical com-
plaints. Assess for other behavioral symptoms to facilitate appropriate
care and follow-up✔✔✔ A 5 year-old with no health problems presents
to the Emergency Department with a sudden onset of chest pain and
shortness of breath. Parents state that the family was involved in a
bad car crash one week ago. A thorough assessment and workup has
not revealed any abnormalities. Which of the following steps is the
best next step to take?
2. Ensuring all firearms in the home are locked in a safe place with no
access by the patient.
Promoting injury prevention with caregivers of patients with a history of
depression or suicidal ideation by encouraging that all firearms and med-
ications are under lock to prevent overdoses or suicide attempt✔✔✔ You
are discharging a patient to home with a history of depression.
Discharge teaching should include which of the following?
3. Obtain vascular access for rapid fluid administration
1/
,Rapid vascular access and fluid administration are the priority interven-
tions✔✔✔ A 2-year old has uniformly demarcated burns to bilateral
lower extremities, approximately 30% of the childs total body surface
area. The father states he briefly left the room while the child was in
the bath and the child apparently played with the faucet. Which of the
following interventions has the highest priority?
4. Draw and send a metabolic panel and venous blood gas, administer a
fluid bolus, and obtain a point of care glucose
Electrolyte imbalances need to be identified and treated to prevent another
seizure✔✔✔ A 7-year-old arrives via ambulance. The patient's mother
reports wit- nessing a seizure at home. The patient has no seizure
history. Upon examination, the patient is post-ictal with a heart rate of
142 beats per minute, respiratory
rate of 36 breaths per minute, and blood pressure of 86/72 mm Hg.
Significant burns are noted to the patient's back and lower extremities.
The mother states the burns accidentally occurred 3 days ago, but she
was afraid to bring patient in due to an ongoing child welfare
investigation. Which of the following are the MOST appropriate
immediate interventions?
5. ventilation to address hypoxia is the priority intervention✔✔✔ What
is the priority intervention for symptomatic bradycardia in a four-
year-old child?
2/
, 6. Commotio cordis
Comotio Cordis "occurs when chest is struck during the refractory period
of the cardiac conduction cycle. This type of injury usually occurs in
recreation- al sports such as baseball or ice hockey.": A 14-year-old high
school student who was pitching for his baseball team was hit in the
chest by the ball and had
a sudden cardiac arrest. Of the following, which is the most likely
cause of the cardiac arrest?
7. Focused Assessment: Vital Signs: "As the patient compensates for
altered tissue perfusion, the pulse pressure narrows and the heart rate
increases" - (need to rewrite either the question or the answers)
Widening Pulse pressure - not correct (suppose to be narrow pulse
pressure) Bradycardia - not correct
Decreasing diastolic blood pressure - late sign
Weak peripheral pulses - late sign: A 5-year-old child presents to the
emergency department after being hit by a car. She complains of left
upper quadrant pain and the focused assessment with sonography for
trauma (FAST) exam shows fluid around her spleen. Which of the
following findings would be an early indication of ongoing blood loss?
8. Increasing heart rate
Pathophysiology: Cardiac Output. In pediatric patients, cardiac out is pri-
marily regulate by increasing heart rate: A 5-year-old patient presents
3/
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