ENPC

Which of the following vital signs is the most consistent with an adolescent in neurogenic shock after a spinal cord injury?

Pulse 50 beats/minute, B/P 80/30

According to the American Academy of Pediatrics guidelines, which of the following describes how a neonate riding in a car should be positioned?

Rear facing in a convertible car seat until at least the age of 2

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

Removal of the clothing and decontamination

A 5 year old with no health problems presents to the ED with a sudden onset of chest pain and SOB. Parents state that the family was involved in a bad car crash one week ago. A thorough assessment and work up has not revealed any abnormalities. Which of the following steps is the best next step to take?

Repeat a head to toe exam to identify any missed traumatic injuries (NOT CORRECT)

Spinal shock results in which of the following transient conditions?

Pain at the site of injury and hyperesthesia above the level of injury

During the tertiary survey, the emergency nurse should continue to conduct reevaluations of the Pediatric Assessment Triangle (PAT), abnormal findings, and which of the following other assessment components?

Primary survey, vital signs, pain management, and effectiveness of therapeutic interventions

Which of the following describes a neonates normal position?

Flexion with extremities close to the body

The parents of a 5 year old child arrive at an ED. The child's lip and face are swollen with hives on face. The parents report the child ate peanut butter crackers in the last hour. The child has no known allergies. The nurse recognizes the findings are associated with:

Food allergy

The type of vascular access is appropriate in all of the patient situations except which of the following?

Peripherally inserted central catheter line for a one time fluid bolus

During the assessment of a 16 year old male patient the ED nurse identifies him as a possible sex trafficking victim. The trauma informed approach to care emphasizes certain principles in caring for these types of patients. Which of the following care principles has the highest priority?

Physical and psychological safety

Which of the following is the most appropriate intervention for a child experiencing a seizure?

Prepare to administer intranasal midazolam

Which of the following actions by the nurse promotes pediatric patient safety?

Preparing medications in a distraction free zone

Which of the following statements indicates the caregiver understands your discharge teaching on influenza?

"My child can go to daycare since they have been off Tylenol and fever free for 24 hours"

Which of the following indicates the need for additional parent/guardian education regarding UTI?

"My child will grow out of their frequent UTIs".

Which of the following patients should be evaluated first?

18 month old with bilious emesis

A 3 year old is brought to the emergency department with a 2 day history of a runny nose, low grade fever, and a "barky" cough at night. A caregiver tells the ED nurse that the coughing is getting worse. The child is awake and alert with stridor. The nurse should anticipate which of the following?

Administration of nebulized epinephrine

The emergency nurse is caring for a 14 year old patient who sustained a displaced fracture of the radius and ulna after falling from a bicycle. Which of the following pain interventions is most likely to result in improvement in symptoms?

Application of a splint to the affected extremity

An ambulance arrives with a 16 year old male who was involved in a dirt bike crash who was intubated prior to arrival. Which of the following is the priority assessment or intervention?

Assess the ET tube placement and patency

A 16 year old is noted to have external rotation and shortening of the left lower extremity and pain with palpation of the pelvis after being ejected from a motorcycle. Which of the following assessment findings is most concerning for a potentially life threatening condition?

Bony crepitus and instability with gentle anterior posterior compression

Which of the following patient presentations should increase suspicion of potential child maltreatment?

Bruising to the left ear of a newborn from sleeping on his side

In which of the following primary survey components can assessment of the fontanel provides the most useful information?

Circulation and disability

Which of the following would be an abnormal finding in a patient with glomerulonephritis?

Clear urine

A high school student who was pitching for his baseball team was hit in the chest by the ball and had a sudden cardiac arrest. Of the following, which is the most likely cause of the cardiac arrest?

Commotis cordis

A toddler has a chemical eye injury. Which of the following is a priority intervention?

Copious eye irrigation with an isotonic solution

A 6 month old is brought to the ED for recurrent respiratory infections. When gathering a history from the care giver, the emergency nurse learns that in addition to respiratory symptoms, the infant has had fatty stools. The emergency nurse should be concerned about which of the following disease processes?

Cystic fibrosis

A 4 day old who is brought to the ED with the parental complaint of "not acting right' is found to be hypoglycemic. The appropriate glucose concentration to administer to this neonate is which of the following?

D10

Which of the following statements about the assessment and management of pediatric hypovolemia is accurate?

Delayed cap refill is one reason to administer a fluid bolus

a 7 year old arrives via ambulance. The patients mother reports witnessing a seizure at home. The patient has no seizure history. Upon examination the patient is post-ictal with a heart rate of 142 bpm. Respiratory rate of 36 bpm, and B/P of 88/72. Significant burns are noted to the patients back and lower extremities. The mother states the burns accidentally occurred 3 days ago but she was afraid to bring the patient in due to an ongoing child welfare investigation. Which of the following are the most appropriate immediate interventions?

Draw and send a metabolic panel and a venous blood gas, administer a fluid bolus, and obtain a point of care glucose

A 15 year old patient has attempted suicide by overdosing on amitriptyline. The emergency nurse should expect which of the following symptoms?

Dysrhythmias

A 3 year old is rescued after being submerged in a residential pool for several minutes. On arrival at the ED he is responsive to painful stimuli, has slow respirations with diminished breath sounds throughout, and has an occasional cough. What is the initial management priority?

ET intubation with positive pressure ventilation

All of the vaccine administrations are appropriate EXCEPT which of the following?

Fifth Disease at 6 months

Which of the following interventions would the nurse anticipate for a pediatric patient with a fever and a history of a hematologic or oncologic condition?

IV antibiotics

A 5 year old presents to the ED with severe dehydration due to viral gastroenteritis. He has signs of shock due to his hypovolemia. Which of the following physiologic responses to shock has the greatest impact on improving cardiac output in the pediatric patient?

Increasing heart rate

Which of these is the priority intervention for a pediatric patient with DKA?

Insulin infusion

A 12 year old who was recently started on anti-psychotic medication for schizophrenia is brought to the ED with severe muscle rigidity and hyperthermia. These symptoms are most likely caused by which of the following?

Neuroleptic malignant syndrome

Which of the following tasks can the nurse do to decrease adverse medication events?

Obtain the patients weight in kg

A 2 year old has uniform demarcated burns to bilateral lower extremities, approximately 30% of the childs total body surface area. The father states he briefly left the room while the child was in the bath and the child apparently played with the faucet. Which of the following interventions has the highest priority?

Obtain vascular access for rapid fluid administration

Which of the following is a known cause of pediatric seizures?

Overdiluted formula

A 6 year old child presents to the ED with caregivers who report a cough with nasal congestion and pink eye that started 2 days ago. They have been treating with an OTC medicine without relief. Today they noticed a raised red rash on the face and papules in the mouth. You suspect which of the following?

Rubeola

A 14 year old patient presents to the ED with her aunt after being assaulted. The patient has multiple bruises inconsistent with the assault history and seems guarded with her answers. A urine test is positive for pregnancy although the patient denies being sexually active. The aunt repeatedly asks when they will be discharged. The ED nurse recognizes these findings as red flags for which of the following?

Sex trafficking

Acute chest syndrome, stroke, and splenic sequestration are complications of which of the following diseases?

Sickle cell anemia

The emergency nurse is caring for a patient with significant facial trauma and a suspected globe rupture. Which of the following medications would the nurse question?

Succinylcholine

Which of the following statements demonstrates a nurses understanding of pediatric submersion injuries?

The best indicator of survival after submersion is the duration of time of submersion

A 2 month old infant is brought to the ED. The mother states he has had trouble breathing for the past two days. The PAT reveals age-appropriate general appearance, rapid breathing with mild distress, and pink skin. Mucous is noted to both nares. Which of the following is the best next step?

Using a bulb syringe suction nasal passages

What is the priority intervention for symptomatic bradycardia in a 4 year old child?

Ventilation

A 5 year old child presents to the ED after being hit by a car. She complains of left upper quadrant pain and the focused assessment with sonography for trauma (FAST) exam shows fluid around her spleen. Which of the following would be an early indication of ongoing blood loss?

Widening pulse pressure (NOT CORRECT)

The neurosurgeon has decided to perform an invasive procedure in the emergency department to monitor the ICP on a 5 year old pt. The family does not speak English and has identified their religion as Muslim. Which of the following interventions is most supportive of the family?

A. allowing caregivers to remain with the pediatric pt B. allow the extended family members to serve as interpreters during the procedure c. dedicate a healthcare team member with a qualified interpreter to be with the family during the procedure d. provide access to a quiet area IDK MAYBE A

A nurse providing crisis intervention to the family of a seriously ill child can best keep the family informed of the childs condition by doing which of the following?

Appointing one staff member to communicate with them

You are discharging a patient home with a history of depression. Discharge teaching should include which of the following?

Ensuring all firearms in the house are locked up in a safe place with no access by the patient