NUNP 6541 Pediatric Final Exam-Walden
U Questions With Correct Answers
Recommended |treatment |for |RSV |in |a |7 |month |old |(outpatient) |- |CORRECT |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 |- |CORRECT |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 |- |CORRECT |ANSWER✔✔-Haemophilus |influenzae |type |B |(Hib) |vaccine
Steeple |sign |- |CORRECT |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
Foreign |body |aspiration |antibiotic? |- |CORRECT |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? |- |CORRECT |ANSWER✔✔-Use |of |saline |drops |and |suctioning |of |the
|nares. |There |is |no |evidence |to |support |the |routine |use |of |antibiotics
Antibiotics |for |croup? |- |CORRECT |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? |- |CORRECT |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 |- |CORRECT |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.
Step |1 |Asthma |management |for |children |0-4 |years |old |- |CORRECT |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 |- |CORRECT |ANSWER✔✔-Step |2: |
Consider |consultation |with |asthma |specialist. |Low |dose |of |inhaled |corticosteroids.
Step |3 |asthma |mgmt |for |children |0-4 |yrs |- |CORRECT |ANSWER✔✔-Step |3: |Medium-dose |of |
inhaled |corticosteroids
Steps |4-6 |asthma |mgmt |for |children |0-4 |yrs |- |CORRECT |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 |- |CORRECT |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. |
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 |- |CORRECT |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 |- |CORRECT |ANSWER✔✔-Strep |pharyngitis
Peritonsillar |abscess
Viral |pharyngitis
Infectious |mononucleosis
U Questions With Correct Answers
Recommended |treatment |for |RSV |in |a |7 |month |old |(outpatient) |- |CORRECT |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 |- |CORRECT |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 |- |CORRECT |ANSWER✔✔-Haemophilus |influenzae |type |B |(Hib) |vaccine
Steeple |sign |- |CORRECT |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
Foreign |body |aspiration |antibiotic? |- |CORRECT |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? |- |CORRECT |ANSWER✔✔-Use |of |saline |drops |and |suctioning |of |the
|nares. |There |is |no |evidence |to |support |the |routine |use |of |antibiotics
Antibiotics |for |croup? |- |CORRECT |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? |- |CORRECT |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 |- |CORRECT |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.
Step |1 |Asthma |management |for |children |0-4 |years |old |- |CORRECT |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 |- |CORRECT |ANSWER✔✔-Step |2: |
Consider |consultation |with |asthma |specialist. |Low |dose |of |inhaled |corticosteroids.
Step |3 |asthma |mgmt |for |children |0-4 |yrs |- |CORRECT |ANSWER✔✔-Step |3: |Medium-dose |of |
inhaled |corticosteroids
Steps |4-6 |asthma |mgmt |for |children |0-4 |yrs |- |CORRECT |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 |- |CORRECT |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. |
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 |- |CORRECT |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 |- |CORRECT |ANSWER✔✔-Strep |pharyngitis
Peritonsillar |abscess
Viral |pharyngitis
Infectious |mononucleosis
