Chapter 4 End of Chapter Test A+
Solutions
When selecting an appropriately sized blood pressure cuff for a pediatric patient, which of the
following guidelines will help you? Ans- The width of the cuff should be 2/3 the circumference
of the arm.
Which of the following childhood respiratory diseases has increased dramatically over the past
few decades? Ans- Asthma
Your patient is a seven-month-old child whose mother called because he suddenly became
lethargic and pale. Your assessment reveals that he is in a supraventricular tachycardia at a rate
of 244 per minute. The patient's extremities are mottled and his capillary refill time is 4 seconds.
Which of the following is the best treatment plan for this patient? Ans- Synchronized
cardioversion beginning at 0.5-1.0 joules/kg
You suspect your 5 year old patient has been a victim of child abuse. What information should
you include in the patient care report? Ans- Objective information including a full assessment of
the child
,Your patient is a 13 year-old male drowning victim. He was initially in cardiac arrest with a
pulseless, wide-complex bradycardia. He is intubated and being ventilated with supplemental
oxygen. After CPR and intubation, the patient is now in ventricular tachycardia with a weak
radial pulse. Which of the following would be an appropriate treatment for this patient? Ans-
Synchronized cardioversion starting at 0.5-1.0 joules/kg
The most common cardiac dysrhythmias in pediatric patients are: Ans- Bradyarrhythmias
Your patient is a four-year-old male with a history of asthma. He ran out of his inhaled
bronchodilator while visiting his grandparent's farm. On your arrival, you learn that the patient
has been having increasing respiratory distress for 20 minutes. The patient has pale, cool, moist
skin with cyanosis of his nail beds. He is sitting on the edge of a kitchen chair, leaning forward
to breathe. He has a respiratory rate of 50 with the use of accessory muscles and a heart rate of
130. He is anxious and unable to speak more than one or two words at a time. Auscultation of the
chest reveals scattered wheezing. As you prepare to treat the patient, he becomes drowsy and his
respiratory rate decreases to 12. You can no longer auscultate his wheezes. Which of the
following best explains the significance of the change in your patient's status? Ans- Because of
decreased respiratory, cardiovascular, and stored energy reserves, the child's muscles have
fatigued and he is now in respiratory failure.
, Your 12-month-old patient has burns covering the full length of both lower extremities
circumferentially. Which of the following is the most accurate estimate of the percentage of total
body surface area involved? Ans- 28 percent
Your patient is a nine-year-old female who was struck by a vehicle as she ran across the street.
She is unresponsive and has a hematoma over the left parietal area and an open, depressed skull
fracture on the right parietal area. She has bruising on the left flank and hip. She is breathing
irregularly at 8 times per minute and has a heart rate of 56. She has a faint carotid pulse but no
radial pulse. Which of the following is/are most likely to account for your patient's heart rate?
1. Normal range for a healthy, fit, nine-year-old child
2. Hypoxia due to impaired respiratory status secondary to traumatic brain injury
3. Increasing intracranial pressure due to traumatic brain injury exacerbated by hypoxia
4. Myocardial contusion Ans- 2 and 3
If unable to establish an airway by any other means, in which of the following patients would
needle cricothyrotomy be contraindicated? Ans- Neither of the above
Your patient is a two-year-old male who has ingested approximately 30 tablets of children's
chewable acetaminophen tablets anywhere from 15 to 30 minutes before your arrival. He is
awake and appears stable, but he is intermittently crying. You have a 20-minute transport time to
Solutions
When selecting an appropriately sized blood pressure cuff for a pediatric patient, which of the
following guidelines will help you? Ans- The width of the cuff should be 2/3 the circumference
of the arm.
Which of the following childhood respiratory diseases has increased dramatically over the past
few decades? Ans- Asthma
Your patient is a seven-month-old child whose mother called because he suddenly became
lethargic and pale. Your assessment reveals that he is in a supraventricular tachycardia at a rate
of 244 per minute. The patient's extremities are mottled and his capillary refill time is 4 seconds.
Which of the following is the best treatment plan for this patient? Ans- Synchronized
cardioversion beginning at 0.5-1.0 joules/kg
You suspect your 5 year old patient has been a victim of child abuse. What information should
you include in the patient care report? Ans- Objective information including a full assessment of
the child
,Your patient is a 13 year-old male drowning victim. He was initially in cardiac arrest with a
pulseless, wide-complex bradycardia. He is intubated and being ventilated with supplemental
oxygen. After CPR and intubation, the patient is now in ventricular tachycardia with a weak
radial pulse. Which of the following would be an appropriate treatment for this patient? Ans-
Synchronized cardioversion starting at 0.5-1.0 joules/kg
The most common cardiac dysrhythmias in pediatric patients are: Ans- Bradyarrhythmias
Your patient is a four-year-old male with a history of asthma. He ran out of his inhaled
bronchodilator while visiting his grandparent's farm. On your arrival, you learn that the patient
has been having increasing respiratory distress for 20 minutes. The patient has pale, cool, moist
skin with cyanosis of his nail beds. He is sitting on the edge of a kitchen chair, leaning forward
to breathe. He has a respiratory rate of 50 with the use of accessory muscles and a heart rate of
130. He is anxious and unable to speak more than one or two words at a time. Auscultation of the
chest reveals scattered wheezing. As you prepare to treat the patient, he becomes drowsy and his
respiratory rate decreases to 12. You can no longer auscultate his wheezes. Which of the
following best explains the significance of the change in your patient's status? Ans- Because of
decreased respiratory, cardiovascular, and stored energy reserves, the child's muscles have
fatigued and he is now in respiratory failure.
, Your 12-month-old patient has burns covering the full length of both lower extremities
circumferentially. Which of the following is the most accurate estimate of the percentage of total
body surface area involved? Ans- 28 percent
Your patient is a nine-year-old female who was struck by a vehicle as she ran across the street.
She is unresponsive and has a hematoma over the left parietal area and an open, depressed skull
fracture on the right parietal area. She has bruising on the left flank and hip. She is breathing
irregularly at 8 times per minute and has a heart rate of 56. She has a faint carotid pulse but no
radial pulse. Which of the following is/are most likely to account for your patient's heart rate?
1. Normal range for a healthy, fit, nine-year-old child
2. Hypoxia due to impaired respiratory status secondary to traumatic brain injury
3. Increasing intracranial pressure due to traumatic brain injury exacerbated by hypoxia
4. Myocardial contusion Ans- 2 and 3
If unable to establish an airway by any other means, in which of the following patients would
needle cricothyrotomy be contraindicated? Ans- Neither of the above
Your patient is a two-year-old male who has ingested approximately 30 tablets of children's
chewable acetaminophen tablets anywhere from 15 to 30 minutes before your arrival. He is
awake and appears stable, but he is intermittently crying. You have a 20-minute transport time to
