DOH Nursing Pediatric Nursing 2 — Questions and Answers
Question 1: A child with suspected epiglottitis arrives at the emergency department. What action should the nurse avoid?
- Attempting to visualize the throat with a tongue depressor (Correct answer)
- Administering nebulized epinephrine
- Starting IV access
- Positioning the child in a comfortable upright position
Correct answer: Attempting to visualize the throat with a tongue depressor
In epiglottitis, inserting a tongue depressor or attempting throat examination can trigger laryngospasm and complete airway obstruction. The airway must be secured in a controlled setting (OR with anesthesia backup) before any oral examination.
Question 2: What is the recommended site for intraosseous (IO) access in a child in cardiac arrest when IV access cannot be established?
- Proximal tibia, 1–2 cm below the tibial tuberosity (Correct answer)
- Distal tibia at the ankle
- Distal femur above the knee
- Iliac crest
Correct answer: Proximal tibia, 1–2 cm below the tibial tuberosity
The proximal tibia is the preferred IO site in children because it is easily accessible, has a flat medial surface, and is distant from chest compressions. IO access provides rapid vascular access for fluids and medications when IV access fails.
Question 3: A 10-month-old infant is brought in after being found unresponsive. The nurse suspects non-accidental trauma. Which injury pattern is most associated with abusive head trauma?
- Retinal hemorrhages and subdural hematoma without adequate explanation (Correct answer)
- Single linear skull fracture from a reported fall
- Bilateral forearm fractures from a motor vehicle accident
- Soft tissue bruising on the forehead from a table edge
Correct answer: Retinal hemorrhages and subdural hematoma without adequate explanation
Abusive head trauma (shaken baby syndrome) classically causes bilateral retinal hemorrhages, subdural hematoma (from bridging vein tears), and diffuse axonal injury — all without adequate history. Unexplained intracranial injury in infants is a red flag for abuse.
Question 4: Which immunization is recommended at birth for all neonates in the UAE?
- Hepatitis B vaccine (Correct answer)
- BCG and Hepatitis B vaccine
- Rotavirus vaccine
- MMR vaccine
Correct answer: Hepatitis B vaccine
In the UAE National Immunization Schedule, neonates receive BCG (tuberculosis prevention) and the first dose of Hepatitis B vaccine at birth. The Hepatitis B birth dose prevents vertical transmission from HBsAg-positive mothers.
Question 5: A 7-year-old has a blood glucose of 38 mg/dL and is conscious and able to swallow. What is the priority treatment?
- Give 15 g of fast-acting carbohydrates orally and recheck glucose in 15 minutes (Correct answer)
- Administer IV dextrose 50% immediately
- Give IM glucagon injection
- Wait for physician orders before treating
Correct answer: Give 15 g of fast-acting carbohydrates orally and recheck glucose in 15 minutes
The '15-15 rule' for conscious hypoglycemic children: give 15 g of fast-acting carbohydrate (4 oz juice, glucose tablets), wait 15 minutes, recheck blood glucose. If still <70 mg/dL, repeat. IV dextrose and glucagon are for unconscious patients.
Question 6: Which finding in a newborn requires immediate reporting to the physician?
- Respiratory rate of 68 breaths per minute at rest (Correct answer)
- Acrocyanosis in the first hour of life
- Heart rate of 148 beats per minute
- Passage of meconium within 24 hours of birth
Correct answer: Respiratory rate of 68 breaths per minute at rest
Normal neonatal respiratory rate is 30–60 breaths per minute. A rate of 68 bpm (tachypnea) at rest suggests respiratory distress and requires immediate assessment. Acrocyanosis, HR 148, and meconium within 24 hours are all normal neonatal findings.
DOH Nursing Pediatric Nursing 2
A child with suspected epiglottitis arrives at the emergency department.
What action should the nurse avoid?