CPEN Pediatric Assessment 3 — Questions and Answers
Question 1: The AVPU scale is used to rapidly assess a child's level of consciousness. What does the 'P' stand for?
- Pain response (Correct answer)
- Purposeful movement
- Posturing
- Peripheral perfusion
Correct answer: Pain response
In the AVPU scale, 'P' stands for responding to Pain, indicating the child responds only to painful stimuli.
Question 2: A 10-year-old child weighing 30 kg presents in cardiac arrest. Using the Broselow tape, the nurse should anticipate an epinephrine dose of:
- 0.03 mg IV
- 0.3 mg IV (Correct answer)
- 3 mg IV
- 0.003 mg IV
Correct answer: 0.3 mg IV
Epinephrine for cardiac arrest is dosed at 0.01 mg/kg IV/IO; for a 30 kg child this equals 0.3 mg.
Question 3: Which sign differentiates obstructive shock from distributive shock in a pediatric patient?
- Tachycardia
- Distended neck veins and muffled heart sounds (Correct answer)
- Warm, flushed skin
- Wide pulse pressure
Correct answer: Distended neck veins and muffled heart sounds
Jugular venous distension and muffled heart sounds (Beck's triad) suggest obstructive shock from cardiac tamponade, distinguishing it from distributive shock.
Question 4: When assessing respiratory distress in a toddler, nasal flaring PRIMARILY indicates:
- Upper airway obstruction only
- Increased respiratory effort to maximize airflow (Correct answer)
- Impending respiratory failure
- Normal breathing variant in children under 2
Correct answer: Increased respiratory effort to maximize airflow
Nasal flaring is a compensatory mechanism in young children that dilates the nares to decrease airway resistance and increase airflow during respiratory distress.
Question 5: A 7-year-old has a Glasgow Coma Scale (GCS) score of 8. Which airway intervention is MOST indicated?
- Supplemental oxygen by nasal cannula
- Bag-mask ventilation
- Definitive airway management (intubation) (Correct answer)
- Jaw thrust maneuver only
Correct answer: Definitive airway management (intubation)
A GCS of 8 or below is a widely accepted threshold indicating inability to protect the airway and the need for definitive airway management.
Question 6: During trauma assessment of a 5-year-old, the nurse notes paradoxical chest wall movement. This finding is MOST consistent with:
- Simple pneumothorax
- Flail chest (Correct answer)
- Diaphragmatic hernia
- Pulmonary contusion
Correct answer: Flail chest
Paradoxical movement—the chest segment moves inward during inhalation—is the hallmark of a flail chest caused by multiple rib fractures.
Question 7: A 4-month-old infant presents with lethargy, bulging fontanelle, and high-pitched cry. Which diagnosis should be IMMEDIATELY considered?
- Colic
- Bacterial meningitis (Correct answer)
- Benign intracranial hypertension
- Normal developmental variant
Correct answer: Bacterial meningitis
The triad of lethargy, bulging fontanelle, and high-pitched cry in an infant is a classic presentation of bacterial meningitis requiring urgent assessment and treatment.
CPEN Pediatric Assessment 3
The AVPU scale is used to rapidly assess a child's level of consciousness.
What does the 'P' stand for?