Pediatric Emergency Care > Pediatrics
Exam Review
Pediatric Emergencies
Total Questions : 20
Showing 20 questions, Sign in for moreA 2-year-old child is brought to the emergency room with high fever, irritability, and a rash. The nurse suspects bacterial meningitis. What is the appropriate intervention?
Explanation
A. Administering an antipyretic without further evaluation is not appropriate for a suspected case of bacterial meningitis.
B. Performing a lumbar puncture to analyze cerebrospinal fluid and starting antibiotics is the standard intervention for suspected bacterial meningitis.
C. Administering an antihistamine is not the appropriate intervention for bacterial meningitis, which is a bacterial infection of the meninges.
D. Ordering a head CT scan is not the first-line diagnostic test for suspected bacterial meningitis. A lumbar puncture is the diagnostic procedure of choice.
A child with known peanut allergy accidentally ingests peanuts and develops severe difficulty in breathing, facial swelling, and hives. What is the priority action by the nurse?
Explanation
A. Administering an antipyretic is not appropriate for anaphylaxis, a severe allergic reaction that requires immediate intervention.
B. Administering epinephrine is the first-line treatment for anaphylaxis. After administering epinephrine, calling for emergency medical assistance is crucial.
C. Offering a cold drink is not the appropriate intervention for anaphylaxis and will not address the life-threatening symptoms.
D. Providing a heating pad is not relevant to the situation and will not address the symptoms of anaphylaxis.
A 3-year-old child is suspected of ingesting an unknown substance. What action should the nurse take first?
Explanation
A. Administering ipecac syrup to induce vomiting is no longer recommended as a first-aid measure for poisoning. The Poison Control Center should be consulted first for guidance.
B. Calling the Poison Control Center is the first action to take in case of suspected poisoning. They provide expert guidance on managing poisoning cases.
C. Administering activated charcoal can be done under the guidance of the Poison Control Center, but it is not the first action to take.
D. Performing abdominal thrusts is used for foreign body airway obstruction, not poisoning.
A parent brings in a 1-year-old child who is coughing and choking. The child is unable to breathe, cry, or make any sound. What should the nurse do first?
Explanation
A. Performing back blows and chest thrusts is the appropriate intervention for foreign body airway obstruction in an infant who is unable to breathe, cry, or make any sound.
B. Abdominal thrusts are used for conscious adults and children over 1 year old with foreign body airway obstruction.
C. Administering a drink is not appropriate and can worsen the situation by causing further obstruction.
D. Performing a finger sweep of the mouth can push the object farther down the airway and is not recommended.
A 5-year-old child falls from a tree and loses consciousness briefly. The child wakes up but appears drowsy and confused. What is the priority action by the nurse?
Explanation
A. Applying a cold compress can provide comfort but is not the priority action for a child with head trauma and altered mental status.
B. Administering pain medication is not the priority; the child needs a thorough evaluation and possible imaging studies to assess for head injury.
C. Monitoring closely is important, but with the history of head trauma, immediate medical evaluation is crucial to rule out any serious injury.
D. Transporting the child to the emergency department immediately is the priority to ensure proper assessment and management of head trauma.
A 8-year-old child with a history of heart disease suddenly becomes pale, lethargic, and complains of chest pain. Vital signs show tachycardia and weak pulses. What is the likely cause of the child's symptoms?
Explanation
A. Febrile seizure presents with sudden convulsions and fever in children and does not cause pale, lethargic symptoms with chest pain and tachycardia.
B. Hypoglycemia can cause weakness and altered mental status, but it does not typically present with chest pain, tachycardia, and weak pulses.
C. Cardiogenic shock, often seen in children with heart disease, can present with pale, lethargic appearance, chest pain, tachycardia, and weak pulses due to poor cardiac output.
D. Foreign body aspiration can cause sudden respiratory distress and choking, but it does not present with chest pain, pale appearance, tachycardia, and weak pulses.
A 6-year-old child is found unconscious and not breathing. What is the initial action by the nurse?
Explanation
A. Administering epinephrine is part of advanced life support protocols and is done after initiating chest compressions and rescue breaths in pediatric cardiac arrest.
B. Initiating chest compressions and rescue breaths is the immediate action for an unconscious child who is not breathing.
C. Checking for a pulse is not the first step in pediatric cardiac arrest. Starting chest compressions and rescue breaths takes priority.
D. Calling for emergency medical assistance should be done simultaneously with starting chest compressions and rescue breaths.
A nurse is caring for a child with suspected septic shock. Which intervention is a priority in managing this condition?
Explanation
A. Administering pain medication is not the priority in septic shock. Prompt administration of antibiotics and fluids is crucial to address the underlying infection and support hemodynamic stability.
B. Administering antibiotics and fluids is the priority intervention in managing septic shock. Early initiation of appropriate antibiotics and fluid resuscitation are key components of septic shock management.
C. Providing antipyretics can be done to address fever, but it is not the priority in managing septic shock.
D. Elevating the head of the bed may be done for comfort or respiratory support but is not the priority in septic shock management.
A 10-year-old child is suspected of ingesting an unknown amount of acetaminophen. What intervention should the nurse anticipate?
Explanation
A. Administration of an antidote, such as N-acetylcysteine (NAC), is the specific treatment for acetaminophen poisoning if given within the appropriate timeframe after ingestion.
B. Inducing vomiting is not recommended as a first-line intervention for acetaminophen poisoning due to the risk of aspiration.
C. Administering activated charcoal can be considered in certain cases of poisoning, but it is not specific for acetaminophen poisoning.
D. Administering laxatives is not the appropriate intervention for acetaminophen poisoning.
A nurse is caring for a child in status epilepticus. What is the priority action by the nurse?
Explanation
A. Administering an antipyretic is not the priority in managing status epilepticus. Controlling the seizure activity takes precedence.
B. Administering intravenous diazepam or lorazepam is the first-line treatment for status epilepticus to stop ongoing seizures.
C. Administering oral phenytoin is not appropriate in the acute management of status epilepticus. Intravenous benzodiazepines are the preferred initial treatment.
D. Administering an antihistamine is not the appropriate intervention for status epilepticus. Intravenous benzodiazepines are used to stop the seizure activity.
A 4-year-old child is brought to the emergency room with a fever, sore throat, and difficulty swallowing. The nurse suspects streptococcal pharyngitis. What is the appropriate intervention?
Explanation
A. Administering a broad-spectrum antibiotic without confirmation of streptococcal infection is not appropriate and can contribute to antibiotic resistance.
B. Antiviral medications are not effective against bacterial infections such as streptococcal pharyngitis.
C. Performing a throat culture or rapid strep test is the appropriate intervention to confirm the diagnosis of streptococcal pharyngitis. If positive, antibiotic treatment can be initiated.
D. Administering a pain reliever can provide symptomatic relief but does not confirm the diagnosis. Throat culture or rapid strep test is necessary.
A 2-year-old child with a history of asthma is experiencing difficulty breathing, wheezing, and a persistent cough. What is the priority intervention by the nurse?
Explanation
A. Administering a bronchodilator inhaler, such as albuterol, is the priority intervention for a child with asthma experiencing difficulty breathing, wheezing, and coughing.
B. Antihistamines are not the primary treatment for acute asthma exacerbations.
C. Mucolytic medications can help thin mucus but are not the first-line treatment for acute asthma symptoms.
D. Cough suppressants are not recommended for children with asthma as they can worsen respiratory distress.
A 6-month-old infant is brought to the emergency room with signs of dehydration, sunken fontanelles, and decreased urine output. What is the priority nursing intervention?
Explanation
A. Offering oral rehydration solution (ORS) may not be effective for severe dehydration in an infant who is unable to drink or tolerate oral fluids.
B. Administering intravenous fluids is the priority intervention for a severely dehydrated infant to restore fluid balance and prevent complications.
C. Monitoring vital signs is important but does not address the immediate need for fluid replacement in severe dehydration.
D. Obtaining a urine sample is not the priority; intravenous fluids should be initiated promptly in a severely dehydrated infant.
A 5-year-old child is experiencing a febrile seizure. What is the nurse's immediate action?
Explanation
A. Administering a fever reducer is not the immediate action during a febrile seizure.
B. Placing the child in a tub of cold water is not recommended. The best approach is to keep the child safe and monitor them during the seizure.
C. Placing the child on the side helps prevent choking and aspiration during a seizure. This is the immediate action to take during a febrile seizure.
D. Administering an antiepileptic medication is not necessary during a febrile seizure, which is usually a brief and self-limiting event.
A 7-year-old child sustains a deep cut on the arm while playing outside. The wound is bleeding heavily. What is the nurse's initial action?
Explanation
A. Applying a tourniquet is not the initial action for controlling bleeding. Direct pressure and elevation are more appropriate.
B. Applying direct pressure and elevating the arm above the level of the heart help control bleeding from the wound.
C. Cleaning the wound with alcohol can wait until after bleeding is controlled. Direct pressure and elevation are the immediate priorities.
D. Administering an oral pain reliever is not the immediate concern; controlling bleeding and preventing infection are the priorities.
A 9-month-old infant is brought to the emergency room with suspected poisoning. What action should the nurse take first?
Explanation
A. Administering activated charcoal can be done under the guidance of the Poison Control Center, but it is not the first action to take.
B. Inducing vomiting is not recommended as a first-line intervention for poisoning and should not be done without consulting the Poison Control Center.
C. Contacting the Poison Control Center is the first and most important action in cases of suspected poisoning. They provide expert guidance on managing poisoning cases.
D. Administering syrup of ipecac is no longer recommended as a first-aid measure for poisoning. The Poison Control Center should be consulted first.
A 3-year-old child is brought to the emergency room with a head injury after falling from a height. The child is unconscious and not breathing. What is the nurse's immediate action?
Explanation
A. Administering rescue breaths is the immediate action for an unconscious child who is not breathing. CPR should be initiated immediately.
B. Checking for a pulse can be done after initiating rescue breaths and chest compressions.
C. Initiating chest compressions is part of CPR but should be preceded by rescue breaths.
D. Initiating abdominal thrusts is used for foreign body airway obstruction, not for an unconscious child with a head injury and respiratory distress.
A 6-year-old child with diabetes experiences symptoms of hypoglycemia, including irritability, shakiness, and confusion. What is the appropriate intervention?
Explanation
A. Administering insulin is not appropriate for hypoglycemia; it would further lower blood sugar levels.
B. Administering a high-sugar snack or drink is the appropriate intervention for hypoglycemia to raise blood sugar levels quickly.
C. Administering a pain reliever is not the appropriate intervention for hypoglycemia.
D. Administering a sedative is not the appropriate intervention for hypoglycemia and can mask symptoms.
A 10-year-old child is found unconscious in the water after a near-drowning incident. What is the nurse's immediate action?
Explanation
A. Administering rescue breaths and chest compressions is the immediate action for an unconscious child found after a near-drowning incident. CPR should be initiated immediately.
B. Placing the child in the recovery position is not appropriate for an unconscious child requiring CPR.
C. Initiating abdominal thrusts is used for foreign body airway obstruction, not for an unconscious child found after a near-drowning incident.
D. Administering a sedative is not the appropriate intervention for an unconscious child and can further depress respiratory function.
A 8-year-old child is brought to the emergency room with a deep cut on the leg. The wound is bleeding profusely. What is the nurse's initial action?
Explanation
A. Applying a tourniquet is not the initial action for controlling bleeding. Direct pressure and elevation are more appropriate.
B. Applying direct pressure and elevating the leg above the level of the heart help control bleeding from the wound.
C. Cleaning the wound with alcohol can wait until after bleeding is controlled. Direct pressure and elevation are the immediate priorities.
D. Administering an oral pain reliever is not the immediate concern; controlling bleeding and preventing infection are the priorities.
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