CPEN Trauma Care 5

Question 1

A 10-year-old sustains burns over the entire front torso and both arms. Using the Rule of Nines (modified for children), what percentage of total body surface area (TBSA) is burned?

Accepted Answer

27%

Answer

In children, the anterior torso is 18% and each arm is 9% (9% × 2 = 18%), but the Lund-Browder chart or pediatric-modified Rule of Nines gives the anterior trunk as 18% and both arms as 9% total, making approximately 27% TBSA.

Question 2

What is the Parkland formula for burn resuscitation, and how is it calculated for a 20 kg child with 30% TBSA burns?

Accepted Answer

4 mL × kg × %TBSA = 2400 mL in first 24 hours

Answer

The Parkland formula is 4 mL × weight (kg) × %TBSA = total mL in first 24 hours; for this patient: 4 × 20 × 30 = 2400 mL.

Question 3

A 13-year-old with penetrating abdominal trauma has tachycardia and peritoneal signs. The MOST appropriate next step is:

Accepted Answer

Immediate surgical consultation for exploratory laparotomy

Answer

Peritoneal signs (rigidity, rebound tenderness) after penetrating trauma indicate the need for emergent surgical consultation and likely operative intervention.

Question 4

Which cervical spine clearance criterion is validated for use in children and helps avoid unnecessary CT radiation?

Accepted Answer

NEXUS criteria

Answer

The NEXUS (National Emergency X-Radiography Utilization Study) criteria are validated for pediatric cervical spine clearance and include assessment of midline tenderness, distracting injury, intoxication, altered mentation, and neurological deficit.

Question 5

A 4-year-old is brought in after a near-drowning event in a backyard pool. Initial resuscitation is successful. The nurse should prioritize monitoring for:

Accepted Answer

Delayed pulmonary edema and secondary drowning

Answer

Secondary drowning can occur hours after apparent recovery due to pulmonary edema from aspirated water, requiring at least 6-8 hours of observation.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Trauma Care 5