Pediatric Nurse Exam Pediatric Nurse Common Pediatric Emergencies 2 — Questions and Answers
Question 1: A 4-year-old presents with sudden onset stridor, drooling, and a muffled voice. The child prefers to sit upright and looks toxic. What is the most likely diagnosis?
- Croup
- Epiglottitis (Correct answer)
- Foreign body aspiration
- Bacterial tracheitis
Correct answer: Epiglottitis
Epiglottitis presents with the classic triad of drooling, dysphagia, and distress along with a toxic appearance and preference for the tripod position.
Question 2: A 6-week-old infant is brought in with projectile vomiting after every feeding. The infant appears hungry and is losing weight. What condition does the nurse suspect?
- Gastroesophageal reflux
- Pyloric stenosis (Correct answer)
- Intussusception
- Hirschsprung disease
Correct answer: Pyloric stenosis
Pyloric stenosis classically presents at 2–8 weeks with projectile, non-bilious vomiting and a constantly hungry infant who is losing weight.
Question 3: During assessment of a child in anaphylaxis, which intervention takes the highest priority?
- Administering oral diphenhydramine
- Establishing IV access for fluid bolus
- Administering intramuscular epinephrine to the lateral thigh (Correct answer)
- Applying supplemental oxygen via non-rebreather mask
Correct answer: Administering intramuscular epinephrine to the lateral thigh
Intramuscular epinephrine to the anterolateral thigh is the first-line treatment for anaphylaxis and should be given before all other interventions.
Question 4: A 3-year-old is found unresponsive with a suspected opioid ingestion. Respirations are 6/min and shallow. What is the priority intervention?
- Administer activated charcoal
- Administer naloxone and provide bag-valve-mask ventilation (Correct answer)
- Start chest compressions immediately
- Obtain IV access and run a normal saline bolus
Correct answer: Administer naloxone and provide bag-valve-mask ventilation
Respiratory depression from opioid toxicity is reversed with naloxone while providing assisted ventilation to correct hypoxia.
Question 5: A 10-year-old diabetic child presents with fruity breath, Kussmaul respirations, and a blood glucose of 520 mg/dL. Which electrolyte abnormality is of greatest concern during insulin therapy?
- Hypernatremia
- Hypocalcemia
- Hypokalemia (Correct answer)
- Hyperphosphatemia
Correct answer: Hypokalemia
Insulin drives potassium into cells, causing potentially fatal hypokalemia during DKA treatment; potassium must be monitored closely.
Question 6: A toddler swallowed a button battery 2 hours ago. X-ray confirms it is lodged in the esophagus. What is the appropriate management?
- Observe at home and repeat X-ray in 24 hours
- Administer syrup of ipecac to induce vomiting
- Emergency endoscopic removal within the hour (Correct answer)
- Administer activated charcoal and admit for observation
Correct answer: Emergency endoscopic removal within the hour
Esophageal button batteries must be removed endoscopically within 2 hours because they can cause severe liquefactive necrosis and life-threatening perforation.
Question 7: A 7-year-old presents after a bee sting with hives, lip swelling, and a hoarse voice. Vital signs: BP 80/50, HR 148. What is the correct epinephrine dose for IM administration?
- 0.01 mg/kg of 1:1,000 solution, max 0.3 mg (Correct answer)
- 0.1 mg/kg of 1:10,000 solution, max 1 mg
- 0.5 mg/kg of 1:1,000 solution, max 1 mg
- 0.01 mg/kg of 1:10,000 solution, max 0.1 mg
Correct answer: 0.01 mg/kg of 1:1,000 solution, max 0.3 mg
The IM dose for anaphylaxis is 0.01 mg/kg of 1:1,000 epinephrine to the anterolateral thigh, with a maximum single dose of 0.3–0.5 mg.
Pediatric Nurse Exam Pediatric Nurse Common Pediatric Emergencies 2
A 4-year-old presents with sudden onset stridor, drooling, and a muffled voice.
The child prefers to sit upright and looks toxic.
What is the most likely diagnosis?