CPEN Respiratory Emergencies 4

Question 1

Which capnography waveform pattern is most consistent with severe bronchospasm in an intubated child?

Accepted Answer

Shark fin (upsloping plateau)

Answer

The 'shark fin' pattern on capnography indicates incomplete exhalation due to bronchospasm, causing a prolonged, upsloping expiratory phase.

Question 2

A 4-year-old is found apneic. After 2 rescue breaths fail to produce chest rise, the next step is:

Accepted Answer

Attempt to ventilate again with head repositioned

Answer

If initial rescue breaths do not produce chest rise, the head-tilt/chin-lift should be repositioned before a second attempt, as poor positioning is the most common cause.

Question 3

For a 2-year-old (10 kg) in status asthmaticus requiring magnesium sulfate, the correct IV dose is:

Accepted Answer

25–50 mg/kg (max 2 g)

Answer

IV magnesium sulfate for pediatric asthma is dosed at 25–75 mg/kg (max 2 g) infused over 20–30 minutes.

Question 4

Which clinical sign BEST indicates impending respiratory failure in an infant with bronchiolitis?

Accepted Answer

Apneic episodes

Answer

Apneic episodes indicate exhaustion and central respiratory compromise — a sign of impending respiratory failure requiring immediate intervention.

Question 5

A 9-year-old with cystic fibrosis presents with acute hemoptysis, fever, and increased sputum. The PRIORITY nursing action is:

Accepted Answer

Position the patient with the affected side down

Answer

Positioning the patient with the bleeding (affected) lung down prevents blood from flooding the contralateral lung and maintains ventilation.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Respiratory Emergencies 4