CPEN Respiratory Emergencies 2

Question 1

A 3-year-old presents with sudden onset of unilateral wheezing and decreased breath sounds on the right. The most likely diagnosis is:

Accepted Answer

Foreign body aspiration

Answer

Sudden unilateral wheezing with decreased breath sounds in a toddler is classic for foreign body aspiration, which commonly lodges in the right mainstem bronchus.

Question 2

When calculating the correct endotracheal tube size for a child aged 6 years using the uncuffed formula, the result is:

Accepted Answer

5.0 mm

Answer

The uncuffed ETT formula is (age/4) + 4, so for a 6-year-old: (6/4) + 4 = 5.5; however the cuffed formula (age/4 + 3.5) gives 5.0 mm, which is now preferred — select 5.0 for cuffed.

Question 3

A child with epiglottitis is most likely to assume which position to maximize airway patency?

Accepted Answer

Tripod (sniffing) position

Answer

Children with epiglottitis instinctively sit in the tripod (sniffing) position — leaning forward with neck extended — to open the supraglottic airway.

Question 4

Which finding most strongly differentiates viral croup from bacterial tracheitis?

Accepted Answer

High fever with toxic appearance

Answer

Bacterial tracheitis presents with high fever, toxic appearance, and rapid deterioration — distinguishing it from the milder, viral presentation of croup.

Question 5

A 7-week-old infant presents with a 2-week history of post-tussive emesis and inspiratory 'whoop.' The priority intervention is:

Accepted Answer

Place on contact and droplet precautions and start azithromycin

Answer

Pertussis in young infants is life-threatening; isolation (droplet precautions) and azithromycin are the priority interventions.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Respiratory Emergencies 2