EXAM
WITH 100% CORRECT
ANSWERS
A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss,
and dry mucous membranes. Vital signs reveal deep respirations at 44
breaths per minute, BP of 70/44 mm Hg, and HR of 144 beats per minute.
Which of the following laboratory values would be most expected in this
child? - answer Hypoglycemia (wrong)
Remediation feedback:
Children can present with new onset diabetes in diabetic ketoacidosis.
Manifestations include signs of dehydration ( dry mucous membranes,
hypotension, tachycardia), incontinence
(polyuria), vomiting, abdominal pain, Kussmaul respirations (to counter the
acidosis), polydipsia, anorexia, and weight loss. Expected laboratory values
would reveal an acidotic state with a pH level below 7.3, an elevated serum
bIcarbonate level, and an elevated blood glucose level > 200 mg.dL.
An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing
noted on
auscultation in the right upper lobe of the lung field after a choking event 4
days ago. The white blood cell count is elevated and the patient noted to be
tachypneic, tachycardic, agitated, and has an increased respiratory effort. At
the time of the event, the patient was started on antibiotics with subsequent
increasing manifestations instead of improvement. Which of the following
would be considered to be def - answer Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a choking incident with
subsequent failure to improve on antibiotics. Wheezing or decreased lung
sounds in one area of the pulmonary system is a high indicator for a foreign
body along with signs of hypoxia such as cyanosis, tachypnea, tachycardia,
, increased respiratory effort, agitation or lethargy, and elevated white blood
cell counts indicating an infectious process. The definitive treatment would
be a bronchoscopy in order to retrieve the suspected foreign body instead of
diagnostic tests to locate the foreign body itself.
A child in cardiopulmonary arrest is receiving chest compressions and
manual ventilations with a bag-mask device. Once return of spontaneous
circulation has been confirmed, which of the following would be the priority
intervention? - answer Establishing a secure airway
Parents report their 3-year-old child has developed noisy breathing. On
assessment, highpitched wheezes are audible and auscultated on inspiration
and expiration. What medication would be appropriate to administer first? -
answer Humidified oxygen (wrong)
Remediation feedback:
Wheezing is most often identified with asthma in the pediatric population.
Initial medication intervention includes an inhaled short-acting beta agonist.
A 6-week-old is brought to the emergency department by the caregivers for
poor feeding, listlessness, and fever. Assessment reveals a crying infant, HR
160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F (35.5
C), and a bulging anterior fontanel. Capillary refill is 4 seconds. Based on
these findings what is the most likely diagnostic test the nurse should
anticipate? - answer Lumbar puncture
A 12-year-old is being prepped for surgical intervention of acute appendicitis.
Which of the following intravenous medication orders should the nurse
question? - answer Hydromorphone (wrong)
Remediation feedback:
Ketorolac is an appropriate medication for moderate to severe pain, however,
it should not be used pre-operatively due to its potential to increase the
bleeding risk.
ENPC 6TH EDITION