©SIRJOEL EXAM SOLUTIONS
12/3/2024 11:27AM
NUNP 6541 Pediatric Final Exam-Walden U
Questions With Correct Answers
Recommended treatment for RSV in a 7 month old (outpatient) - answer✔Use of saline drops
and suctioning of the nares. Indications of when to use antipyretics. Signs of respiratory distress
or dehydration. Guidelines for feeding an infant with signs of mild respiratory distress which
includes smaller more frequent feedings; monitoring of the respiratory rate; and guarding against
vomiting. The parents should be educated that the child may have the symptoms over the course
of 2-3 weeks
Epiglottitis s/s - answer✔Acute and rapid onset of high fever, chills, and toxicity. Severe sore
throat and drooling saliva. Will not eat or drink, muffled (hot potato) voice, and anxiety. Sitting
posture with hyperextended neck with open-mouth breathing. Stridor, tachycardia, and
tachypnea
Epiglottitis prevention - answer✔Haemophilus influenzae type B (Hib) vaccine
Steeple sign - answer✔a radiologic sign found on radiograph where the subglottic tracheal
narrowing produces a shape of a church steeple which supports a diagnosis of croup
, ©SIRJOEL EXAM SOLUTIONS
12/3/2024 11:27AM
Foreign body aspiration antibiotic? - answer✔Depends on the nature of the material aspirated,
plus the location and degree of obstruction. Bronchial or laryngeal foreign body aspiration, a
bronchoscopy must be performed for removal of the foreign body
Antibiotics for bronchiolitis? - answer✔Use of saline drops and suctioning of the nares. There is
no evidence to support the routine use of antibiotics
Antibiotics for croup? - answer✔Nebulized epinephrine, corticosteroids (dexamethasone oral or
IM), blow by oxygen or heliox in severe croup. Racemic epinephrine with the use of
corticosteroids to limit rebound swelling
Antibiotics for epiglottitis? - answer✔Establish an airway preferably by nasotracheal intubation.
Administer IV antibiotics such as rocephin to cover H.influenzae. Administer oxygen and
respiratory support. Antibiotics should be continued for 10 days. Rifampin prophylaxis 20 mg/kg
in a single dose (maximum of 600 mg) for 4 days for infants and children, 600 mg once a day for
adults for 4 days. Should be provided for household contacts who are at risk (Younger than 4
years old who is non-immunized or incompletely immunized, children less than 12 months who
have not received primary series of Hib, and immunocompromised children.
Asthma treatment - answer✔The pharmacological management of asthma in children is based on
the severity of asthma and the child's age. After initial control, decrease treatment to the least
amount of medication needed to maintain control. Systemic corticosteroids may be needed at any
time and stepped up if there is a major flare-up of symptoms.
, ©SIRJOEL EXAM SOLUTIONS
12/3/2024 11:27AM
Step 1 Asthma management for children 0-4 years old - answer✔Step 1: SABA (Short acting
beta2-agonist) PRN: With viral respiratory symptoms short acting beta 2-agonist should be used
every 4-6 hours up to 24 hours (longer with a physician consult). Consider short course of oral
systemic corticosteroids if severe exacerbation. Frequent use of SABA may indicate the need to
step up treatment
Step 2 Asthma management for children 0-4 years old - answer✔Step 2: Consider consultation
with asthma specialist. Low dose of inhaled corticosteroids.
Step 3 asthma mgmt for children 0-4 yrs - answer✔Step 3: Medium-dose of inhaled
corticosteroids
Steps 4-6 asthma mgmt for children 0-4 yrs - answer✔Step 4: Medium-dose ICS and Long
acting beta2-agonist or montelukast.
Step 5: High dose ICS and Long acting beta 2-agonist or montelukast.
Step 6: High dose of ICS and LABA or montelukast and oral corticosteroids
Steps 1-3 asthma mgmt for children 5-11 yrs - answer✔Step 1: SABA (Short acting beta 2-
agonist) PRN: Increasing the use of short-acting beta 2-agonist or use greater than 2 days a week
for symptom relief generally indicates inadequate control and the need to step up treatment.
, ©SIRJOEL EXAM SOLUTIONS
12/3/2024 11:27AM
Step 2: Consider consultation with asthma specialist. Low dose of inhaled corticosteroids.
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium dose of inhaled
corticosteroids.
Steps 4-6 asthma mgmt for children 5-11 yrs - answer✔Step 4: Medium-dose ICS and LABA or
medium dose of inhaled corticosteroid and leukotriene receptor antagonist or theophylline. .
Step 5: High dose ICS and LABA or high dose of inhaled corticosteroid and leukotriene receptor
antagonist or theophylline. .
Step 6: High dose of ICS and LABA and oral corticosteroids or high dose of inhaled
corticosteroids and leukotriene receptor antagonist or theophylline and oral corticosteroids.
** Theophylline levels must be monitored.
Differentials for patient with sore throat - answer✔Strep pharyngitis
Peritonsillar abscess
12/3/2024 11:27AM
NUNP 6541 Pediatric Final Exam-Walden U
Questions With Correct Answers
Recommended treatment for RSV in a 7 month old (outpatient) - answer✔Use of saline drops
and suctioning of the nares. Indications of when to use antipyretics. Signs of respiratory distress
or dehydration. Guidelines for feeding an infant with signs of mild respiratory distress which
includes smaller more frequent feedings; monitoring of the respiratory rate; and guarding against
vomiting. The parents should be educated that the child may have the symptoms over the course
of 2-3 weeks
Epiglottitis s/s - answer✔Acute and rapid onset of high fever, chills, and toxicity. Severe sore
throat and drooling saliva. Will not eat or drink, muffled (hot potato) voice, and anxiety. Sitting
posture with hyperextended neck with open-mouth breathing. Stridor, tachycardia, and
tachypnea
Epiglottitis prevention - answer✔Haemophilus influenzae type B (Hib) vaccine
Steeple sign - answer✔a radiologic sign found on radiograph where the subglottic tracheal
narrowing produces a shape of a church steeple which supports a diagnosis of croup
, ©SIRJOEL EXAM SOLUTIONS
12/3/2024 11:27AM
Foreign body aspiration antibiotic? - answer✔Depends on the nature of the material aspirated,
plus the location and degree of obstruction. Bronchial or laryngeal foreign body aspiration, a
bronchoscopy must be performed for removal of the foreign body
Antibiotics for bronchiolitis? - answer✔Use of saline drops and suctioning of the nares. There is
no evidence to support the routine use of antibiotics
Antibiotics for croup? - answer✔Nebulized epinephrine, corticosteroids (dexamethasone oral or
IM), blow by oxygen or heliox in severe croup. Racemic epinephrine with the use of
corticosteroids to limit rebound swelling
Antibiotics for epiglottitis? - answer✔Establish an airway preferably by nasotracheal intubation.
Administer IV antibiotics such as rocephin to cover H.influenzae. Administer oxygen and
respiratory support. Antibiotics should be continued for 10 days. Rifampin prophylaxis 20 mg/kg
in a single dose (maximum of 600 mg) for 4 days for infants and children, 600 mg once a day for
adults for 4 days. Should be provided for household contacts who are at risk (Younger than 4
years old who is non-immunized or incompletely immunized, children less than 12 months who
have not received primary series of Hib, and immunocompromised children.
Asthma treatment - answer✔The pharmacological management of asthma in children is based on
the severity of asthma and the child's age. After initial control, decrease treatment to the least
amount of medication needed to maintain control. Systemic corticosteroids may be needed at any
time and stepped up if there is a major flare-up of symptoms.
, ©SIRJOEL EXAM SOLUTIONS
12/3/2024 11:27AM
Step 1 Asthma management for children 0-4 years old - answer✔Step 1: SABA (Short acting
beta2-agonist) PRN: With viral respiratory symptoms short acting beta 2-agonist should be used
every 4-6 hours up to 24 hours (longer with a physician consult). Consider short course of oral
systemic corticosteroids if severe exacerbation. Frequent use of SABA may indicate the need to
step up treatment
Step 2 Asthma management for children 0-4 years old - answer✔Step 2: Consider consultation
with asthma specialist. Low dose of inhaled corticosteroids.
Step 3 asthma mgmt for children 0-4 yrs - answer✔Step 3: Medium-dose of inhaled
corticosteroids
Steps 4-6 asthma mgmt for children 0-4 yrs - answer✔Step 4: Medium-dose ICS and Long
acting beta2-agonist or montelukast.
Step 5: High dose ICS and Long acting beta 2-agonist or montelukast.
Step 6: High dose of ICS and LABA or montelukast and oral corticosteroids
Steps 1-3 asthma mgmt for children 5-11 yrs - answer✔Step 1: SABA (Short acting beta 2-
agonist) PRN: Increasing the use of short-acting beta 2-agonist or use greater than 2 days a week
for symptom relief generally indicates inadequate control and the need to step up treatment.
, ©SIRJOEL EXAM SOLUTIONS
12/3/2024 11:27AM
Step 2: Consider consultation with asthma specialist. Low dose of inhaled corticosteroids.
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium dose of inhaled
corticosteroids.
Steps 4-6 asthma mgmt for children 5-11 yrs - answer✔Step 4: Medium-dose ICS and LABA or
medium dose of inhaled corticosteroid and leukotriene receptor antagonist or theophylline. .
Step 5: High dose ICS and LABA or high dose of inhaled corticosteroid and leukotriene receptor
antagonist or theophylline. .
Step 6: High dose of ICS and LABA and oral corticosteroids or high dose of inhaled
corticosteroids and leukotriene receptor antagonist or theophylline and oral corticosteroids.
** Theophylline levels must be monitored.
Differentials for patient with sore throat - answer✔Strep pharyngitis
Peritonsillar abscess
