FREE Pediatric CCRN Neonatal Question and Answers
During a house fire, firemen find a 6-year-old boy unconscious in his bed; they intubate him, start an intravenous line, and give him fluids. When they take him to the emergency hospital, he has 45% total-body-surface-area (TBSA) burns on his torso and legs. Which of the following issues is most probable to impact this child?
The higher body surface-to-mass ratio of children makes them more vulnerable to hypothermia consequent to severe burn injuries. A child is more likely to experience conductive heat loss and evaporative water loss as an outcome. Until the burn sites have received skin grafts and have fully healed, hypothermia continues to be a serious issue.
An 8-year-old girl and her mother arrive at the emergency room after the girl fell off her bike around four hours earlier. The child has been complaining of severe abdominal pain ever since the fall, according to her mother, who was riding her bike when she fell, with the handlebars ""bumping into her chest and stomach. Upon assessment, the nurse observes a positive Kehr sign. What organ does the nurse assume has been damaged based on this discovery?
The most frequently injured organ in children is the spleen, which is a solid organ. LUQ soreness, bruising, or abrasion, a positive Kehr's sign (LUQ discomfort radiating to the left shoulder), indicators of reduced perfusion, and nausea and vomiting are all symptoms of spleen injury.
A male patient, age 16, arrives at the emergency room complaining of nausea, vomiting, and a severe headache. He spent the afternoon cleaning up a paint thinner spill from his side job as a painter. According to him, these symptoms began around an hour after he finished his shift at work. Upon physical examination, he exhibits some degree of confusion, with a heart rate of 115 and a room air oxygen saturation of 95%. Carboxyhemoglobin levels are 23%, according to carbon monoxide oximetry. Which one of the subsequent interventions should the nurse begin applying immediately?
Headaches, dizziness, nausea, vomiting, and confusion are among the symptoms. When the patient is taken out of the exposure, the symptoms become better. The delivery of 100% oxygen or hyperbaric oxygen is the initial and first-line treatment for CO poisoning because elimination happens largely through the pulmonary circulation due to competitive binding of hemoglobin to oxygen.
Infants born prematurely face a serious risk of intracranial hemorrhage (ICH), which is divided into four classes. Which grade involves intraventricular blood among the following?
Intraventricular blood is present in grade II intracranial hemorrhage.
Which of the following symptoms would indicate a newborn with patent ductus arteriosus (PDA)?
A infant with PDA was assessed, and the results showed a machine-like continuous murmur that is most audible at the left upper sternal boundary. Poor weight gain, tachypnea, tachycardia, and poor feeding are frequently observed. Due to ductal shunting of blood into the low-pressure pulmonary artery, the pulse pressure is wide (not narrow), and peripheral pulses may be strong and collapse rapidly.
Which of the four primary types of cerebral aneurysms is most frequently found in the brain's basilar arteries?
Aneurysms come in four basic categories, and one of them is Fusiform (giant) aneurysms, which typically appear in basilar arteries or the terminal ends of internal carotids, swell or dilate the entire diameter of the affected vessel and may be caused by atherosclerotic changes.
A nurse is educating the family of a baby who has congenital heart disease (CHD) and the DiGeorge syndrome. Prior to delivery, the baby's condition was unclear to the family. What types of help and proactive guidance should be presented?
Breastmilk serves nourishment that is simple to digest and contains antibodies that help suppress the immune system, lower the risk of NEC, and promote proper feeding development. In order to keep the breast milk supply steady until the baby can handle enteral feedings, pumping should be encouraged.
In the pediatric emergency room, an 18-month-old child is identified as having acute laryngotracheobronchitis (LTB). The nurse is getting ready to send the child home after treating and stabilizing the patient. Which at-home remedy should be used, the nurse recommends to the parents?
The child can be placed in a steam-filled space, such as a bathroom with a hot running shower, to assist wet the airway and liquefy mucus secretions, or a cool-mist humidifier can be used. This is frequently recommended upon hospital release and is beneficial for supportive care shortly following emergency treatment.
To get a cardiac biopsy, a pediatric patient is getting ready for a cardiac catheterization. Which allergies need to be examined for before performing this procedure on the patient?
The femoral artery is used to introduce the catheter, which is subsequently threaded to the heart. It is crucial to check for any iodine or shellfish allergies before the surgery. The possibility of an adverse reaction to the contrast dye used in the operation rises if a patient is allergic to either of these.
What pediatric burn injuries ought NOT to be referred to a burn facility?
To receive specialist care for particular types of burn injuries, the American Burn Association (ABA) has established a set of criteria for referring patients to a burn-specific critical care setting. A burn center should be consulted for any child who had second-degree partial-thickness burns that covered more than 10% of their entire body surface.
Digoxin (Lanoxin) is prescribed to a young patient for heart failure. The nurse understands that poisoning is often detected at what value?
The history can be used to estimate a toxic dose, but laboratory analysis of serum levels and careful patient assessment are essential for preventing overdose. Toxicity typically manifests at concentrations higher than 2 ng/mL, which is within the therapeutic trough range of 0.5 to 2 ng/mL.
Which of the following describes the fat embolism syndrome (FES)'s most typical showing feature in children?
The most frequent apparent signs and symptoms of FES are pulmonary abnormalities. The most common initial signs are hypoxemia, dyspnea, and tachypnea, and 90% of cases involve respiratory distress.
Which of the following disorders has been linked to a risk factor for hyperosmolar infusions given to infants too quickly, causing an abrupt rise in systolic blood pressure (BP)?
Hypoxia, placental abruption, respiratory issues, and fast infusion of hyperosmolar infusions are risk factors for IVH and ICH in preterm and term newborns. To avoid abrupt changes in blood pressure, volume replacement should be given to infants gradually.
After suffering from burns that resulted in the epidermis and dermis completely sloughing off, a 16-year-old male patient was taken to the emergency room. What type of burn is that?
When a burn is classified as third-degree (or full-thickness), the epidermis and dermis have been totally damaged. The patient usually feels no pain because sensory innervation (nerve endings) is damaged, resulting in the skin appearing dry and leathery and being difficult to palpate. The damage may be waxy-white in appearance, frequently swelling, or it may be black, brown, or yellow (signifying exposed adipose tissue). Burn centers should be consulted for the treatment of third-degree burns.
Which of the following behaviors best describes a 15-year-old child's developmental activities?
Teenagers (12–18 years old) frequently look for a sense of self and a personal identity during their adolescent years. At this age, socialization is the most crucial component of life because they are growing more independent. A teen's peer group will be of the utmost importance when they start to consider who they are, and they will majorly contribute to their self-esteem. Therefore, the ideal example of a developmentally appropriate activity is hanging out with friends.
The infant being cared for by the nurse has been identified as having transposition of the great arteries (TGA), which will be surgically corrected. Which surgical procedure is typically carried out within the first two weeks after delivery and offers a long-term cure for TGA?
TGA is a congenital cardiac abnormality where the pulmonary artery and aorta are flipped over, resulting in parallel circulations from the left ventricle giving rise to the pulmonary artery and the right ventricle giving rise to the aorta. By performing the arterial switch repair by the time the baby is two weeks old, CHF and the early onset of PVOD can be prevented.