Question 1

Central cyanosis is associated with

Accepted Answer

A)  visible cyanosis but normal arterial oxygen saturation. 
B)  desaturation of arterial blood. 
C)  reduced hemoglobin of 15 g/dL. 
D)  permanent cerebral hypoxia. 
A)  visible cyanosis but normal arterial oxygen saturation. 
B)  desaturation of arterial blood. 
C)  reduced hemoglobin of 15 g/dL. 
D)  permanent cerebral hypoxia. B

Question 2

Which of the following drugs is used for weaning from iatrogenic narcotic dependency?

Accepted Answer

A)  Morphine 
B)  Fentanyl 
C)  Meperidine 
D)  Methadone 
A)  Morphine 
B)  Fentanyl 
C)  Meperidine 
D)  Methadone D

Question 3

Optimal treatment of a pediatric patient with status asthmaticus includes which of the following?

Accepted Answer

A)  Placing the patient in the knee-chest position 
B)  Extending the neck to promote opening of the airway 
C)  Giving humidified oxygen 
D)  Giving ?-adrenergic therapy 
E)  Giving corticosteroids 
A)  Placing the patient in the knee-chest position 
B)  Extending the neck to promote opening of the airway 
C)  Giving humidified oxygen 
D)  Giving ?-adrenergic therapy 
E)  Giving corticosteroids C,D,E

Question 4

A 3-year-old patient is being admitted to the critical care unit with the diagnosis of head trauma as the result of a motor vehicle accident.The nurse knows that the primary complications of head injuries include

Accepted Answer

A)  infection. 
B)  seizures. 
C)  hemorrhage. 
D)  cerebral bleeding. 
E)  brain herniation. 
A)  infection. 
B)  seizures. 
C)  hemorrhage. 
D)  cerebral bleeding. 
E)  brain herniation.

Question 5

A 4-year-old child is admitted to the critical care unit with fever,chills,headache,vomiting,lethargy,photophobia,and nuchal rigidity.The patient has been unable to eat,and tube feedings are to be initiated.The preferred method for determining the insertion length of the nasogastric tube is to measure from the

Accepted Answer

A)  naris to ear to xiphoid process. 
B)  ear to the umbilicus. 
C)  naris to the xiphoid to ear. 
D)  naris to ear to a point between the xiphoid process and the umbilicus. 
A)  naris to ear to xiphoid process. 
B)  ear to the umbilicus. 
C)  naris to the xiphoid to ear. 
D)  naris to ear to a point between the xiphoid process and the umbilicus.

Question 6

The initial setting on a manual defibrillator for a patient older than 1 year is

Accepted Answer

A)  100 joules. 
B)  360 joules. 
C)  2 joules/kg. 
D)  4 joules/kg. 
A)  100 joules. 
B)  360 joules. 
C)  2 joules/kg. 
D)  4 joules/kg.

Question 7

What is the daily fluid requirement for a 60-kg child?

Accepted Answer

A)  2600 mL/m² per day 
B)  1500 mL/m² per day 
C)  2400 mL/m² per day 
D)  3000 mL/m² per day 
A)  2600 mL/m² per day 
B)  1500 mL/m² per day 
C)  2400 mL/m² per day 
D)  3000 mL/m² per day

Question 8

Initial treatment for hypoxia,acidosis,or hypothermia is

Accepted Answer

A)  vasopressin. 
B)  bronchodilators. 
C)  oxygenation and ventilation. 
D)  hydration. 
A)  vasopressin. 
B)  bronchodilators. 
C)  oxygenation and ventilation. 
D)  hydration.

Question 9

What is the circulating blood volume of a neonate?

Accepted Answer

A)  40 to 60 mL/kg 
B)  75 to 80 mL/kg 
C)  80 to 85 mL/kg 
D)  65 to 70 mL/kg 
A)  40 to 60 mL/kg 
B)  75 to 80 mL/kg 
C)  80 to 85 mL/kg 
D)  65 to 70 mL/kg

Question 10

The pathophysiologic characteristic of a left-to-right shunt resulting from a congenital heart defect is

Accepted Answer

A)  decreased pulmonary blood flow. 
B)  mixed lesions with variable clinical symptoms. 
C)  increased pulmonary blood flow. 
D)  obstruction of blood flow to the ventricles. 
A)  decreased pulmonary blood flow. 
B)  mixed lesions with variable clinical symptoms. 
C)  increased pulmonary blood flow. 
D)  obstruction of blood flow to the ventricles.

Question 11

A 5-year-old boy has been admitted with severe asthma.His initial PaCO2 was 30 mm Hg.One hour later his PaCO2 is 45 mm Hg,and 1 hour after that,his PaCO2 is 56 mm Hg.Which of the following interventions would be anticipated?

Accepted Answer

A)  High-dose steroids 
B)  Chest percussion and vibration 
C)  Fluid resuscitation with normal saline 
D)  Mechanical ventilation 
A)  High-dose steroids 
B)  Chest percussion and vibration 
C)  Fluid resuscitation with normal saline 
D)  Mechanical ventilation

Question 12

What elements help a child cope successfully with a critical care crisis?

Accepted Answer

A)  An outside support system 
B)  Resilient personality 
C)  The health care team applying family-centered concepts to help the family cope with the illness 
D)  A supportive family 
E)  Treating the patient as an adult 
A)  An outside support system 
B)  Resilient personality 
C)  The health care team applying family-centered concepts to help the family cope with the illness 
D)  A supportive family 
E)  Treating the patient as an adult

Question 13

The nurse is caring for a 6-month-old infant who has had an apparent life-threatening event (ALTE).The nurse is aware that treatment of the infant after ALTE will include all of the following EXCEPT

Accepted Answer

A)  prone positioning. 
B)  supine positioning. 
C)  nasal continuous positive airway pressure. 
D)  continuous gavage feedings. 
A)  prone positioning. 
B)  supine positioning. 
C)  nasal continuous positive airway pressure. 
D)  continuous gavage feedings.

Question 14

The pathophysiologic consequences of respiratory syncytial virus include

Accepted Answer

A)  replacement of the epithelium with nonciliated tissue, leading to submucosal edema and eventual necrosis. 
B)  necrosis of the alveoli, resulting in collapse. 
C)  inflammation of the diaphragm, resulting in alveolar hypoventilation. 
D)  bronchoconstriction, resulting in severe airflow obstruction. 
A)  replacement of the epithelium with nonciliated tissue, leading to submucosal edema and eventual necrosis. 
B)  necrosis of the alveoli, resulting in collapse. 
C)  inflammation of the diaphragm, resulting in alveolar hypoventilation. 
D)  bronchoconstriction, resulting in severe airflow obstruction.

Question 15

Which of the following anatomic and physiologic findings are normal in infants younger than 1 year old?

Accepted Answer

A)  The epiglottis is large and floppy. 
B)  The basal metabolic rate is lower than that of an adult. 
C)  The size of the head is smaller compared with the rest of the body. 
D)  The hormonal and metabolic response to pain is the same as that of an adult. 
E)  A positive Babinski response is a normal finding. 
A)  The epiglottis is large and floppy. 
B)  The basal metabolic rate is lower than that of an adult. 
C)  The size of the head is smaller compared with the rest of the body. 
D)  The hormonal and metabolic response to pain is the same as that of an adult. 
E)  A positive Babinski response is a normal finding.

Question 16

Causes associated with the diagnosis status epilepticus include

Accepted Answer

A)  high fever. 
B)  encephalitis. 
C)  metabolic disorder. 
D)  meningitis. 
E)  gradual weaning of anticonvulsant drugs. 
A)  high fever. 
B)  encephalitis. 
C)  metabolic disorder. 
D)  meningitis. 
E)  gradual weaning of anticonvulsant drugs.

Question 17

The upper airway of an infant is different from that of an adult in that the infant's

Accepted Answer

A)  epiglottis is located lower than an adult's. 
B)  tongue is larger, and it fills the oral cavity. 
C)  larynx is tubular shaped with its narrowest portion at the epiglottis. 
D)  airway is more rigid than an adult's. 
A)  epiglottis is located lower than an adult's. 
B)  tongue is larger, and it fills the oral cavity. 
C)  larynx is tubular shaped with its narrowest portion at the epiglottis. 
D)  airway is more rigid than an adult's.

Question 18

A 3-month old infant presents with vomiting and diarrhea.The infant appears to be drowsy; his pulse rate is 180 beats/min; and he has had a dry diaper for the past 3 hours.The nurse suspects the patient has developed

Accepted Answer

A)  mild dehydration. 
B)  moderate dehydration. 
C)  a gastrointestinal virus. 
D)  severe dehydration. 
A)  mild dehydration. 
B)  moderate dehydration. 
C)  a gastrointestinal virus. 
D)  severe dehydration.

Question 19

To establish a patent airway in an infant or child younger than 2 years of age,the nurse would

Accepted Answer

A)  perform the head tilt/chin lift maneuver. 
B)  hyperextend the neck and pull the jaw forward. 
C)  place a towel under the upper shoulders with the jaw slightly extended into "sniffing" position. 
D)  place a folded towel under the head to extend the neck. 
A)  perform the head tilt/chin lift maneuver. 
B)  hyperextend the neck and pull the jaw forward. 
C)  place a towel under the upper shoulders with the jaw slightly extended into "sniffing" position. 
D)  place a folded towel under the head to extend the neck.

Question 20

The key to effective pain management is to perform a(n)

Accepted Answer

A)  behavioral assessment. 
B)  pain assessment. 
C)  physical assessment. 
D)  activity assessment. 
A)  behavioral assessment. 
B)  pain assessment. 
C)  physical assessment. 
D)  activity assessment.

Exam 40: The Pediatric Patient

Central cyanosis is associated with

Which of the following drugs is used for weaning from iatrogenic narcotic dependency?

Optimal treatment of a pediatric patient with status asthmaticus includes which of the following?

A 3-year-old patient is being admitted to the critical care unit with the diagnosis of head trauma as the result of a motor vehicle accident.The nurse knows that the primary complications of head injuries include

The initial setting on a manual defibrillator for a patient older than 1 year is

What is the daily fluid requirement for a 60-kg child?

Initial treatment for hypoxia,acidosis,or hypothermia is

What is the circulating blood volume of a neonate?

The pathophysiologic characteristic of a left-to-right shunt resulting from a congenital heart defect is

A 5-year-old boy has been admitted with severe asthma.His initial PaCO2 was 30 mm Hg.One hour later his PaCO2 is 45 mm Hg,and 1 hour after that,his PaCO2 is 56 mm Hg.Which of the following interventions would be anticipated?

What elements help a child cope successfully with a critical care crisis?

The nurse is caring for a 6-month-old infant who has had an apparent life-threatening event (ALTE).The nurse is aware that treatment of the infant after ALTE will include all of the following EXCEPT

The pathophysiologic consequences of respiratory syncytial virus include

Which of the following anatomic and physiologic findings are normal in infants younger than 1 year old?

Causes associated with the diagnosis status epilepticus include

The upper airway of an infant is different from that of an adult in that the infant's

A 3-month old infant presents with vomiting and diarrhea.The infant appears to be drowsy; his pulse rate is 180 beats/min; and he has had a dry diaper for the past 3 hours.The nurse suspects the patient has developed

To establish a patent airway in an infant or child younger than 2 years of age,the nurse would

The key to effective pain management is to perform a(n)

Critical Care Nursing Practice

Ethical Issues

Legal Issues

Genetics and Genomics in Critical Care

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Sleep Alterations and Management

Nutrition Alterations and Management

Pain and Pain Management

Sedation,Agitation,Delirium: Assessment and Management

End-Of-Life Issues

Cardiovascular Anatomy and Physiology

Cardiovascular Clinical Assessment

Cardiovascular Diagnostic Procedures

Cardiovascular Disorders

Cardiovascular Therapeutic Management

Pulmonary Anatomy and Physiology

Pulmonary Clinical Assessment

Pulmonary Diagnostic Procedures

Pulmonary Disorders

Pulmonary Therapeutic Management

Neurologic Anatomy and Physiology

Neurologic Clinical Assessment and Diagnostic Procedures

Neurologic Disorders and Therapeutic Management

Kidney Anatomy and Physiology

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Anatomy and Physiology

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Gastrointestinal Disorders and Therapeutic Management

Endocrine Anatomy and Physiology

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

Trauma

Shock,sepsis,and Multiple Organ Dysfunction Syndrome

Burns

Organ Donation and Transplantation

Hematologic Disorders and Oncologic Emergencies

The Obstetric Patient

The Older Adult Patient

The Perianesthesia Patient

Filters

A 5-year-old boy has been admitted with severe asthma.His initial PaCO₂ was 30 mm Hg.One hour later his PaCO₂ is 45 mm Hg,and 1 hour after that,his PaCO₂ is 56 mm Hg.Which of the following interventions would be anticipated?