CEN Pediatric Emergencies 2

Question 1

A 4-year-old presents with sudden choking while eating peanuts, and now has unilateral decreased breath sounds and hyperresonance on the right. What is the most likely diagnosis?

Accepted Answer

Foreign body airway obstruction in the right mainstem bronchus

Answer

Unilateral decreased breath sounds and hyperresonance after choking in a child is classic for a right-sided bronchial foreign body, as the right mainstem bronchus is more vertical.

Question 2

What is the Pediatric Assessment Triangle (PAT) composed of?

Accepted Answer

Appearance, work of breathing, and circulation to skin

Answer

The PAT assesses three components—Appearance (tone, interactivity), Work of Breathing, and Circulation to skin—to rapidly determine if a child is stable or critically ill.

Question 3

A 14-month-old presents with a spiral femur fracture and bruising in multiple stages of healing. The history is inconsistent. What must be considered?

Accepted Answer

Non-accidental trauma (child abuse)

Answer

Spiral fractures in non-ambulatory infants, multiple bruises in different stages of healing, and inconsistent history are red flags for non-accidental trauma.

Question 4

Intussusception most commonly occurs at which anatomical location?

Accepted Answer

Ileocecal valve (ileocolic)

Answer

Ileocolic intussusception at the ileocecal valve is the most common type in children, often presenting with intermittent colicky pain and currant jelly stools.

Question 5

What is the appropriate initial fluid bolus for a child in septic shock?

Accepted Answer

20 mL/kg NS or LR IV over 5–10 minutes, reassess after each bolus

Answer

PALS recommends 20 mL/kg of isotonic crystalloid (NS or LR) IV over 5–10 minutes for pediatric septic shock, reassessing after each bolus for response and fluid overload.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Pediatric Emergencies 2