Pediatric Nurse Exam Pediatric Nurse Management of Acute Illness 2 — Questions and Answers
Question 1: A 4-year-old presents with sudden-onset stridor, drooling, and tripod positioning. Which action is the nurse's PRIORITY?
- Obtain throat culture immediately
- Keep the child calm and avoid throat examination (Correct answer)
- Administer nebulized racemic epinephrine
- Place the child supine for airway assessment
Correct answer: Keep the child calm and avoid throat examination
Suspected epiglottitis requires keeping the child calm and avoiding any throat manipulation that could precipitate complete airway obstruction.
Question 2: A 9-month-old with bronchiolitis has an O2 saturation of 91% on room air. What is the most appropriate nursing intervention?
- Begin broad-spectrum antibiotics
- Apply supplemental oxygen via nasal cannula (Correct answer)
- Prepare for immediate intubation
- Administer albuterol nebulization
Correct answer: Apply supplemental oxygen via nasal cannula
Supplemental oxygen is indicated when SpO2 falls below 90-92% in infants with bronchiolitis; albuterol is not routinely recommended.
Question 3: A nurse is caring for a 7-year-old in status asthmaticus who is not responding to repeated albuterol treatments. Which medication should the nurse anticipate administering next?
- Oral prednisolone
- IV magnesium sulfate (Correct answer)
- Inhaled ipratropium alone
- Subcutaneous terbutaline only
Correct answer: IV magnesium sulfate
IV magnesium sulfate is used as a second-line bronchodilator in severe asthma unresponsive to initial beta-agonist therapy.
Question 4: Which assessment finding in a 2-year-old with croup indicates the need for immediate intervention?
- Barky cough worse at night
- Mild inspiratory stridor at rest (Correct answer)
- Low-grade fever of 38.1°C
- Hoarse voice without stridor
Correct answer: Mild inspiratory stridor at rest
Stridor at rest (not just with agitation) indicates significant airway narrowing requiring prompt treatment.
Question 5: A 6-year-old with diabetic ketoacidosis (DKA) receives IV fluid resuscitation. The nurse notes the child becomes confused and complains of headache. What complication should be suspected?
- Hypokalemia
- Cerebral edema (Correct answer)
- Hypernatremia
- Hypoglycemia
Correct answer: Cerebral edema
Cerebral edema is a life-threatening complication of DKA treatment, presenting with headache, altered mental status, and deteriorating neurological status.
Question 6: A toddler with febrile seizure has stopped seizing. The parents ask if they should give rectal diazepam for future seizures. What is the best response?
- Yes, give rectal diazepam for any fever above 38°C
- Routine prophylactic anticonvulsants are not recommended for simple febrile seizures (Correct answer)
- Phenobarbital daily is the standard prevention strategy
- Valproic acid should be started immediately
Correct answer: Routine prophylactic anticonvulsants are not recommended for simple febrile seizures
Simple febrile seizures are benign and self-limited; routine prophylactic anticonvulsant therapy is not recommended.
Question 7: A 10-year-old with appendicitis develops sudden relief of abdominal pain followed by diffuse rigidity and high fever. The nurse should recognize this as a sign of:
- Intussusception
- Perforated appendix with peritonitis (Correct answer)
- Mesenteric lymphadenitis
- Resolving appendicitis
Correct answer: Perforated appendix with peritonitis
Sudden pain relief followed by diffuse rigidity and fever suggests appendiceal perforation and peritonitis, a surgical emergency.
Pediatric Nurse Exam Pediatric Nurse Management of Acute Illness 2
A 4-year-old presents with sudden-onset stridor, drooling, and tripod positioning.
Which action is the nurse's PRIORITY?