CPEN Environmental Emergencies 3

Question 1

A 5-year-old is stung by a scorpion in Arizona. The child is drooling, has roving eye movements, and is agitated with abnormal limb movements. Which medication is MOST effective for severe scorpion envenomation in the US?

Accepted Answer

Antivenom (Anascorp)

Answer

Centruroides scorpion antivenom (Anascorp) rapidly reverses neurotoxic symptoms including cranial nerve dysfunction, excessive secretions, and motor abnormalities.

Question 2

An 8-year-old develops a wound with a bulls-eye rash 5 days after a camping trip in the Northeastern US. She reports fatigue and arthralgia. The nurse suspects Lyme disease. Which treatment should be anticipated?

Accepted Answer

Amoxicillin for 14–21 days

Answer

Amoxicillin is the preferred antibiotic for early Lyme disease in children under 8; doxycycline is reserved for children ≥8 years due to dental staining risk.

Question 3

A 2-year-old is found in a garage with suspected CO exposure. The child is crying and has a carboxyhemoglobin (COHb) level of 22%. SpO₂ by pulse oximetry reads 98%. Which statement BEST explains this discrepancy?

Accepted Answer

Pulse oximetry cannot distinguish COHb from oxyhemoglobin

Answer

Standard pulse oximeters cannot differentiate carboxyhemoglobin from oxyhemoglobin, giving falsely normal SpO₂ readings; co-oximetry blood gas is required.

Question 4

A 12-year-old rock climber falls into a fast-moving river and is submerged for 6 minutes in 8°C water before rescue. He has a core temp of 28°C and is pulseless. What is the MOST appropriate resuscitation approach?

Accepted Answer

Begin CPR and transport for ECMO-supported rewarming

Answer

Cold water submersion victims with hypothermic cardiac arrest should receive CPR and be transported for extracorporeal rewarming (ECMO), as hypothermia is protective and full recovery is possible.

Question 5

A 9-year-old develops a painful, blistered wound on the foot after stepping on a stingray. Which treatment is MOST effective for pain control?

Accepted Answer

Immerse the foot in hot water (43–45°C) for 30–90 minutes

Answer

Hot water immersion (as hot as tolerated, 43–45°C) denatures the heat-labile proteins in stingray venom, providing rapid pain relief.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Environmental Emergencies 3