CFRN Pediatric and Neonatal Patients 4

Question 1

A 2-week-old term neonate presents with poor feeding, hypotonia, and a serum sodium of 118 mEq/L. The SAFEST rate of sodium correction is:

Accepted Answer

Increase serum sodium no faster than 0.5 mEq/L/hr (max 10–12 mEq/L/24 hr)

Answer

Overcorrection of hyponatremia risks osmotic demyelination; the safe rate is no faster than 0.5 mEq/L/hr or 10–12 mEq/L per 24 hours.

Question 2

A 5-month-old in respiratory distress has nasal flaring, subcostal retractions, and diffuse wheezing. RSV bronchiolitis is suspected. Which intervention has the BEST evidence for flight transport?

Accepted Answer

High-flow nasal cannula oxygen therapy

Answer

High-flow nasal cannula therapy is the best-supported intervention for moderate-to-severe bronchiolitis, reducing work of breathing without the inconsistent response seen with bronchodilators.

Question 3

A premature neonate on a ventilator develops sudden oxygen desaturation, absent breath sounds on the left, and a trachea deviated to the right. The flight nurse should first:

Accepted Answer

Needle decompress the left chest at the 2nd ICS MCL

Answer

Absent unilateral breath sounds with tracheal deviation in a ventilated neonate is a tension pneumothorax requiring immediate needle decompression.

Question 4

A 9-year-old with status epilepticus has failed two doses of lorazepam. Per current pediatric guidelines, what is the next appropriate medication?

Accepted Answer

Fosphenytoin 20 PE/kg IV

Answer

Fosphenytoin 20 PE/kg IV is the recommended second-line agent for pediatric benzodiazepine-refractory status epilepticus per current guidelines.

Question 5

A 12-hour-old neonate has a blood glucose of 32 mg/dL and is symptomatic with jitteriness. The appropriate initial IV treatment is:

Accepted Answer

D10W 2 mL/kg IV bolus followed by D10W infusion at GIR 6 mg/kg/min

Answer

Symptomatic neonatal hypoglycemia is treated with D10W 2 mL/kg IV bolus (200 mg/kg), then a continuous D10W infusion to maintain glucose; D50W is too concentrated for neonates.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Pediatric and Neonatal Patients 4