FREE CPEN Exam Question and Answers
After being stung by a bee, a boy experiences acute facial edema, dyspnea, and hypotension, all of which indicate anaphylaxis. The most crucial intervention is:
Explanation:
The most crucial treatment for a child who has been stung by a bee and has significant facial edema, dyspnea, and hypotension indicative of anaphylaxis is epinephrine since it reverses the vasodilation and tightness of the airway. Diphenhydramine, antihistamines, and steroids like prednisone may also be used in addition to epinephrine. To reverse hypotension, prompt fluid restriction is also important. Dyspnea can be treated with oxygen therapy.
When a 4-year-old who swallowed a little toy has inspiratory stridor, the obstruction is probably:
Explanation:
When a 4-year-old presents with inspiratory stridor after ingesting a tiny toy, the obstruction is most likely at or above the vocal cords. Other obstructions at his level could be caused by mucous, blood, or teeth that have been swallowed. Expiratory stridor is more likely when there is an impediment below the vocal chords. The youngster will typically show signs of agitation, including diaphoresis, retractions of the chest wall, and cyanosis.
Phimosis is a common occurrence in children who have not been circumcised and often goes away by the age of:
Explanation:
Phimosis is a common finding in uncircumcised children and typically goes away by the time they are between the ages of five and seven. Gently retracting the foreskin for cleaning is permissible, but parents of male babies and young boys should be warned against doing so because it can cause tissue damage and scarring. Infection or scarring are two conditions that can lead to pathologic phimosis. Topical corticosteroids may be used for 6-7 weeks as a treatment for restricted phimosis. Circumcision might be advised in unusual circumstances.
For both parents and kids, informed consent must include the following:
Explanation:
A discussion of the risks and advantages of receiving treatment versus not receiving treatment, as well as alternative options (independent of cost or insurance coverage for treatment), is a requirement of informed consent for parents and children. An explanation of the diagnosis, the kind of treatment or operation, and the justification for the recommendation should all be included in the informed consent process. Informed consent is required in all 50 states.
A 15-year-old student has a rapid onset of fever, chills, and headache along with signs of confusion and hallucinations. He displays nuchal stiffness and photophobia. The indications from Brudzinski and Kernig are encouraging. The key diagnostic procedure is:
Explanation:
For a diagnosis of bacterial meningitis that is in line with the symptoms, a lumbar puncture and cerebrospinal fluid analysis are required. Meningitis alone causes the rare occurrence of Kernig's and Brudzinski's symptoms, which are peculiar to that condition:
> Kernig's sign: Flex each hip, and while doing so, strive to straighten the knee. This is uncomfortable and challenging with meningitis due to spasms of the hamstrings.
> Brudzinski's sign: With the child resting supine, bend the neck by bringing the head toward the chest. With meningitis, the stiffness in the neck leads the hips and knees to flex.
The sick vs not sick visual assessment's objectives are to:
Explanation:
In order to avoid delays in administering life-saving therapy, the sick vs. not sick visual assessment is used to distinguish between those who are critically ill and those who seem stable. Each patient is swiftly reviewed by the nurse, who notes the ABCs (airway, breathing, and circulation), degree of consciousness, any signs of bleeding, body alignment/position, and skin condition. People who are deemed "ill" demonstrate life-threatening issues in these areas; people who are deemed "not sick" do not, even though they might sustain non-life-threatening injuries.
An 8-year-old child with gastroenteritis who has experienced significant nausea and vomiting and is at risk for hypokalemia. Which of the aforementioned indications or symptoms best describes hypokalemia?
Explanation:
People who experience severe nausea and vomiting and those who employ nasogastric suctioning are at risk for developing hypokalemia. Hypotension, lethargy, and exhaustion are all signs of hypokalemia, as well as muscle weakness, cramps, and hyporeflexia. Despite the fact that this youngster has diarrhea, hypokalemia can cause constipation and bloating in the abdomen. Polyuria and polydipsia can eventually develop from hypokalemia, which will affect kidney function. Premature ventricular complexes, a prolonged QT interval, a depressed ST segment, and flat or inverted T waves are all signs of hypokalemia on the ECG.