BCEN Pediatric Emergencies 4

Question 1

A 2-year-old presents with sudden onset of cough, unilateral wheeze, and decreased breath sounds on the right. The most likely diagnosis is:

Accepted Answer

Foreign body aspiration

Answer

Sudden onset of unilateral wheeze and decreased breath sounds in a toddler strongly suggests foreign body aspiration, most commonly in the right mainstem bronchus.

Question 2

A 5-year-old with meningococcemia develops non-blanching petechiae that rapidly spread and becomes hypotensive. The priority intervention is:

Accepted Answer

IV ceftriaxone and fluid resuscitation

Answer

Meningococcemia with purpura fulminans is a life-threatening emergency requiring immediate IV antibiotics and fluid resuscitation without delay.

Question 3

Which of the following is the correct intraosseous (IO) medication dose for pediatric epinephrine during cardiac arrest?

Accepted Answer

0.01 mg/kg of 1:10,000 solution

Answer

The PALS dose for epinephrine in cardiac arrest is 0.01 mg/kg (0.1 mL/kg of 1:10,000) IV/IO.

Question 4

A 7-year-old is brought in after a syncopal episode during exercise. EKG shows a prolonged QTc. The most dangerous arrhythmia risk is:

Accepted Answer

Torsades de pointes

Answer

Prolonged QT syndrome predisposes to Torsades de Pointes, a polymorphic ventricular tachycardia that can cause sudden cardiac death.

Question 5

A 6-month-old presents with high fever, bulging fontanelle, and irritability. Lumbar puncture reveals cloudy CSF, low glucose, and elevated protein. The most likely pathogen is:

Accepted Answer

Group B Streptococcus

Answer

Group B Streptococcus is the leading cause of bacterial meningitis in infants under 3 months; in a 6-month-old it remains a key pathogen along with Strep pneumoniae, but GBS is most classically associated with this age range.

(BCEN) Board of Certification of Emergency Nursing Practice Test

(BCEN) Board of Certification of Emergency Nursing Practice Test

BCEN Pediatric Emergencies 4