Questions and Answers
What is the definition of Human chorionic gonadotropin?
Hormone produced during pregnancy
Which of the following manifestations would most likely rule out the potential of a primary etiology in a 7-year-old with new onset headaches? (Select all that apply)
What is a first-line treatment for atopic dermatitis?
Skin hydration therapy
Which assessment indicates appropriate measures were taken in treating a 9-month-old after a seizure?
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What is the estimated urinary output of a 4-month-old infant if the wet diaper weighs 22 grams?
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Which of the following assessment findings indicates that a 3-year-old's body is compensating for fluid loss after frequent emesis and diarrhea? (Select all that apply)
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A 4-year-old presents with symptoms suggesting diabetic ketoacidosis. Which of the following laboratory values would be most expected in this child?
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What is the definitive treatment for a suspected lower airway foreign body in an 18-month-old?
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After confirming return of spontaneous circulation in a child in cardiopulmonary arrest, what is the priority intervention?
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In a child with noisy breathing and wheezing, which medication should be administered first?
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What is the most likely diagnostic test for a 6-week-old presenting with fever and listlessness?
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Which intravenous medication order should be questioned before surgery for acute appendicitis?
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What is the most appropriate action for a nurse when a pregnant teenager presents with vaginal bleeding?
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What is the next best option for establishing vascular access in a 2-year-old in hypovolemic shock?
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What type of specimen sample provides visual information regarding a potential complication after an electrical injury?
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What intervention best ensures comfort and control for parents with an infant requiring multiple procedures?
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Which vital sign should be taken first on a stable infant?
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What is the best choice for topical anesthesia preparation for a toddler's arm laceration?
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What is the appropriate administration of N-acetylcysteine (NAC) for acetaminophen overdose?
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In a trauma situation, what order should prompt a nurse to discuss with the provider before proceeding?
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What is the most appropriate method for obtaining a urine sample for a child with foul-smelling urine and hypotension?
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What should be included in the plan of care for a child with bipolar disorder presenting with irritability?
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What should discharge teaching include for a patient with a history of depression?
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What is the priority intervention for a child experiencing hives and stridor after eating?
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Which pathologic process would be attributed to cystic fibrosis?
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What symptom indicates the need for intravenous rehydration in a 2-year-old with vomiting and diarrhea?
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What is a family-centered care concept?
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What should a nurse prepare for a child presenting with non-bilious vomiting, abdominal pain, and a palpable abdominal mass?
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How would you categorize an 18-month-old who is alert but not using their left arm?
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What assessment finding is expected in a patient with testicular torsion?
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What is the first emergent intervention for a child with traumatic respiratory distress and hypotension?
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What is the most likely intervention for a minimally responsive child with active bleeding post-trauma?
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What assessment finding indicates effective interventions for a child suspected of tension pneumothorax?
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What is the appropriate intervention for a child experiencing generalized tonic-clonic activity?
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What is the most likely cause of a midshaft femur fracture in a 6-month-old with blue-grey sclera?
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What should discharge instructions for a temporomandibular joint dislocation patient include?
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What physiologic response will most improve cardiac output in a child with severe dehydration?
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What is the priority in caring for a 8-year-old presenting with hallucinations and violent behavior?
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What type of neglect is exemplified by a child not receiving prescribed antiepileptic medications due to caregiver beliefs?
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What is the priority diagnostic for a 14-year-old with abnormal neurological signs and no history of trauma?
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Which finding leads an infant to be placed in isolation?
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What site is most effective for assessing bilateral breath sounds in an infant?
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What is the highest priority for a child presenting with poor oral intake, being pale and lethargic?
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What blood pressure finding indicates the need for a second fluid bolus in a dehydrated child?
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What should the nurse prioritize when caring for a 3-week-old with irritability and hypotonia?
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What is the priority intervention for a 10-year-old who lost consciousness after being hit in the chest with a ball?
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What laboratory tests should be prioritized for a 12-year-old with acute abdominal pain and nausea?
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Study Notes
Key Presentations and Emergency Interventions
- A 4-year-old with signs of dehydration, tachycardia, and Kussmaul respirations likely indicates diabetic ketoacidosis; expected lab results include a pH < 7.3 and elevated blood glucose > 200 mg/dL.
- In cases of suspected lower airway foreign bodies in children, an initial choking incident followed by worsening symptoms indicates a need for bronchoscopy instead of diagnostics.
- The priority intervention post-cardiopulmonary resuscitation in a child is establishing a secure airway.
- High-pitched wheezes in a child typically suggest asthma; a short-acting beta agonist should be administered first.
Assessment and Diagnostics
- For a 6-week-old infant showing signs of potential meningitis (fever and bulging fontanel), a lumbar puncture is crucial for diagnosis.
- Ketorolac should be questioned pre-operatively in a 12-year-old due to its risk of increased bleeding.
- The distressed parents of an infant in the ED should receive frequent updates and re-education to ensure comfort and control.
- A tachycardic, hypotensive child with non-bilious vomiting should be assessed for potential rehydration needs by measuring capillary refill.
Pediatric Emergencies and Conditions
- Electrical injuries can cause significant internal damage, evidenced by dark, red-tinged urine from myoglobin excretion.
- Urinary catheter placement is contraindicated in cases of suspected pelvic injury or blood at the urinary meatus.
- For a child with bipolar disorder presenting with agitation, conducting a suicide risk assessment is essential.
- The presence of abdominal pain, vomiting, and an irregular gait in a 14-year-old with Down syndrome necessitates cervical spine radiographs.
Treatment Protocols
- Administer intramuscular epinephrine immediately for severe allergic reactions presenting with stridor and swelling.
- N-acetylcysteine (NAC) for acetaminophen overdose should begin with a bolus infusion of 150 mg/kg.
- In children with severe dehydration from viral gastroenteritis, increased heart rate helps improve cardiac output.
- Skin hydration therapy is a first-line treatment for atopic dermatitis in pediatric patients.
Monitoring and Reassessment
- Reassessment of vital signs and clinical status is essential after fluid boluses; a drop in blood pressure indicates further intervention may be necessary.
- For infants with irritability and hypotonia, serum blood glucose levels must be prioritized to rule out hypoglycemia.
- Following a seizure, resolution of fever may indicate effective treatment and stabilization of the patient.
Special Considerations
- Triage in an ED requires isolation for infants with purpuric rashes due to possible meningitis.
- Any change in a child's condition post-injury, especially related to respiratory distress and altered heart rate, necessitates immediate emergent procedures like needle decompression for tension pneumothorax.
- Monitoring urinary output in infants can be calculated based on diaper weight; a wet diaper weighing 22 grams reflects an output of 22 mL.
Nursing Responsibilities
- Nurses should prioritize patient and staff safety when managing agitated or violent pediatric patients.
- Understanding the potential neglect cases, such as medical neglect due to failure to fill prescriptions, is crucial in child welfare assessments.
- Establishing a caring environment includes assessing cultural backgrounds in family-centered care.
Additional Notes
- In cases of neurological concerns or abnormal behaviors, obtaining appropriate diagnostic tests during ED visits is critical to ensure proper management and care.
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Description
Test your knowledge with flashcards designed for the Emergency Nursing Pediatric Course (ENPC) 6th Edition. This quiz focuses on clinical cases, including symptoms and expected laboratory values in pediatric emergencies. Perfect for nursing students and professionals preparing for certification.
