CPEN Sepsis and Infectious Disease Emergencies 3

Question 1

A 6-week-old presents with paroxysmal coughing episodes, post-tussive vomiting, and an apneic episode. The infant was born to an incompletely vaccinated mother. Which diagnosis is MOST likely?

Accepted Answer

Pertussis (whooping cough)

Answer

Pertussis in young infants presents with paroxysmal cough, post-tussive vomiting, and apnea; the classic inspiratory 'whoop' may be absent in neonates and young infants.

Question 2

A child presents sitting upright and leaning forward in the 'sniffing position' with high fever, drooling, and severe respiratory distress. Epiglottitis is suspected. What is the MOST important immediate action?

Accepted Answer

Minimize agitation, prepare for definitive airway management, and call for anesthesia/ENT backup

Answer

Epiglottitis can cause complete airway obstruction with any agitation; the priority is keeping the child calm and immediately mobilizing resources for controlled intubation or surgical airway.

Question 3

Which radiographic finding on a lateral neck X-ray is MOST consistent with epiglottitis?

Accepted Answer

Thumb sign representing an enlarged, rounded epiglottis

Answer

The 'thumb sign' on lateral neck X-ray represents the swollen, rounded epiglottis projecting posteriorly and is the classic radiographic finding of epiglottitis.

Question 4

A 4-year-old presents with fever, headache, and a rash that began on the wrists and ankles 3 days ago and has now spread to the trunk. There is a history of tick exposure. Which infection is MOST likely?

Accepted Answer

Rocky Mountain Spotted Fever (RMSF)

Answer

RMSF classically begins with a macular or petechial rash on the palms, wrists, and ankles that spreads centripetally (inward toward the trunk), along with fever and tick exposure history.

Question 5

What is the drug of choice for Rocky Mountain Spotted Fever in a 5-year-old child, despite typical age-related concerns?

Accepted Answer

Doxycycline

Answer

Doxycycline is the recommended treatment for RMSF in all children, including those under 8 years, because the risk of death from untreated RMSF far outweighs the risk of dental staining from a short course.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Sepsis and Infectious Disease Emergencies 3