treated with corticosteroid therapy and the mother
asks a nurse why the physician did not order
antibiotics. The appropriate response would be:
1. The child may be allergic to antibiotics
2. The child is too young to take antibiotics
3. Antibiotics are not indicated unless a bacterial infection is
present
4. The child still has the maternal antibodies from birth and
doesn't need antibiotics - ANSWER 3. Antibiotics are not indicated unless a bacterial
infection is
present
• A child with croup is receiving a nebulized dose of
racemic epinephrine. The mother is concerned because
the child is frightened, consistently crying and pulling the
mask off. The best nursing action would be to:
1. Put the child in restraints to prevent them from pulling the mask off
2. Call the physician and get an order for a mild sedative
3. Use a dinosaur-shaped mask to administer the medication
4. Have the mother hold the child on her lap during the treatment - ANSWER 4. Have the
mother hold the child on her lap during the treatment
A 16 year old male comes into the school nurse and
,says, "My chest had a sudden, sharp pain and it still
hurts." The school nurse examines an anxious
appearing, tachypneic young man and notes decreased,
possibly absent breath sounds to the left lower lobe.
The most likely diagnosis is:
1. Cystic Fibrosis
2. Anxiety Disorder
3. Pneumothorax
4. Asthma - ANSWER 3. Pneumothorax
What is the most appropriate equipment to have
available for the child admitted with epiglottitis?
1. Bag-mask and bronchodilators
2. Tracheotomy set up and oxygen
3. Suction set up and oxygen
4. Antibiotics and suction - ANSWER 2. Tracheotomy set up and oxygen
• The nurse recommends the use of which of the following to prevent
otitis media?
1. Hydrogen peroxide ear canal cleaning
2. Continuous, small dose antibiotic therapy administration
3. Regular instillation of ear drops
4. Holding the infant upright while bottle feeding - ANSWER 4. Holding the infant upright
while bottle feeding
Mom reports her 5 year old daughter has been home from
school sick for the past three days, with a fever of 38.90
C that goes down to 37.20 C when she takes acetaminophen.
,Mom
reports she has not had any energy. She has be-
coughing and complaining that her chest hurts. The
most likely diagnosis is:
1. Bronchiolitis
2. Asthma exacerbation
3. Pneumonia
4. None of the above - ANSWER 3. Pneumonia
Mom calls you to assess her 4 month old child. She tells
you he keeps crying and she cannot seem to console
him. You note head bobbing, intercostal retractions, and
decreased breath sound on the left and rhonchi
bilaterally. Your first priority is to:
1. Calm mom down as the infant will pick up on her anxiety
2. Call the pediatrician to come examine the child
3. Suction the nares, if no improvement nasopharyngeal suction
4. Manage the airway, increase oxygen, suction - ANSWER 4. Manage the airway,
increase oxygen, suction
• Which of the following, when described by the parents of
a child with CF, indicate they understand the underlying
problem of this disease?
1. An abnormality in the body's mucous secreting glands
2. Formation of fibrous cysts in various body organs
3. Underdevelopment of pancreatic ducts
4. Reaction of the production of antibodies to streptococcus - ANSWER 1. An
abnormality of the mucous secreting glands of the body
, • A 4 yr old boy was brought to the ED by his nanny, "he
was at the playground and they were all running around
and all of a sudden he was coughing and breathing
amusing." You record vital signs T - 37.20C, P - 110, R - 32,
BP - 110/74, SpO2 - 90% on room air, audible stridor,
intercostal retraction. The child interjects between breaths,
"Am I in trouble?" You reassure him that he is not in trouble and
that you are going to attempt to make him feel better. You ask him
if he has ever had difficulty breathing like this prior to this and
he says "no." The nanny says "he is a very healthy and
active boy." You apply oxygen and give a dose of racemic
epinephrine, which has limited effect on the stridor. You
transport him to get a chest x-ray.
• What is the most likely cause of this child's breathing
trouble?
1. Asthma exacerbation
2. Pneumothorax
3. Epiglottitis
4. Croup
5. Foreign body aspiration - ANSWER 4. Croup
• The major pharmacologic action of albuterol (Proventil)
is:
1. Decreasing airway reactivity
2. Reducing the amount of inflammation and airway obstruction
3. Improved mobility of cilia to transport trapped mucous upwards
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