Question 1

What is the initial treatment for hypoxia,acidosis,or hypothermia?

Accepted Answer

A)  Vasopressin 
B)  Bronchodilators 
C)  Oxygenation and ventilation 
D)  Hydration 
A)  Vasopressin 
B)  Bronchodilators 
C)  Oxygenation and ventilation 
D)  Hydration C

Question 2

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 intervention would the nurse anticipate being ordered by the practitioner?

Accepted Answer

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

Question 3

What are the normal cerebral perfusion pressure values for a child?

Accepted Answer

A)  30 to 50 mm Hg 
B)  40 to 60 mm Hg 
C)  Values are unknown 
D)  60 to 100 mm Hg 
A)  30 to 50 mm Hg 
B)  40 to 60 mm Hg 
C)  Values are unknown 
D)  60 to 100 mm Hg C

Question 4

Which 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 reflex 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 reflex is a normal finding.

Question 5

Which medication is used for weaning a child with an opioid dependency?

Accepted Answer

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

Question 6

The patient is a 1-month-old infant with stable supraventricular tachycardia (SVT)at a rate of 250 beats/min.She weighs 6 kg.How much adenosine should be given?

Accepted Answer

A)  0.05 mg rapid IV push 
B)  0.1 mg rapid IV push 
C)  0.6 mg rapid IV push 
D)  0.5 mg rapid IV push 
A)  0.05 mg rapid IV push 
B)  0.1 mg rapid IV push 
C)  0.6 mg rapid IV push 
D)  0.5 mg rapid IV push

Question 7

What is the difference between the upper airway of an infant and that of an adult?

Accepted Answer

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

Question 8

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 9

A 3-year-old patient is admitted with head trauma as the result of a motor vehicle crash.The nurse knows that the complications of a head injury include which conditions?

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 10

What is the key to effective pain management in children?

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

Question 11

What is the initial setting on a manual defibrillator for a patient older than 1 year?

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 12

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

Accepted Answer

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

Question 13

What are the causes of status epilepticus in children?

Accepted Answer

A)  High fever 
B)  Encephalitis 
C)  Metabolic disorders 
D)  Meningitis 
E)  Gradual weaning of anticonvulsant drugs 
A)  High fever 
B)  Encephalitis 
C)  Metabolic disorders 
D)  Meningitis 
E)  Gradual weaning of anticonvulsant drugs

Question 14

The nurse is caring for a 6-month-old infant who is having frequent episodes of apparent life-threatening events (ALTEs).The practitioner has ordered a number of treatments for the patient.Which treatment would the nurse question as being inappropriate in this situation?

Accepted Answer

A)  Prone positioning 
B)  Moderate sedation 
C)  Nasal continuous positive airway pressure 
D)  Recurrent cutaneous stimulation 
A)  Prone positioning 
B)  Moderate sedation 
C)  Nasal continuous positive airway pressure 
D)  Recurrent cutaneous stimulation

Question 15

Which process is a pathophysiologic consequence of respiratory syncytial virus (RSV)?

Accepted Answer

A)  Replacement of the epithelium with nonciliated tissue resulting in submucosal edema and eventual necrosis 
B)  Necrosis of the alveoli resulting in collapse and destruction 
C)  Inflammation of the diaphragm resulting in alveolar hypoventilation 
D)  Bronchoconstriction resulting in airway inflammation and eventual airflow obstruction 
A)  Replacement of the epithelium with nonciliated tissue resulting in submucosal edema and eventual necrosis 
B)  Necrosis of the alveoli resulting in collapse and destruction 
C)  Inflammation of the diaphragm resulting in alveolar hypoventilation 
D)  Bronchoconstriction resulting in airway inflammation and eventual airflow obstruction

Question 16

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

Accepted Answer

A)  An outside support system 
B)  A resilient personality 
C)  Another child with the same illness 
D)  A supportive family 
E)  A fatalistic practitioner 
A)  An outside support system 
B)  A resilient personality 
C)  Another child with the same illness 
D)  A supportive family 
E)  A fatalistic practitioner

Question 17

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 18

Central cyanosis is associated with which phenomena?

Accepted Answer

A)  Decreased peripheral blood flow 
B)  Desaturation of arterial blood 
C)  Reduced hemoglobin of 15 g/dL 
D)  Permanent cerebral hypoxia 
A)  Decreased peripheral blood flow 
B)  Desaturation of arterial blood 
C)  Reduced hemoglobin of 15 g/dL 
D)  Permanent cerebral hypoxia

Question 19

What is the pathophysiologic characteristic of a left-to-right shunt resulting from a congenital heart defect?

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 20

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

Accepted Answer

A)  Initiate 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)  Initiate 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.

Exam 39: The Pediatric Patient

What is the initial treatment for hypoxia,acidosis,or hypothermia?

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 intervention would the nurse anticipate being ordered by the practitioner?

What are the normal cerebral perfusion pressure values for a child?

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

Which medication is used for weaning a child with an opioid dependency?

The patient is a 1-month-old infant with stable supraventricular tachycardia (SVT)at a rate of 250 beats/min.She weighs 6 kg.How much adenosine should be given?

What is the difference between the upper airway of an infant and that of an adult?

What is the circulating blood volume of a neonate?

A 3-year-old patient is admitted with head trauma as the result of a motor vehicle crash.The nurse knows that the complications of a head injury include which conditions?

What is the key to effective pain management in children?

What is the initial setting on a manual defibrillator for a patient older than 1 year?

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

What are the causes of status epilepticus in children?

The nurse is caring for a 6-month-old infant who is having frequent episodes of apparent life-threatening events (ALTEs).The practitioner has ordered a number of treatments for the patient.Which treatment would the nurse question as being inappropriate in this situation?

Which process is a pathophysiologic consequence of respiratory syncytial virus (RSV)?

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

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

Central cyanosis is associated with which phenomena?

What is the pathophysiologic characteristic of a left-to-right shunt resulting from a congenital heart defect?

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

Critical Care Nursing Practice

Ethical Issues

Legal Issues

Genetic Issues

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Nutrition Alterations and Management

Pain and Pain Management

Sedation,Agitation,and Delirium Management

End-Of-Life Care

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 and Oncologic Emergencies

The Obstetric Patient

The Older Adult Patient

The Perianesthesia Patient

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