CPEN Sepsis and Infectious Disease Emergencies 5

Question 1

A 5-year-old presents with high fever, drooling, stridor, and tripod positioning. The child appears toxic. Which action is MOST appropriate?

Accepted Answer

Keep the child calm, call anesthesia/ENT, prepare for emergency airway

Answer

In suspected epiglottitis, airway stability is paramount; agitating the child or attempting examination can precipitate complete obstruction — immediate expert airway management is required.

Question 2

Which antibiotic combination is recommended as empiric therapy for a neonate (< 28 days) with suspected sepsis without a focal source?

Accepted Answer

Ampicillin and gentamicin

Answer

Ampicillin plus gentamicin provides coverage for GBS, Listeria monocytogenes, and gram-negative organisms that are the most common neonatal pathogens.

Question 3

A 9-year-old with septic shock is on norepinephrine and epinephrine infusions but remains hypotensive. Bedside echocardiography shows severely depressed LV function. Which additional agent is MOST appropriate?

Accepted Answer

Add milrinone

Answer

Milrinone, a phosphodiesterase-3 inhibitor, improves cardiac contractility and reduces afterload, making it appropriate for septic shock with significant myocardial dysfunction.

Question 4

Which clinical feature BEST distinguishes Kawasaki disease from sepsis in a febrile child?

Accepted Answer

Fever lasting more than 5 days with conjunctivitis, oral changes, rash, and extremity changes

Answer

Kawasaki disease is defined by fever ≥5 days plus at least 4 of 5 classic features (conjunctivitis, oral changes, rash, extremity changes, cervical lymphadenopathy), differentiating it from sepsis.

Question 5

A 12-year-old returns from a camping trip with fever, headache, myalgias, and a macular rash starting on the wrists and ankles spreading centrally. Which treatment should be initiated IMMEDIATELY?

Accepted Answer

Doxycycline

Answer

Rocky Mountain Spotted Fever (RMSF) is treated with doxycycline in all age groups, including children, and delay in treatment significantly increases mortality.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Sepsis and Infectious Disease Emergencies 5