Pediatric Emergency Questions And Answers
When a poison has been ingested by a child, the parents should be
instructed to do which of the following first?
a) Induce vomiting.
b) Call the local poison control center.
c) Administer an emetic.
d) Get to an emergency facility. Correct Ans ~ Call the local poison
control center.
Correct
Explanation:
Not all poisons should be vomited. Strong acids, for example, could cause as
much destruction of tissue being vomited as being swallowed. The poison
control center will provide the most accurate information on the next steps
for the patient.
Assessment of a child reveals a tension pneumothorax. The nurse would
prepare the child for which of the following?
a) Needle thoracotomy
b) Suctioning
c) Intubation
d) Defibrillation Correct Ans ~ Needle thoracotomy
Correct
Explanation:
A needle thoracotomy is indicated for tension pneumothorax to relieve the
air collected in the space. Intubation is indicated for apnea and in situations
in which the airway cannot be maintained. Suctioning would be indicated for
excessive airway secretions that influence airway patency. Defibrillation is
used to stimulate or alter the heart's electrical rhythm.
A 6-year-old girl who is being treated for shock is pulseless with an irregular
heart rate of 32 BPM. Choose the priority intervention:
a) Administer doses defibrillator shocks in a row
b) Initiate cardiac compressions
c) Give three doses of epinephrine
d) Defibrillate once followed by three cycles of cardiopulmonary
resuscitation (CPR) Correct Ans ~ Initiate cardiac compressions
Correct
Explanation:
The American Heart Association (AHA) emphasizes the importance of cardiac
compressions in pulseless clients with arrhythmias, making this the priority
,intervention in this situation. Current AHA recommendations are for
defibrillation to be administered once followed by five cycles of CPR. The AHA
now recommends against using multiple doses of epinephrine because they
have not been shown to be helpful and may actually cause harm to the child.
A 3-year-old girl had a near-drowning incident when she fell into a wading
pool. Which intervention would be of the highest priority?
a) Inserting a nasogastric tube to decompress stomach
b) Assuring the child stays still during an X-ray
c) Suctioning the upper airway to ensure airway patency
d) Covering the child with warming blankets Correct Ans ~ Suctioning the
upper airway to ensure airway patency
Correct
Explanation:
Due to the potentially devastating effects of drowning-related hypoxia on a
child's brain, airway interventions must be initiated immediately. The child's
airway should be suctioned to ensure patency. Other interventions such as
covering the child with blankets, inserting a nasogastric tube, and assuring
that the child remains still during X-ray are interventions that are appropriate
once airway patency is achieved and maintained.
The nurse is preparing an in-service program on pediatric cardiopulmonary
resuscitation. The nurse would include a discussion that cardiopulmonary
arrest in infants and children is most likely the result of which of the
following?
a) Underlying heart disease
b) Respiratory failure
c) Neurologic trauma
d) Lethal arrhythmia Correct Ans ~ Respiratory failure
Correct
Explanation:
Cardiopulmonary arrest in infants and children typically results from
disorders that lead to respiratory failure and shock. In adults, the most
common causes of cardiopulmonary arrest are lethal arrhythmias secondary
to heart disease. Although neurologic trauma can lead to respiratory failure,
it alone is not the most likely factor.
A 13-year-old girl suffered a serious fall while hiking with friends and injured
her head. She is now being evaluated by a nurse in the emergency room.
The nurse notices clear fluid flowing from the girl's nose. The girl's friend said
that she had been suffering from pollen allergy recently. Which of the
following interventions should the nurse implement to determine whether
the fluid is cerebrospinal fluid (CSF) or rhinitis from an allergy?
, a) Evaluate the client's level of consciousness
b) Assess the client's blood pressure
c) Perform a skull x-ray
d) Test the fluid with a glucose reagent strip Correct Ans ~ Test the fluid
with a glucose reagent strip
Correct
Explanation:
Rhinorrhea or otorrhea (clear fluid draining from the nose or ear,
respectively) may be noticeable. The fluid is cerebrospinal fluid (CSF) and is
a serious finding because it means that the child's central nervous system is
open to infection. If it's not clear if the fluid is CSF or rhinitis from an allergy,
test the fluid with a glucose reagent strip. CSF will test positive for glucose,
whereas the clear, watery drainage from an upper respiratory tract infection
or allergy will not. The other interventions would not help determine whether
the fluid was CSF or rhinitis.
Which medication is used for symptomatic bradycardia unresponsive to
ventilation and oxygenation?
a) Atropine
b) Naloxone
c) Sodium bicarbonate
d) Calcium carbonate Correct Ans ~ Atropine
Correct
Explanation:
Atropine is used for symptomatic bradycardia unresponsive to ventilation
and oxygenation. Sodium bicarbonate is used for metabolic acidosis.
Naloxone reverses the effect of opioids. Calcium carbonate is used for
documented or suspected hypocalcemia, hyperkalemia, hypermagnesemia,
and calcium channel blocker overdose.
The nurse must calculate the adolescent's cardiac output. The child's heart
rate is 76 beats per minute and the stroke volume is 75 mL. Calculate the
child's cardiac output. Correct Ans ~ 5700
Explanation:
Cardiac output (CO) is equal to heart rate (HR) times ventricular stroke
volume (SV). That is, CO = HR x SV 76 beats per minute x 75 mL = 5,700
A 4-year-old girl has been admitted to the emergency department after
accidently ingesting a cleaning product. Which of the following treatments is
most likely appropriate in the immediate treatment of the girl's poisoning?
a) Intravenous rehydration
b) Administration of activated charcoal
c) Gastric lavage
d) Inducing vomiting Correct Ans ~ Administration of activated charcoal
When a poison has been ingested by a child, the parents should be
instructed to do which of the following first?
a) Induce vomiting.
b) Call the local poison control center.
c) Administer an emetic.
d) Get to an emergency facility. Correct Ans ~ Call the local poison
control center.
Correct
Explanation:
Not all poisons should be vomited. Strong acids, for example, could cause as
much destruction of tissue being vomited as being swallowed. The poison
control center will provide the most accurate information on the next steps
for the patient.
Assessment of a child reveals a tension pneumothorax. The nurse would
prepare the child for which of the following?
a) Needle thoracotomy
b) Suctioning
c) Intubation
d) Defibrillation Correct Ans ~ Needle thoracotomy
Correct
Explanation:
A needle thoracotomy is indicated for tension pneumothorax to relieve the
air collected in the space. Intubation is indicated for apnea and in situations
in which the airway cannot be maintained. Suctioning would be indicated for
excessive airway secretions that influence airway patency. Defibrillation is
used to stimulate or alter the heart's electrical rhythm.
A 6-year-old girl who is being treated for shock is pulseless with an irregular
heart rate of 32 BPM. Choose the priority intervention:
a) Administer doses defibrillator shocks in a row
b) Initiate cardiac compressions
c) Give three doses of epinephrine
d) Defibrillate once followed by three cycles of cardiopulmonary
resuscitation (CPR) Correct Ans ~ Initiate cardiac compressions
Correct
Explanation:
The American Heart Association (AHA) emphasizes the importance of cardiac
compressions in pulseless clients with arrhythmias, making this the priority
,intervention in this situation. Current AHA recommendations are for
defibrillation to be administered once followed by five cycles of CPR. The AHA
now recommends against using multiple doses of epinephrine because they
have not been shown to be helpful and may actually cause harm to the child.
A 3-year-old girl had a near-drowning incident when she fell into a wading
pool. Which intervention would be of the highest priority?
a) Inserting a nasogastric tube to decompress stomach
b) Assuring the child stays still during an X-ray
c) Suctioning the upper airway to ensure airway patency
d) Covering the child with warming blankets Correct Ans ~ Suctioning the
upper airway to ensure airway patency
Correct
Explanation:
Due to the potentially devastating effects of drowning-related hypoxia on a
child's brain, airway interventions must be initiated immediately. The child's
airway should be suctioned to ensure patency. Other interventions such as
covering the child with blankets, inserting a nasogastric tube, and assuring
that the child remains still during X-ray are interventions that are appropriate
once airway patency is achieved and maintained.
The nurse is preparing an in-service program on pediatric cardiopulmonary
resuscitation. The nurse would include a discussion that cardiopulmonary
arrest in infants and children is most likely the result of which of the
following?
a) Underlying heart disease
b) Respiratory failure
c) Neurologic trauma
d) Lethal arrhythmia Correct Ans ~ Respiratory failure
Correct
Explanation:
Cardiopulmonary arrest in infants and children typically results from
disorders that lead to respiratory failure and shock. In adults, the most
common causes of cardiopulmonary arrest are lethal arrhythmias secondary
to heart disease. Although neurologic trauma can lead to respiratory failure,
it alone is not the most likely factor.
A 13-year-old girl suffered a serious fall while hiking with friends and injured
her head. She is now being evaluated by a nurse in the emergency room.
The nurse notices clear fluid flowing from the girl's nose. The girl's friend said
that she had been suffering from pollen allergy recently. Which of the
following interventions should the nurse implement to determine whether
the fluid is cerebrospinal fluid (CSF) or rhinitis from an allergy?
, a) Evaluate the client's level of consciousness
b) Assess the client's blood pressure
c) Perform a skull x-ray
d) Test the fluid with a glucose reagent strip Correct Ans ~ Test the fluid
with a glucose reagent strip
Correct
Explanation:
Rhinorrhea or otorrhea (clear fluid draining from the nose or ear,
respectively) may be noticeable. The fluid is cerebrospinal fluid (CSF) and is
a serious finding because it means that the child's central nervous system is
open to infection. If it's not clear if the fluid is CSF or rhinitis from an allergy,
test the fluid with a glucose reagent strip. CSF will test positive for glucose,
whereas the clear, watery drainage from an upper respiratory tract infection
or allergy will not. The other interventions would not help determine whether
the fluid was CSF or rhinitis.
Which medication is used for symptomatic bradycardia unresponsive to
ventilation and oxygenation?
a) Atropine
b) Naloxone
c) Sodium bicarbonate
d) Calcium carbonate Correct Ans ~ Atropine
Correct
Explanation:
Atropine is used for symptomatic bradycardia unresponsive to ventilation
and oxygenation. Sodium bicarbonate is used for metabolic acidosis.
Naloxone reverses the effect of opioids. Calcium carbonate is used for
documented or suspected hypocalcemia, hyperkalemia, hypermagnesemia,
and calcium channel blocker overdose.
The nurse must calculate the adolescent's cardiac output. The child's heart
rate is 76 beats per minute and the stroke volume is 75 mL. Calculate the
child's cardiac output. Correct Ans ~ 5700
Explanation:
Cardiac output (CO) is equal to heart rate (HR) times ventricular stroke
volume (SV). That is, CO = HR x SV 76 beats per minute x 75 mL = 5,700
A 4-year-old girl has been admitted to the emergency department after
accidently ingesting a cleaning product. Which of the following treatments is
most likely appropriate in the immediate treatment of the girl's poisoning?
a) Intravenous rehydration
b) Administration of activated charcoal
c) Gastric lavage
d) Inducing vomiting Correct Ans ~ Administration of activated charcoal
