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Critical Care Nursing: Treatment Measures and Procedures, Exams of Nursing

The School of Architecture at Taliesin (SOAT)Nursing

A comprehensive overview of various treatment measures and procedures in critical care nursing, covering topics such as salicylate intoxication, peep management, and bronchopulmonary dysplasia. It includes multiple-choice questions and answers, making it an excellent resource for students and professionals seeking to enhance their knowledge in this field.

Typology: Exams

2023/2024

Available from 06/11/2024

dennistutor
dennistutor 🇺🇸

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CCRN PEDS AACN Questions &
Answers
1. In caring for a patient with salicylate intoxication, the critical care nurse would
anticipate which of the following as a primary treatment measure?
A. Administration of protamine sulfate
B. Administration of glucose
C. Transfusion of packed RBCs
D. Replacement of fluid and electrolytes -
✔D. Replacement of fluid and electrolytes
2. An adolescent with the developmental age of a 4-year-old requires placement of a
chest tube. The best way to prepare the patient for this procedure is to
A. Use short simple sentences and limit descriptions to concrete explanations.
B. Show the patient a chest tube and explain how it will feel.
C. Explain in detail why a chest tube is needed and how it works.
D. Tell the parents what will be done so they can explain it to their child. -
✔Use short simple sentences and limit descriptions to concrete explanations.
3. A child admitted with a gunshot wound to the head, accidentally inflicted by an
older sibling. The parents are overcome with grief and appear to be ignoring the
following statements made by the older sibling: "It was an accident; I didn't mean to
do it; I'm sorry!" Which of the following actions by the nurse would be most
appropriate?
A. Discuss the importance of gun safety with the older sibling while the parents are
at the bedside.
B. Seek additional support for the parents for ways they can assist the older sibling
C. Tell the parents that they need to provide support for the older sibling
D. Tell the older sibling, "Accidents happen; I know you didn't mean to do it." -
✔Seek additional support for the parents for ways they can assist the older
sibling
4. Which of the following laboratory findings is indicative of the syndrome of
inappropriate ADH secretion (SIADH)?
A. Serum sodium = 148 mEq/L
B. Decreased serum osmolality
C. Blood urea nitrogen (BUN) = 28 mg/dl
D. Serum potassium = 5.1 mEq/L -
✔Decreased serum osmolality
5. A 3-year-old is admitted to the ICU with a 10-hour history of an acute-onset
asthma attack. Initial assessment reveals the following
HR 160
pH 7.25
RR 48
pCO2 35
BP 112/76
pO2 40
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19
pf1a
pf1b

Partial preview of the text

Download Critical Care Nursing: Treatment Measures and Procedures and more Exams Nursing in PDF only on Docsity!

CCRN PEDS AACN Questions &

Answers

  1. In caring for a patient with salicylate intoxication, the critical care nurse would anticipate which of the following as a primary treatment measure? A. Administration of protamine sulfate B. Administration of glucose C. Transfusion of packed RBCs D. Replacement of fluid and electrolytes - ✔D. Replacement of fluid and electrolytes
  2. An adolescent with the developmental age of a 4-year-old requires placement of a chest tube. The best way to prepare the patient for this procedure is to A. Use short simple sentences and limit descriptions to concrete explanations. B. Show the patient a chest tube and explain how it will feel. C. Explain in detail why a chest tube is needed and how it works. D. Tell the parents what will be done so they can explain it to their child. - ✔Use short simple sentences and limit descriptions to concrete explanations.
  3. A child admitted with a gunshot wound to the head, accidentally inflicted by an older sibling. The parents are overcome with grief and appear to be ignoring the following statements made by the older sibling: "It was an accident; I didn't mean to do it; I'm sorry!" Which of the following actions by the nurse would be most appropriate? A. Discuss the importance of gun safety with the older sibling while the parents are at the bedside. B. Seek additional support for the parents for ways they can assist the older sibling C. Tell the parents that they need to provide support for the older sibling D. Tell the older sibling, "Accidents happen; I know you didn't mean to do it." - ✔Seek additional support for the parents for ways they can assist the older sibling
  4. Which of the following laboratory findings is indicative of the syndrome of inappropriate ADH secretion (SIADH)? A. Serum sodium = 148 mEq/L B. Decreased serum osmolality C. Blood urea nitrogen (BUN) = 28 mg/dl D. Serum potassium = 5.1 mEq/L - ✔Decreased serum osmolality
  5. A 3-year-old is admitted to the ICU with a 10-hour history of an acute-onset asthma attack. Initial assessment reveals the following HR 160 pH 7. RR 48 pCO2 35 BP 112/ pO2 40

T 32*C

HCO3 22

A. Administration of NaHCO B. Fluid resuscitation C. Racemic epinephrine D. Intubation - ✔Intubation

  1. A 2-year-old is experiencing manifestations of digoxin (Lanoxin) toxicity. BP is 94/60, capillary refill time is 2 seconds and the electrocardiogram reveals AV block with a heart rate of 60. The critical care nurse would anticipate which of the following interventions? A. Performance of cardioversion B. Administration of Atropine C. Performance of vasovagal maneuvers D. Monitoring of HR and rhythm and perfusion status - ✔Monitoring of HR and rhythm and perfusion status
  2. An adolescent with asthma is readmitted just a week after discharge from the hospital. On questioning, the nurse learns that the patient refuses to use the inhalers at school. The nurse should A. Talk to the teen about long-term consequences of the disease if the treatment plan is not followed B. Talk to the school nurse to find out why they are not monitoring the medications at school C. Help the parents set up a disciplinary contract with the teen D. Arrange for the teen to attend an asthma support group - ✔Arrange for the teen to attend an asthma support group
  3. An unconscious 5-month-old is admitted. The parent reports the baby fell off the table during a diaper change by an older sibling. What findings would indicate further inquiry of the history? A. A reddened or bruised are on the skull B. Poorly reactive pupils C. Retinal hemorrhage D. A linear skull fracture - ✔Retinal hemorrhage
  4. A 1-month-old infant presents with poor feeding, vomiting and diarrhea since birth. The infant is lethargic and in mild respiratory distress. The mother reports having another infant with the same symptoms who died at 2 months of age. Which finding would cause the nurse to suspect an inborn error of metabolism? A. micrognathia B. microglossia C. petite facial features D. abnormal urine odor - ✔abnormal urine odor
  5. Cardiac defects associated with increased pulmonary blood flow place the patient at greatest risk for A. heart failure.

added to the pump. - ✔Parents must bring the child back to the clinic to have the medicine added to the pump.

  1. A nurse is interested in including other disciplines in the educational process of developmental care in the NICU. The best way to convince administration that this venture is financially worthwhile is to A. present a report summarizing research relating developmental care to decreased length of stay. B. request that the neonatologist present the plan. C. present case studies demonstrating favorable outcomes to developmental care. D. invite members of administration to attend the classes. - ✔present a report summarizing research relating developmental care to decreased length of stay.
  2. PEEP is intended to do which of the following? A. increase functional residual capacity B. decrease functional residual capacity C. increase venous return to the heart D. increase cardiac output - ✔increase functional residual capacity An 8-month-old with bronchopulmonary dysplasia (BPD) is admitted with heart failure. Nursing interventions should be done to A. decrease preload. B. increase afterload. C. decrease heart rate. D. increase contractility. - ✔decrease preload
  3. A 2-month-old with a history of unrepaired Tetralogy of Fallot begins to cry while intravenous access is attempted. Cyanosis, diaphoresis and tachypnea are noted. Nursing interventions are aimed at A. Increasing pulmonary flow and relaxing the infundibulum. B. Decreasing systemic flow and increasing pulmonary vascular resistance. C. Decreasing pulmonary flow and increasing systemic vascular resistance (SVR). D. Increasing systemic flow and relaxing the left ventricular outflow tract. - ✔Increasing pulmonary flow and relaxing the infundibulum. During surgery on a 2-month-old with Tetralogy of Fallot, a trans-thoracic PA catheter was placed. Upon removal of this line, the PA pressure is 29 mm Hg systolic. As the line is 'pulled back' into the right ventricle, the pressure measures 72 mm Hg systolic. RA Sat=72, PA Sat=72. This change in measurement may indicate a/an A. right bundle branch block. B. residual VSD. C. incompetent pulmonic valve.

D. residual right ventricular outflow obstruction - ✔residual right ventricular outflow obstruction A 4-year-old has been admitted twice in the past six months for status asthmaticus. The parents smell of smoke when they come to the hospital, but state they don't smoke in the house. The most appropriate discharge planning intervention would be to A. discuss with the parents how to avoid asthma triggers at home. B. give the parents literature about smoking cessation treatment and support groups. C. call Child Protective Services to report a medically unsafe home environment. D. remind parents they shouldn't smoke around the child. - ✔give the parents literature about smoking cessation treatment and support groups. A 4-year-old presents with a chief complaint of blood in her urine. A review of the medical records shows multiple admissions for the same symptom. No etiology has been found. The patient is symptomatic only when the mother is present. The most appropriate diagnosis for this patient would be A. Munchausen syndrome by proxy. B. non-accidental trauma. C. physical abuse D. sexual abuse. - ✔Munchausen syndrome by proxy A 13-year-old male with diabetes is admitted after collapsing in class. On admission, he is tachycardic, has shallow respirations, dilated pupils, and is hyperreflexic. The plan of care would be to administer A. glucagon IM. B. naloxone (Narcan IV). C. 50% dextrose IV. D. regular insulin SQ. - ✔50% dextrose IV. The initial therapy for children at risk for pulmonary embolus related to venous thromboembolism from a central venous line (CVL) is A. placement of an inferior vena cava filter. B. administration of anticoagulants. C. immediate removal of the CVL. D. thrombectomy by a surgeon. - ✔administration of anticoagulants In an infant with bronchopulmonary dysplasia (BPD), factors that impair the release of oxygen by negatively affecting oxyhemoglobin dissociation include A. hyperthermia. B. metabolic acidosis C. respiratory acidosis

HR 180

pH 7. RR 72 pCO2 30 BP 48/Doppler pO2 48 CRT greater than 5 sec. HCO3 16 The patient is intubated and placed on mechanical ventilation at a rate of 20; PIP/PEEP=24/4 cm water; FiO2=100%. Subsequent ABG results show: pH 7. pCO2 28 pO2 50 HCO3 15 The most probable etiology of the patient's cardiopulmonary status is A. Tetralogy of Fallot. B. hypoplastic left heart syndrome. C. persistent pulmonary hypertension. D. diaphragmatic hernia. - ✔hypoplastic left heart syndrome A teenager post cardiac arrest has a new diagnosis of hypertrophic cardiomyopathy. The parents are concerned about what to do if their son collapses again. The nurse's best response would be A. "Now that your son has been diagnosed and treated, you need not worry." B. "Would teaching you CPR help ease your anxieties?" C. "Do you know how to access the EMS system?" D. "I will have your son's cardiologist talk to you." - ✔"Would teaching you CPR help ease your anxieties?" A child is admitted after sustaining a head injury. The most important aspect of the nurse's continuing neurological assessment is A. level of consciousness. B. papillary response. C. motor response. D. assessment of the cranial nerves. - ✔level of consciousness A survey reveals that all of a hospital's nurses feel that the routine 4 a.m. chest x-rays cause an interruption in children's sleep patterns. The best strategy for addressing this issue would be to A. Assemble a work group to discuss the current hospital policy. B. Reschedule all non-emergent 4 a.m. chest x-rays during daytime hours. C. Request an in-service for the radiology department on the effects of sleep deprivation in children. D. Send the results of the survey to the hospital administrator. - ✔Assemble a work group to discuss the current hospital policy The chest x-ray of a patient with status asthmaticus will reveal

A. hyperinflation. B. foreign-body aspiration. C. perihilar infiltrations. D. an elevated diaphragm - ✔hyperinflation Which of the following rhythms is expected one day post cardiac catheterization for repair of an arterial septal defect (ASD)? A. premature atrial contraction B. junctional ectopic tachycardia C. sinus bradycardia D. sinus tachycardia - ✔premature atrial contraction A patient who does not speak or understand English is admitted. Guidelines for using a translator may include A. having the translator ask questions that you don't feel comfortable asking. B. standing next to the translator and as close to the patient as possible. C. providing all of the information, then allowing for translation and asking of questions. D. allowing time for the translator to decode the medical jargon used in the teaching. - ✔standing next to the translator and as close to the patient as possible An infant post cardiac surgery is displaying signs of hypovolemia. The nurse suspects there is an increased insensible fluid loss due to A. decreased activity. B. hypothermia. C. the radiant warmer. D. sedation. - ✔the radiant warmer The primary objective in the treatment of an infant with persistent pulmonary hypertension is to A. maintain the pH level at less than 7.40. B. dilate the pulmonary vascular bed. C. dilate the systemic vascular bed. D. constrict the pulmonary vascular bed. - ✔dilate the pulmonary vascular bed

  1. A 26-week-gestation infant with multiple congenital abnormalities dies shortly after admission to the NICU. The parents saw the infant briefly in the delivery room, but decline to come to the NICU. The nurse should first A. Take the infant to the parents. B. Refer the parents to a genetic counselor. C. Prepare a memory box for the parents. D. Take an instant photo of the infant to the parents. - ✔Take an instant photo of the infant to the parents. For an acetaminophen level of 140 mcg/mL, the treatment choice is

✔Absence of spontaneous breathing when PaCO2 goes above 60 mmHg

  1. The acute treatment of esophageal varices includes A. Placement of a large NGT to low intermittent suction B. Immediate surgical intervention C. Administration of vasopressin (Pitressin) or octreotide (Sandostatin) D. Placement of a central venous line for hyperalimentation (TPN) - ✔Administration of vasopressin (Pitressin) or octreotide (Sandostatin)
  2. A 1-year-old who in ventilator dependent has been hospitalized since birth. He is now being discharged home with a tracheostomy and a gastrostomy. In order to determine the discharge needs of the patient, the should arrange for A. Home nursing care for the first few days following discharge B. A social worker to meet with the family and assess the adequacy of the home environment C. An outreach educator to determine the learning needs of the family D. A multidisciplinary care conference prior to discharge - ✔A multidisciplinary care conference prior to discharge
  3. A 10-year old patient is intubated due to a sudden deterioration in respiratory status. ABGs post intubation are as follows: pH 7. pCO2 50 pO2 80 HCO3 22 O2 Sat 95% The blood gases reflect A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Metabolic acidosis - ✔Respiratory acidosis
  4. A 4-year-old has been admitted following repair of coarctation of the aorta. The child's vital signs are: HR 80 BP 150/ RR 20 CVP 10 The arterial blood gas results are: pH 7. pCO2 42 pO2 96 HCO3 23 The child is comfortable and resting quietly. The most likely cause of the hypertension is A. Expected physiologic response to an aortic incision B. Excessive volume expansion during the surgical period C. Diminished baroreflex sensitivity to changes in arterial pressure D. Inadequate pain control following a thoracotomy - ✔Diminished baroreflex sensitivity to changes in arterial pressure
  1. A 10-year-old is admitted for colitis. Eight hours after admission the patient develops respiratory distress, abdominal distension and capillary refill time greater than 4 seconds. The nurse should suspect A. Aspiration pneumonia B. Malabsorption syndrome C. Adhesions D. Bowel perforation - ✔Bowel perforation
  2. A hospital's current policy states that medication drips should be changed within 24 hours after surgery. Nurses note that many postoperative cardiac patients develop blood pressure instability after inotrope syringes are changed. The best approach to solving this problem is to A. Notify the physician of a patient's blood pressure instability B. Disregard the policy and wait for the syringes to empty C. Form a committee to examine the problem and look for solutions D. Give a bolus of inotrope immediately prior to changing a drip - ✔Form a committee to examine the problem and look for solutions
  3. An acutely ill infant is born to a Vietnamese family. The father asks few questions about the infant's condition and the mother asks none. Both parents appear to be proficient in English. Which of the following would be the most useful resource for a nurse caring for this patient? A. Classes conducted by the primary nurse as the need arises B. An interpreter proficient in the parents' language C. Information about Vietnamese culture D. Ongoing classes addressing the cultural needs of the local community - ✔Information about Vietnamese culture
  4. The pediatric patient with suspected asphyxia from smoke inhalation will typically present with A. Tachypnea B. Cyanosis C. Confusion D. Hypertension - ✔Confusion
  5. A child with myelomeningocele is started on a bowel management plan. The nurse would recognize that more education is needed when the mother states, "My child A. Tends to more prone to diarrhea B. Will be unable to control his stools C. Will require more activity to increase stools D. Needs to have a stool every day - ✔Tends to more prone to diarrhea
  6. A 3-month-old infant has been admitted with encephalitis. The nurse should first assess the patient's A. Pupillary response
  1. Prior to the administration of digoxin (Lanoxin), the nurse assesses the heart rate and rhythm, as well as the A. Serum calcium level and QRS duration B. Serum potassium level and PR interval C. Serum calcium level and QT interval D. Serum potassium level and ST segment - ✔Serum potassium level and PR interval
  2. Medications used in the medical management of a closure of a PDA include A. Prostaglandin (PGE1) B. Digoxin (Lanoxin) C. Indomethacin (Indocin) D. Lasix (Furosemide) - ✔Indomethacin (Indocin)
  3. A patient with receptive aphasia and dementia is to be enrolled in a clinical trial. How should the nurse proceed to ensure informed consent is ethically obtained? A. Involve the patient's legal guardian in the consent process B. Ensure that the investigator is aware of the patient's condition C. Inform the institutional review board (IRB) of the potential risk to the patient D. Obtain a copy of the consent form to place in the patient's chart - ✔Involve the patient's legal guardian in the consent process
  4. A 5-year-old with a history of congenital hydrocephalus and VP shunt placement at 4 weeks of age is admitted. Over the last two days the child has been sleeping more, appetite has decreased and complains of a headache. This morning the child vomited twice. The nurse should anticipate A. The physician ordering lumbar puncture and blood and urine cultures B. The patient getting a CT scan followed by possible shunt revision C. Administering mannitol or hypertonic saline D. Administering a loading dose of phenytoin (Dilantin) - ✔The patient getting a CT scan followed by possible shunt revision
  5. A 2-month-old is admitted to the PICU status post surgical repair of a malrotation. Twenty-four hours later the patient has absent bowel sounds and increased drainage from the nasogastric tube. The most likely cause is A. Intestinal ileus B. Recurrent malrotation C. Postoperative infection D. Small bowel obstruction - ✔Intestinal ileus
  6. Signs and symptoms that indicate occlusion of the blalock-Taussig shunt are decreased oxygen saturation, as well as A. Decreased capillary refill and respiratory alkalosis B. Decreased capillary refill and metabolic alkalosis C. Increased cyanosis and respiratory acidosis D. Decreased cyanosis and metabolic acidosis - ✔Increased cyanosis and respiratory acidosis
  1. The best explanation for a patient's esophageal/gastrointestinal hemorrhage is A. Gastric ulcerations B. Systemic hypertension C. Portal hypertension D. Increased ammonia levels - ✔Portal hypertension
  2. Which of the following are expected findings in a child admitted in the early stage of septic shock A. Flushed skin, bounding pulses and wide pulse pressure B. Flushed skin, weak pulses and narrow pulse pressure C. Pale and mottled skin, bounding pulses and wide pulse pressure D. Pale and mottled skin, weak pulses and narrow pulse pressure - ✔Flushed skin, bounding pulses and wide pulse pressure
  3. In the patient with distributive shock and low systemic vascular resistance (SVR), the nurse would expect which early physical findings? A. Decreased urine output, hypotension, decreased level of consciousness and prolonged capillary refill B. Hypotension, hyperthermia, respiratory distress, and hypoxemia C. Hyperthermia, warm, pink flushed extremities, capillary refill time less than 2 seconds and hypotension D. Brisk capillary refill, increased urine output, hypoxemia and hyperthermia - ✔Hyperthermia, warm, pink flushed extremities, capillary refill time less than 2 seconds and hypotension
  4. In the pediatric patient with severe trauma, the progression of multiple organ dysfunction syndrome (MODS) is typically A. Respiratory failure, cardiovascular collapse, pulmonary embolism, liver failure and infection B. Circulatory collapse, renal failure, respiratory failure, GI tract and liver failure, and infection. C. Respiratory arrest, hepatic failure, renal failure, cardiac arrest and disseminated intravascular coagulation (DIC). D. Circulatory collapse, respiratory failure, GI tract and liver failure, renal failure and neurological dysfunction - ✔Circulatory collapse, respiratory failure, GI tract and liver failure, renal failure and neurological dysfunction
  5. A 5-year-old has been admitted after a motor vehicle crash. The child is tachypneic, pale and hypotensive; nailbeds are dusky. Paradoxical chest movement is observed. These signs and symptoms are most indicative of a A. Compound rib fracture B. Fractured sternum C. Flail chest D. Ruptured diaphragm - ✔Flail chest
  6. The purpose of administering mannitol (Osmitrol) to a patient with a head injury is to

A. WBCs 200/mm B. RBCs 3/mm C. Protein 120 mg/dL D. Glucose 90 mg/dL - ✔Protein 120 mg/dL

  1. A patient transferring out of the ICU says, "Why can't I just stay a few days longer? I don't feel strong enough." Which of the following is the most appropriate response? A. "There's a very sick patient who needs the bed." B. "You sound concerned about leaving the ICU." C. "Most people do just fine after transfer." D. "Your insurance limits the time you can stay in the ICU." - ✔"You sound concerned about leaving the ICU."
  2. A 9-month-old born at 26-weeks has grunting, tachypnea and cool extremities. The following ABG findings are obtained on room air: pH 7. PO2 50 PCO2 80 HCO3 7 These blood gas results indicate A. Uncompensated respiratory acidosis B. Compensated metabolic acidosis C. Alveolar hypoventilation D. Alveolar hyperventilation - ✔Alveolar hypoventilation
  3. Which of the following conditions occurs at the renal tubular cell to initiate acute tubular necrosis? A. Azotemia B. Hyperphosphatemia C. Ischemia D. Hyperkalemia - ✔Ischemia
  4. A 2-year-old is admitted with a diagnosis of hemolytic uremic syndrome. The child presents with petechial rash, bloody stools and oliguria. In addition to an increased BUN and creatinine, expected laboratory values should be Hgb HCT Platelets K+ A. 7.1 19.5 90,000 5. B. 3.1 36.7 117,000 4. C. 7.5 19.8 200,000 5. D. 14.4 44.7 47,000 3.8 - ✔7.1 19.5 90,000 5.
  5. A 10-month-old is admitted to the hospital due to abdominal distention and poor weight gain. The nurse should be concerned if the infant A. Stopped an action in response to being told "no."

B. Turned the head when name was called C. Cried when a nurse entered the room D. Avoided eye contact with the nurse - ✔Avoided eye contact with the nurse

  1. Which complication is most common in infants with congenital diaphragmatic hernia? A. Alveolar-arterial ratio mismatch B. Inhibition of surfactant delivery C. Left-to-right shunting through patent ductus arteriosus D. Sever pulmonary hypertension - ✔Sever pulmonary hypertension
  2. The parent of a mechanically ventilated patient is to be taught how to suction. When developing a teaching plan, the nurse must first A. Obtain written information about the procedure B. Determine a schedule for demonstrating the technique C. Assess the knowledge and skills the parent needs to learn D. Encourage the parent to observe the procedure on other patients - ✔Assess the knowledge and skills the parent needs to learn
  3. Which of the following findings is indicative of diabetes insipidus (DI)? Serum Na+ Urine Specific Gravity A. 155 1. B. 140 1. C. 130 1. D. 12 1.030 - ✔A. 155 1.
  4. A 2-month-old born with spina bifida is admitted with dehydration and sepsis. Before the infant was discharged from the hospital a month ago the parents had been instructed on the proper technique and importance of performing catheterization every six hours. While interviewing the parents, the nurse learns this was not done consistently for the past two weeks. Interventions at this point should include A. Involving social services B. Notifying law enforcement C. Demonstrating catheterization technique D. Eliminating parental visitation - ✔Involving social services
  5. In patients with dilated cardiomyopathy, which of the following intracardiac pressure changes would be seen? Left Atrial Pressure Right Atrial Pressure A. Increased Increased B. Decreased Decreased C. Decreased Increased D. Increased Decreased -

A. "The numbers indicate when the patient is having problems." B. "The numbers help us determine the best treatment." C. "Which numbers on the monitor concern you?" D. "What don't you understand about the monitor?" - ✔"Which numbers on the monitor concern you?"

  1. A child presents with fever, tachycardia, BP 60/42, weak pulses, warm and flushed skin. The first intervention should be A. 20 mL/kg normal saline fluid bolus B. Epinephrine infusion at 0.05 mcg/kg/min C. Oxygen via endotracheal tube D. Dopamine (Inotrope) infusion at 3 mcg/kg/min - ✔20 mL/kg normal saline fluid bolus
  2. A neutropenic patient is admitted showing signs of respiratory infection. Blood and sputum cultures are obtained. The nurse should anticipated A. Beginning antibiotics immediately B. Immediate placement in strict isolation C. No intervention until the causative organism is identified D. Transbronchial biopsy - ✔Beginning antibiotics immediately
  3. A child weighing 15 kg is admitted with chronic renal failure. Which of the following assessment findings should be reported immediately? A. Urine output of 2-5 mL/hr B. Elevated BUN, elevated creatinine C. Hyperalbuminemia D. Headache, nausea and vomiting - ✔Urine output of 2-5 mL/hr
  4. A 4-month-old born at 26-weeks is admitted with respiratory distress. The patient was discharged from the NICU with minimal O2 and an apnea monitor. Three weeks after admission the patient fails extubation for the third time, and it is determined that a tracheostomy and home ventilator will be needed. The nurse should A. Involve the discharge coordinator in obtaining home care and needed equipment B. Reassure the family that the tracheostomy can probably be removed in a year or so C. Begin tracheostomy teaching care with the mother and explain that the child will probably need a gastrostomy tube also D. Wait until after the tracheostomy is completely healed to start the process of home ventilator teaching - ✔Involve the discharge coordinator in obtaining home care and needed equipment
  5. A 2-year-old ingested several unidentified pills. Which symptoms would indicate a tricyclic antidepressant overdose? A. Dry mouth, lethargy and hypotension B. Hypertension, agitation and nystagmus C. Slurred speech, bradycardia and ataxia

D. Hypotension, bradycardia and nausea/vomiting - ✔Dry mouth, lethargy and hypotension

  1. A 2-year-old currently being treated for acute lymphocytic leukemia (ALL) is admitted with nausea, vomiting and neutropenia. Cultures obtained from a blood sample and the Hickman catheter site insertion are positive. Vital Signs are: T 101.8F (38.8C) HR 92 RR 30 BP 94/ A CBC and differential yield the following results: Hgb 8.1 g/dL HCT 29% Platelets 30,000/mL Differential: Band neutrophils 6% Segmented neutrophils 72% Lymphocytes 16% Monocytes 3% Eosinophils 2% Basophils 1% The patient's differential indicates a A. Leukemic relapse B. Viral infection C. Bacterial infection D. Normal count - ✔Bacterial infection
  2. The pathophysiology of asthma can best be explained by A. Airway narrowing and T-lymphocyte activation B. Mast cell migration, V/Q mismatch and mucosal drying C. Bronchospasm, mucosal edema and tenacious secretions D. Cilliary paralysis and prolonged inspiratory phase - ✔Bronchospasm, mucosal edema and tenacious secretions
  3. To verify a diagnosis of DIC, a significant laboratory findings is an elevation in A. Fibrin split products B. Prothrombin C. Fibrinogen D. Platelets - ✔Fibrin split products
  4. Children with acute renal failure run the risk of developing acute uremic encephalopathy. The first sign of cerebral dysfunction is often A. Confusion