ENPC 4th Edition Study test in depth Examination and 100% correctly verified Solutions Latest version 2024/2025
A 2-year-old has a suspected cervical spinal injury. In order to ensure neutral spinal alignment, padding should be placed under which area
A. Shoulders
Rationale: The younger child ...
ENPC 4th Edition Study test in depth
Examination and 100% correctly
verified Solutions Latest version
2024/2025
A 2-year-old has a suspected cervical spinal injury. In order to
ensure neutral spinal alignment, padding should be placed under
which area
A. Shoulders
Rationale: The younger child has a larger head proportionally to
the body and when lying supine is naturally in a position of
cervical flexion. Padding under the shoulders or upper torso will
bring the cervical spine into neutral alignment. The shoulder
should be horizontally aligned with the external auditory meatus
B. Head
Rationale: Padding under the head will exacerbate this flexion
C. Neck
Rationale: Padding under the neck will not correct the anatomic
flexion
D. Waist
Rationale: Padding under the waist will not affect the cervical
spinal alignment - correct answer A. Shoulders
Rationale: The younger child has a larger head proportionally to
the body and when lying supine is naturally in a position of
cervical flexion. Padding under the shoulders or upper torso will
bring the cervical spine into neutral alignment. The shoulder
should be horizontally aligned with the external auditory meatus
,The nurse is preparing to administer a feeding through a
nasogastric feeding tube. The tube position was verified by
radiograph after insertion 2 hours ago. What is the best way to
verify placement before feeding
A. Instill air and listen over the epigastrium
Rationale: The research regarding verification of gastric or
feeding tube placement has demonstrated that the standard
method of instillation of air and auscultation over the
epigastrium for gurgling has been associated with improper
placement and adverse outcomes
B. Test the ph of the gastric contents
Rationale: The research regarding verification of gastric or
feeding tube placement has demonstrated that the standard
method of instillation of air and auscultation over the
epigastrium for gurgling has been associated with improper
placement and adverse outcomes. The use of ph testing had been
demonstrated to be safer and has been adopted as policy in many
institutions
C. Observe color of a gastric aspirate sample
Rationale: Aspiration of gastric contents is done to perform ph
testing, not observation of color
D. Repeat the radiograph
Rationale: Verification of placement by radiograph is generally
done initially, but subsequent verifications are better established
by ph testing - correct answer B.) Test the ph of the gastric
contents.
Rationale: The research regarding verification of gastric or
feeding tube placement has demonstrated that the standard
method of instillation of air and auscultation over the
epigastrium for gurgling has been associated with improper
placement and adverse outcomes. The use of ph testing had been
,demonstrated to be safer and has been adopted as policy in many
institutions
What is the best method to rapidly administer a 20 ml/kg bolus of
0.9% normal saline to a pediatric patient weighing 8 kg
A. A 20-ml syringe with a stopcock
Rationale: With a 20-ml syringe and a three-way stopcock, the
nurse can quickly deliver an appropriate bolus of 0.9% normal
saline by drawing up and administering 20 ml once for each
kilogram of the pediatric patient's weight or 8 times for this
patient
B. A syringe pump
Rationale: A syringe pump is good for medication administration
that needs to infuse over time, but it will take longer than the
method using a 20-ml syringe and a stopcock
C. A rapid infuser
Rationale: Rapid infuser devices are used on patients weighing at
least 25 kg and receiving a minimum of 500ml. This patient does
not meet either requirement for use
D. A pressure bag
Rationale: A pressure bag is sometimes quite useful in
administering a large amount of fluid; however, the higher
pressures generated may result in venous rupture in younger
children - correct answer A.) A 20-ml syringe with a stopcock.
Rationale: With a 20-ml syringe and a three-way stopcock, the
nurse can quickly deliver an appropriate bolus of 0.9% normal
saline by drawing up and administering 20 ml once for each
kilogram of the pediatric patient's weight or 8 times for this
patient
, Immediately after intraosseous insertion the nurse assesses the
infusion and notes that the fluid is not dripping. How should the
nurse respond
A. Use an infusion pump to deliver the fluids
Rationale: Fluids infusing through an intraosseous device do not
necessarily run by gravity. The use of an infusion pump is usually
required
B. Remove the device and insert in another site
Rationale: Fluids infusing through an intraosseous device do not
necessarily run by gravity. This does not mean it is nonfunctional
and removal is not indicated
C. Advance the device and reassess the flow
Rationale: Advancing the device if it is currently correctly placed
may penetrate the far wall of the bone and produce infiltration
D. Attempt to aspirate bone marrow
Rationale: Aspiration of bone marrow confirms correct
placement of an intraosseous device, but lack of return is not a
sign of incorrect placement. Bone marrow aspiration is not
always possible in some severely dehydrated
Pediatric patients - correct answer A.) Use an infusion pump
to deliver the fluids
Rationale: Fluids infusing through an intraosseous device do not
necessarily run by gravity. The use of an infusion pump is usually
required
A 13-month-old presents to the emergency department with a 2-
day history of a low-grade fever, increased work of breathing,
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