EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES
ALREADY GRADEDA+.
A 5-year-old child presents with lethargy, increased work of breathing, and pale color.
The primary assessment reveals that the airway is open and the respiratory rate is
30/min, with crackles heard on auscultation. The cardiac monitor shows sinus
tachycardia at a rate of 165/min. The pulse oximeter displays an oxygen saturation of
95% and a pulse rate of 93/min. On the basis of this information, which of the following
provides the best interpretation of the oxygen saturation of 95% by pulse oximetry?
Reliable; no supplementary oxygen is indicated
Reliable; supplementary oxygen should be administered
Unreliable; no supplementary oxygen is indicated
Unreliable; supplementary oxygen should be administered -CORRECT
ANS>>Unreliable; supplementary oxygen should be administered
A 3-year-old child was recently diagnosed with leukemia and has been treated with
chemotherapy. The child presents with lethargy and a high fever. Heart rate is 195/min,
respiratory rate is 36/min, blood pressure is 85/40 mm Hg, and capillary refill time is
less than 2 seconds. What is the child's most likely condition?
Septic shock
Hypovolemic shock
Significant bradycardia
Cardiogenic shock -CORRECT ANS>>Septic shock
A 2-week-old infant presents with irritability and a history of poor feeding. Blood
pressure is 55/40 mm Hg. What term describes this infant's blood pressure?
Hypotensive
Normal
Hypertensive
Compensated -CORRECT ANS>>Hypotensive
During a resuscitation attempt, the team leader orders an initial dose of epinephrine at
0.1 mg/kg to be given 10. What should the team member do?
Administer the drug as ordered
Administer 0.01 mg/kg of epinephrine
Respectfully ask the team leader to clarify the dose
Refuse to administer the drug -CORRECT ANS>>Respectfully ask the team leader to
clarify the dose
Which of the following is a characteristic of respiratory failure?
, Inadequate oxygenation and/or ventilation
Hypotension
An increase in serum pH (alkalosis)
Abnormal respiratory sounds -CORRECT ANS>>Inadequate oxygenation and/or
ventilation
Which of the following is most likely to produce a prolonged expiratory phase and
wheezing?
Disordered control of breathing
Hypovolemic shock
Lower airway obstruction
Upper airway obstruction -CORRECT ANS>>Lower airway obstruction
A 4-year-old child presents with seizures and irregular respirations. The seizures
stopped a few minutes ago. Which of the following most likely to be abnormal?
Vascular resistance
Pulse rate
Lung compliance
Control of breathing -CORRECT ANS>>Control of breathing
What abnormality is most likely to be present in children with acute respiratory distress
caused by lung tissue disease?
Decreased oxygen saturation
Stridor
Normal respiratory rate
Decreased respiratory effort -CORRECT ANS>>Decreased oxygen saturation
An alert 2-year-old child with an increased work of breathing and pink color is being
evaluated. Heart rate is 110/min, and respiratory rate is
30/min. What would best describe this patient's condition? A. Respiratory distress
Respiratory arrest
Respiratory failure
Disordered control of breathing -CORRECT ANS>>Respiratory distress
The parents of a 7-year-old child who is undergoing chemotherapy report that the child
has been febrile and has not been feeling well, with recent onset of lethargy. Assessment
reveals the following: The child is difficult to arouse, with pale color. The child's heart
rate is 160/min, respiratory rate is 30/min, blood pressure is 76/45 mm Hg, capillary
refill time is 5 to 6 seconds, and temperature is 103°F (39.4°C). What is the most
appropriate intervention?
Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 30 minutes
Obtain vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10
minutes
Obtain immediate blood cultures and chest x-ray D. Obtain expert consultation with an
oncologist to determine the chemotherapeutic regimen -CORRECT ANS>>Obtain
vascular access and administer 20 mL/kg of isotonic crystalloid over 5 to 10 minutes