Pediatric Emergency Questions Updated 2023.When a poison has been ingested by a child, the parents should be instructed to do which of the following first?
a) Induce vomiting.
b) Call the local poison control center.
c) Administer an emetic.
d) Get to an emergency facility. - ANSWER Call ...
Pediatric Emergency Questions Updated
2023.
When a poison has been ingested by a child, the parents should be instructed to do
which of the following first?
a) Induce vomiting.
b) Call the local poison control center.
c) Administer an emetic.
d) Get to an emergency facility. - ANSWER Call the local poison control center.
Correct
Explanation:
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 patient.
Assessment of a child reveals a tension pneumothorax. The nurse would prepare the
child for which of the following?
a) Needle thoracotomy
b) Suctioning
c) Intubation
d) Defibrillation - ANSWER Needle thoracotomy
Correct
Explanation:
A needle thoracotomy is indicated for tension pneumothorax to relieve the air collected
in the space. Intubation is indicated for apnea and in situations in which the airway
cannot be maintained. Suctioning would be indicated for excessive airway secretions
that influence airway patency. Defibrillation is used to stimulate or alter the heart's
electrical rhythm.
A 6-year-old girl who is being treated for shock is pulseless with an irregular heart rate
of 32 BPM. Choose the priority intervention:
a) Administer doses defibrillator shocks in a row
b) Initiate cardiac compressions
c) Give three doses of epinephrine
d) Defibrillate once followed by three cycles of cardiopulmonary resuscitation (CPR) -
ANSWER Initiate cardiac compressions
Correct
Explanation:
The American Heart Association (AHA) emphasizes the importance of cardiac
compressions in pulseless clients with arrhythmias, making this the priority intervention
,in this situation. Current AHA recommendations are for defibrillation to be administered
once followed by five cycles of CPR. The AHA now recommends against using multiple
doses of epinephrine because they have not been shown to be helpful and may actually
cause harm to the child.
A 3-year-old girl had a near-drowning incident when she fell into a wading pool. Which
intervention would be of the highest priority?
a) Inserting a nasogastric tube to decompress stomach
b) Assuring the child stays still during an X-ray
c) Suctioning the upper airway to ensure airway patency
d) Covering the child with warming blankets - ANSWER Suctioning the upper airway to
ensure airway patency
Correct
Explanation:
Due to the potentially devastating effects of drowning-related hypoxia on a child's brain,
airway interventions must be initiated immediately. The child's airway should be
suctioned to ensure patency. Other interventions such as covering the child with
blankets, inserting a nasogastric tube, and assuring that the child remains still during X-
ray are interventions that are appropriate once airway patency is achieved and
maintained.
The nurse is preparing an in-service program on pediatric cardiopulmonary
resuscitation. The nurse would include a discussion that cardiopulmonary arrest in
infants and children is most likely the result of which of the following?
a) Underlying heart disease
b) Respiratory failure
c) Neurologic trauma
d) Lethal arrhythmia - ANSWER Respiratory failure
Correct
Explanation:
Cardiopulmonary arrest in infants and children typically results from disorders that lead
to respiratory failure and shock. In adults, the most common causes of cardiopulmonary
arrest are lethal arrhythmias secondary to heart disease. Although neurologic trauma
can lead to respiratory failure, it alone is not the most likely factor.
A 13-year-old girl suffered a serious fall while hiking with friends and injured her head.
She is now being evaluated by a nurse in the emergency room. The nurse notices clear
fluid flowing from the girl's nose. The girl's friend said that she had been suffering from
pollen allergy recently. Which of the following interventions should the nurse implement
to determine whether the fluid is cerebrospinal fluid (CSF) or rhinitis from an allergy?
a) Evaluate the client's level of consciousness
b) Assess the client's blood pressure
c) Perform a skull x-ray
, d) Test the fluid with a glucose reagent strip - ANSWER Test the fluid with a glucose
reagent strip
Correct
Explanation:
Rhinorrhea or otorrhea (clear fluid draining from the nose or ear, respectively) may be
noticeable. The fluid is cerebrospinal fluid (CSF) and is a serious finding because it
means that the child's central nervous system is open to infection. If it's not clear if the
fluid is CSF or rhinitis from an allergy, test the fluid with a glucose reagent strip. CSF will
test positive for glucose, whereas the clear, watery drainage from an upper respiratory
tract infection or allergy will not. The other interventions would not help determine
whether the fluid was CSF or rhinitis.
Which medication is used for symptomatic bradycardia unresponsive to ventilation and
oxygenation?
a) Atropine
b) Naloxone
c) Sodium bicarbonate
d) Calcium carbonate - ANSWER Atropine
Correct
Explanation:
Atropine is used for symptomatic bradycardia unresponsive to ventilation and
oxygenation. Sodium bicarbonate is used for metabolic acidosis. Naloxone reverses the
effect of opioids. Calcium carbonate is used for documented or suspected
hypocalcemia, hyperkalemia, hypermagnesemia, and calcium channel blocker
overdose.
The nurse must calculate the adolescent's cardiac output. The child's heart rate is 76
beats per minute and the stroke volume is 75 mL. Calculate the child's cardiac output. -
ANSWER 5700
Explanation:
Cardiac output (CO) is equal to heart rate (HR) times ventricular stroke volume (SV).
That is, CO = HR x SV 76 beats per minute x 75 mL = 5,700
A 4-year-old girl has been admitted to the emergency department after accidently
ingesting a cleaning product. Which of the following treatments is most likely
appropriate in the immediate treatment of the girl's poisoning?
a) Intravenous rehydration
b) Administration of activated charcoal
c) Gastric lavage
d) Inducing vomiting - ANSWER Administration of activated charcoal
Correct
Explanation:
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