C HAPTER 39: T HE P EDIATRIC P ATIENT
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. Central cyanosis is associated with which phenomena?
a. Decreased peripheral blood flow
b. Desaturation of arterial blood
c. Reduced hemoglobin of 15 g/dL
d. Permanent cerebral hypoxia
ANS: B
Cyanosis is visible when hemoglobin is reduced by 5 g per 100 mL of
blood. C yanosis associated with desaturation of arterial blood is called
central cyanosis. Peripheral cyanosis is a condition in which cyanosis
exists but the child has normal arterial oxygen saturation.
DIF: Cognitive Level: Understanding REF: p. 952
OBJ: Nursing Process Step: Assessment TOP:
Pediatrics MSC: NC LEX: Physiologic Integrit y
2. What is the initial treatment for hypoxia, acidosis, or hypothermia?
a. Vasopressin
b. Bronchodilators
c. Oxygenation and ventilation
d. Hydration
, ANS: C
Bradycardia can result from hypoxia, acidosis, or hypothermia.
Bradycardia is defined as a cardiac rate less than 100 beats/min for an
infant and less than 60 beats/min for a child. Treatment initially
includes adequate oxygenation and ventilation for the pediatric patient.
DIF: Cognitive Level: Under standing REF: p. 953
OBJ: Nursing Process Step: Evaluation TOP:
Pediatrics MSC: NC LEX: Physiologic Integrit y
3. What is the initial setting on a manual defibrillator for a patient older than
1 year?
a. 100 joules
b. 360 joules
c. 2 joules/kg
d. 4 joules/kg
ANS: C
On a manual defibrillator, the initial dose of electricit y is 2 joules/kg.
If using an automated external defibrillator, this should onl y be used
for children older than 1 year. Immediately after the shock,
cardiopulmonary resuscitation should be resumed for 2 minutes (five
cycles). The compressions support the heart while it is in a recovery
state even if a perfusion rhythm has returned.
, DIF: Cognitive Level: Remembering REF: p. 955
OBJ: Nursing Process Step: Intervention TOP:
Pediatrics MSC: NC LEX: Physiologic Integrit y
4. A 4-year-old child is admitted with fever, chills, headache, vomiting,
lethargy, photophobia, and nuchal rigidity. Based on these clinical
manifestations, what diagnosis would the nurse anticipate?
a. Status epilepticus
b. Bacterial meningitis
c. Head trauma
d. Septic shock
ANS: B
The clinical manifestations of bacterial meningitis include fever,
chills, headache, vomiting, irritabilit y or lethargy, photophobia, nuchal
rigidit y, and positive Kernig or Brudzinski sign. In meningococcemia,
petechiae and purpura may be observed on the child. The late stages of
this disease may produce an increased intracranial pressure and
cardiovascular collapse.
DIF: Cognitive Level: Appl ying REF: p. 957 OBJ:
Nursing Process Step: Evaluation TOP: Pediatrics MSC:
NCLEX: Physiologic Integrit y
5. A 4-year-old child is admitted with fever, chills, headache, vomiting,
lethargy, photophobia, and nuchal rigidity. Nursing management for this
patient would include which intervention?
a. Measuring and documenting head ci rcumference
b. Allowing the patient’s siblings to visit
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. Central cyanosis is associated with which phenomena?
a. Decreased peripheral blood flow
b. Desaturation of arterial blood
c. Reduced hemoglobin of 15 g/dL
d. Permanent cerebral hypoxia
ANS: B
Cyanosis is visible when hemoglobin is reduced by 5 g per 100 mL of
blood. C yanosis associated with desaturation of arterial blood is called
central cyanosis. Peripheral cyanosis is a condition in which cyanosis
exists but the child has normal arterial oxygen saturation.
DIF: Cognitive Level: Understanding REF: p. 952
OBJ: Nursing Process Step: Assessment TOP:
Pediatrics MSC: NC LEX: Physiologic Integrit y
2. What is the initial treatment for hypoxia, acidosis, or hypothermia?
a. Vasopressin
b. Bronchodilators
c. Oxygenation and ventilation
d. Hydration
, ANS: C
Bradycardia can result from hypoxia, acidosis, or hypothermia.
Bradycardia is defined as a cardiac rate less than 100 beats/min for an
infant and less than 60 beats/min for a child. Treatment initially
includes adequate oxygenation and ventilation for the pediatric patient.
DIF: Cognitive Level: Under standing REF: p. 953
OBJ: Nursing Process Step: Evaluation TOP:
Pediatrics MSC: NC LEX: Physiologic Integrit y
3. What is the initial setting on a manual defibrillator for a patient older than
1 year?
a. 100 joules
b. 360 joules
c. 2 joules/kg
d. 4 joules/kg
ANS: C
On a manual defibrillator, the initial dose of electricit y is 2 joules/kg.
If using an automated external defibrillator, this should onl y be used
for children older than 1 year. Immediately after the shock,
cardiopulmonary resuscitation should be resumed for 2 minutes (five
cycles). The compressions support the heart while it is in a recovery
state even if a perfusion rhythm has returned.
, DIF: Cognitive Level: Remembering REF: p. 955
OBJ: Nursing Process Step: Intervention TOP:
Pediatrics MSC: NC LEX: Physiologic Integrit y
4. A 4-year-old child is admitted with fever, chills, headache, vomiting,
lethargy, photophobia, and nuchal rigidity. Based on these clinical
manifestations, what diagnosis would the nurse anticipate?
a. Status epilepticus
b. Bacterial meningitis
c. Head trauma
d. Septic shock
ANS: B
The clinical manifestations of bacterial meningitis include fever,
chills, headache, vomiting, irritabilit y or lethargy, photophobia, nuchal
rigidit y, and positive Kernig or Brudzinski sign. In meningococcemia,
petechiae and purpura may be observed on the child. The late stages of
this disease may produce an increased intracranial pressure and
cardiovascular collapse.
DIF: Cognitive Level: Appl ying REF: p. 957 OBJ:
Nursing Process Step: Evaluation TOP: Pediatrics MSC:
NCLEX: Physiologic Integrit y
5. A 4-year-old child is admitted with fever, chills, headache, vomiting,
lethargy, photophobia, and nuchal rigidity. Nursing management for this
patient would include which intervention?
a. Measuring and documenting head ci rcumference
b. Allowing the patient’s siblings to visit
