Science Medicine Pediatrics
PNCB Acute Care questions
Save
Students also studied
MUST KNOW PNP-AC Content Acute care PNCB 50 questions Lippincott ACPNP Self Assessment ... PNCB A
147 terms Teacher 50 terms 200 terms 150 term
Amanda_Mucha5 Preview vailkatie45 Preview shelby_cox9 Preview kirs
B. Respiratory distress
In a child with myasthenia gravis, which of
(Characterized by weakness and fatigue of skeletal muscle tissue that results from
the following symptoms would be MOST
autoimmune destruction of acetylcholine receptors (AchR). A crisis event, or
indicative of a myasthenic crisis?
myasthenic crisis, is an acute exacerbation of the disease process that results in
A. Eye drooling
severe weakness from dysfunction of the neuromuscular junctions. It is characterized
B. Respiratory distress
by respiratory failure due to weakness of the airway or respiratory muscles.
C. Excessive salivation
A cholinergic crisis, is a severe weakness caused by overtreatment with cholinergic
D. Muscle fasciculation
medications used to treat MG & crisis present with excessive salivation, excessive
lacrimation, diarrhea, sweating, pupillary constriction, and muscle fasciculation.
A child with a history of congenital heart D. Propranolol (Inderal)
disease fell while playing and presents with
a closed fracture of the humerus. Physical (Decreases heart rate, myocardial contractility, blood pressure, and myocardial
exam reveals mild bradycardia and a oxygen demand. Adverse effects include bradycardia, hypotension, and
moderate pain score. atrioventricular conduction disturbances)
Which of the following medications would
MOST likely explain this child's
bradycardia?
A. Enalapril (Vasotec)
B. Furosemide (Lasix)
C. Levothyroxine (Synthroid)
D. Propranolol (Inderal)
,Enteral nutrition is initiated in a child with A. Phosphate 3.0 ml/dL & potassium 2.8 mEq/L
severe malnutrition. Laboratory values
indicative of refeeding syndrome include a (Refeeding syndrome occurs when malnourished patients are refed too aggressively
magnesium level of 1.5 mg/dL, and: leading. It can occur within 1-3 days after reinstitution of nutrition.
A. Phosphate 3.0 ml/dL & potassium 2.8 The major manifestations include fluid overload, hypophosphatemia (phosphate less
mEq/L than 3.5 mg/dL), hypokalemia (potassium less than 3.5 mEq/L), hypomagnesemia
B. Phosphate 3.0 ml/dL & potassium 6 (magnesium less than 1.8 mg/dL), and thiamine deficiency. Complications include
mEq/L heart failure, dysrhythmias, respiratory muscle weakness, seizures,
C. Phosphate 7.0 ml/dL & potassium 2.8
mEq/L
D. Phosphate 7.0 ml/dL & potassium 6
mEq/L
When informing a family that a report is A. Focus on the child's well being
being made to Child Protective Services
for suspected abuse, it is MOST important
to
A. Focus on the child's well being
B. Identify the suspected perpetrator
C. Identify legal requirements for
mandatory reporting
D. Share details with family to avoid
misunderstanding
Manifestations of abdominal injuries C. Delayed 8-36 hours after exposure
secondary to a blast mechanism are
typically: (Blast attack, as seen in explosions, causes extensive compression and distortion of
A. Acute & immediately apparent the gastrointestinal (GI) tract & other air-filled organs. Manifestations generally
B. Observed less than 6 hours after delayed, presenting 8-36 hours after exposure.)
exposure
C. Delayed 8-36 hours after exposure
D. Chronic & slow to develop
A previously healthy preschooler who is D. Administer a fluid bolus & consult oncology
fully immunized, presents with a history of
fever, URI symptoms, & joint pain over the (The combination of leukocytosis, thrombocytopenia, and anemia should raise red
past several days. Physical exam reveals flags for an oncologic process, most likely leukemia. After initial laboratory values
petechiae and hepatosplenomegaly. Vital are obtained, the child should receive aggressive hydration.)
signs include HR 156, RR 32, temp 101.6
(38.7), BP 86/44 & O2 98% on RA. Lab
results include Na+ 132, K+ 6, Glucose 100,
Ca+ 0.95, Phos 6.3, WBC 105,000, Hgb 6.1 &
Plt 10,000. Which is the BEST course of
action?
A. Obtain LFTS & type & cross for blood
products
B. Administer calcium gluconate & consult
nephrology
C. Obtain blood cultures & administer IV
Ceftriaxone
D. Administer a fluid bolus & consult
oncology
, An adolescent presents with bilateral knee C. Patellofemoral pain syndrome
pain that has occurred for several months,
exacerbated with activities such as (Type of idiopathic anterior knee pain, common in adolescents. This type of knee
climbing stairs and running. Pain is also pain worsens with activity, especially going up and down stairs, and when sitting in
worsened by sitting with the knees flexed one position for a prolonged period of time. Treatment involves an exercise program
for an extended time and is described as a focusing on hip girdle and vastus medialis strengthening with lower extremity
grinding sensation under the kneecaps. No flexibility)
joint swelling is noted on examination. The
MOST likely diagnosis is:
A. Osgood-Schlatter disease
B. Osteochondritis dissecans
C. Patellofemoral pain syndrome
D. Popliteal cyst (Baker's cyst)
A toddler presents with vomiting and D. Ensure adequate airway protection
altered mental status after an ingestion of a
large amount of aspirin about 45 minutes
ago. Prior to the administration of activated
charcoal, the PRIORITY is to:
A. Obtain a urine drug screen
B. Ensure IV access
C. Obtain and EKG
D. Ensure adequate airway protection
Which of the following children is MOST at B. Infant intubated for respiratory failure receiving a morphine infusion for 6 days
risk for opiate withdrawal?
A. Infant intubated for respiratory failure (Opiate withdrawal should be suspected in any child who has received opioids for a
receiving Dexmedetomidine (Precedex) minimum of 3 days. After 5 days, approximately 50% of children are expected to
infusion for 5 days experience some withdrawal symptoms. When opiates are administered for >10 days,
B. Infant intubated for respiratory failure withdrawal should be expected in 100% of patients)
receiving a morphine infusion for 6 days
C. Adolescent post-posterior spinal fusion
receiving hydromorphone via PCA for 3
days
D. Adolescent post-cardiac surgery
receiving PO oxycodone PRN for 2 days
Following an episode of gastroenteritis, a C. PT & OT
child is diagnosed with reactive
inflammatory arthritis that is affecting joints (Maintain joint range of motion and strength of associated muscle groups, to
in the lower extremities. To maximize return decrease pain, and to prevent contractures and deformities, all of which maximize
to the previous level of mobility, the the potential to return to the previous level of activity).
treatment plan should include:
A. Weight-bearing exercise plan
B. Administration of corticosteroids
C. PT & OT
D. Calcium & vitamin D supplementation
Which of the following is the MOST likely D. Frequent temper tantrums
presentation of behavioral and psychiatric
disorders in a preschooler?
A. Fear of the dark
B. Issues with identity formation
C. Learning disabilities
D. Frequent temper tantrums
PNCB Acute Care questions
Save
Students also studied
MUST KNOW PNP-AC Content Acute care PNCB 50 questions Lippincott ACPNP Self Assessment ... PNCB A
147 terms Teacher 50 terms 200 terms 150 term
Amanda_Mucha5 Preview vailkatie45 Preview shelby_cox9 Preview kirs
B. Respiratory distress
In a child with myasthenia gravis, which of
(Characterized by weakness and fatigue of skeletal muscle tissue that results from
the following symptoms would be MOST
autoimmune destruction of acetylcholine receptors (AchR). A crisis event, or
indicative of a myasthenic crisis?
myasthenic crisis, is an acute exacerbation of the disease process that results in
A. Eye drooling
severe weakness from dysfunction of the neuromuscular junctions. It is characterized
B. Respiratory distress
by respiratory failure due to weakness of the airway or respiratory muscles.
C. Excessive salivation
A cholinergic crisis, is a severe weakness caused by overtreatment with cholinergic
D. Muscle fasciculation
medications used to treat MG & crisis present with excessive salivation, excessive
lacrimation, diarrhea, sweating, pupillary constriction, and muscle fasciculation.
A child with a history of congenital heart D. Propranolol (Inderal)
disease fell while playing and presents with
a closed fracture of the humerus. Physical (Decreases heart rate, myocardial contractility, blood pressure, and myocardial
exam reveals mild bradycardia and a oxygen demand. Adverse effects include bradycardia, hypotension, and
moderate pain score. atrioventricular conduction disturbances)
Which of the following medications would
MOST likely explain this child's
bradycardia?
A. Enalapril (Vasotec)
B. Furosemide (Lasix)
C. Levothyroxine (Synthroid)
D. Propranolol (Inderal)
,Enteral nutrition is initiated in a child with A. Phosphate 3.0 ml/dL & potassium 2.8 mEq/L
severe malnutrition. Laboratory values
indicative of refeeding syndrome include a (Refeeding syndrome occurs when malnourished patients are refed too aggressively
magnesium level of 1.5 mg/dL, and: leading. It can occur within 1-3 days after reinstitution of nutrition.
A. Phosphate 3.0 ml/dL & potassium 2.8 The major manifestations include fluid overload, hypophosphatemia (phosphate less
mEq/L than 3.5 mg/dL), hypokalemia (potassium less than 3.5 mEq/L), hypomagnesemia
B. Phosphate 3.0 ml/dL & potassium 6 (magnesium less than 1.8 mg/dL), and thiamine deficiency. Complications include
mEq/L heart failure, dysrhythmias, respiratory muscle weakness, seizures,
C. Phosphate 7.0 ml/dL & potassium 2.8
mEq/L
D. Phosphate 7.0 ml/dL & potassium 6
mEq/L
When informing a family that a report is A. Focus on the child's well being
being made to Child Protective Services
for suspected abuse, it is MOST important
to
A. Focus on the child's well being
B. Identify the suspected perpetrator
C. Identify legal requirements for
mandatory reporting
D. Share details with family to avoid
misunderstanding
Manifestations of abdominal injuries C. Delayed 8-36 hours after exposure
secondary to a blast mechanism are
typically: (Blast attack, as seen in explosions, causes extensive compression and distortion of
A. Acute & immediately apparent the gastrointestinal (GI) tract & other air-filled organs. Manifestations generally
B. Observed less than 6 hours after delayed, presenting 8-36 hours after exposure.)
exposure
C. Delayed 8-36 hours after exposure
D. Chronic & slow to develop
A previously healthy preschooler who is D. Administer a fluid bolus & consult oncology
fully immunized, presents with a history of
fever, URI symptoms, & joint pain over the (The combination of leukocytosis, thrombocytopenia, and anemia should raise red
past several days. Physical exam reveals flags for an oncologic process, most likely leukemia. After initial laboratory values
petechiae and hepatosplenomegaly. Vital are obtained, the child should receive aggressive hydration.)
signs include HR 156, RR 32, temp 101.6
(38.7), BP 86/44 & O2 98% on RA. Lab
results include Na+ 132, K+ 6, Glucose 100,
Ca+ 0.95, Phos 6.3, WBC 105,000, Hgb 6.1 &
Plt 10,000. Which is the BEST course of
action?
A. Obtain LFTS & type & cross for blood
products
B. Administer calcium gluconate & consult
nephrology
C. Obtain blood cultures & administer IV
Ceftriaxone
D. Administer a fluid bolus & consult
oncology
, An adolescent presents with bilateral knee C. Patellofemoral pain syndrome
pain that has occurred for several months,
exacerbated with activities such as (Type of idiopathic anterior knee pain, common in adolescents. This type of knee
climbing stairs and running. Pain is also pain worsens with activity, especially going up and down stairs, and when sitting in
worsened by sitting with the knees flexed one position for a prolonged period of time. Treatment involves an exercise program
for an extended time and is described as a focusing on hip girdle and vastus medialis strengthening with lower extremity
grinding sensation under the kneecaps. No flexibility)
joint swelling is noted on examination. The
MOST likely diagnosis is:
A. Osgood-Schlatter disease
B. Osteochondritis dissecans
C. Patellofemoral pain syndrome
D. Popliteal cyst (Baker's cyst)
A toddler presents with vomiting and D. Ensure adequate airway protection
altered mental status after an ingestion of a
large amount of aspirin about 45 minutes
ago. Prior to the administration of activated
charcoal, the PRIORITY is to:
A. Obtain a urine drug screen
B. Ensure IV access
C. Obtain and EKG
D. Ensure adequate airway protection
Which of the following children is MOST at B. Infant intubated for respiratory failure receiving a morphine infusion for 6 days
risk for opiate withdrawal?
A. Infant intubated for respiratory failure (Opiate withdrawal should be suspected in any child who has received opioids for a
receiving Dexmedetomidine (Precedex) minimum of 3 days. After 5 days, approximately 50% of children are expected to
infusion for 5 days experience some withdrawal symptoms. When opiates are administered for >10 days,
B. Infant intubated for respiratory failure withdrawal should be expected in 100% of patients)
receiving a morphine infusion for 6 days
C. Adolescent post-posterior spinal fusion
receiving hydromorphone via PCA for 3
days
D. Adolescent post-cardiac surgery
receiving PO oxycodone PRN for 2 days
Following an episode of gastroenteritis, a C. PT & OT
child is diagnosed with reactive
inflammatory arthritis that is affecting joints (Maintain joint range of motion and strength of associated muscle groups, to
in the lower extremities. To maximize return decrease pain, and to prevent contractures and deformities, all of which maximize
to the previous level of mobility, the the potential to return to the previous level of activity).
treatment plan should include:
A. Weight-bearing exercise plan
B. Administration of corticosteroids
C. PT & OT
D. Calcium & vitamin D supplementation
Which of the following is the MOST likely D. Frequent temper tantrums
presentation of behavioral and psychiatric
disorders in a preschooler?
A. Fear of the dark
B. Issues with identity formation
C. Learning disabilities
D. Frequent temper tantrums
