ENPC 5th edition
Ask about any new bed-wetting or sleep disturbances
Pediatric patients with anxiety and PTSD may present with physical complaints. Assess for other behavioral symptoms to facilitate appropriate care and follow-up. - ANS A 5 year-old with no health problems presents to t...
Ask about any new bed-wetting or sleep disturbances
Pediatric patients with anxiety and PTSD may present with physical complaints. Assess for
other behavioral symptoms to facilitate appropriate care and follow-up. - ANS 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?
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 medications are under lock to prevent overdoses
or suicide attempt. - ANS You are discharging a patient to home with a history of depression.
Discharge teaching should include which of the following?
Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority interventions. - ANS 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?
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. - ANS A
7-year-old arrives via ambulance. The patient's mother reports witnessing 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?
ventilation to address hypoxia is the priority intervention. - ANS What is the priority intervention
for symptomatic bradycardia in a four-year-old child?
, 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 recreational sports such as baseball or ice
hockey." - ANS 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?
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 - ANS 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?
Increasing heart rate
Pathophysiology: Cardiac Output. In pediatric patients, cardiac out is primarily regulate by
increasing heart rate - ANS A 5-year-old patient presents to the emergency department with
severe dehydration due to viral gastroenteritis. He has signs of shock due to his hypovolemia.
Which of the following physiologic responses to shock has the greatest impact on improving
cardiac output in the pediatric patient?
Bruising to the left ear of a newborn from sleeping on his side
Pg 10- Any bruises in a non exploratory location (especially torso ears, neck) in children
younger than 4
Pg 11Any bruising in a child younger than 4 months. - ANS Which of the following patient
presentations should increase suspicion of potential child maltreatment?
Fifth Disease at 6 months
There is an animal vaccine, but not a human vaccine for Fifth Disease. - ANS All of the vaccine
administrations listed are appropriate EXCEPT for which of the following?
My child can go to daycare since they have been off of Tylenol and fever free for 24 hours.
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