A 5-year-old child presents with hives, swelling of the lips and face, and stridor that developed
about an hour after eating lunch. The child has no known allergies. Which of the following is the
priority intervention?
A. Administer intramuscular epinephrine
B. Auscultate bilateral breath sounds
C. Insert an intravenous catheter
D. Administer inhaled albuterol - ANS A. Administer intramuscular epinephrine
An adolescent is awaiting ICU admission for pneumonia. During reassessment, which of the
following findings would be most indicative that respiratory failure is developing?
A. SpO2 of 94 % on room air
B. Widened pulse pressure
C. Extreme lethargy
D. Flash capillary refill - ANS A. SpO2 of 94 % on room air
A 3-year-old has a two-day history of runny nose, low-grade fever, and a "barky" cough at night.
The child is awake and alert with noted stridor. Pulse oximetry is 96% on room air. Which of the
following interventions would be the most appropriated for this child?
A. Delivery of humidified oxygen by nasal cannula
B. Administration of nebulized epinephrine
C. Suctioning secretions from the oropharynx
D. Administration of albuterol with a spacer - ANS B. Administration of nebulized epinephrine
A 14-year-old patient had a reduction of a temporomandibular joint dislocation in the ED. Which of
the following should be included in the discharge instructions?
A. Practice yawning three to four times a day
B. Resume eating a regular diet later today
C. Apply hot packs to the joint area for pain control
D. Use a nonsteroidal anti-inflammatory for pain control - ANS D. Use a nonsteroidal
anti-inflammatory for pain control
Which of the following parameters would indicate that appropriate post resuscitation
interventions were successfully carried out in the pediatric patient?
A. Pulse oximetry reading of 96%
B. Temperature of 99.8°F (37.6°C)
C. Capillary refill of < 1 second
D. Capnography reading of 60 mm Hg - ANS A. Pulse oximetry reading of 96%
An anxious 12-year-old child presents to the emergency department with a sudden onset of
nausea, diarrhea, abdominal cramping, flushing, and hypotension. Symptoms started about 60
minutes after lunch. Which of the following conditions is the most likely cause of these
symptoms?
A. Anaphylaxis
, B. Renal colic
C. Crohn's Disease
D. Menarche - ANS A. Anaphylaxis
An 8-year-old trauma patient suddenly develops increased respiratory distress with a rise in heart
rate from 112 beats/minute to 142 beats/minute associated with an abrupt hypotensive event.
Distention of the jugular veins is noted. Which of the following emergent interventions should be
anticipated first?
A. High flow oxygen
B. Drug assisted intubation
C. Chest tube insertion
D. Needle decompression - ANS D. Needle decompression
A 4-week-old infant born prematurely is brought to the emergency department due to the rapid
onset of abdominal distention, vomiting, bloody stools, and exhibiting signs of shock. Based on
these findings, what condition should the nurse suspect?
A. Necrotizing enterocolitis
B. Pyloric stenosis
C. Megacolon
D. Congenital diaphragmatic hernia - ANS A. Necrotizing enterocolitis
A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry mucous
membranes. Vital signs reveal deep respirations at 44 breaths per minute, BP of 70/44 mm Hg, and
HR of 144 beats per minute. Which of the following laboratory values would be most expected in
this child?
A. Hypoglycemia
B. Severe anemia
C. Low pH level
D. Elevated serum bicarbonate - ANS C. Low pH level
Which of the following pathologic processes would most likely be attributed to a primary
diagnosis of cystic fibrosis?
A. Hypernatremia
B. Constipation
C. Obesity
D. Epiglottitis - ANS B. Constipation
Which of the following is the highest priority intervention for a well-appearing 2-month-old with a
fever?
A. Lumbar puncture
B. Urine culture
C. Intravenous fluid bolus
D. Chest radiograph - ANS B. Urine culture
The caregivers of a 6-year-old report the child developed a cough with nasal congestion and
"pink-eye" that started two days ago. Today they noticed a raised, red rash on the face, and grey
papules in the mouth. Which of the following is the priority intervention for this patient?
A. Obtain a nasopharyngeal swab
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