CPEN BCEN Timed #1 Questions With Complete Solutions.

CPEN BCEN Timed #1 Questions With Complete Solutions. A 1-year-old presents unconscious and is being ventilated with a bag-mask device. Ventilation has become progressively more difficult. Which of the following is the PRIORITY intervention? Place padding under the shoulders. A patient arrives to the emergency department intubated and ventilated via a bag-mask device. EMS reports that the patient fell from a climbing apparatus at school. Upon assessment, the patient is difficult to ventilate and has absent breath sounds on the left side. A needle decompression is performed. The nurse anticipates the PRIORITY will be to insert a chest tube. An infant presents to the emergency department with feeding intolerance after 3 days of cold-like symptoms. Upon assessment, the infant is found to have an altered mental status, sunken fontanels and decreased muscle tone. Vital signs are as follows: BP 66/30 mmHgHR 198 beats/minRR 50 breaths/minT (rectal) 97.3˚ F (36.3˚ C) The nurse would suspect what type of shock? distributive Which of the following requires the MOST emergent evaluation? 3-year-old whose head is on father's shoulder with vomiting, pale skin, and tachypnea Which of the following is the BEST method to assess adequacy of ventilation during procedural sedation? capnography value An adolescent presents with full- and partial-thickness burns to his hands and face. He is awake and alert with a hoarse voice. The PRIORITY intervention is to prepare for intubation. Which of the following is the highest PRIORITY for a patient with heat stroke? continuous core temperature monitoring An adolescent presents after ingesting four tablets of 500-mg acetaminophen and stating that he "wants to die." The nurse should anticipate referral to psychiatric services. An unresponsive 2-year-old presents with gurgling respirations with retractions. The patient's pulse is present at a rate of 80 beats/min. Which of the following is the PRIORITY intervention? Suction the airway. Which federal regulation ensures that a medical screening exam is performed to determine if an emergent condition exists? Emergency Medical Treatment and Active Labor Act Which of the following age groups are preoperational thinkers and concerned developmentally with initiative versus guilt? preschool Stridor at rest is a normal finding in which of the following situations? tracheomalacia EMS arrives with a 6-year-old who was an improperly restrained rear-seat passenger in a head-on collision. The patient complains of diffuse abdominal pain, nausea, and is tachycardic. Which injury should the nurse MOST suspect? small bowel injury The appropriate method of tick removal within 24 hours is to pull in a steady slow motion. A school-aged child with hydrocephalus may present with which of the following physical findings? papilledema An obese adolescent male present with right hip pain and inability to bear weight. What should the PRIORITY plan of care be? surgical intervention Fluid administration is required after resuscitating a neonate. The nurse should prepare for administration of a bolus of normal saline solution at 10 mL/kg. An 8-year-old is being treated for hypovolemic shock. The expected minimum systolic blood pressure for this patient is 86 mm Hg. A 5-day-old patient presents with feeding intolerance, lethargy, temperature instability, and apnea. The nurse has a high suspicion for neonatal sepsis. An 18-month-old presents to the emergency department with several days of worsening respiratory distress, persistent cough, thick secretions, and lethargy. The parent states that the patient was recently diagnosed with respiratory syncytial virus (RSV). The nurse recognizes these symptoms as consistent with bronchiolitis. A child with 30% body surface area burns is awaiting transfer to the burn center. The nurse should cover the burns with dry towel or sheet A 14-year-old female reports a sudden onset of severe pelvic pain with guarding. Which of the following is MOST concerning? referred shoulder pain A 14-year-old female accompanied by a caregiver presents to the emergency department with complaints of abdominal pain. The nurse notes a tattoo on the abdomen with initials and attempts to discuss the tattoo without success. The patient tries to hide the tattoo. The nurse should be MOST concerned about human trafficking. A patient with a traumatic head injury presents with signs and symptoms of Cushing's triad. Which of the following would be an expected finding? irregular, decreased respirations A 2-month-old presents with difficulty breathing associated with tachypnea, mild retractions, and copious amounts of nasal drainage. The MOST appropriate intervention is to suction the nares. Which of the following is MOST consistent with a diagnosis of tracheoesophageal fistula? cyanosis with feeding A 5-day-old neonate is diagnosed with hyperbilirubinemia. If left untreated, the infant may have long-term issues with intellectual deficits. Abdominal pain can be a characteristic of which respiratory diagnosis? pneumonia Which developmental task is expected in a toddler? autonomy What is the correct maintenance fluid rate for a 23-kg patient? 65 mL/hr Maintenance fluid in a 23 kg patient is: 1500 mL + (20 mL/kg for each kg 20 kg) A school-age girl presents with a straddle injury sustained on a jungle gym. Findings include pain, bruising, and a unilateral labial laceration. Definitive treatment is transfer to the operating room for injury repair. Which of the following injuries is MOST suggestive of child maltreatment? circumferential burns to both feet A 5-year-old presents to the emergency department with a fever for the past 2 days. The patient is dancing around singing songs. The skin is pink and there is no evidence of respiratory distress. Utilizing the Pediatric Assessment Triangle (PAT), the nurse would score the patient as sick. When using the FLACC scale to assess acute pain in an infant, the nurse would evaluate for facial grimacing A 12-year-old child with Asperger's syndrome presents to the emergency department with a caregiver. The BEST approach for the nurse would be to keep the triage assessment brief. A 13-year-old girl presents with severe intermittent lower back and abdominal pain associated with urinary incontinence. She is unsure of her last normal menstrual cycle. Which of the following findings is MOST concerning? vaginal bleeding The Pediatric Assessment Triangle (PAT) reveals an anxious preschooler who is tachypneic, drooling, flushed, and diaphoretic. Which of the following is the PRIORITY intervention? Take the patient to the treatment area. Which of the following laboratory tests would assist in the diagnosis of tumor lysis syndrome? uric acid Continuous monitoring of a child's ETCO2 during cardiac arrest reveals 8 mmHg. This indicates that CPR is ineffective and adjustments need to be made to compressions. A toddler presents with 6 days of fever, irritability, and a rash. The nurse notes an enlarged reddened tongue and cracked lips. Which of the following orders should the nurse anticipate? echocardiogram A child is brought to the emergency department appearing anxious, drooling, sitting forward and has had a fever for the past 12 hours. The nurse should recognize that the patient is demonstrating symptoms of epiglottitis. A child presents with a fever, visible rash, and is complaining of neck pain. The PRIORITY nursing intervention is to isolate the child Parents arrive with an unresponsive toddler and report finding her lying in the yard. Glascow Coma Scale (GCS) score is 5. Which of the following is the PRIORITY intervention for this patient? Perform jaw thrust with cervical spine motion restriction. Which of the following children have highest potential to contract pertussis? 4 month old A caregiver brings in a pale, ventilator-dependent 8-year-old. Which of the following questions has the HIGHEST priority? "What is different today than usual with the child?" A 5-week-old presenting with vomiting is noted to have a slightly bulging fontanel, hypothermia, and petechiae. The nurse should anticipate a workup for meningitis. An active toddler presents with stridor at rest. The caregiver denies any past medical history or recent illness. Based on the above presentation, the MOST likely cause of the stridor is foreign body obstruction. A child presents complaining of urticaria and wheezing after eating. Which of the following is the nurse's HIGHEST priority? Administer intramuscular epinephrine A child presents with fever, left eye pain, swelling, and impaired extraocular movement. The nurse anticipates a workup for orbital cellulitis. Which strategy is BEST for decreasing the incidence of drowning in children? physical supervision during a bath An 8-year-old presents with mild dyspnea and drooling following an all-terrain vehicle crash. There is bruising around the neck at the laryngeal area. Upon palpation, the nurse should expect to feel subcutaneous emphysema. A 4-year-old arrives via EMS after being hit by a car. An intraosseous needle (IO) has been placed in the left tibia for fluid resuscitation. Inspection of the left lower leg reveals swelling and tightness of the left calf. The MOST likely cause of this finding is extravasation of the IO. A child trips on his untied shoes as he walks into triage. His mother yells, "Can't you walk? I should just put you in a stroller like a baby." The child displays a flat affect. The nurse should suspect that the child may be a victim of: emotional maltreatment.