ADD 3

Which of the following questions reflects the concept of the "teach-back" method?

"Would you repeat those instructions, so I can make sure I was clear?"

A 6-year-old child weighing 20 kg (44.1 lb) arrives in full arrest following an electrocution event. CPR is in progress after defibrillation for ventricular fibrillation. What is the intravenous dose of epinephrine for this patient?

0.01 mg (wrong) Remediation feedback: The pediatric dose of intravenous epinephrine during a cardiac arrest is 0.01 mg/kg.

A 5-year-old presents with sudden onset nausea, vomiting, abdominal cramping, hives, and hypotension after eating lunch. Which of the following is the priority intervention?

Intramuscular epinephrine

A term infant is delivered in the emergency department. Which assessment finding is most concerning?

Acrocyanosis (wrong) Remediation feedback: Normal findings for a newborn include a heart rate between 90-180 bpm, respiratory rate of 30-55 breaths/minute, and systolic blood pressure of 67-84 mm Hg. They may also exhibit acrocyanosis, particularly when in cool environments.

A 3-year-old has a two-day history of runny nose, low-grade fever, and a "barky" cough at night. The child is awake and alert with noted stridor. Pulse oximetry is 96% on room air. Which of the following interventions would be the most appropriated for this child?

Administration of nebulized epinephrine

A 4-week-old infant born prematurely is brought to the emergency department due to the rapid onset of abdominal distention, vomiting, bloody stools, and exhibiting signs of shock. Based on these findings, what condition should the nurse suspect?

Necrotizing enterocolitis

Which patient reflects an EMTALA compliant transfer?

An infant with respiratory difficulties being transferred to another hospital with the same level of pediatric care. Parents are not present, and records are copied. (wrong) Remediation feedback:

An anxious 12-year-old child presents to the emergency department with a sudden onset of nausea, diarrhea, abdominal cramping, flushing, and hypotension. Symptoms started about 60 minutes after lunch. Which of the following conditions is the most likely cause of these symptoms?

Anaphylaxis

A 6-year-old involved in a boating crash is awaiting admission for surgical repair of a fractured ankle. Which of the following manifestations during reassessments would cause the greatest concern for possible intra-abdominal trauma?

Constant left shoulder pain

A child with an injury to the lower cervical spine with spinal cord involvment would most likely demonstrate which of the following findings during assessment?

Decreased respiratory effort

An adolescent is awaiting ICU admission for pneumonia. During reassessment, which of the following findings would be most indicative that respiratory failure is developing?

Extreme lethargy

A 5-year-old presents with decreased level of consciousness and a wide complex and rapid rate on the electrocardiogram. Which of the following characteristics would indicate ventricular tachycardia as opposed to other tachydysrhythmias?

Heart rate between 120 to 200 beats/minute

A six-week-old infant presents to the emergency department with seizures. The infant is afebrile with a normal glucose level ,and caregivers report no signs of illness other than formula intolerance, which they treated by adding extra water to the formula. The nurse would expect to find which of the following laboratory abnormalities?

Hyponatremia

A school-aged child arrives in the emergency department with a 2-day history of vomiting. The child is cool and pale, with weak pulses, elevated heart rate, and capillary refill of 4 to 5 seconds. Which of the following is the priority intervention for the child?

Initiate a fluid bolus

Immediately following birth, a full-term neonate is not breathing and has a heart rate of 45 beats/minute. The neonate has been warmed, dried, stimulated, and suctioned without improvement. What the next step in resuscitation?

Initiate positive-pressure ventilation with 21% oxygen at 40-60 breaths per minute.

Which of the following is the recommended method of insulin administration for a pediatric patient with diabetic ketoacidosis?

Insulin infusion

A parent presents to the emergency department carrying her 12-week-old infant. The PAT reveals an infant who is quiet and opens eyes with stimulation, whose breathing is regular and even, and whose skin is pale, with a scattered vesicular rash. What is the priority intervention for this infant?

Obtain a full set of vital signs (wrong) Remediation feedback: An abnormal PAT in the presence of a rash should be considered life-threatening until proven otherwise and the patient placed in isolation.

A caregiver states their 3-year-old child ate some marijuana gummies approximately 3 hours prior to arrival. The PAT reveals the child is pink, difficult to arouse, and work of breathing is normal. What is your initial intervention?

Obtain a full set of vital signs (wrong) Remediation feedback: When assessing patients with a toxic ingestion, if the ABCs are within normal limits you move to Disability. You should check blood sugar for any altered level of consciousness.

After an explosion at a school, you are helping triage patients. In your field triage room you find a 5-year-old patient who is not breathing. What is the appropriate initial intervention?

Open the airway and assess for breathing.

During the assessment of a 16-year-old patient, the ED nurse identifies them as a potential sex trafficking victim. Which of the following trauma-informed care principles has the highest priority for this patient?

Physical and psychological safety

Which of the following is the priority intervention for the nurse caring for an immunocompromised pediatric patient with a fever?

Placement in a negative pressure room

A child was found unresponsive under the monkey bars during recess and arrives with the following assessment: eyes open only with supraorbital pressure stimulus, no verbal response is elicited, and withdraws arms and legs when a swab is inserted in the nose. Which of the following is the priority intervention for this child?

Prepare for immediate intubation

During your primary assessment of a 3-year-old, the child is pale, with a respiratory rate of 70 breaths/minute, costal retractions, poor air movement, and a pulse oximetry reading of 89%. What is the priority intervention for this patient?

Prepare for intubation

A 2-year-old arrives with parents stating the child may have ingested a button battery. The patient initially choked and coughed and is now drooling with bloody sputum. Which of the following is the priority intervention?

Prepare the patient for hospitalization

The triage nurse is assessing a 14 year old male who was brought in by ambulance. The patient reports he was playing his video games at home when he had a sudden onset of groin pain that was so severe he became nauseated and vomited. Further assessment reveals a swollen scrotum. What is the priority intervention for this patient?

Preparing the patient for ultrasound

A pediatric resuscitation has ended with the death of the child. Coroner notification has not been made yet. In dealing with the family of this child, how can the nurse facilitate their grieving process until legally required notification has been made?

Provide simple, straightforward information

A fertilizer silo exploded during a school tour of a working farm. The children are able to manage their own secretions but all are incontinent and salivating, with excess tearing. Which of the following is the priority intervention?

Removal of clothing and decontamination

Which of the following is the highest priority intervention for a well-appearing 2-month-old with a fever?

Urine culture

A 12-year-old complains of a severe headache for the past 8 hours. Which of the following past history disease processes would be considered a "red flag" and warrant immediate evaluation for this patient?

Sickle cell disease

Which of the following is a first-line treatment for atopic dermatitis?

Skin hydration therapy

A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is noted to have hypotension, tachycardia, and contusions and discoloration across the lap area. On exam a splenic rupture is suspected. Which of the following diagnoses should be suspected as a companion injury with these findings and associated mechanism of injury?

Subdural hematoma (wrong) Remediation feedback: A chance fracture (fracture of the lumbar spine) is often associated with belted passengers. Injuries associated with the "seatbelt sign" are small bowel, abdominal vasculature, ureteral, and splenic and liver injuries.

A parent brings in a 4-month-old infant reporting seizure-like activity at home. The parent denies a fever and reports that the infant is otherwise healthy. Which of the following is most important for the nurse to inquire about?

The likelihood of the infant ingesting a harmful substance (wrong) Remediation feedback: In infants less than six months of age with an otherwise normal exam, hyponatremia is the leading cause of new-onset non-febrile seizures. The most common contributing factor is over-dilution of infant formula.

Which of the following physiological changes in an infant increase the chances of drowning?

Weak neck muscles