pepppretest.txt


A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny


nose for the past 3 days. She is alert and sitting on her mother?s lap. Assessment reveals that shehas warm, flushed skin, is using her abdominal muscles to breathe, and has increased work ofbreathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of48 breaths/min. The first step in treatment is to:administer humidified oxygen via blow-by method


A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny


nose for the past 3 days. She is alert and sitting on her mother?s lap. Assessment reveals that shehas warm, flushed skin, is using her abdominal muscles to breathe, and has increased work ofbreathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of48 breaths/min. Abdominal breathing in this patient should be viewed as a:normal finding for a toddler


A 2-year-old girl who is having difficulty breathing and a barky cough has had a fever and runny


nose for the past 3 days. She is alert and sitting on her mother?s lap. Assessment reveals that shehas warm, flushed skin, is using her abdominal muscles to breathe, and has increased work ofbreathing. She has a blood pressure of 88/66 mm Hg, a pulse of 128 beats/min, and respirations of48 breaths/min. This patient is likely to have:stridor


A 6-year-old boy who was struck by a car while he was riding his bicycle is unresponsive and has pale, cool skin. Assessment reveals abrasions to his left shoulder and back and a swollen, deformed left thigh. He has a blood pressure of 74/62 mm Hg, a pulse of 152 beats/min, and respirations of 44 breaths/min. without increased work of breathing. What do these findings tell you about the patient s condition?


His blood pressure is low because compensatory mechanisms for blood loss are failing


A 3-month-old infant who is extremely lethargic has had a cough, vomiting, and diarrhea for the


past 3 days. Assessment reveals that he responds to pain, has mottled skin color, and a capillaryrefill time of 4 seconds. He has a blood pressure of 74/60 mm Hg, a pulse of 190 beats/min, andrapid respirations (60 breaths/min) without increased work of breathing. The tachycardia in this infant is most likely due to:hypovolemia


A 3-month-old infant who is extremely lethargic has had a cough, vomiting, and diarrhea for the


past 3 days. Assessment reveals that he responds to pain, has mottled skin color, and a capillaryrefill time of 4 seconds. He has a blood pressure of 74/60 mm Hg, a pulse of 190 beats/min, andrapid respirations (60 breaths/min) without increased work of breathing. The appropriate initial treatment is to:administer 100% oxygen by mask


Which of the following findings in a 2-year-old child assists in identifying the cause of a grand mal seizure?


Fever


A 10-year-old girl is unresponsive when she surfaces after diving into a quarry. Bystanders report that she was shaking all over as they pulled her out of the water. The first step in caring for this patient is to:


stabilize her cervical spine to reduce the risk of further spinal injury


Activated charcoal is contraindicated in a patient who has ingested a toxic substance if:


the substance was corrosive


An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. What is the best approach to conducting the assessment of this patient?


Exposing only those areas currently being assessed and then covering them


An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. After completing your initial assessment, the first step in caring for this patient is to:


manually stabilize the cervical spine to reduce the risk of spinal injury


An 8-year-old boy fell 7 feet out of a tree, landing on his right arm and falling to his right side. He is crying and appears agitated. Assessment reveals that he has pale, warm skin, multiple abrasions on his right shoulder and hip, and a deformed right forearm. He has a blood pressure of 92/74 mm Hg, a pulse of 128 beats/min, and respirations of 32 breaths/min. What is the most likely cause for the abnormal appearance of this patient?


Pain


Ascertaining the due date of a newborn during an impending delivery helps you to:


assemble the correct size of equipment to care for the baby


During transport, what is the correct way to manage the respiratory status of a boy who is on a ventilator but also breathes on his own?


Allow the patient to remain on the ventilator if he is not in respiratory distress


What information is important to obtain about a child with smoke inhalation?


Possibility of concurrent trauma


Assessment of a newborn 5 minutes after delivery reveals cyanosis of the hands, feet, trunk, and face. Vital signs include a pulse of 160 beats/min and respiratory rate of 44 breaths/min. Treatment of this newborn includes:


applying free-flow oxygen by mask at 5 liters/min


Which of the following substances can be infused via an intraosseous needle?


All medications and intravenous fluids


What is the correct method to confirm proper placement of an endotracheal tube?


Auscultate for bubbling or gurgling sounds over the epigastrium and for breath sounds at the midaxillary regions


What is the danger of using a mask that is too large on a child who requires ventilatory assistance?


It will be more difficult to obtain a seal for ventilation


An infant less than one month should be evaluated by a physician if which of the following signs or symptoms is present?


Acting fussier than usual


A 3-year-old boy who has a tracheostomy has had difficulty breathing and coughing for 2 days because of increased secretions. He is on continuous oxygen. His mother states that his breathing is getting much worse. Assessment reveals that he is lethargic, has cool, mottled skin, and has copious secretions in the tracheostomy tube. Which of the following signs suggests significant obstruction of the tracheostomy tube?


A slow heart rate and poor air exchange


When should the child?s head be secured to the spine board during the immobilization procedure?


After the body straps and lateral stabilization devices have been applied


An 18-month-old boy who reportedly fell down the stairs earlier in the day ?just isn?t acting right,? according to his caregivers. Assessment reveals multiple bruises on his


thighs and back and a deformity of his right thigh. He is alert and crying. What is the best way to interact with the caregivers?Explain that you are very concerned about the child?s condition and that he needs to be examined at the hospital for a possible a broken leg.


A woman who is about to deliver a baby at home reports that the fluid was thick and green when her bag of waters broke. The most important treatment of the newborn is to:


copiously suction the mouth and nose


A 6-month-old infant who is being cared for by a baby-sitter is unresponsive and has warm, pink skin and irregular respirations without increased work of breathing. The baby-sitter appears anxious and frustrated and explains that the infant had been crying for hours and would not stop. The baby-sitter states, ?I couldn?t get her to stop crying. I tried everything. All of a sudden she got really quiet, and I couldn?t wake her up. Please help her. I can?t take her crying any more.? The baby-sitter states that she does not think that


the infant has been sick recently. The infant?s altered level of consciousness is most likely due to:shaken baby syndrome