CEN Pediatric Emergencies 3

Question 1

A 10-year-old with Type 1 diabetes presents with Kussmaul respirations, fruity breath, blood glucose of 480 mg/dL, and pH 7.18. What is the priority treatment?

Accepted Answer

IV fluid resuscitation with normal saline followed by insulin infusion

Answer

Fluid resuscitation with NS is the first priority in pediatric DKA to correct dehydration and restore perfusion; insulin infusion is started after fluids.

Question 2

What is the most common cause of cardiac arrest in pediatric patients?

Accepted Answer

Respiratory failure or shock leading to asystole

Answer

Unlike adults, pediatric cardiac arrests are rarely due to primary cardiac arrhythmia; they are most commonly caused by respiratory failure or shock that progresses to asystole.

Question 3

A 7-year-old is in anaphylaxis with urticaria, stridor, and hypotension. What is the priority intervention?

Accepted Answer

Epinephrine 0.01 mg/kg IM (1:1000 solution) in the anterolateral thigh

Answer

Epinephrine IM is the only drug proven to reverse anaphylaxis and is the first-line treatment; all other medications are adjuncts.

Question 4

Which size endotracheal tube is appropriate for a 5-year-old undergoing emergency intubation?

Accepted Answer

4.5–5.0 mm cuffed or uncuffed

Answer

The formula (age/4 + 4) estimates uncuffed ETT size; for a 5-year-old, this gives 5.25, so a 4.5–5.0 mm tube is appropriate.

Question 5

A 3-year-old presents with a temperature of 39.5°C, petechiae spreading rapidly, and altered mental status. What diagnosis requires immediate action?

Accepted Answer

Meningococcal septicemia

Answer

Rapidly spreading petechiae or purpura with fever and altered mental status is meningococcal septicemia until proven otherwise, requiring immediate IV ceftriaxone and ICU care.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Pediatric Emergencies 3