CPEN Sepsis and Infectious Disease Emergencies 2

Question 1

A 3-year-old presents with high fever, severe headache, neck stiffness, and a non-blanching petechial rash spreading rapidly. What is the PRIORITY intervention?

Accepted Answer

Administer IV ceftriaxone immediately without waiting for LP

Answer

Suspected meningococcemia requires immediate IV antibiotics (ceftriaxone) without delay, as each hour of treatment delay significantly increases mortality.

Question 2

Which CSF analysis result is MOST consistent with bacterial meningitis?

Accepted Answer

Turbid fluid, elevated protein, decreased glucose, neutrophilic pleocytosis

Answer

Bacterial meningitis typically shows turbid CSF with elevated protein, decreased glucose relative to serum, and neutrophilic pleocytosis due to bacterial invasion.

Question 3

A 2-year-old has had fever for 6 days with bilateral non-purulent conjunctival injection, erythematous cracked lips, strawberry tongue, and a diffuse macular rash. Which diagnosis BEST fits this presentation?

Accepted Answer

Kawasaki disease

Answer

Kawasaki disease requires fever for 5 or more days plus at least 4 of 5 criteria: bilateral non-exudative conjunctivitis, oral mucosal changes, rash, extremity changes, and cervical lymphadenopathy.

Question 4

What is the standard first-line treatment for Kawasaki disease?

Accepted Answer

IV immunoglobulin (IVIG) and high-dose aspirin

Answer

IVIG (2 g/kg single infusion) and high-dose aspirin are the standard treatment for Kawasaki disease to reduce inflammation and prevent coronary artery aneurysms.

Question 5

A 5-year-old develops fever, sore throat, and a diffuse 'sandpaper-like' rash after a positive rapid strep test. What is the MOST appropriate antibiotic treatment?

Accepted Answer

Amoxicillin for 10 days

Answer

Amoxicillin for 10 days (or penicillin) is first-line treatment for Group A Streptococcal pharyngitis/scarlet fever to eradicate the organism and prevent rheumatic fever.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Sepsis and Infectious Disease Emergencies 2