CFRN Pediatric and Neonatal Patients 3

Question 1

A 5-year-old with suspected meningitis develops a petechial/purpuric rash en route. The MOST critical immediate intervention is:

Accepted Answer

Administer IV ceftriaxone immediately

Answer

Purpuric rash with meningitis signs suggests meningococcal septicemia; immediate ceftriaxone administration takes priority over cultures or LP in the flight environment.

Question 2

A neonate born at 34 weeks has a pre-ductal SpO2 of 92% and post-ductal SpO2 of 78%. This gradient most likely indicates:

Accepted Answer

Pulmonary hypertension with right-to-left ductal shunting

Answer

A pre-ductal SpO2 higher than post-ductal SpO2 indicates right-to-left shunting across the ductus arteriosus, consistent with persistent pulmonary hypertension of the newborn.

Question 3

What is the correct initial defibrillation dose for a 20 kg child in ventricular fibrillation per current PALS guidelines?

Accepted Answer

2 J/kg

Answer

PALS recommends an initial defibrillation dose of 2 J/kg for pediatric VF/pulseless VT, with subsequent shocks at 4 J/kg.

Question 4

A 4-month-old presents with inspiratory stridor, a 'seal-bark' cough, and a Westley croup score of 8. The flight nurse should prioritize:

Accepted Answer

Racemic epinephrine nebulization and dexamethasone

Answer

Severe croup (Westley ≥6) is managed with racemic epinephrine for rapid airway dilation and dexamethasone for sustained anti-inflammatory effect before considering intubation.

Question 5

A 7-year-old with a closed head injury has a GCS of 8 and ICP suspected to be elevated. During transport, head positioning should be:

Accepted Answer

30-degree head elevation with the head in midline

Answer

Elevating the head of bed 30 degrees with the head in a neutral midline position promotes venous drainage and reduces ICP without compromising CPP.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Pediatric and Neonatal Patients 3